Repair Fails More Frequently Than Reconstruction in Acute Posterolateral Corner Knee Injuries: A Systematic Review of Outcomes Following Surgical Management.

Purpose: To synthesize the current literature on posterolateral corner (PLC) reconstruction and repair, focusing on a comparison of surgical techniques and outcomes based on injury chronicity in the setting of sports-related ligament tears.

Methods: A systematic review of the literature, including queries of the PubMed/MEDLINE, Embase, and Cochrane Library databases, was performed in March 2024. Studies were included if they were of Level IV evidence or greater, reported PLC reconstruction or repair outcomes, and had a minimum 2-year follow-up.

How Do We Improve Sleep Quality After Total Joint Arthroplasty? A Systematic Review of Randomized Controlled Trials.

Background: Despite the importance of sleep for physiological function, rehabilitation, and recovery, sleep quality after total joint arthroplasty (TJA) remains poor. The objective of this systematic review was to identify, summarize, and evaluate postoperative interventions aimed at improving sleep quality after TJA.

Methods: A systematic review of PubMed (MEDLINE) and Scopus (Embase, MEDLINE, COMPENDEX) from inception to April 2024 was conducted (PROSPERO ID: CRD42023447317).

Increased Risk of Postoperative Complications in Patients Who Have Obstructive Sleep Apnea Undergoing Total Joint Arthroplasty: A Systematic Review and Meta-Analysis.

Background: Obstructive sleep apnea (OSA) has been linked to multiple adverse health outcomes and postoperative complications. Despite the high prevalence of OSA in patients undergoing total joint arthroplasty (TJA), few studies have evaluated the postoperative course of OSA patients after joint arthroplasty surgery.

Methods: PubMed (MEDLINE) and Scopus (EMBASE, MEDLINE, and COMPENDEX) were used to conduct a systematic review of articles from inception to July 2023.

Direct Variable Cost Comparison of Endoscopic Versus Open Carpal Tunnel Release: A Time-Driven Activity-Based Costing Analysis.

Introduction: To improve the delivery of value-based health care, a deeper understanding of the cost drivers in hand surgery is warranted. Time-driven activity-based costing (TDABC) offers a more accurate estimation of resource utilization compared with top-down accounting methods. This study used TDABC to compare the facility costs of open carpal tunnel release (OCTR) and endoscopic carpal tunnel release (ECTR).

Ulnar-Sided Wrist Pain: A Diagnostic Evaluation Guide From 30-Plus Years of Experience.

Introduction: While multiple ulnar-sided wrist pain (USWP) diagnostic evaluation guides have been presented, none have included original clinical data or statistical analysis. The purpose of this study is to provide a diagnostic evaluation guide derived from original clinical data and analysis to help clinicians arrive at a differential diagnosis for USWP.

Methods: Using a computer search of patients presenting with sprains, instability, and laxity of the wrist, 385 patient charts were identified.

Outcomes Following Fully Threaded Intramedullary Nailing of Metacarpal Fractures.

Purpose: Intramedullary screw fixation has emerged as a popular approach for the treatment of displaced metacarpal fractures. The purpose of this study was to investigate the functional and radiographic outcomes of a newly designed, headless noncompressive fully threaded intramedullary nail (TIMN) for the treatment of metacarpal fractures.

Methods: A retrospective chart review was performed on patients who were treated with the INnate TIMN (ExsoMed) at a single academic institution with a minimum of 1-year follow-up.

High Incidence of Acute Kidney Injury Following Antibiotic-Loaded Spacer Insertion for Periprosthetic Joint Infection: An Updated Review of the Literature.

Background: The use of antibiotic-impregnated cement during 2-stage revision arthroplasty for periprosthetic joint infection poses a risk of renal complications following spacer insertion. This systematic review aimed to investigate the rate of acute kidney injury (AKI) following antibiotic-loaded spacer insertion and to identify risk factors associated with this complication.

Methods: A systematic review was performed using PubMed, Cochrane Central, and Scopus databases.

Early Experience With Uniplanar Versus Biplanar Expandable Interbody Fusion Devices in Single-Level Minimally Invasive Transforaminal Lumbar Interbody Fusion.

Objective: To compare the early radiographic and clinical outcomes of expandable uniplanar versus biplanar interbody cages used for single-level minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF).

Methods: A retrospective review of 1-level MIS-TLIFs performed with uniplanar and biplanar polyetheretherketone cages was performed. Radiographic measurements were performed on radiographs taken preoperatively, at 6-week follow-up, and 1-year follow-up.

Clinical Outcomes of Lunocapitate Arthrodesis: A Retrograde Single-Screw Approach.

Background: A single-site retrospective study was designed to evaluate the clinical outcomes of single-screw lunocapitate arthrodesis (LCA) using a retrograde approach for the treatment of scapholunate advanced collapse (SLAC) wrist.

Methods: We retrospectively identified 31 patients (33 cases) between September 2010 and December 2019 with SLAC wrist changes who were treated with single-screw LCA. Objective outcomes included time to fusion, union rate, range of motion, and grip and pinch strength recovery.

Complications Following Intramedullary Screw Fixation for Metacarpal Fractures: A Systematic Review.

Purpose: There has been a recent increase in the use of intramedullary screws (IMS) for the surgical treatment of metacarpal fractures. While IMS fixation has been shown to produce excellent functional outcomes, postoperative complications have yet to be fully explored in a comprehensive way. This systematic review quantified the incidence, treatment, and results of complications following IMS fixation for metacarpal fractures.

Identifying High Direct Variable Costs of Open Carpal Tunnel Release Patients Using Time-Driven Activity-Based Costing.

Purpose: To improve value in health care delivery, a deeper understanding of the cost drivers in hand surgery is necessary. Time-driven activity-based costing (TDABC) more accurately reflects true resource use compared with traditional accounting methods. This study used TDABC to explore the facility cost of carpal tunnel release and identify preoperative characteristics of high-cost patients.

Single-Portal Antegrade Endoscopic Trigger Finger Release: Cadaveric and Clinical Outcomes.

Background: This study aimed to examine the relationship between anatomical surface landmarks in fresh frozen cadavers as related to in vivo endoscopic trigger finger release (ETFR) and present clinical outcomes after a single-portal antegrade ETFR technique.

Methods: Endoscopic trigger finger release was performed on 40 cadaveric digits. Each digit was dissected and the following measurements were recorded: distance from palmar digital crease and A1 pulley, length of the A1 pulley, percentage of A1 pulley released, and injury to vulnerable anatomy.

Reliability of Routine Radiographs for Conservatively Treated Metacarpal Shaft and Neck Fractures.

Background: To investigate the reliability of orthopedic hand surgeons to evaluate radiographic healing in initial and follow-up radiographs of the conservatively treated metacarpal shaft and neck fractures. The rationale for this study was to reduce the rate of unnecessary, routine radiographs when treating metacarpal fractures.

Methods: Forty sets of digital x-rays, twenty at the initial visit and twenty at the 4-week follow-up, were randomly selected and reviewed.

The Influence of Race, Income, and Sex on Treatment and Complications of Common Pediatric Orthopedic Fractures.

Despite best intentions, health care disparities exist and can consequently impact patient care. Few studies have examined the impact of disparities in pediatric orthopedic populations. The current study aimed to determine if the treatment type or complication rates of supracondylar, both-bone forearm, or femur fractures are associated with race, ethnicity, sex, or socioeconomic status.

Return to Sport After Anterior Cruciate Ligament Reconstruction Requires Evaluation of >2 Functional Tests, Psychological Readiness, Quadriceps/Hamstring Strength, and Time After Surgery of 8 Months.

Purpose: The purpose of this study was to examine the factors commonly used to determine readiness for return to sport (RTS) in the ACL reconstruction (ACL-R) patient population and assess which were most influential to successfully returning to sport and avoiding re-tear.

Methods: The PUBMED, EMBASE and Cochrane Library databases were queried for studies related to RTS in ACL-R. Inclusion and exclusion criteria were applied to identify studies with greater than 1-year outcomes detailing the rate of return and re-tear given a described RTS protocol.

Radiographic Outcomes of Casting Versus Splinting for Conservatively Treated Metacarpal Fractures.

Introduction While many have studied alternate forms of casting for conservative treatment of metacarpal fracture, few have compared casting and splinting. This study aims to compare radiographic alignment in metacarpal shaft and neck fractures immobilized with splints to those treated with casts. Methods A retrospective review was conducted to identify all metacarpal fractures treated by a single orthopedic hand surgeon from 2016-2020.

Periprosthetic Joint Infection Following Clean Hand Surgery: A Systematic Review.

Purpose: We assessed the rate of periprosthetic joint infection (PJI) following hand surgery in patients with prosthetic joints, and determined the efficacy of prophylactic antibiotics for preventing PJI in this patient subset.

Methods: A systematic review of PubMed (MEDLINE) and Scopus (EMBASE, MEDLINE, COMPENDEX) from 1968 to 2021 was conducted. Primary articles that studied PJIs following hand surgery in patients with prosthetic joints (hip, knee, shoulder, elbow, or ankle) and/or the use of prophylactic antibiotics prior to hand surgery in patients with prosthetic joints were included.

Serum Glucose Variability Increases the Risk of Complications Following Aseptic Revision Hip and Knee Arthroplasty.

Background: Increased serum glucose variability has been proposed as a risk factor for perioperative morbidity and mortality. Given the greater surgical complexity and complication risk of revision total joint arthroplasty (TJA), previous findings may not be generalizable to the revision population. The purpose of this study was to investigate the association between glucose variability and postoperative complications following aseptic revision TJA.

Static versus Expandable Interbody Fusion Devices: A Comparison of 1-Year Clinical and Radiographic Outcomes in Minimally Invasive Transforaminal Lumbar Interbody Fusion.

Study Design: Retrospective cohort study.

Purpose: To compare the radiographic and clinical outcomes of static versus expandable interbody cages in transforaminal lumbar interbody fusion using minimally invasive surgery (MIS-TLIF).

Overview Of Literature: Expandable interbody cages may potentially improve radiographic and clinical outcomes following MIS-TLIF compared to static pages, but at a potentially higher cost and increased rates of subsidence.

Intramedullary K-wires versus Alternate Techniques for Metacarpal Shaft and Neck Fractures: A Systematic Review and Meta-analysis.

Intramedullary K-wire (IMKW) fixation is one of the mainstays for surgically treating metacarpal shaft and neck fractures. However, there remains a lack of literature comparing outcomes of the various available surgical repair techniques in all indicated metacarpals. Therefore, we conducted a systematic review and meta-analysis to investigate the clinical advantages and drawbacks of IMKW compared with alternate fracture repair techniques.

Pin-Related Complications in Computer Navigated and Robotic-Assisted Knee Arthroplasty: A Systematic Review.

Background: Computer-assisted navigation (CAN) and robotic-assisted (RA) knee arthroplasty procedures carry unique risks of tracking pin-related complications. This systematic review aimed to quantitatively assess the incidence, timing, treatment, and clinical outcomes of all tracking pin-related complications following CAN and RA knee arthroplasty.

Methods: A systematic review was performed using PubMed, Cochrane Central and Scopus databases.

Complications Following Endoscopic and Open Trigger Finger Release: A Retrospective Comparative Study.

Background: Open trigger finger release (OTFR) and endoscopic trigger finger release (ETFR) are effective methods in treating stenosing tenosynovitis. However, a paucity of literature exists comparing the techniques. This study describes and compares postoperative complications following OTFR and ETFR at a single institution.

Premeasured Intramedullary Nails for the Treatment of Metacarpal Fractures: Novel Instrumentation and Technique.

With nearly 36% of hand fractures occurring at the metacarpal, a variety of treatment interventions have been developed. Although many nondisplaced metacarpal fractures can be treated with conservative management, displaced, unstable, open, and extra-articular fractures require surgical attention. Compared with open reduction with plate fixation, closed reduction with intramedullary fixation has shown advantages of a simplified technique, minimal soft tissue dissection, and reduced tendon irritation and scar formation.

Classification and Treatment of Ulnar Nerve Subluxation Following Endoscopic Cubital Tunnel Release.

Purpose: Endoscopic cubital tunnel release (ECuTR) is an effective procedure to alleviate cubital tunnel syndrome. To improve patient outcomes and lessen concerns regarding ulnar nerve subluxation (UNS) after ECuTR, the current study proposes an intraoperative UNS classification system and subsequent treatment protocol. We present a preliminary report of patients treated under these guidelines.