Resource utilization and costs for robotic-assisted and manual total knee arthroplasty - a premier healthcare database study.

Introduction: The impact of robotic-assisted total knee arthroplasty (rTKA) vs. traditional, manual TKA (mTKA) on hospital costs is not well documented and is analyzed herein.

Research Design And Methods: Patients in the Premier billing Healthcare Database undergoing elective rTKA or mTKA ("index') in the in- or outpatient setting for knee osteoarthritis between Oct 1, 2015, to September 30th, 2021, were identified.

A Modified Technique for Applying Closed Incision Negative Pressure Therapy Dressing Following Total Joint Arthroplasty.

Postoperative incisional management subsequent to total joint replacement arthroplasty is of importance to the orthopedic surgical team. The application of closed incision negative pressure therapy (ciNPT) to surgical incisions following replacement arthroplasty has demonstrated positive outcomes in orthopedics. This paper describes a technique involving the postoperative application of ciNPT over closed incisions originating from joint arthroplasty to facilitate a reduction in the incidence of surgical site complications (SSCs).

Open Ankle Fractures: What Predicts Infection? A Multicenter Study.

Objective: To identify the patient, injury, and treatment factors associated with an acute infection during the treatment of open ankle fractures in a large multicenter retrospective review. To evaluate the effect of infectious complications on the rates of nonunion, malunion, and loss of reduction.

Design: Multicenter retrospective review.

Prospective, Randomized Study of Direct Anterior Approach vs Posterolateral Approach Total Hip Arthroplasty: A Concise 5-Year Follow-Up Evaluation.

Background: Interest in direct anterior approach (DAA) has increased over the last decade. In our previously published study comparing DAA to posterolateral approach (PA), early 3-month benefits were noted in terms of pain and function. There was no difference noted at 6 or 12 months.

Trends in Orthopedic Fracture and Injury Severity: A Level I Trauma Center Experience.

The purpose of this study was to define the trends in fracture complexity and overall injury severity of orthopedic trauma patients at a level I trauma center. A retrospective review of a prospectively collected trauma database was performed to determine the Injury Severity Score (ISS) and AO/OTA classification of the most common fractures among all patients presenting from 1995 to 1999 and from 2008 to 2012. Inclusion criteria were lower extremity fractures of the femur and tibia and pelvic fractures within the years of interest.

Does Pelvic Embolization Increase Infection Rates in Patients Who Undergo Open Treatment of Acetabular Fractures?

Objective: Evaluate the impact of pelvic embolization on postoperative infection rate after acetabular fracture fixation.

Design: Retrospective study of 3 separate cohorts.

Setting: Level I Trauma Center.

Heterotopic Ossification in Acetabular Fracture Surgery.

Heterotopic ossification (HO) is a common complication of the surgical treatment of acetabular fractures. HO is the formation of trabecular bone in soft tissues where bone does not usually occur. Over the last decade, many risk factors have been identified for HO after surgical fixation of acetabular fractures; however, prophylaxis and treatment of this condition are controversial.

Occult Cranial Cervical Dislocation: A Case Report and Brief Literature Review.

Study Design. Retrospective case report and review. Objective.

Effects of age and insulin-like growth factor-1 on rat neurotrophin receptor expression after nerve injury.

Introduction: Neurotrophin receptors, such as p75(NTR) , direct neuronal response to injury. Insulin-like growth factor-1 receptor (IGF-1R) mediates the increase in p75(NTR) during aging. The aim of this study was to examine the effect of aging and insulin-like growth factor-1 (IGF-1) treatment on recovery after peripheral nerve injury.

Intraoperative Distal Femoral Fine Wire Traction to Facilitate Intramedullary Nailing of the Femur.

Many techniques have been employed to facilitate intramedullary nailing of femur fractures. Maintaining limb length during the operation can be difficult. The authors describe the use of distal femoral fine wire skeletal traction as a technique to maintain reduction while allowing intramedullary nailing of femur fractures.

Novel Strategies for the Diagnosis of Posttraumatic Infections in Orthopaedic Trauma Patients.

Orthopaedic infections that occur after trauma are common. Clinical examination, laboratory markers, imaging modalities, and culture and molecular technologies are used to aid the diagnosis of infection. Culture methods comprise the backbone of diagnostic systems used in hospital laboratory settings; however, several studies have questioned the ability of these techniques to adequately identify infections, particularly in cases where orthopaedic implants were used or when the presence of biofilm bacteria is suspected.

Association of atypical femoral fractures with bisphosphonate use by patients with varus hip geometry.

Background: There is increasing evidence associating "atypical" femoral fractures with prolonged exposure to bisphosphonate therapy. The cause of these fractures is unknown and likely multifactorial. This study evaluated the hypothesis that patients with primary osteoporosis who sustain atypical femoral fracture(s) while on chronic bisphosphonate therapy have a more varus proximal femoral geometry than patients who use bisphosphonates for primary osteoporosis but do not sustain a femoral fracture.

Upper cervical spine trauma.

Injuries to the upper cervical spine are potentially lethal; thus, full characterization of the injuries requires an accurate history and physical examination, and management requires an in-depth understanding of the radiographic projection of the craniocervical complex. Occipital condyle fractures may represent major ligament avulsions and may be highly unstable, requiring surgery. Craniocervical dissociation results from disruption of the primary osseoligamentous stabilizers between the occiput and C2.

Prognostic value of computed tomography classification systems for intra-articular calcaneus fractures.

Background: There are several published computed tomography (CT) classification systems for calcaneus fractures, each validated by a different standard. The goal of this study was to measure which system would best predict clinical outcomes as measured by a widely used and validated musculoskeletal health status questionnaire.

Methods: Forty-nine patients with isolated intra-articular joint depression calcaneus fractures more than 2 years after treatment were identified.

Single provider reduction and splinting of displaced ankle fractures: a modification of Quigley's classic technique.

Ankle fractures are commonly treated by orthopaedic surgeons and often require manipulative reduction. This can be painful for the patient and frequently uses 2 or more providers. Intra-articular injection of local anesthetic into the ankle joint precludes the need for conscious sedation (intravenous narcotics and benzodiazepines, propofol, or ketamine).

Is there a difference in neurologic outcome in medical versus early operative management of cervical epidural abscesses?

Background Context: The ideal management of cervical spine epidural abscess (CSEA), medical versus surgical, is controversial. The medical failure rate and neurologic consequences of delayed surgery are not known.

Purpose: The purpose of this study is to assess the neurologic outcome of patients with CSEA managed medically or with early surgical intervention and to identify the risk factors for medical failure and the consequences of delayed surgery.

Pediatric cervical spondylolysis and American football.

Background Context: Cervical spondylolysis (CS) is a rare condition and is even more uncommon in pediatric patients. It is characterized by a disruption of the articular mass at the junction of the superior and inferior facet joints and often is diagnosed incidentally. The C6 level is most commonly involved, and the cause of CS remains unknown.

Spinal epidural abscesses: risk factors, medical versus surgical management, a retrospective review of 128 cases.

Background Context: Spinal epidural abscess (SEA) is a rare, serious and increasingly frequent diagnosis. Ideal management (medical vs. surgical) remains controversial.

Do anchor density or pedicle screw density correlate with short-term outcome measures in adolescent idiopathic scoliosis surgery?

Study Design: Retrospective review.

Objective: Determine if factors under surgeon control (anchor density or pedicle screw density) or those not under surgeon control (curve magnitude, levels requiring fusion, and curve flexibility) correlate with standard, short-term quality and outcome measures for adolescent idiopathic scoliosis.

Summary Of Background Data: Pedicle screw fixation has revolutionized posterior spinal instrumentation and fusion for adolescent idiopathic scoliosis and seems to provide greater radiographical coronal plane curve correction than less expensive constructs.