Dermal Graft Thickness Over 2 mm and Grafts Oriented Parallel to Skin Tension Lines Increased Graft Strength and Suture Retention: A Biomechanical Study.

Purpose: To assess the variability in graft biomechanical properties of an acellular human dermal matrix patch.

Methods: A total of 22 strips obtained from 6 separate graft specimens (AlloPatch HD) were tested. Load elongation properties after cyclic loading, including ultimate load at break, energy at break, and extension at break, were tested and compared by graft thickness.

Optimizing stability and motion in reverse shoulder arthroplasty with a 135° neck-shaft-angle: a computer model study of standard versus retentive humeral inserts.

Background: There has been a trend to shift from a 155° and 145° neck-shaft-angle (NSA) to a more "anatomical" reverse shoulder arthroplasty with less distalization and a 135° NSA. Multiple studies have shown that a 135° NSA is beneficial for motion. There are some concerns about primary implant stability with a 135° NSA.

Selective Genicular Artery Embolization in the Management of Osteoarthritic Knee Pain-A Narrative Review.

Many people with pain from osteoarthritis (OA) of the knee are either not ready for surgery or may never be surgical candidates. Genicular artery embolization (GAE) is a new proposed management for those with pain despite maximum medical management. It has historically been used to manage recurrent spontaneous haemarthrosis following total knee replacement, but newer studies are showing a positive effect in managing pre-arthroplasty knee OA.

Biomechanical and Histological Study of Retrieved LARS Synthetic Ligaments.

Background: Synthetic grafts have been used for a number of years in anterior cruciate ligament (ACL) reconstruction surgery. One of the more recent additions to the stable of synthetic ligaments is the Ligament Augmentation and Reconstruction System (LARS) ligament.

Purpose: To analyze the biomechanics and histology of LARS grafts retrieved due to failure of the device.

Evolution in the Management of Patella Fractures.

Patella fractures usually occur as a result of direct trauma to the anterior knee joint, indirect injury as a result of eccentric muscle contraction, or rapid knee flexion against a contracted quadriceps muscle. The patella functions as part of the extensor mechanism of the knee, where large forces are transmitted, and its subcutaneous nature has made treatment of patella fractures a challenge. In this review article, we evaluate how the management of these fractures has evolved over time and the advantages associated with the various treatment techniques.

Humeral head size predicts baseplate lateralization in reverse shoulder arthroplasty: a comparative computer model study.

Background: In reverse shoulder arthroplasty (RSA), the ideal combination of baseplate lateralization (BL), glenosphere size (GS), and glenosphere overhang (GOH) with a commonly used 145° neck shaft angle (NSA) is unclear. This is the first study evaluating correlations of body height (BH), humeral head size (HS), glenoid height (GH), and association of gender with best glenoid configurations for range of motion (ROM) maintaining anatomic lateralization (aLAT) for optimized muscle length in 145° and less distalized 135° RSA.

Methods: In this computer model study, 22 computed tomographies without joint narrowing were analyzed (11 male/female).

Tackling efficiency in a high demand orthopaedic clinic.

Background: Surgical outpatient clinics continuously face challenges in delivering efficient and effective care. An expanding population and chronic staff shortages makes sustainability critical. The primary objective of this study was to identify modifiable factors contributing to longer wait times in an orthopaedic outpatient clinic.

Correction: Bauer et al. Challenges for Optimization of Reverse Shoulder Arthroplasty Part II: Subacromial Space, Scapular Posture, Moment Arms and Muscle Tensioning. 2023, , 1616.

In the original publication [...

Incidence, Management, and Hospital Costs of Orthopaedic Injuries of E-Scooter Riders in Western Australia.

The use of electric scooters (e-scooters) is increasing in Australia and internationally. The increasing availability of e-scooters has led to a rise in the number of injuries, with most patients sustaining orthopaedic injuries. This retrospective case series describes the incidence, management, and hospital costs of the orthopaedic injuries, which presented to the emergency department (ED) of the major trauma center in Western Australia.

Angioembolisation for arterial haemorrhage related to pelvic ring injury.

Introduction: Haemorrhage related to pelvic fractures has been associated with mortality rates of up to 50%. Angioembolisation for the management of pelvic haemorrhage was performed as early as 1972; however, there remains uncertainty over its exact use, timing and priority as a component of modern pelvic management protocols.

Methods: We retrospectively analysed cases of angioembolisation for arterial haemorrhage related to pelvic ring fractures at a level 1 trauma centre.

Advances in Hip Replacement Surgery.

Total hip arthroplasty (THA) is one of the most successful types of surgical operation, with some considering it "the operation of the century" [...

Evolution of Concepts: Can Personalized Hip Arthroplasty Improve Joint Stability?

Hip arthroplasty procedures are successful and reproducible. However, within the first two post-operative years, hip dislocations are the most common cause for revisions. This is despite the majority of the dislocations having the acetabular component within what is described as the 'safe zone'.

Resurfacing Hip Arthroplasty Is a Safe and Effective Alternative to Total Hip Arthroplasty in Young Patients: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed at comparing resurfacing hip arthroplasty (RHA) and total hip arthroplasty (THA) in terms of rate of complications, revisions, functional outcomes, blood loss, operative time and metal ions levels. The search was conducted on three databases (PubMed, Cochrane and Web of Science) updated until 13 October 2022. The inclusion criteria were RCTs) written in the English language, with no time limitation, comparing RHA and THA.

Challenges for Optimization of Reverse Shoulder Arthroplasty Part I: External Rotation, Extension and Internal Rotation.

A detailed overview of the basic science and clinical literature reporting on the challenges for the optimization of reverse shoulder arthroplasty (RSA) is presented in two review articles. Part I looks at (I) external rotation and extension, (II) internal rotation and the analysis and discussion of the interplay of different factors influencing these challenges. In part II, we focus on (III) the conservation of sufficient subacromial and coracohumeral space, (IV) scapular posture and (V) moment arms and muscle tensioning.

Challenges for Optimization of Reverse Shoulder Arthroplasty Part II: Subacromial Space, Scapular Posture, Moment Arms and Muscle Tensioning.

In part II of this comprehensive review on the optimization of reverse shoulder arthroplasty (RSA), we focus on three other challenges: 1. "Conservation of sufficient subacromial and coracohumeral space"; 2. "Scapular posture"; and 3.

Robotics in Total Hip Arthroplasty: Current Concepts.

This current concepts article reviews the literature pertaining to the use of robot-assisted systems in total hip arthroplasty (THA). The bulk of the literature is regarding the MAKO (currently the most used system worldwide) and the historic ROBODOC robotic systems. There is a paucity of literature available on other systems, with several still in pilot-phase development.

Posteroinferior relevant scapular neck offset in reverse shoulder arthroplasty: key player for motion and friction-type impingement in a computer model.

Background: Range of motion (ROM) and prevention of notching remain a challenge for reverse shoulder arthroplasty (RSA). Both may be affected by the morphology of the scapula. The purpose of this study was to define anteroinferior (a) and posteroinferior (p) relevant scapular neck offset (RSNO) and to examine the hypothesis that pRSNO is significantly smaller than aRSNO, and influences rigid body motion (RBM).

Modernizing Total Hip Arthroplasty Perioperative Pathways: The Implementation of ERAS-Outpatient Protocol.

Pressure to reduce healthcare costs, limited hospital availability along with improvements in surgical technique and perioperative care motivated many centers to focus on outpatient pathway implementation. However, in many short-stay protocols, the focus has shifted away from aiming to reduce complications and improved rehabilitation, to using length of stay as the main factor of success. To improve patient outcomes and maintain safety, the best way to implement a successful outpatient program would be to combine it with the principles of enhanced recovery after surgery (ERAS), and to improve patient recovery to a level where the patient is able to leave the hospital sooner.

Personalized Hip Joint Replacement with Large Diameter Head: Current Concepts.

Hip arthroplasty is a common procedure in elective orthopaedic surgery that has excellent outcomes. Hip replacement surgery aims to create a "forgotten" joint, i.e.

Understanding shoulder pseudoparalysis: Part I: Definition to diagnosis.

Variable definitions of pseudoparalysis have been used in the literature. Recent systematic reviews and biomechanical studies call for a grading of loss of force couple balance and the use of the terms 'pseudoparesis' and 'pseudoparalysis'. Pain should be excluded as the cause of loss of active function.

Understanding shoulder pseudoparalysis. Part II: Treatment.

Decision-making for the treatment of pseudoparalytic shoulders is complex and a high level of experience in shoulder surgery and outcome evaluation is required. Management and results depend on clinical findings, tear and tissue quality, patient and surgeon criteria. Clinical findings determine the exact definition and direction of pseudoparesis and pseudoparalysis.

Validation of the distal filling ratio in uncemented convertible short-stem shoulder arthroplasty.

Introduction: Radiographic stress shielding is a common finding in uncemented convertible short-stem shoulder arthroplasty (UCSSSA). The distal filling ratio (DFR) has been described as a predictor for the occurrence of stress shielding. A DFR > 70% was mentioned as a risk factor for the occurrence of stress shielding for some UCSSSA.

Lateralization in Reverse Shoulder Arthroplasty.

Indications for Reverse Shoulder Arthroplasty (RSA) have been extended over the last 25 years, and RSA has become the most frequently implanted shoulder arthroplasty worldwide. The initial Grammont design with medialization of the joint center of rotation (JCOR), placement of the JCOR at the bone-implant interface, distalization and semi-constrained configuration has been associated with drawbacks such as reduced rotation and range of motion (ROM), notching, instability and loss of shoulder contour. This review summarizes new strategies to overcome these drawbacks and analyzes the use of glenoid-sided, humeral-sided or global bipolar lateralization, which are applied differently by surgeons and current implant manufacturers.

Development and assessment of 3-dimensional computed tomography measures of proximal humeral bone density: a comparison to established 2-dimensional measures and intraoperative findings in patients undergoing shoulder arthroplasty.

Background: The purpose of this study was to develop novel three-dimensional (3D) measures of bone density from computed tomography (CT) scans and to compare them with validated two-dimensional (2D) radiographic assessments of bone density. Patient demographic data were also analyzed to see if there were any predictors of bone density (age, sex, etiology).

Methods: The study group consisted of 290 consecutive patients undergoing primary shoulder arthroplasty surgery (total anatomic, reverse, and hemiarthroplasty).