AAOS 2024 best paper in the shoulder and elbow classification: watchful waiting provides higher value with similar functional outcomes to physical therapy for frozen shoulder: a prospective randomized controlled trial.

Background: Physical therapy remains a ubiquitous treatment modality for the management of frozen shoulder (adhesive capsulitis) despite limited high-level evidence supporting its use. Leveraging patient-reported outcome measures (PROMs) and healthcare costs, this study compared patient outcomes and value achieved through watchful waiting (WW) vs. physical therapy (PT) for conservative management of frozen shoulder.

Hip Arthroscopy Versus Physical Therapy for the Treatment of Symptomatic Acetabular Labral Tears in Patients Older Than 40 Years: 24-Month Results From a Randomized Controlled Trial.

Background: The indications for hip arthroscopy in patients aged ≥40 years remain controversial, as observational studies have suggested that advanced age portends poor functional outcomes, poor durability of improvement, and high rates of conversion to total hip arthroplasty.

Purpose: To compare hip arthroscopy versus nonoperative management for symptomatic labral tears in patients aged ≥40 years with limited radiographic osteoarthritis.

Study Design: Randomized controlled trial; Level of evidence, 1.

Risk of Subsequent Fusion After Isolated Decompression of Lumbar Facet Cysts.

Introduction: Lumbar facet cysts represent a potential source of nerve root compression in elderly patients. Isolated decompression without fusion has proven to be a reasonable treatment option in properly indicated patients. However, the risk of lumbar fusion after isolated decompression and facet cyst excision has yet to be elucidated.

Reimbursement of Lumbar Fusion at an Orthopaedic Specialty Hospital Versus Tertiary Referral Center.

Study Design: Retrospective Cohort Study.

Objective: To explore the differences in Medicare reimbursement for lumbar fusion performed at an orthopaedic specialty hospital (OSH) and a tertiary referral center and to elucidate drivers of Medicare reimbursement differences.

Summary Of Background Data: To provide more cost-efficient care, appropriately selected patients are increasingly being transitioned to OSHs for lumbar fusion procedures.

Does decompression adjacent to arthrodesis in the lumbar spine predispose patients to adjacent segment degeneration and disease: A retrospective analysis.

Background: The treatment for multi-level spinal stenosis in the setting of single-level instability is a common operative scenario for surgeons who treat degenerative lumbar spine pathology. However, there is conflicting evidence regarding the inclusion of adjacent "stable" levels in the arthrodesis construct because of the potential for iatrogenic instability placed on those segments with decompressive laminectomy alone. This study aims to determine whether decompression adjacent to arthrodesis in the lumbar spine is a risk factor for adjacent segment disease (AS Disease).

Puncture Capsulotomy Technique for Hip Arthroscopy: Midterm Functional Outcomes.

Background: The most common surgical approaches in hip arthroscopy are interportal and T-capsulotomy. However, these methods may introduce capsular instability. Puncture capsulotomy preserves capsuloligamentous integrity by avoiding iatrogenic transection of the iliofemoral capsular ligament.

Modified Frailty Index as a Predictor of Postoperative Complications and Patient-Reported Outcomes after Posterior Cervical Decompression and Fusion.

Study Design: A retrospective cohort study.

Purpose: To determine whether the 11-item modified frailty index (mFI) is associated with readmission rates, complication rates, revision rates, or differences in patient-reported outcome measures (PROMs) for patients undergoing posterior cervical decompression and fusion (PCDF).

Overview Of Literature: mFI incorporates preexisting medical comorbidities and dependency status to determine physiological reserve.

Risk stratification of patients undergoing outpatient lumbar decompression surgery.

Background Context: Reimbursement has slowly transitioned from a fee-for-service model to a bundled payment model after introduction of the United States Centers for Medicare and Medicaid Services bundled payment program. To minimize healthcare costs, some surgeons are trying to minimize healthcare expenditures by transitioning appropriately selected lumbar decompression patients to outpatient procedure centers.

Purpose: To prepare a risk stratification calculator based on machine learning algorithms to improve surgeon's preoperative predictive capability of determining whether a patient undergoing lumbar decompression will meet inpatient vs.

MRSA Prophylaxis in Spine Surgery Decreases Postoperative Infections.

Study Design: Retrospective cohort study.

Objective: To compare infection rates before and after the implementation of a quality improvement protocol focused on methicillin-resistant Staphylococcus aureus (MRSA) screening and decolonization in patients undergoing lumbar fusion and/or decompression.

Summary Of Background Data: Prior studies have demonstrated MRSA infections comprise a sizable portion of SSIs.

Management of C0 Sacral Fractures Based on the AO Spine Sacral Injury Classification: A Narrative Review.

The Arbeitsgemeinschaft fur Osteosynthese fragen Spine Sacral Injury Classification hierarchically separates fractures based on their injury severity with A-type fractures representing less severe injuries and C-type fractures representing the most severe fracture types. C0 fractures represent moderately severe injuries and have historically been referred to as nondisplaced "U-type" fractures. Injury management of these fractures can be controversial.

Adult Isthmic Spondylolisthesis: A Radiographic and Outcomes Analysis Comparing Circumferential Fusions Versus TLIF Procedures.

Study Design: This was a retrospective cohort study.

Objective: The objective of this study was to compare radiographic and patient-reported outcome measures (PROMs) between circumferential fusions and transforaminal lumbar interbody fusion (TLIF) for adult isthmic spondylolisthesis (IS).

Summary Of Background Data: Definitive management of adult IS typically requires decompression and fusion.

Does Cervical Spondylolisthesis Influence Patient-Reported Outcomes After Anterior Cervical Discectomy and Fusion Surgery?

Background: No prior work has explored whether the presence of degenerative spondylolisthesis impacts patient-reported outcome measurements (PROMs) after an anterior cervical discectomy and fusion (ACDF); therefore, the goal of the current study was to determine whether the presence of a spondylolisthesis affects PROMs after an ACDF.

Methods: A retrospective cohort study was conducted on patients over the age of 18 who underwent a 1- or 2-level ACDF. All patients received preoperative standing lateral x-rays and were placed into 1 of 2 groups based on the presence of cervical spondylolisthesis from C2-T1: (1) no spondylolisthesis (NS) group or (2) spondylolisthesis (S) group.

The Effect of L5-S1 Degenerative Disc Disease on Outcomes of L4-L5 Fusion.

Study Design: Retrospective cohort study.

Objective: The aim was to investigate the clinical relevance of preoperative caudal adjacent segment degeneration (ASD) in patients undergoing isolated L4-5 fusion to determine a threshold of degeneration at which a primary L4-S1 fusion would be warranted.

Summary Of Background Data: Increased motion and biomechanical forces across the adjacent caudal segment in isolated L4-L5 fusion leads to concerns regarding the increased incidence of revision surgery because of the development of ASD.

Effect of a Mandatory Prescription Drug Monitoring Program on Patient-initiated Phone Calls After Spine Surgery.

Study Design: This was a retrospective cohort study.

Objective: The objective of this study was to determine the effect of a statewide, government-mandated prescription drug monitoring program (PDMP) on patient-initiated phone calls after lumbar and cervical spinal surgery.

Summary Of Background Data: Prior studies have examined the most common reasons for a postoperative phone calls, most of which pertain to pain or prescription medications.

Cervical Alignment and Proximal and Distal Junctional Failure in Posterior Cervical Fusion: A Multicenter Comparison of 2 Surgical Approaches.

Study Design: This was a multicenter retrospective cohort study.

Objective: The purpose of this study was to compare the surgical and radiographic outcomes of patients undergoing posterior cervical fusion (PCF) with constructs extending from C2 to T2 to patients with constructs extending from C3 to T1.

Summary Of Background Data: Limited evidence exists regarding the appropriate level of proximal and distal extension of PCF constructs.

Reimbursement of Lumbar Decompression at an Orthopedic Specialty Hospital Versus Tertiary Referral Center.

Study Design: Retrospective cohort study.

Objective: The aim of this study was to investigate the differences in Medicare reimbursement for one- to three-level lumbar decompression procedures performed at a tertiary referral center versus an orthopedic specialty hospital (OSH).

Summary Of Background Data: Lumbar decompression surgery is one of the most commonly performed spinal procedures.

Circumferential fusion with open versus percutaneous posterior fusion for lumbar isthmic spondylolisthesis.

Study Design: Retrospective cohort study.

Objective: To investigate the clinical and radiographic differences between patients who underwent anterior lumber interbody fusion (ALIF) with either open or percutaneous posterior fusion for lumbar isthmic spondylolisthesis.

Summary Of Background Data: Circumferential fusion for isthmic spondylolisthesis is commonly performed with superior clinical outcomes, fusion rates, and restoration of sagittal balance when compared to posterior fusion alone.

How Does the Presence of a Surgical Trainee Impact Patient Outcomes in Lumbar Fusion Surgery?

Background: While the impact of trainee involvement in other surgical fields is well established, there is a paucity of literature assessing this relationship in orthopaedic spine surgery. The goal of this study was to further elucidate this relationship.

Methods: A retrospective cohort study was initiated on patients undergoing 1-3 level lumbar spine fusion at a single academic center.

Hip Arthroscopy Versus Physical Therapy for the Treatment of Symptomatic Acetabular Labral Tears in Patients Older Than 40 Years: A Randomized Controlled Trial.

Background: Previous observational studies have suggested poor results of arthroscopic surgery for the treatment of acetabular labral tears in patients older than 40 years.

Purpose: To compare hip arthroscopy versus nonoperative management for symptomatic labral tears in patients older than 40 years who have limited radiographic osteoarthritis.

Study Design: Randomized controlled trial; Level of evidence, 1.

Dysphagia and Satisfaction Following Anterior Cervical Spine Surgery: A Prospective Observation Trial.

Study Design: Prospective observation.

Objective: To assess the effect of dysphagia on patient satisfaction following anterior cervical discectomy and fusion.

Background: Difficulty with swallowing is a common complaint following anterior cervical spine surgery.

Endoscopic Repair of Full-Thickness Gluteus Medius and Minimus Tears-Prospective Study With a Minimum 2-Year Follow-Up.

Purpose: To evaluate the short-term outcomes of endoscopic repair of full-thickness gluteus medius and minimus tendon tears with a minimum of 2-year follow-up and add to the paucity of literature on abductor tendon tears.

Methods: All patients who underwent endoscopic abductor tendon repair between December 2013 and August 2017 were prospectively evaluated. The inclusion criteria for this study were primary full-thickness gluteal tendon tears and at least 2-years of follow-up.

Proton Pump Inhibitor Use Affects Pseudarthrosis Rates and Influences Patient-Reported Outcomes.

Study Design: Retrospective cohort review.

Objectives: Cervical pseudarthrosis is a frequent cause of need for revision anterior cervical discectomy and fusion (ACDF) and may lead to worse patient-reported outcomes. The effect of proton pump inhibitors on cervical fusion rates are unknown.

Prevalence of ulnar nerve palsy with flexion-type supracondylar fractures of the humerus.

The aim of this study is to report the rate and type of neurologic injury associated with flexion supracondylar fractures at a tertiary, university institution treated over a 10-year period. All supracondylar humerus fracture cases treated at our institution between January 2004 and January 2014 were retrospectively reviewed. Twenty-three flexion-type fractures were identified.