Long non-coding RNA fine-tunes bone homeostasis and repair by orchestrating cellular crosstalk and β-catenin-OPG/Jagged1 pathway.

The IncRNA was initially believed to be dispensable for physiology due to the lack of observable phenotypes in knockout (KO) mice. However, our study challenges this conclusion. We found that both KO and conditional KO mice in the osteoblast lineage exhibit significant osteoporosis.

Anterior Iliac Crest Bone Graft Harvest Using Acetabular Reamers.

https://ota.org/education/ota-online-resources/video-library-procedures-techniques/anterior-iliac-crest-bone-0.

Intraosseous Shelf Plate Fixation for Depressed Articular Fragments in Tibial Plateau Fractures: A Technical Trick and Case Series.

Tibial plateau fractures with severely displaced articular injuries and significant deformity to the surrounding metaphyseal bone (including the hyperextension varus bicondylar pattern) can be challenging to stabilize due to resulting large bone voids uncontained by metaphyseal cortex. The purpose of this report was to describe a technique to support the plateau articular surface in these cases and report on outcomes of a small series. This technique uses a small or mini fragment plate, contoured to function as an intraosseous shelf plate, with the "shelf" portion inserted into the bone beneath the articular surface to support it.

Locked plate constructs are not necessarily stiffer than nonlocked constructs: A biomechanical investigation of locked versus nonlocked diaphyseal fixation in a human cadaveric model of nonosteoporotic and osteoporotic distal femoral fractures.

Objectives: The objective of this study was to compare the biomechanical properties of locked and nonlocked diaphyseal fixation in a model of distal femur fractures using osteoporotic and nonosteoporotic human cadaveric bone.

Methods: A supracondylar osteotomy was created to mimic a fracture (OTA/AO 33A3) in osteoporotic (n = 4) and nonosteoporotic (n = 5) cadaveric distal femurs. The left and right femurs of each pair were instrumented with a distal femoral locking plate and randomly assigned to have diaphyseal fixation with either locked or nonlocked screws.

Dorsal Hook Plating of Patella Fractures With Immediate Range of Motion Results in Reliable Fixation, Low Implant Removal Rates, and Satisfactory Clinical Outcomes.

Objectives: To evaluate radiographic and clinical patient-reported outcomes following dorsal hook plating of displaced patella fractures with permittance of immediate postoperative active closed chain range of motion.

Design: Retrospective review of prospectively collected data.

Setting: Urban academic level 1 trauma center.

Long non-coding RNA Malat1 fine-tunes bone homeostasis and repair by orchestrating cellular crosstalk and the β-catenin-OPG/Jagged1 pathway.

The IncRNA Malat1 was initially believed to be dispensable for physiology due to the lack of observable phenotypes in Malat1 knockout (KO) mice. However, our study challenges this conclusion. We found that both Malat1 KO and conditional KO mice in the osteoblast lineage exhibit significant osteoporosis.

Stability of Intertrochanteric Femur Fractures.

The stability of intertrochanteric fractures depends upon multiple factors including the fracture displacement, location and pattern, the type of fixation used for stabilization, and the loading that the fracture undergoes postfixation. Traditional classification systems are of limited utility because they typically stratify intertrochanteric fractures as stable or unstable based purely on the fracture pattern without consideration of the stability after fixation. Biomechanical studies evaluating the stability of various fixation constructs should include physiologic loading, including rotation around the axis of the femoral neck, and reproduce clinical failure modes to be clinically relevant.

Distal Tibia Apex Posterior Angulation: A Normal Anatomic Variant Related to Hindfoot Alignment With Side-to-Side Symmetry.

Objectives: The sagittal plane of the distal tibia has not been well-described. This study sought to characterize sagittal plane morphology, determine symmetry from side to side, and identify differences based on hindfoot alignment.

Methods: One hundred twelve bilateral lateral weight-bearing ankle radiographs were retrospectively evaluated (224 ankles).

Updated Blocking Techniques for Lower Extremity Medullary Nailing: Beyond the Concavity of Deformity.

Modern blocking techniques are useful to achieve anatomic alignment and stable fixation during end-segment nailing. Whether with screws or drill bits, blocking implants can correct both angular and translational deformities. Understanding the biomechanics of blocking implants allows the surgeon to properly plan their placement based on principles rather than dogma.

Syndesmotic Suture Button Fixation Results in Higher Tegner Activity Scale Scores When Compared to Screw Fixation: A Multicenter Investigation.

Background: Suture buttons and metal screws have been used and compared in biomechanical, radiographic, and clinical outcome studies for syndesmotic injuries, with neither implant demonstrating clear superiority. The aim of this study was to compare clinical outcomes of both implants.

Methods: Patients who underwent syndesmosis fixation at 2 separate academic centers from 2010 through 2017 were compared.

Krackow Suture Technique Effect on Patella Tendon Vascularity: Quantitative MRI Analysis.

Objectives: To assess the effects of Krackow suture technique on the vascularity of the patellar tendon.

Methods: Six fresh-frozen matched pair cadaveric knee specimens were used. The superficial femoral arteries were cannulated in all knees.

Locked Plating versus Nailing for Proximal Tibia Fractures: A Multicenter RCT.

Objectives: The main 2 forms of treatment for extraarticular proximal tibial fractures are intramedullary nailing (IMN) and locked lateral plating (LLP). The goal of this multicenter, randomized controlled trial was to determine whether there are significant differences in outcomes between these forms of treatment.

Design: Multicenter, randomized controlled trial.

Apex posterior angulation of the humerus: A characterization of normal sagittal plane anatomy with implications for surgical fixation.

Introduction: An understanding of the sagittal plane morphology of the humerus is relevant during surgical fixation of humeral fractures but is not well described in the literature. The purpose of this study was to better characterize the native sagittal plane morphology of the humerus.

Materials And Methods: 170 patients with uninjured full length lateral humerus radiographs were retrospectively evaluated.

Locked Lateral Plating Versus Retrograde Nailing for Distal Femur Fractures: A Multicenter Randomized Trial.

Objectives: The 2 main forms of treatment for distal femur fractures are locked lateral plating and retrograde nailing. The goal of this trial was to determine whether there are significant differences in outcomes between these forms of treatment.

Design: Multicenter randomized controlled trial.

Relative Sagittal Alignment of the Medial and Lateral Articular Surfaces of the Tibial Plateau Using Radiographic Parameters: A Radiographic Cadaveric Study.

Objectives: To characterize anatomic slope (sagittal alignment) of medial and lateral articular surfaces of the tibial plateau using x-ray and computed tomography (CT).

Methods: Fluoroscopy was used to acquire "perfect" anteroposterior (AP) images of 8 cadaveric knees by tilting a C-arm through a 30-degree cranial/caudal arc in 0.5-degree increments.

Proximal tibia fracture dislocations: Management and outcomes of a severe and under-recognized injury.

Introduction: Proximal tibia fracture dislocations (PTFDs) are a subset of plateau fractures with little in the literature since description by Hohl (1967) and classification by Moore (1981). We sought to evaluate reliability in diagnosis of fracture-dislocations by traumatologists and to compare their outcomes with bicondylar tibial plateau fractures (BTPFs).

Methods: This was a retrospective cohort study at 14 level 1 trauma centers throughout North America.

Changes in Orthopaedic diagnoses during the COVID-19 pandemic.

Background: The coronavirus disease 2019 (COVID-19) pandemic has been accompanied by significant reductions in patient volumes for non-COVID-19-related conditions ranging from acute coronary syndrome to ischemic strokes to acute trauma. However, the impact of the COVID-19 pandemic on patient volumes for a broad range of orthopedic conditions remains unknown. The purpose of this study was to investigate the association of the COVID-19 pandemic with changes in patient volumes of 35 emergent (e.

Increased Comorbidity Burden Among Hip Fracture Patients During the COVID-19 Pandemic in New York City.

Background: The coronavirus disease 19 (COVID-19) pandemic had a devastating effect on New York City in the spring of 2020. Several global reports suggested worse early outcomes among COVID-positive patients with hip fractures. However, there is limited data comparing baseline comorbidities among patients treated during the pandemic relative to those treated in non-pandemic conditions.

The history of orthopaedic surgery in India: from antiquity to present.

Indian orthopedists have a legacy dating back more than 4000 years. Starting with the Harappan civilization, ancient orthopaedic surgeons reduced fractures and conducted therapeutic trepanations. Since then, Indian physicians have pioneered many of the orthopaedic techniques still used today - including the use of prosthetics, fracture tables, and rehabilitative physical therapy.

Open Reduction and Internal Fixation of Patella Fracture With Contoured Dorsal Plating.

In this article, we present a novel patella fixation technique using a low-profile highly contoured dorsal mini-fragment locking plate. This procedure is ideally indicated in patients with fracture patterns that are transverse without significant comminution. Long-term clinical studies are being performed to evaluate the effectiveness of this surgical technique.

Patient Experience and Satisfaction with Telemedicine During Coronavirus Disease 2019: A Multi-Institution Experience.

The coronavirus disease 2019 (COVID-19) heralded an unprecedented increase in telemedicine utilization. Our objective was to assess patient satisfaction with telemedicine during the COVID-19 era. Telemedicine visit data were gathered from Stanford Health Care (Stanford) and the Hospital for Special Surgery (HSS).