273 results match your criteria: "Atrium Health - Musculoskeletal Institute[Affiliation]"

Objective: The purpose of this study is to evaluate one institution's use of a supplemental essay and its effect on the total number and demographics of applicants as compared to previous years.

Design: A retrospective cohort review of candidates applying to our institution's Orthopedic Surgery residency program in the 2020 to 2021 cycle was performed. All applicants were presented a prompt for a short supplemental essay.

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Total elbow arthroplasty (TEA) has become a well-accepted treatment option for many pathologies of the elbow joint. Its use in distal humerus fractures in elderly patients has become increasingly popular and has good clinical results. However, with the aging population and the increasing number of TEAs performed, so comes the potential for an increasing number of revision TEA cases.

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Introduction: A novel technique using an adjustable-loop cortical suspension toggle device for reduction of a fibular head avulsion fracture (arcuate fracture) in posterolateral corner (PLC) reconstruction is described. Results of clinical follow-up are presented.

Materials And Methods: 9 patients were retrospectively identified who underwent posterolateral corner reconstruction using an adjustable-loop cortical suspension toggle device.

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Background: Open wound management in prosthetic joint infection (PJI) patients has been used in problematic dehisced wounds hoping to stimulate granulation tissue and closure. However, infections that start as a monomicrobial PJI can become polymicrobial with resultant worse outcomes following open wound management. This study assessed the relationship between open wound management and the development of polymicrobial periprosthetic joint infections.

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Several fields of orthopedics have concluded benefits from volume thresholds. We postulate that we could similarly optimize periprosthetic joint infection (PJI) treatment by creating a regional referral center, concentrating expertise and resources. Here, we review our reasoning and our first-year experience of a PJI referral center in the United States.

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Open Ankle Arthrodesis for Deformity Correction.

Foot Ankle Clin

March 2022

OrthoCarolina Foot and Ankle Institute, Atrium Health Musculoskeletal Institute, 2001 Vail Avenue, Charlotte, NC 28207, USA. Electronic address: https://twitter.com/ToddIrwinMD.

Open ankle arthrodesis remains a reliable solution for ankle arthritis, especially in the setting of deformity. Careful preoperative evaluation needs to be performed, both clinically and radiographically. The specific deformity present helps determine the approach used and the fixation choices.

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Article Synopsis
  • Standard treatment for periprosthetic joint infection (PJI) typically involves a 2-stage exchange using antibiotic-impregnated cement spacers (ACS), but concerns exist about their role in causing acute kidney injury (AKI).
  • A clinical trial found that patients undergoing the first stage of a 2-stage exchange were significantly more likely to experience AKI compared to those who had a 1-stage exchange (22.7% vs 6.6%).
  • The study concluded that high-dose ACS is an independent risk factor for AKI, suggesting the need for strategies to reduce kidney damage during PJI revisions.
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Background: Supracondylar humerus (SCH) fracture is the most common elbow injury in children and often treated with closed reduction and percutaneous pinning (CRPP). There is little published evidence supporting or refuting the use of perioperative prophylactic antibiotics for SCH CRPP in the pediatric population. The purpose of this study is to evaluate the rate of surgical site infection for patients with and without preoperative antibiotics.

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Background: With the overwhelming use of cementless femoral fixation for primary total hip arthroplasty in the United States, the associations of stem fixation on the risk of revision and mortality are poorly understood. We evaluated the relationship between femoral fixation and risk of revision and mortality in patients included in the American Joint Replacement Registry.

Methods: Elective, primary, unilateral total hip arthroplasties in the American Joint Replacement Registry, in patients over the age of 65 years were considered.

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Background And Objectives: Posttraumatic stress disorder (PTSD) is associated with higher rates of chronic pain and increased risk of developing Opioid use disorder. This paper evaluates the impact of PRIMUM, an electronic health record-embedded (EHR) clinical decision support intervention on opioid prescribing patterns for patients with diagnosis of PTSD.

Methods: Inpatient, emergency department (ED), urgent care, and outpatient encounters with ICD-10 codes F43.

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Patient Optimization Strategies Prior to Elective Total Hip and Knee Arthroplasty.

J Surg Orthop Adv

February 2022

Atrium Health - Musculoskeletal Institute, Charlotte, North Carolina; OrthoCarolina - Hip & Knee Center, Charlotte, North Carolina.

Periprosthetic joint infection (PJI) following elective total hip and knee arthroplasty remains a devastating complication. PJI is associated with high morbidity and mortality to the patient as well as high expenses to the health care system. Although patient optimization prior to elective arthroplasty has gained notoriety and shown to help prevent complications, surgeons continue to operate on patients who are not optimized for surgery.

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Prosthetic joint infection is a feared complication following elective total joint arthroplasty of the hip and knee. Infection following arthroplasty leads to high morbidity and even mortality and is a major burden to the health care system. Although many advances are being made in the treatment of prosthetic joint infection, with the increasing volume of total joint arthroplasty anticipated over the next decade, a significant emphasis should be placed on prevention.

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Wound Management in Total Knee Prosthetic Joint Infections.

J Surg Orthop Adv

February 2022

Atrium Health - Musculoskeletal Institute, Charlott e, North Carolina; OrthoCarolina - Hand Center, Charlott e, North Carolina.

Total knee arthroplasty complicated by periprosthetic joint infection can be devastating. Patients undergoing treatment for prosthetic joint infection have often undergone multiple surgeries and may have associated soft tissue defects that complicate treatment. These defects often require soft tissue reconstruction in order to cover the prosthesis.

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Background: Severe lower extremity trauma among working-age adults is highly consequential for returning to work; however, the economic impact attributed to injury has not been fully quantified. The purpose of this study was to examine work and productivity loss during the year following lower extremity trauma and to calculate the economic losses associated with lost employment, lost work time (absenteeism), and productivity loss while at work (presenteeism).

Methods: This is an analysis of data collected prospectively across 3 multicenter studies of lower extremity trauma outcomes in the United States.

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Opioid-free shoulder arthroplasty is safe, effective, and predictable compared with a traditional perioperative opiate regimen: a randomized controlled trial of a new clinical care pathway.

J Shoulder Elbow Surg

July 2022

OrthoCarolina Research Institute, Charlotte, NC, USA; Atrium Health Musculoskeletal Institute, Charlotte, NC, USA; OrthoCarolina Sports Medicine Center, Charlotte, NC, USA; OrthoCarolina Hand Center, Charlotte, NC, USA; OrthoCarolina Foot and Ankle Center, Charlotte, NC, USA; OrthoCarolina Spine Center, Charlotte, NC, USA; OrthoCarolina Hip and Knee Center, Charlotte, NC, USA.

Background: Opiate-based regimens have been used as a foundation of postoperative analgesia in orthopedic surgery for decades, and the vast majority of orthopedic patients in the United States receive postoperative opioid prescriptions. Both the safety and efficacy of opioid use in orthopedic patients have been questioned because of mounting evidence that postoperative opioid use can be detrimental to outcomes and patient satisfaction. The purpose of this study is to compare a new, opioid-free pain management pathway with a traditional opioid-containing, multimodal pathway in patients undergoing shoulder arthroplasty.

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Background: The management of displaced intraarticular calcaneus fractures (DIACFs) is a difficult problem with disappointing results from open reduction internal fixation (ORIF). Alternatively, ORIF with primary subtalar arthrodesis (PSTA) has gained increasing popularity. The purpose of this study is to review patient-centered and radiographic outcomes of ORIF plus PSTA using only screws through a sinus tarsi approach.

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Objective: To compare the retrospective decision of an expert panel who assessed likelihood of acute compartment syndrome (ACS) in a patient with a high-risk tibia fracture with decision to perform fasciotomy.

Design: Prospective observational study.

Setting: Seven Level 1 trauma centers.

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Limited data are available on the longer-term physical and psychosocial consequences after major extremity trauma apart from literature on the consequences after major limb amputation. The existing literature suggests that although variations in outcome exist, a significant proportion of service members and civilians sustaining major limb trauma will have less than optimal outcomes or health and rehabilitation needs over their life course. The proposed pilot study will address this gap in current research by locating and consenting METRC participants with the period of 5-7 years postinjury, identifying potential participation barriers and appropriate use of incentives, and conducting the follow-up examination at several data collection sites.

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Optimal timing and procedure selection that define staged treatment strategies can affect outcomes dramatically and remain an area of major debate in the treatment of multiply injured orthopaedic trauma patients. Decisions regarding timing and choice of orthopaedic procedure(s) are currently based on the physiologic condition of the patient, resource availability, and the expected magnitude of the intervention. Surgical decision-making algorithms rarely rely on precision-type data that account for demographics, magnitude of injury, and the physiologic/immunologic response to injury on a patient-specific basis.

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Physical and psychological impairment resulting from traumatic injuries is often significant and affects employment and functional independence. Extremity trauma has been shown to negatively affect long-term self-reported physical function, the ability to work, and participation in recreational activities and contributes to increased rates of anxiety and/or depression. High pain levels early in the recovery process and psychosocial factors play a prominent role in recovery after traumatic lower extremity injury.

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Perceptions of the Universal Interview Offer Day in the Orthopaedic Surgery Residency Interview Process.

J Am Acad Orthop Surg

July 2022

From the Department of Orthopaedic Surgery, The Hughston Foundation, Columbus, GA (Jardaly and Ponce), the Department of Orthopaedic Surgery, The University of Chicago, Chicago, IL (Balach), the Department of Orthopaedic Surgery, Columbia University, New York City, NY (Levine), the Department of Orthopaedic Surgery, Rush University, Chicago, IL (Kogan), and the Department of Orthopaedic Surgery, Carolinas Medical Center, Atrium Health Musculoskeletal Institute, Charlotte, NC (Patt).

Introduction: The American Orthopaedic Association's Council of Orthopaedic Residency Directors recommended implementing a universal offer day (UOD) in the 2020 residency match. Although this decision was an attempt to benefit applicants, it is important to assess how this endeavor was perceived.

Methods: Questionnaires for applicants and program directors asked about the perception of the UOD and the experience with it.

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