ACR Appropriateness Criteria® Acute Elbow and Forearm Pain.

Acute elbow pain can be the result of traumatic and atraumatic processes. Pathologic processes include osseous, ligamentous, and tendinous etiologies. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel.

Vehicles for Consolidation and Expansion of Physician Practices: Private Equity, Medical Services Organizations, and Strategic Partnerships.

As reimbursements decline and the health care sector experiences consolidation, running a small practice is increasingly difficult. The past 15 years has seen a significant rise in practice consolidation, private equity investment, and regional health system affiliation. In a rapidly changing health care landscape, positioning one's practice for the future is challenging.

Gender Differences in Self-Description: A Linguistic Analysis of Orthopedic Surgery Residency Application Personal Statements.

Objective: The purpose of this study is to assess differences in language characteristics in personal statements written by male and female applicants to an orthopedic surgery residency program.

Design: This is a blinded retrospective analysis of personal statements from all applicants to an orthopedic surgery residency training program during 1 application cycle. Language characteristics were analyzed using a linguistic analysis software.

Diabetes Mellitus and Total Ankle Arthroplasty Complications.

Background: Postoperative infection, aseptic loosening, and perioperative medical complications after total ankle arthroplasty (TAA) are all devastating problems. While previous studies have shown diabetes as a risk factor predisposing patients to postoperative complications, not all literature supports this association following TAA. The goal of this study is to determine if diabetes influences midterm outcomes following TAA.

Catastrophic Sports Injuries: Causation and Prevention.

➤ Catastrophic injuries in U.S. high school and college athletes are rare but devastating injuries.

Radiographic and Dynamic Assessment for Resection of Cam Lesions in Patients With Femoroacetabular Impingement.

Cam-type femoroacetabular impingement is characterized by a pathologic asphericity of the femoral head-neck junction, and arthroscopic femoral osteoplasty is indicated to correct the bony abnormality and restore normal hip mechanics when symptomatic. Residual femoroacetabular impingement deformity after arthroscopy is a leading cause of failure, and it is therefore critical to perform a thorough fluoroscopic and dynamic assessment when addressing cam deformities arthroscopically. The fluoroscopic assessment uses 6 anteroposterior views, including 3 in hip extension (30° internal rotation, neutral rotation, and 30° external rotation) and 3 in 50° flexion (neutral rotation, 40° external rotation, 60° of external rotation), performed before, during, and after the femoral resection.

ACR Appropriateness Criteria® Chronic Shoulder Pain: 2022 Update.

Chronic shoulder pain is an extremely common presenting complaint. Potential pain generators include the rotator cuff tendons, biceps tendon, labrum, glenohumeral articular cartilage, acromioclavicular joint, bones, suprascapular and axillary nerves, and the joint capsule/synovium. Radiographs are typically the initial imaging study obtained in patients with chronic shoulder pain.

Acute and Emergent Spinal Injury Assessment and Treatment.

Sports participation is a leading cause of catastrophic cervical spine injury (CSI) in the United States. Appropriate prehospital care for athletes with suspected CSIs should be available at all levels of sport. Planning the process of transport for home venues before the start of the season and ensuring that a medical time out occurs at home and away games can reduce complications of transport decisions on the field of play and expedite transport of the spine-injured athlete.

Procedure Costs of Peripheral Nerve Graft Reconstruction.

Unlabelled: Peripheral nerve injuries not repaired in an effective and timely manner may lead to permanent functional loss and/or pain. For gaps greater than 5 mm, autograft has been the gold standard. Allograft has recently emerged as an attractive alternative, delivering comparable functional recovery without risk of second surgical site morbidities.

ACR Appropriateness Criteria® Chronic Elbow Pain.

Chronic elbow pain can be osseous, soft tissue, cartilaginous, and nerve related in etiology. Imaging plays an important role in differentiating between these causes of chronic elbow pain. This document provides recommendations for imaging of chronic elbow pain in adult patients.

Repair of Quadriceps and Patellar Tendon Tears.

Tears of the quadriceps or patellar tendon usually occur after a sudden eabccentric contraction and are diagnosed by a palpable gap at the injury site combined with an inability to perform a straight leg raise. Bilateral knee radiographs may demonstrate patella alta with patellar tendon tears and patella baja with quadriceps tendon tears compared with the uninjured knee. Ultrasound and magnetic resonance imaging can be helpful when there is uncertainty in the diagnosis.

Outcomes Between Stemmed and Stemless Total Shoulder Arthroplasty: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Introduction: Both stemmed and stemless designs for total shoulder arthroplasty (TSA) have demonstrated efficacious outcomes for the surgical treatment of primary glenohumeral joint osteoarthritis. The purpose of this systematic review and meta-analysis was to compare the clinical outcomes of stemmed versus stemless TSA in randomized controlled trials. We hypothesized that there would be no differences in Constant Score (CS), range of motion, or adverse events, such as periprosthetic fracture and/or revision surgery.

Acute Compartment Syndrome as a Complication of Radial Artery Catheterization.

Acute compartment syndrome is a rare complication of radial artery catheterization. If not identified and treated emergently, it can lead to profound disability or limb loss. Here, we discuss a rare case of acute compartment syndrome in the forearm of a 54-year-old man after transradial catheterization and anticoagulation for myocardial infarction, which ultimately required emergent fasciotomies and prolonged hospital care.

Report on the Evidence-Based Practice Committee's Survey on Dupuytren Disease.

Purpose: The Evidence-Based Practice Committee of the American Society for Surgery of the Hand (ASSH) set out to assess the membership's practice patterns (PPs) and knowledge of evidence-based principles for Dupuytren disease (DD).

Methods: A 21-item multiple-choice survey was distributed to all ASSH members via email in June 2020. Questions were divided into 2 types: evidence-based practice (EBP) and PPs.

High Utility of the 1st Metatarsal Phalangeal Joint Fusion.

Fusion of the first metatarsophalangeal joint has been used by foot and ankle surgeons as a reproducible and useful means of treating end-stage arthritis of the great toe. However, the overall utility and successful outcomes of this procedure have led to its incorporation into the treatment of more significant bunion deformities, reconstruction forefoot, and salvage procedures. The authors review surgical fixation methods, offer insightful technical pearls for challenging cases and share examples of complex reconstructive and salvage procedures.

Editorial Commentary: Both Femoral Acetabular Anteversion and Retroversion May Contribute to the Effect of Femoroacetabular Impingement: What's Your Version?

Femoral anteversion may be a protective factor for hip impingement, whereas hip arthroscopy outcomes are worse for patients with femoral retroversion. Changes in version also affect the location of impingement. The association of increased anteversion with cam lesions may also explain the high number of patients with asymptomatic cam lesions.

Safety Profile of Synthetic Elastic Degradable Matrix for Soft Tissue Reconstruction in Foot & Ankle Surgery.

Background: Augmentation of soft tissue repairs has been helpful in protecting surgically repaired tissues as they heal. FlexBand (Artelon, Marietta, Georgia) is a synthetic, degradable, polycaprolactone-based polyurethane urea (PUUR) matrix that has been investigated and used for soft tissue repair in a variety of settings. The purpose of this study was to evaluate the safety profile of a PUUR matrix in a large cohort of patients undergoing soft tissue repairs about the foot and ankle.

Mechanism of non-contact ACL injury: OREF Clinical Research Award 2021.

Anterior cruciate ligament (ACL) ruptures significantly impact athletes in terms of return to play and loss of long-term quality of life. Before the onset of this study, understanding the mechanism of ACL injury was limited. Thus, the primary focus of this manuscript is to describe our multi-faceted approach to uncovering the mechanism of noncontact ACL injury (NC-ACLI) with the goal of developing preventive strategies.

Protocol for a multicenter, randomised controlled trial of surgeon-directed home therapy vs. outpatient rehabilitation by physical therapists for reverse total shoulder arthroplasty: the SHORT trial.

Background: Reverse total shoulder arthroplasty (RTSA) has emerged as a successful surgery with expanding indications. Outcomes may be influenced by post-operative rehabilitation; however, there is a dearth of research regarding optimal rehabilitation strategy following RTSA. The primary purpose of this study is to compare patient reported and clinical outcomes after RTSA in two groups: in one group rehabilitation is directed by formal, outpatient clinic-based physical therapists (PT group) as compared to a home therapy group, in which patients are instructed in their rehabilitative exercises by surgeons at post-operative appointments (HT group).