Bullying in Orthopaedic Surgery: A Survey of US Orthopaedic Trainees and Attending Surgeons.

Introduction: Bullying is a notable problem in surgery, creating a hostile environment for surgeons and trainees, and may negatively affect patient care. However, specific details regarding bullying in orthopaedic surgery are lacking. The primary aim of this study was to determine the prevalence and nature of bullying within orthopaedic surgery in the United States.

Displaced Versus Nondisplaced Femoral Neck Fractures: Is Arthroplasty the Answer for Both?

Background: Traditionally, nondisplaced geriatric femoral neck fractures (FNFs) have undergone operative fixation, while displaced geriatric FNFs have undergone hip arthroplasty. The purpose of this study was to evaluate differences between outcomes in patients with nondisplaced (Garden I and II) fractures and displaced (Garden III and IV) fractures that were treated with arthroplasty.

Methods: This was a retrospective review of patients who had a minimum of 1 year follow-up from nine academic medical centers who underwent arthroplasty for FNFs between 2010 and 2020.

Comparison Between Orthopaedic Trauma Versus Arthroplasty Fellowship Training on Outcomes of Total Hip Arthroplasty for Femoral Neck Fracture.

Background: This study aimed to identify differences in patient characteristics, perioperative management methods, and outcomes for total hip arthroplasty (THA) for femoral neck fracture (FNF) when performed by orthopaedic surgeons who have arthroplasty versus orthopaedic trauma training.

Methods: This study was a multicenter retrospective review of 636 patients who underwent THA for FNF between 2010 and 2019. There were 373 patients who underwent THA by an arthroplasty surgeon, and 263 who underwent THA by an orthopaedic trauma surgeon.

Benefits of an Orthopedic Education Research Collaborative: An Innovative Approach.

Background Graduate Medical Education (GME) research in orthopedic surgery is an important but underrepresented subject in the medical literature. It was unknown if orthopedic residency leaders were interested in a surgical education research collaborative (). The objectives of this study were to assess the potential benefit of an orthopedic collaborative from orthopedic residency leaders and investigate the factors associated with the support of a research collaborative within a surgical subspecialty.

The Mechanism of Anterior Cruciate Ligament Injuries in the National Football League: A Systematic Video Review.

Introduction Anterior cruciate ligament (ACL) injuries are common among American football athletes, although few studies have performed video analyses of ACL injuries to better understand the injury mechanism. This work aims to characterize the mechanism of ACL injury during professional football competitions using video analysis. We hypothesize that football-specific injury trends will emerge, including high rates of contact injuries and associations with shallow knee and hip flexion angles (0°-30°).

Estimating the location of the posterior interosseus nerve during an extensor digitorum communis-splitting approach: a comparison of methods using the transepicondylar distance.

Background: The posterior interosseus nerve (PIN) may be encountered when using the extensile extensor digitorum communis (EDC)-splitting approach to the elbow. An accurate means of estimating its location remains elusive. The purpose of this investigation is to identify whether the methods described in previous studies can be improved upon to more accurately estimate the PIN's location using the transepicondylar distance (TED).

Meniscal and Articular Cartilage Predictors of Outcome After Revision ACL Reconstruction: A 6-Year Follow-up Cohort Study.

Background: Meniscal and chondral damage is common in the patient undergoing revision anterior cruciate ligament (ACL) reconstruction.

Purpose: To determine if meniscal and/or articular cartilage pathology at the time of revision ACL surgery significantly influences a patient's outcome at 6-year follow-up.

Study Design: Cohort study; Level of evidence, 3.

Extensor Mechanism Reconstruction for Chronic Patellar Tendon Tears.

Objectives: Reconstruction for a chronic patellar tendon rupture in a native knee is an uncommon surgical procedure. Although there have been case series investigating patient-reported outcomes, there is no systematic review of these studies to date. The purpose of this review is to synthesize the literature on this procedure to better understand its outcomes, complications, and surgical technique options.

American Shoulder and Elbow Surgeons SLAP/Biceps Anchor Study Group evidence review: pathoanatomy and diagnosis in clinically significant labral injuries.

Glenoid superior biceps-labral pathology diagnosis, treatment, and outcomes are an evolving area of shoulder surgery. Historically, described as superior labrum anterior posterior (SLAP) tears, these lesions were identified as a source of pain in throwing athletes. Diagnosis and treatments applied to these SLAP lesions resulted in less than optimal outcomes in some patients and a prevailing sense of confusion.

Current Requirements and Attitudes Toward Research: A Survey-Based Analysis of Orthopedic Surgery Programs.

Objective The Accreditation Council for Graduate Medical Education (ACGME) guidelines require scholarly activity but do not specify what research-related activity is necessary to meet this requirement. The current components and opinions regarding research and its implementation that qualify as scholarly activity are unknown among US orthopedic surgery programs. We aimed to survey program directors of orthopedic surgery programs to evaluate and better understand the current state of research during training.

Assessing tobramycin levels and renal function following the implantation of CaSO4 beads impregnated with tobramycin: A prospective cohort study.

This study aimed to evaluate the risk of serum tobramycin concentrations exceeding therapeutic levels after administration of calcium sulfate (CaSO4) beads containing either 240 mg or 400 mg tobramycin and 1000 mg vancomycin. This single-center, prospective. This single-center, prospective study included included Piedmont Columbus, Regional orthopedic surgery patients.

The Importance of Mentorship and Interest Group Involvement for the Orthopedic Surgery Applicant.

Background: Mentorship in medical education is important for students' professional development career planning. Orthopedic Surgery Interest Groups (OSIG) exist as formal organizations and serve as a conduit for undergraduate mentorship, though the role of mentorship via OSIGs within orthopedic medicine has not been thoroughly evaluated. Similarly, OSIGs within institutions are not standardized nor well defined.

Treatment of Open Traumatic Medial Malleolus Bone Loss With Osteochondral Allograft: A Case Report.

Osteochondral damage to the ankle joint can be a difficult problem to manage in a young active patient. There are several described surgical treatments ranging from cartilage repair techniques to arthrodesis and ankle replacement. In this case, we present a 28-year-old male who sustained a right type IIIA open medial malleolus fracture following an all-terrain vehicle crash.

Impact of the Percentage of Overlapping Surgery on Patient Outcomes: A Retrospective Cohort Study of 87,000 Surgical Cases.

Objectives: The primary objective of this study was to analyze the relationship of percentage of surgical overlap with patient outcomes to determine if a detrimental level of overlap exists.

Background: Overlapping surgery is defined as 1 attending physician supervising 2 or more operative cases simultaneously, without the critical portions of the cases occurring concurrently. To date, no study has examined the relationship of percent overlap, or the percentage of 1 case that is spent overlapping with another, to outcomes, efficiency, safety, and complications.

Changes in Plasma Levels of ADAMTS13 and von Willebrand Factor in Patients Undergoing Elective Joint Arthroplasty.

The risk of venous thromboembolic events (VTE) increases in patients undergoing total shoulder arthroplasty (TSA). However, there is no guidelines for prophylaxis. A decreased ratio of ADAMTS13 to VWF has been reported in patients with VTE.

Second Harmonic Generation Microscopy as a Novel Intraoperative Assessment of Rat Median Nerve Injury.

Purpose: Nerves that are functionally injured but appear macroscopically intact pose the biggest clinical dilemma. Second Harmonic Generation (SHG) Microscopy may provide a real-time assessment of nerve damage, with the ultimate goal of allowing surgeons to accurately quantify the degree of nerve damage present. The aim of this study was to demonstrate the utility of SHG microscopy to detect nerve damage in vivo in an animal model.

Porous Polyetheretherketone Interbody Cages for Anterior Cervical Discectomy and Fusion at 3 or More Levels: Clinical and Radiographic Outcomes.

Background: Anterior cervical discectomy and fusion (ACDF) at 3 or more levels remains challenging, with reported high pseudarthrosis rates and implant-related complications. Porous surface polyetheretherketone (PEEK) interbody cages are newer implants for ACDF with limited data available for their use in ACDF procedures at 3 or more levels. The objective of this study was to assess the clinical and radiographic outcomes of porous PEEK devices for ACDF at 3 or more levels.

Nerve block with liposomal bupivacaine yields fewer complications and similar pain relief when compared to an interscalene catheter for arthroscopic shoulder surgery: a randomized controlled trial.

Background: Following orthopedic surgery, patients frequently experience pain and discomfort. Multiple methods of regional anesthesia are available; however, the optimal technique to adequately manage pain while minimizing complications remains under investigation. This study aims to compare the complication rates and pain relief of single-injection, liposomal bupivacaine brachial plexus nerve block to a conventional, indwelling ropivacaine interscalene catheter (ISC) in patients undergoing arthroscopic shoulder surgery.

Insurance status is not a predictor of rotator cuff tear magnitude.

Background: Rotator cuff tear (RCT) chronicity is an important factor in considering treatment options and outcomes for surgical repair. Many factors may contribute to delayed treatment, including timely access to care due to insurance status. The purpose of this study was to evaluate the relationship between the magnitude of RCT on presentation and insurance status.

Orthopedic consequences of modern gladiators: a systematic review of lower extremity musculoskeletal issues in retired NFL players.

Objectives: The stressors that National Football League (NFL) athletes face are well-described and documented with regard to multisystem afflictions and injury prevalence. However, the majority of literature discusses the short-term effects rather than long-term outcomes of playing professional football. The purpose of this study was to characterize the long-term musculoskeletal issues in the retired NFL population.

Evaluation of Rotator Cuff Augmentation of Proximal Humerus Fracture Fixation.

Proximal humerus fractures represent one of the most common fractures in the elderly, and are increasingly treated with surgical fixation. Suture augmentation attaching the rotator cuff to the plate has been advocated to combat varus collapse and other associated complications. The objective of this study was to evaluate the contribution of rotator cuff augmentation to stability of proximal humerus fracture fixation.

Incorporating Expected Outcomes Into Clinical Decision-Making for Total Knee Arthroplasty.

Objective: Expected outcomes (e.g., expected survivorship after a cancer treatment) have improved decision-making around treatment options in many clinical fields.

Comparing complications of outpatient management of slipped capital femoral epiphysis and Blount's disease: A database study.

Background: Currents trends in pediatric orthopaedics has seen an increase in surgeries being successfully completed in an outpatient setting. Two recent examples include slipped capital femoral epiphysis (SCFE) and Blount's disease. Surgical indications are well-studied for each pathology, but to our knowledge, there is an absence in literature analyzing safety and efficacy of inpatient outpatient management of either condition.