Do Percutaneously Applied Medial Proximal Tibia Plates Need To Go Beneath the Pes Tendons?

Background: Bicondylar tibial plateau fractures are often associated with significant soft tissue compromise making operative treatment challenging. Dual plating through a two-incision approach following temporary external fixation has been shown to improve complication rates although deep infection rates remain high.The objective was to evaluate early outcomes following a novel technique of percutaneous application of the medial plate superficial to the pes anserinus tendons.

Is Femoral Head to Acetabular Cup Ratio Associated With Dislocation After Total Hip Arthroplasty?

Background: Dislocation remains a common complication following total hip arthroplasty (THA). Previous literature has shown that the femoral head-to-neck ratio is essential in hip motion, function, and stability. While large femoral heads and dual mobility bearings have been developed to improve stability, it remains unknown if the ratio between femoral head size to acetabular cup size also plays a role in stability.

Trochleoplasty in Pediatric Patients - A Systematic Review.

Background: Trochleoplasty is a surgical consideration for the treatment of high-grade trochlear dysplasia. The safety profile of this procedure remains particularly unclear in the skeletally immature population where concerns exist regarding physeal arrest and the development of premature patellofemoral arthritis. The purpose of this study was to systematically review the literature to evaluate trochleoplasty use, outcomes and complications observed among pediatric patients.

The Fragility of Statistical Findings in Meniscus Repair Literature: A Systematic Review of Randomized Controlled Trials.

Background: Within the realm of orthopedic literature, the determination of statistical significance for outcomes relies on probability analysis and the reporting of P-values. The aim of this study was to employ fragility analysis as a means of evaluating the resilience of randomized controlled trials (RCTs) that assess meniscus surgeries. It was hypothesized that dichotomous outcomes would be statistically fragile and comparable to other orthopedic specialties.

The Efficacy of Prophylactic Vancomycin in Decreasing Surgical Site Infections in Adolescent Idiopathic Scoliosis Patients: A Large Multicenter Cohort Study.

Background: The use of vancomycin powder in spine surgery has been supported in adult populations, however, its efficacy in preventing postoperative surgical site infections in AIS patients is yet to be determined.

Methods: A multi-center review was conducted from June 2010 to February 2019, using ICD and CPT codes to identify AIS patients who underwent primary PSF. The patients were divided into two groups: the vancomycin cohort (receiving local vancomycin powder prior to wound closure) and the non-vancomycin cohort.

The Cost of Routine Clinic Visits Following Spinal Fusion for Adolescent Idiopathic Scoliosis.

Background: The institutional standard follow-up schedule for patients undergoing spinal instrumentation and fusion for adolescent idiopathic scoliosis (AIS) is return to clinic at 6-weeks and 3 months post-procedure for radiographs. COVID-19 prompted a change in this practice and most routine post-op visits were performed virtually during that time. The purpose of this study is to estimate the cost and benefit of in-person visits to inform the relative value of in-person follow-up using data from the year prior to COVID changes.

Standardized Multimodal Pain Protocol Minimizes Inpatient Opioid Administration in Pediatric Orthopedic Surgery Population.

Background: Optimal management of post-operative pain is a critical component of orthopedic surgical care. There is a heightened awareness of narcotic prescribing habits given the current "opioid epidemic." The lack of standardized protocols has led to increased errors, delayed access to prescribed medications, and excessive narcotic prescribing.

Trends in Research Productivity Among Residents Applying For United States Orthopedic Foot and Ankle Fellowships.

Background: Little empirical research has been done on factors evaluated in the fellowship matching process, this study intends to evaluate the impact of research productivity.

Objective: The purpose of this study is to identify research trends and characterize the academic profiles of recent Foot and Ankle (F&A) fellows in the United States when they applied for fellowship.

Methods: The American Orthopedic F&A Society website was used to identify accepted fellows between the years 2017-2023.

Coronal Malalignment Is Infrequently Present in Patients With Aseptic Tibial Loosening.

Background: Coronal lower extremity malalignment and improper implant position have been described as risk factors for aseptic tibial loosening following primary total knee arthroplasty (TKA). However, several prior studies have shown no association between alignment and implant loosening. Meanwhile, there is increasing interest in kinematic alignment.

Efficacy of Intraoperative Cell Salvage on Perioperative Blood Transfusion in Pelvic and Acetabular Surgery: A Matched Cohort Analysis.

Background: Pelvic fractures often result in traumatic and intraoperative blood loss. Cell salvage (CS) is a tool where autologous blood lost during surgery is collected and recycled with anticoagulation, centrifugation to separate red blood cells, and washing to be reinfused back to the patient. The purpose of this study was to investigate our experience with CS in pelvic and acetabular surgery and its relationship to perioperative transfusion requirements.

Canal Fill Ratio in Hemiarthroplasty Compared to Total Hip Arthroplasty: A Case Control Study.

Background: Cementless stems are commonly used in hemiarthroplasty (HA) for femoral neck fractures. Recent studies have reported increased risk of periprosthetic fracture with cementless stems compared to cemented HA. In elective total hip arthroplasty (THA), lower proximal canal fill ratios (CFR) of cementless stems have been associated with worse outcomes.

Cancer in Orthopaedic Surgeons: Results of an American Academy of Orthopaedic Surgeons (AAOS) Survey.

Background: There is a currently limited data regarding cancer risk in Orthopaedic Surgeons. This study summarizes a survey on cancer prevalence in orthopaedic surgeons.

Methods: A cancer prevalence survey was emailed to all 23,370 members of the American Academy of Orthopaedic Surgeons (AAOS).

Tarsal Tunnel Syndrome - A Comprehensive Review.

Tarsal tunnel syndrome (TTS) refers to compression of the posterior tibial nerve as it traverses the tarsal tunnel in the ankle. First described by Keck and Lam in 1962, TTS is an underdiagnosed cause of heel pain and foot dysfunction. The tarsal tunnel contains the tibial nerve, posterior tibial artery, and tendons of the tibialis posterior, flexor digitorum longus, and flexor hallucis longus muscles.

The Albright-Losee Low Profile Pivot Shift Test for ACL Deficiency.

Background: Recognizing ACL injuries on the field and in the office can be very challenging in awake and apprehensive patients. Despite high specificity, many published "pivot-shift" techniques have limited acceptance mainly because of unsatisfactory sensitivity. We describe in detail, four specific modifications and provide a critical review of our clinical experiences to empower the new user's readiness to master a novel screening procedure for ACL disruption.

Did the Covid-19 Pandemic Impact Time to Surgery, Length of Hospital Stay, or Discharge Location for Subaxial Cervical Spine Fractures Requiring Surgical Intervention?

Background: The COVID-19 pandemic disrupted healthcare systems across the United States resources were consumed caring for COVID-19 patients. Past research on trauma activations during COVID-19 has found changes to hospital length of stay and discharge locations. Subaxial spine fractures are potentially debilitating injuries that require timely surgery and extensive rehabilitation.

Bayesian modeling framework for optimizing pre-hospital stroke triage decisions.

Ischemic stroke is responsible for significant morbidity and mortality in the United States and worldwide. Stroke treatment optimization requires emergency medical personnel to make rapid triage decisions concerning destination hospitals that may differ in their ability to provide highly time-sensitive pharmaceutical and surgical interventions. These decisions are particularly crucial in rural areas, where transport decisions can have a large impact on treatment times - often involving a trade-off between delay in pharmaceutical therapy or a delay in endovascular thrombectomy.

Lost Highways: An Examination of the Question of Risk Involved in Sexual Homicides of Hitchhiking Victims.

Despite cultural references to the dangers of hitchhiking, particularly for sexual homicide, no published research investigates these incidents from both an offender and crime scene perspective. Using the Sexual Homicide International Database (SHIelD), we explore lifestyle risk by comparing sexual homicide cases involving hitchhiking victims to those involving victims engaged in sex trade work. The results, based on the use of bivariate and multivariate statistics, indicate that offenders view hitchhiking victims as opportunities for confinement without physical restraint, often engaging in sexual acts and theft.

Impact of driver licensing renewal policies on older driver crash involvement and injury rates in 13 states, 2000-2019.

Background: Motor vehicle crashes are the second leading cause of injury death among adults aged 65 and older in the U.S., second only to falls.

Lack of thermal acclimation in multiple indices of climate vulnerability in bumblebees.

Indices of climate vulnerability are used to predict species' vulnerability to climate change based on intrinsic physiological traits, such as thermal tolerance, thermal sensitivity and thermal acclimation, but rarely is the consistency among indices evaluated simultaneously. We compared the thermal physiology of queen bumblebees between a species experiencing local declines () and a species exhibiting continent-wide increases (). We conducted a multi-week acclimation experiment under simulated climate warming to measure critical thermal maximum (CT), critical thermal minimum (CT), the thermal sensitivity of metabolic rate and water loss rate and acclimation in each of these traits.

Prenatal stress alters mouse offspring dorsal striatal development and placental function in sex-specific ways.

Prenatal stress is a risk factor for neurodevelopmental disorders (NDDs), including autism spectrum disorder (ASD). However, how early stress modification of brain development contributes to this pathophysiology is poorly understood. Ventral forebrain regions such as dorsal striatum are of particular interest: dorsal striatum modulates movement and cognition, is altered in NDDs, and has a primarily GABAergic population.

Diabetes Endothelial Keratoplasty Study: Methods and Impact on the Use of Corneas From Donors With Diabetes for Descemet Membrane Endothelial Keratoplasty.

Purpose: Describe aims, methods, characteristics of donors, donor corneas and recipients, and potential impact of the Diabetes Endothelial Keratoplasty Study (DEKS).

Methods: The DEKS is a randomized, clinical trial to assess graft success and endothelial cell density (ECD) 1 year after Descemet membrane endothelial keratoplasty (DMEK) using corneas from donors with versus without diabetes in a 1:2 minimization assignment. Diabetes severity in the donor is assessed by medical history, postmortem HbA1c, and donor skin advanced glycation end-products and oxidation markers.

Increased Incidence of Surgical Intervention for Otitis Media With Effusion Among Patients With Type 2 Inflammatory Diseases.

Background: Otitis media with effusion (OME) is associated with comorbidities such as allergic rhinitis, gastroesophageal reflux disease, asthma, and more. Many of these comorbidities can be caused by type 2 inflammation (T2I). This study aims to determine the risk of undergoing OME surgery in patients with and without T2I disease.

Optimizing automated photo identification for population assessments.

Several legal acts mandate that management agencies regularly assess biological populations. For species with distinct markings, these assessments can be conducted noninvasively via capture-recapture and photographic identification (photo-ID), which involves processing considerable quantities of photographic data. To ease this burden, agencies increasingly rely on automated identification (ID) algorithms.