Rehabilitation protocols in proximal humerus fracture management: A systematic review.

Background: Proximal humerus fractures (PHFs) are relatively common, although optimal rehabilitation is unknown. This review aims to characterize the published rehabilitation regimens utilized for PHFs.

Methods: A systematic review was performed per PRISMA guidelines, utilizing PubMed/MEDLINE, Embase, and Cochrane.

TENDINopathy Severity assessment-Achilles (TENDINS-A): evaluation of reliability and validity in accordance with COSMIN recommendations.

Objective: To evaluate the construct validity (structural validity and hypothesis testing), reliability (test-retest reliability, measurement error and internal consistency) and minimal important change (MIC) of the 13-item TENDINopathy Severity assessment-Achilles (TENDINS-A).

Methods: Participants with Achilles pain completed an online survey including: demographics, TENDINS-A, Foot and Ankle Outcome Score (FAOS) and Victorian Institute of Sport Assessment-Achilles (VISA-A). Exploratory factor analysis (EFA) assessed dimensionality.

Cannabidiol for Postoperative Pain Control After Arthroscopic Rotator Cuff Repair Demonstrates No Deficits in Patient-Reported Outcomes Versus Placebo: 1-Year Follow-up of a Randomized Controlled Trial.

Background: Cannabidiol (CBD) has been shown recently to positively affect patient pain and satisfaction immediately after arthroscopic rotator cuff repair (ARCR). However, it is unclear whether the addition of CBD to a perioperative regimen could affect postoperative outcomes.

Purpose: To evaluate patient-reported outcomes among patients who underwent ARCR and received buccally absorbed CBD or an identical placebo for early postoperative pain management at 1-year follow-up.

Perceptions and Opinions on Cannabidiol in the Orthopaedic Sports Medicine Community.

Background: Cannabidiol (CBD) is a known pain modulator that is garnering increased attention in the orthopaedic world. There may be a considerable knowledge gap among orthopaedic sports medicine providers and their perception of its therapeutic value.

Purpose: To (1) examine the knowledge and beliefs of sports medicine orthopaedic providers with respect to CBD, (2) deliver an educational component, and (3) elucidate potential barriers to its widespread application.

Combining radiographic and CT measurements to rival MRI for the diagnosis of acute isolated syndesmotic injury.

Background: Acute isolated syndesmotic injuries (AISIs) have a high potential to be misdiagnosed or underdiagnosed at initial presentation to the hospital. Although magnetic resonance imaging (MRI) is the gold standard in noninvasive diagnostics, it is not always available immediately and is much more expensive than other imaging modalities. This study identifies improvements in conventional radiography and computed tomography (CT) to diagnose AISI and aims to reduce the number of MRI scans needed to verify the diagnosis.

Defining Operative Indications in Lisfranc Injuries: A Systematic Review.

Objective: The aim of this review was to determine operative indications for Lisfranc injuries.

Methods: A systematic review using a MEDLINE literature search was performed using the index "Lisfranc Injury" from 1980 onward using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines where applicable. Inclusion criteria were all clinical studies reporting on the management of Lisfranc injuries obtained via the search index, including case reports, review articles, cohort studies, and randomized trials.

A systematic review of the patient reported outcome measures utilized in level 1 randomized controlled trials involving achilles tendon ruptures.

Background: Patient Reported Outcome Measures (PROMs) are utilized in level 1 randomized controlled trials involving Achilles tendon ruptures. However, the characteristics of these PROMs and current practices has not yet been reported. We hypothesize that there will be heterogeneous PROM usage in this context.

First MTP joint injuries: MR imaging findings in surgically managed patients.

Objectives: Determine whether MR imaging findings or demographics predict surgical management in patients with first MTP joint injuries.

Materials And Methods: Retrospective study of 161 forefoot MRs for traumatic first MTP injury (M:F 92:69, mean age 33 ± 13 yrs.).

Minimum 2-Year Outcomes of a Novel 3D-printed Fully Porous Titanium Acetabular Shell in Revision Total Hip Arthroplasty.

Background: Fully porous acetabular shells are an appealing choice for patients with extensive acetabular defects undergoing revision total hip arthroplasty (rTHA). This study reports on the early outcomes of a novel 3-D printed fully porous titanium acetabular shell in revision acetabular reconstruction.

Methods: A multicenter retrospective study of patients who received a fully porous titanium acetabular shell for rTHA with a minimum of 2 years of follow-up was conducted.

Buccally Absorbed Cannabidiol Shows Significantly Superior Pain Control and Improved Satisfaction Immediately After Arthroscopic Rotator Cuff Repair: A Placebo-Controlled, Double-Blinded, Randomized Trial.

Background: Despite the widespread use and sales of cannabidiol (CBD) products in the United States, there is a paucity of literature to evaluate its effectiveness, safety, or ideal route of administration for postoperative pain.

Purpose: To evaluate the potential analgesic effects of buccally absorbed CBD in patients who have undergone arthroscopic rotator cuff repair (ARCR).

Study Design: Randomized controlled trial; Level of evidence, 1.

Rerupture and wound complications following Achilles tendon repair: A systematic review.

Despite the relatively high frequency of Achilles ruptures, there is no general consensus on the optimal treatment method. A general trend toward more patients being treated nonoperatively has emerged recently with the advent of functional rehabilitation. However, much of the recent data on this subject has been highly variable.

Rotational abnormalities in dysplastic hips and how to predict acetabular torsion.

Objectives: The aim of this study was to investigate the degree to which conventional radiography can represent the acetabular and femoral rotational alignment profile between dysplastic and borderline-dysplastic hips.

Methods: A retrospective trial was conducted including 56 borderline-dysplastic and dysplastic hips at a mean age of 28.9 years (range from 18 to 46).

The Fragility of Statistical Findings in Achilles Tendon Injury Research: A Systematic Review.

Introduction: Probability analysis with the reporting of P values is often used to determine the statistical significance of study findings in the Achilles literature. The purpose of this study was to determine the utility of applying a fragility analysis to comparative trials evaluating Achilles tendon injuries.

Methods: We identified all dichotomous outcome data for comparative studies of Achilles tendon injuries published in 11 orthopaedic journals from 2000 to 2020.

Functional Outcomes of Insertional Achilles Tendinopathy Treatment: A Systematic Review.

Background: Achilles tendinopathy is a common clinical problem that can be either insertional or noninsertional, and effective treatment of each type can vary. We sought to investigate the current evidence on different treatment methods for insertional Achilles tendinopathy with a focus on functional outcomes.

Methods: We performed a systematic review of the available literature using the PubMed/MEDLINE and Cochrane Central Register of Controlled Trials databases.

Risk Factors for Anterior Tibial Tendon Pathology.

Background: Though the tibialis anterior (TA) serves a vital role in ankle dorsiflexion, there is little information regarding risk factors and demographic information that might predispose one to tendinopathy or rupture. This study investigates the features of patients in a single institution who presented with either TA tendinopathy or rupture. The circumstances surrounding rupture were also noted.

COVID-19 and Orthopaedic International Humanitarianism.

As the world continues to adjust to life with COVID-19, one topic that requires further thought and discussion is whether elective international medical volunteerism can continue, and, if so, what challenges will need to be addressed. During a pandemic, the medical community is attentive to controlling the disease outbreak, and most of the literature regarding physician involvement during a pandemic focuses primarily on physicians traveling to areas of need to help treat the disease. As a result, little has been written about medical volunteerism that focuses on medical treatment unrelated to the disease outbreak.

Outcome measures reported for the management of proximal humeral fractures: a systematic review.

Background: The American Shoulder and Elbow Surgeons multicenter taskforce studying proximal humerus fractures reached no consensus on which outcome measures to include in future studies, and currently no gold standard exists. Knowledge of commonly used outcome measures will allow standardization, enabling more consistent proximal humerus fracture treatment comparison. This study identifies the most commonly reported outcome measures for proximal humerus fracture management in recent literature.

Clinical outcomes and complications of reverse shoulder arthroplasty used for failed prior shoulder surgery: a systematic review and meta-analysis.

Background: Reverse shoulder arthroplasty (RSA) is frequently performed in the revision setting as a salvage procedure. The purpose of this study was to report the clinical outcomes and complication, reoperation, and revision rates after revision RSA (RRSA) stratified according to the primary shoulder procedure undergoing revision.

Methods: Four databases (Embase, MEDLINE, SPORTDiscus, and Cochrane Controlled Trials Register) were searched for eligible studies published between January 1985 and September 2017.

Labral Ossification and Sacroiliac Joint Disease: Could There Be a Link to an Autoimmune Etiology?

Purpose: To determine the prevalence of ipsilateral sacroiliac (SI) joint disease among patients with symptomatic femoroacetabular impingement (FAI) associated with labral ossification (LO) who underwent hip arthroscopy compared with a matched control group of patients with symptomatic FAI and no LO.

Methods: Computed tomography (CT) scans of all patients undergoing arthroscopic correction of FAI were obtained. The inclusion criterion for the study group was a diagnosis of FAI with a secondary diagnosis of LO made by plain radiography, CT, or magnetic resonance imaging or made intraoperatively.

Quality of internet-based decision aids for shoulder arthritis: what are patients reading?

Background: The objective of this study was to assess the source, quality, accuracy, and completeness of Internet-based information for shoulder arthritis.

Methods: A web search was performed using three common Internet search engines and the top 50 sites from each search were analyzed. Information sources were categorized into academic, commercial, non-profit, and physician sites.

What Factors are Associated With Clinically Important Improvement After Shoulder Hemiarthroplasty for Cuff Tear Arthropathy?

Background: In selected patients with a desire to maintain activity levels greater than those recommended after reverse total shoulder arthroplasty, hemiarthroplasty remains an option for treatment of cuff tear arthropathy (CTA). However, given the relatively small case series that have been reported to date, little is known regarding which patients will show functional improvement after this surgery.

Questions/purposes: We asked: What factors are associated with achieving the minimum clinically important difference in the simple shoulder test (SST) after hemiarthroplasty for cuff tear arthropathy?

Patients And Methods: Between 1991 and 2007, two surgeons at one academic center performed 48 shoulder hemiarthroplasties for CTA.

Knotless rotator cuff repair in an external rotation model: the importance of medial-row horizontal mattress sutures.

Purpose: To evaluate the effect of the addition of 2 horizontal mattress knots to the medial row of a knotless rotator cuff construct on the biomechanical properties in terms of both cyclic and failure testing parameters in an external rotation model.

Methods: In 8 fresh-frozen human cadaveric shoulders, a knotless transosseous repair was performed, whereas in 8 contralateral matched-pair specimens, 2 horizontal mattress knots were added to the medial-row fixation. A custom jig was used that allowed external rotation (0° to 30°) with loading.

Quantitative muscle hardness as a noninvasive means for detecting patients at risk of compartment syndromes.

The purpose of this project was to study the efficacy of quantitative muscle hardness (QH) curve analysis for noninvasive measurement of muscle compartment interstitial pressure (IMP), and to eliminate the need for a comparison normal QH measurement to determine a pathologic reading. Elevation of IMP may lead to limb compartment syndrome, which may result in irreversible dysfunction, chronic pain and contracture. Two studies were performed by two separate independent examiners on male volunteers, where IMP measurements and QH curves were obtained.

Evaluation of limb compartments with increased interstitial pressure. An improved noninvasive method for determining quantitative hardness.

The purpose of this project was to study a noninvasive method of evaluating limbs at risk of compartment syndrome. Untreated limb compartment syndrome may lead to irreversible dysfunction, chronic pain and contracture. An improved means of obtaining quantitative hardness measurements is reported.