A Novel Machine Learning Model to Predict Revision ACL Reconstruction Failure in the MARS Cohort.

Background: As machine learning becomes increasingly utilized in orthopaedic clinical research, the application of machine learning methodology to cohort data from the Multicenter ACL Revision Study (MARS) presents a valuable opportunity to translate data into patient-specific insights.

Purpose: To apply novel machine learning methodology to MARS cohort data to determine a predictive model of revision anterior cruciate ligament reconstruction (rACLR) graft failure and features most predictive of failure.

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

Surgical Predictors of Clinical Outcome 6 Years After Revision ACL Reconstruction.

Background: Revision anterior cruciate ligament (ACL) reconstruction has been documented to have inferior outcomes compared with primary ACL reconstruction. The reasons why remain unknown.

Purpose: To determine whether surgical factors performed at the time of revision ACL reconstruction can influence a patient's outcome at 6-year follow-up.

Variation in Reported Learning Outcomes and Measurement Instruments in Hip Arthroscopy Simulation Training: A Systematic Review.

Purpose: To systematically review the current literature on the effectiveness of hip arthroscopy simulation training and to determine the consistency of reporting and validation of simulation used in hip arthroscopy.

Methods: Three databases (PubMed, EMBase, and CINAHL) were screened using PRISMA guidelines in January 2022 for published literature on virtual simulation in hip arthroscopy. Studies reporting on the use of hip arthroscopy simulation training in orthopedic surgical trainees were included and assessed for quality and risk of bias using MINORS criteria.

A Case of Proximal Humerus Fracture Dislocation Presenting With Failed Primary Open Reduction and Internal Fixation Followed by Salvage Reverse Total Shoulder Arthroplasty.

The treatment of proximal humerus fractures is complex. Factors like fracture pattern, patient age, pre-injury activity level, soft tissue status, and comorbidities play a role in decision-making for non-operative versus operative management. Complications of non-operative vs operative management of proximal humerus fractures include but are not limited to arthrofibrosis, fracture nonunion, and avascular necrosis.

Fungal Osteomyelitis due to Phaeoacremonium venezuelense: A Case Report.

Case: A 56-year-old immunosuppressed man presented with pain and swelling in the medial and anterior right foot with accompanied numbness in the second and third toes 1 month after a puncture wound by a Sylvester palm tree thorn. An intraoperative culture/biopsy returned positive for septic arthritis of the naviculocuneiform joint and fungal osteomyelitis of the navicular, medial, and intermediate cuneiforms due to Phaeoacremonium venezuelense.

Conclusion: Fungal osteomyelitis is extremely rare.

Differential regional perfusion of the human anterior cruciate ligament: quantitative magnetic resonance imaging assessment.

Purpose: Surgical reconstruction is the current standard for ACL rupture treatment in active individuals. Recently, there is renewed interest in primary repair of proximal ACL tears. Despite this, ACL biology and healing potential are currently not well understood.

James A. Rand Young Investigator's Award: Questioning the "Nickel Free" Total Knee Arthroplasty.

Background: A study was performed to measure metal ions present in the knee joint after performing a total knee arthroplasty (TKA) with standard cobalt chromium (CoCr) components as well as with "nickel-free" oxidized zirconium femoral and titanium tibial (OxZr/Ti) components.

Methods: Knee joint fluid was collected prior to arthrotomy, and on postoperative day one to determine the amount of metal debris generated when performing a TKA with standard instrumentation from consecutive cases with CoCr components (n = 24) and OxZr/Ti components (n = 16).

Results: CoCr implant patients had statistically higher levels of nickel (Ni) (29.

Intra-articular administration of vancomycin and tobramycin during primary cementless total knee arthroplasty : determination of intra-articular and serum elution profiles.

Aims: Intra-articular administration of antibiotics during primary total knee arthroplasty (TKA) may represent a safe, cost-effective strategy to reduce the risk of acute periprosthetic joint infection (PJI). Vancomycin with an aminoglycoside provides antimicrobial cover for most organisms isolated from acute PJI after TKA. However, the intra-articular doses required to achieve sustained therapeutic intra-articular levels while remaining below toxic serum levels is unknown.

Outcomes of Arthroscopic Fixation of Unstable Distal Clavicle Fractures: A Systematic Review.

Background: Surgical management of unstable distal clavicle fractures (DCFs) remains controversial. Traditional open techniques result in acceptable union rates but are fraught with complications. In response to these limitations, arthroscopic techniques have been developed; however, clinical outcome data are limited.

A systematic review of ankle fracture treatment modalities in diabetic patients.

Aim: This systematic review evaluated the surgical outcomes of various ankle fracture treatment modalities in patients with Diabetes Mellitus as well as the methodological quality of the studies.

Methods: For our review, four online databases were searched: PubMed, MEDLINE (Clarivate Analytics), CINAHL (Cumulative Index to Nursing and Allied Health) and Web of Science (Clarivate Analytics). The overall methodological quality of the studies was assessed with the Coleman Methodology Score.

Epidemiology of Sports-Specific Foot and Ankle Injuries.

The epidemiology of any given topic sometimes is overlooked. This is true particularly with sports physicians and sports injuries. The identification of sports-specific injury patterns by collection and examination of data can help prevent injuries.

Spanish translation and cross-language validation of the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form.

Background: The American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form is one of the most frequently used outcomes score for shoulder pathology. The patient report section of the ASES questionnaire (p-ASES) is easy to complete, can be quickly administered, and is applicable to a wide range of shoulder pathologies, yet a validated Spanish translation of this questionnaire does not currently exist for diverse Spanish-speaking populations. The purpose of this study was to translate and culturally adapt the patient report section of the ASES to Spanish and to assess its validity and reliability among a culturally diverse group of Spanish-speaking patients, typically seen in the United States.

Pain Relief after Surgical Decompression of the Distal Brachial Plexus.

 Brachial plexopathy causes pain and loss of function in the affected extremity. Entrapment of the brachial plexus terminal branches within the surrounding connective tissue, or medial brachial fascial compartment, may manifest in debilitating symptoms. Open fasciotomy and external neurolysis of the neurovascular bundle in the medial brachial fascial compartment were performed as a surgical treatment for pain and functional decline in the upper extremity.

Increased Vascularity in the Neonatal versus Adult Meniscus: Evaluation with Magnetic Resonance Imaging.

. Quantification of meniscus vascularity has been limited with previous techniques, and minimal data exist describing differential vascular zones in the skeletally immature meniscus. The objective of this study is to use quantitative contrast-enhanced magnetic resonance imaging (MRI) to compare meniscal vascularity in neonatal specimens with adults.

Prerehabilitation alanine aminotransferase blood levels and one-year mortality rates in older adults following hip fracture.

Low alanine aminotransferase (ALT) blood levels prior to rehabilitation are associated with poor function in older adults following hip fracture. We hypothesized that low ALT blood levels prior to rehabilitation were also associated with one-year mortality in this population. Included were 456 older adults (age ≥ 60 years, 82.

periprosthetic knee infection complicated by autoimmune-mediated systemic inflammatory response syndrome.

periprosthetic knee infection has rarely been reported in the literature due to its low frequency. Notwithstanding, it is important to keep it among the differential diagnoses to avoid delays in treatment. The current report presents the case of infectious knee monoarthritis in an immunocompetent patient after unicompartmental knee arthroplasty.

The Practice of Overlapping Surgery Is Safe in Total Knee and Hip Arthroplasty.

Background: Overlapping surgery occurs when a surgeon performs 2 procedures in an overlapping time frame. This practice is commonplace in the setting of total joint arthroplasty and is intended to increase patient access to experienced surgeons, improve efficiency, and advance the surgical competence of surgeons and trainees. The practice of overlapping surgery has been questioned because of safety and ethical concerns.

Fully Automated 10-Minute 3D CAIPIRINHA SPACE TSE MRI of the Knee in Adults: A Multicenter, Multireader, Multifield-Strength Validation Study.

Objectives: The aim of this study was to test the hypothesis that magnetic resonance imaging (MRI) of the knee with 10-minute 3-dimensional (3D) controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA) sampling perfection with application optimized contrast using different flip angle evolutions (SPACE) turbo spin echo (TSE) protocols can replace 20-minute 2-dimensional (2D) TSE standard-of-reference protocols for the diagnosis of internal derangement.

Materials And Methods: After internal review board approval and prospective informed consent, 100 symptomatic subjects underwent MRI of the knee at 3 T and 50 symptomatic subjects at 1.5 T, consisting of 10-minute 3D CAIPIRINHA SPACE TSE and 20-minute standard-of-reference 2D TSE protocols.

Management of Clubfoot Relapses With the Ponseti Method: Results of a Survey of the POSNA Members.

Background: Despite the high rate of initial success using the Ponseti method to manage idiopathic clubfoot deformity, relapse continues to be a problem. We surveyed the Pediatric Orthopedic Society of North America (POSNA) members about their experience with relapsed deformity following the initial correction of clubfeet.

Methods: We created a survey to focus on the management of clubfeet after initial correction of deformity.

Prospective Randomized Evaluation of Intraoperative Application of Autologous Platelet-Rich Plasma on Surgical Site Infection or Delayed Wound Healing.

Background: Prevention of surgical site infections and the reduction of wound-related complication rates have become increasingly emphasized by hospital task groups and government agencies given the degree of economic burden it places on the health care system. Platelet-rich plasma (PRP) contains growth factors and other biomolecules that promote endogenous microbicidal activity. We hypothesized that PRP would help prevent postoperative infection and delayed wound healing (DWH).