Estimating peak height velocity in individuals: a comparison of statistical methods.

Background: Estimates pertaining to the timing of the adolescent growth spurt (e.g. peak height velocity; PHV), including age at peak height velocity (aPHV), play a critical role in the diagnosis, treatment, and management of skeletal growth and/or developmental disorders.

An Intact Ligamentum Teres Predicts a Superior Prognosis in Patients With Borderline Dysplasia: A Matched-Pair Controlled Study With Minimum 5-Year Outcomes After Hip Arthroscopic Surgery.

Background: Hip arthroscopic surgery in patients with borderline dysplasia continues to be controversial. In addition, it has been suggested that ligamentum teres (LT) tears may lead to inferior short-term patient-reported outcomes (PROs) when compared with a match-controlled group.

Purposes: (1) To report minimum 5-year PROs in patients with borderline dysplasia and LT tears who underwent hip arthroscopic surgery and (2) to compare these PROs to those of a matched-pair control group of patients with borderline dysplastic hips without LT tears.

Vascular Injuries following Knee Dislocation.

Knee dislocations (KDs) are frequently found in high-energy impact injuries, ranging from automobile accidents to contact sports. KDs require careful examination due to the limb-threatening nature of these injuries. A key examination in any KD comprises a proper assessment of the vascular status.

Pulsed electromagnetic fields promote repair of focal articular cartilage defects with engineered osteochondral constructs.

Articular cartilage injuries are a common source of joint pain and dysfunction. We hypothesized that pulsed electromagnetic fields (PEMFs) would improve growth and healing of tissue-engineered cartilage grafts in a direction-dependent manner. PEMF stimulation of engineered cartilage constructs was first evaluated in vitro using passaged adult canine chondrocytes embedded in an agarose hydrogel scaffold.

Evidence of the non-linear nature of skeletal maturation.

Objective: The aim of this study was to assess longitudinal trajectories of skeletal maturation to determine if children exhibit periods of rapid maturation during normal childhood and adolescence.

Design: Retrospective longitudinal study.

Patients: 345 participants, with an average of 25 assessments per participant, between 3 and 20 years of age from the Fels Longitudinal Study.

Tibial Inlay Posterior Cruciate Ligament Reconstruction.

Reconstruction of the posterior cruciate ligament is typically made through either tibial inlay or transtibial methods. Double-bundle reconstruction can be combined with either technique and has clear biomechanical advantages. On the basis of prior evidence and the author's own surgical experiences, this technique paper provides the reasoning for using these methods.

Pediatric Patients with Spondylolysis Have High Rates of Vitamin-D Deficiency.

The objective of this study was to document the 25-hydroxyvitamin D status of patients with a confirmed diagnosis of spondylolysis to determine if these patients have increased rates of vitamin D deficiency. After confirming the diagnosis of spondylolysis, patients were prospectively enrolled in this study. A total of 39 patients (30 male, 9 female) with a mean age of 14.

Sustained low-dose dexamethasone delivery via a PLGA microsphere-embedded agarose implant for enhanced osteochondral repair.

Articular cartilage defects are a common source of joint pain and dysfunction. We hypothesized that sustained low-dose dexamethasone (DEX) delivery via an acellular osteochondral implant would have a dual pro-anabolic and anti-catabolic effect, both supporting the functional integrity of adjacent graft and host tissue while also attenuating inflammation caused by iatrogenic injury. An acellular agarose hydrogel carrier with embedded DEX-loaded poly(lactic-co-glycolic) acid (PLGA) microspheres (DLMS) was developed to provide sustained release for at least 99 days.

Effects of Compliance With Procedure-Specific Postoperative Rehabilitation Protocols on Initial Outcomes After Osteochondral and Meniscal Allograft Transplantation in the Knee.

Background: Osteochondral and meniscal allograft transplantation have been performed in the knee for more than 40 years, with the number of patients treated each year growing as allograft quantity and quality increase. To date, the effects of postoperative management on outcomes after these procedures have received relatively little focus in the peer-reviewed literature.

Hypothesis: Compliance with the recommended postoperative management protocol will be associated with significantly higher initial success and significantly lower revision and failure rates for patients undergoing osteochondral and/or meniscal allograft transplantation in the knee.

T1ρ, T2 mapping, and EPIC-µCT Imaging in a Canine Model of Knee Osteochondral Injury.

The dog is the most commonly used large animal model for the study of osteoarthritis. Optimizing methods for assessing cartilage health would prove useful in reducing the number of dogs needed for a valid study of osteoarthritis and cartilage repair. Twelve beagles had critical-sized osteochondral defects created in the medial femoral condyle of both knees.

Advancing spinal fellowship training: an international multi-centre educational perspective.

Purpose: The purpose of this article is to review the importance of contemporary spine surgery fellowships and educational strategies to assist with fellowship design and delivery.

Methods: Spine surgery fellowship includes trainees from orthopaedic and neurosurgical backgrounds and is increasingly indicated for individuals wishing to pursue spine surgery as a career, recognizing how spinal surgery evolved significantly in scope and complexity. We combine expert opinion with a review of the literature and international experience to expound spine fellowship training.

Three-dimensional Printing Technology in Orthopaedics.

Three-dimensional (3-D) printing technology is affecting how orthopaedic surgeries are planned and executed. Like many innovations, 3-D printers are becoming smaller, more affordable, and more accessible. Free access to open-source 3-D imaging software has also made clinical implementation of this technology widely feasible.

Predicting adult facial type from mandibular landmark data at young ages.

Objectives: To assess the potential of predicting adult facial types at different stages of mandibular development.

Setting And Sample Population: A total of 941 participants from the Bolton-Brush, Denver, Fels, Iowa, Michigan and Oregon growth studies with longitudinal lateral cephalograms (total of 7166) between ages 6-21 years.

Material And Methods: Each participant was placed into one of three facial types based on mandibular plane angle (MPA) from cephalograms taken closest to 18 years of age (range of 15-21 years): hypo-divergent (MPA < 28°), normo-divergent (28°≤ MPA ≤ 39°) and hyper-divergent (MPA > 39°).

Patients, pictures, and privacy: managing clinical photographs in the smartphone era.

It is easy to capture and share clinical photographs and x-ray images using modern smartphones. This technology affords health-care providers the ability to rapidly collaborate and facilitate care for their patients. This improvement, however, has increased concerns regarding patient privacy and the safeguarding of protected health information.

Effect of dose and release rate of CTGF and TGFβ3 on avascular meniscus healing.

Meniscus tears in the avascular region rarely functionally heal due to poor intrinsic healing capacity, frequently resulting in tear propagation, followed by meniscus deterioration. Recently, we have reported that time-controlled application of connective tissue growth factor (CTGF) and transforming tissue growth factor β3 (TGFβ3) significantly improved healing of avascular meniscus tears by inducing recruitment and step-wise fibrocartilaginous differentiation of mesenchymal stem/progenitor cells (MSCs). In this study, we investigated effects of the dose of CTGF and the release rate of TGFβ3 on avascular meniscus healing in our existing explant model.

Biomechanical Properties of Bioabsorbable Fixation for Osteochondral Shell Allografts.

This study compares bioabsorbable nail to metal screw fixation of shell osteochondral allograft (OCAs) for compression and shear strength. Cadaveric distal femurs ( = 5) yielding six 1.5 cm shell grafts ( = 30) were used.

Nutrition and Inflammation Influence 1-Year Mortality of Surgically Treated Elderly Intertrochanteric Fractures: A Prospective International Multicenter Case Series.

Introduction: Hip fracture is a common and devastating event in older adults causing increased dependence, comorbidity, and mortality. Since new surgical techniques have not significantly improved the mortality rate, a better understanding of patient risk factors could improve the treatment algorithm and outcomes. This prospective study aimed to document the 1-year survival rate of patients with intertrochanteric fracture treated surgically in Latin America and to investigate risk factors associated with 1-year mortality.

Cooled Radio Frequency Ablation for the Treatment of Osteoarthritis-Related Knee Pain: Evidence, Indications, and Outcomes.

Knee osteoarthritis (OA) is a common condition associated with pain and physical impairment in a large segment of the population. The traditional treatment algorithm progresses from conservative modalities to nonsurgical options to surgical intervention. Surgical intervention often provides reliable pain relief but not all patients are surgical candidates and there are some patients who prefer not to have surgery.

Onlay Reconstruction of the Posterior Cruciate Ligament: Biomechanical Comparison of Unicortical and Bicortical Tibial Fixation.

Posterior cruciate ligament (PCL) injuries are generally associated with high-energy trauma. There are many controversies regarding optimal surgical technique in regard to graft selection and fixation methods. The recently described onlay technique allows for direct fixation of a hamstring autograft to the posterior aspect of the tibia with cancellous screw and spiked washer, while protecting the neurovascular structures and avoiding the so-called "killer turn.

Early Maturity as the New Normal: A Century-long Study of Bone Age.

Background: Epiphyseal fusion (EF) marks the completion of longitudinal bone growth, a critical milestone monitored during treatment of skeletal growth and/or developmental disorders. Recently, a trend toward accelerated skeletal maturation in children has been documented. Because current methods for assessing skeletal maturation include children in their reference populations born as early as the 1930s, the timing of EF events in contemporary patients may differ substantially from those standards.

The 2017 American Orthopaedic Association North American Traveling Fellowship.

Initially established in 1967, the American Orthopaedic Association (AOA) North American Traveling Fellowship was designed to promote leadership development, network creation, and knowledge exchange among emerging leaders in orthopaedic surgery, and it remains one of the AOA's flagship tours. In 2017, the fellows visited 10 academic medical centers on the West Coast of Canada and the United States, participating in leadership, academic, clinical, and team-building activities. On the tour, we formed countless new friendships and collaborations, including exceptionally strong ones with each other.

Engineered Healing of Avascular Meniscus Tears by Stem Cell Recruitment.

Meniscus injuries are extremely common with approximately one million patients undergoing surgical treatment annually in the U.S. alone.