Atypical Femur Fracture in a Teenager on Chronic Imatinib Therapy.

Atypical femoral fractures (AFFs) are rare fractures usually associated with medications that can ultimately alter bone metabolism. Imatinib, a drug prescribed for treatment of chronic myeloid leukemia (CML), has been associated with altered bone homeostasis, however, with unknown clinical significance. Here, we present the case of a 17-year-old female, with a diagnosis of CML undergoing chronic imatinib therapy, who developed an AFF treated successfully with prophylactic fixation with intramedullary nailing.

Restorative Neurostimulation Therapy Compared to Optimal Medical Management: A Randomized Evaluation (RESTORE) for the Treatment of Chronic Mechanical Low Back Pain due to Multifidus Dysfunction.

Introduction: Many interventional strategies are commonly used to treat chronic low back pain (CLBP), though few are specifically intended to target the distinct underlying pathomechanisms causing low back pain. Restorative neurostimulation has been suggested as a specific treatment for mechanical CLBP resulting from multifidus dysfunction. In this randomized controlled trial, we report outcomes from a cohort of patients with CLBP associated with multifidus dysfunction treated with restorative neurostimulation compared to those randomized to a control group receiving optimal medical management (OMM) over 1 year.

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.

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.

Injury Patterns and Surgical Approaches.

Effective management of bony and cartilaginous thoracic injury is a vital part of the care of the polytraumatized patient. Commonly because of high-energy accidents including motor vehicle collisions and falls, these patients routinely require multidisciplinary care and surgical intervention. As our understanding of unstable chest wall injuries and pulmonary sequelae of the injury grows, it is imperative that injury patterns and surgical approaches become familiar to the orthopaedic trauma-trained surgeon.

Anatomy of the Ribs, Sternum, and Costal Margin.

The ribs, sternum, and costal margin provide a rigid, but flexible chest wall that functions to provide protection to the vital cardiothoracic organs, while also allowing for varying levels of respiration based on physiologic need. The latter function is accomplished through various muscular attachments and rib articulations with both the axial spine posteriorly and the sternum anteriorly. The accessory muscles of inspiration rely on the downward slope and outward curve of each rib, which when contracted move the ribs upward and outward, in turn forcing the sternum anterior and increasing the thoracic volume.

Corrigendum to 'Machine Learning-Based Predictive Models for 90-Day Readmission of Total Joint Arthroplasty Using Comprehensive Electronic Health Records and Patient-Reported Outcome Measures'. [Arthroplasty Today Volume 25, February 2024, 101308].

[This corrects the article DOI: 10.1016/j.artd.

Custom-Made 3D-Printed Augments and Cages: An Effective Solution for Managing Severe Acetabular Bone Loss.

Introduction: Total hip arthroplasty (THA) is recognized as one of the most effective surgical procedures for the treatment of end-stage hip arthritis. However, the increasing number of primary THA cases has led to a corresponding rise in the frequency of revision surgeries, which are often more complex and challenging due to severe acetabular bone loss. In such cases, managing Paprosky type 3A and 3B defects requires precise implant design and advanced surgical techniques.

A Contemporary Analysis of Discharge Disposition Following Total Joint Arthroplasty.

Background: Total joint arthroplasty (TJA) represents the single largest procedural cost for the Centers for Medicare & Medicaid Services. Discharge to a skilled nursing facility (SNF) remains a primary driver of post-acute care costs. The COVID-19 pandemic led to a decrease in number of discharges to SNFs.

Prevention and Management of Posterior Wound Complications Following Oncologic Spine Surgery: Narrative Review of Available Evidence and Proposed Clinical Decision-Making Algorithm.

Study Design: Narrative Review.

Objective: Contextualized by a narrative review of recent literature, we propose a wound complication prevention and management algorithm for spinal oncology patients. We highlight available strategies and motivate future research to identify optimal and individualized wound management for this population.

Role of Posterior Carbon Fiber Implants in Spine Tumor Surgery.

Study Design: Narrative Review.

Objective: The management of spinal tumors requires a multi-disciplinary approach including surgery, radiation, and systemic therapy. Surgical approaches typically require posterior segmental instrumentation to maintain long-term spinal stability.

Knotless Versus Knotted Suture Anchors for Labral Repair of the Hip: A Systematic Review of Clinical and Biomechanical Outcomes.

Background: Arthroscopic labral repair of the hip is successfully performed with increasing frequency using either knotless or knotted suture anchors, each with its own risks and benefits.

Purpose: To examine biomechanical and clinical outcomes for labral repair of the hip based on the use of knotted or knotless suture anchors.

Study Design: Systematic review; Level of evidence, 4.

Return to Work, Sport, and Sport- Related Activity After Distal Triceps Tendon Repair: A Systematic Review.

Background: Distal triceps tendon injuries are relatively rare injuries, often occurring in highly active patients with physically demanding jobs or lifestyles. Information on return to work, sport, and activity is essential for patient education and counseling after a distal triceps tendon rupture.

Purpose: To determine the rates of return to work, sport, and sport-related activity after distal triceps tendon repair.

Lateral Sternoclavicular Joint Dislocation: A Case Report.

Case: We report a case of a 29-year-old woman who sustained a left lateral sternoclavicular joint (SCJ) dislocation. Imaging demonstrated a 30-mm gap between the sternum and medial clavicle. Given well-preserved shoulder range of motion and well-controlled pain, she was ultimately treated nonoperatively.

Reoperation Rate Following Thumb Basal Joint Arthroplasty: A Minimum Follow-Up Period of 5 Years.

Purpose: Thumb basal joint arthroplasty (BJA) performed for thumb basal joint arthritis is associated with high patient satisfaction. However, complications requiring reoperation occur, with a previously reported early reoperation rate (within 2 years) of 1.5%.

Debridement Technique for Single-Stage Revision Shoulder Arthroplasty.

Background: The incidence of revision shoulder arthroplasty continues to rise, and infection is a common indication for revision surgery. Treatment of periprosthetic joint infection (PJI) in the shoulder remains a controversial topic, with the literature reporting varying methodologies, including the use of debridement and implant retention, single-stage and 2-stage surgeries, antibiotic spacers, and resection arthroplasty. Single-stage revision has been shown to have a low rate of recurrent infection, making it more favorable because it precludes the morbidity of a 2-stage operation.

Inpatient Multimodal Pain Regimens Do Not Impact Hospital Length of Stay or Long-term Postoperative Opioid Use Following 1 and 2-Level Lumbar Fusion.

Study Design: Retrospective cohort study.

Objective: To determine hospital length of stay (LOS) and long-term opioid consumption among patients who received inpatient multimodal analgesia following lumbar spine surgery, as opposed to those who received opioids alone.

Summary Of Background Data: Opioids have long been the historical choice for managing postoperative pain.

Return to Sport After Treatment of Stable Osteochondritis Dissecans Lesions of the Knee in Adolescents: A Systematic Review.

Background: Treatment of stable osteochondritis dissecans (OCD) lesions of the knee in young patients poses the challenge of abstaining from competitive sports for months. Outcomes relevant to this patient population additionally include successful return to sport (RTS), return to the same level of sport, and the time needed to achieve both.

Purpose: To evaluate the adolescent population for RTS outcomes after treatment of stable OCD lesions of the knee and to compare RTS outcomes between patients treated nonoperatively and those who required surgery.

Posterolateral Corner Reconstruction: A Systematic Review and Meta-analysis of Biomechanical Studies.

Background: Surgical reconstruction is the standard treatment for injuries to the posterolateral corner (PLC) of the knee and can be performed using either a fibular-based or combined tibiofibular-based technique. Although some comparative studies have been performed, there is no consensus regarding the reconstructive approach that confers optimal biomechanical properties of the PLC.

Purpose: To perform a systematic review and meta-analysis to evaluate the biomechanical properties of the knee after PLC reconstruction with fibular-based and tibiofibular-based techniques.

Spatial and temporal evaluation of iodine uptake and radiodensity in meniscus tissue using contrast-enhanced micro-CT.

Rationale And Objective: The visualization of soft tissues, like the meniscus, through X-ray micro-computed tomography (micro-CT), requires the use of contrast agents (CAs). While other studies have investigated CA diffusion in fibrocartilagineous tissues, this work aimed to optimize iodine staining protocols for meniscal tissue that improve their visualization by micro-CT. Specific objectives included evaluating the diffusion of CAs within meniscal samples over time, assessing volume changes due to staining, and identifying the iodine ions absorbed by the tissue.

The Influence of Cognitive Dual Tasking on the Outcomes of the Triple Hop Test Following Anterior Cruciate Ligament Reconstruction.

Introduction: Anterior cruciate ligament (ACL) reconstruction involves prolonged rehabilitation, with Return to Sport (RTS) as a key goal for athletes. Integrating Dual Task (DT) strategies, which combine cognitive and physical tasks, is critical, as multitasking mirrors real-world and sports-specific demands. Assessing how distractions affect performance is essential to optimize RTS outcomes for both the reconstructed and healthy limbs.

The Use of Liposomal Bupivacaine for Pain Control After Shoulder Surgery: A Systematic Review and Meta-analysis.

Background: Liposomal bupivacaine (LB) is a relatively novel anesthetic agent used in the management of postoperative pain in patients who have undergone shoulder surgery.

Purpose: To explore the literature on LB in the setting of shoulder surgery and assess its efficacy and utility in managing postoperative pain.

Study Design: Systematic review and meta-analysis; Level of evidence, 1.

Opioid-Prescribing Trends in Dermatology From 2014 to 2020 in the United States.

Introduction The opioid epidemic is a critical public health crisis, with opioid overdose deaths being a leading cause of injury-related deaths in the United States. Dermatology, though a small contributor to overall opioid prescriptions, still accounts for over 700,000 opioid pills annually. Reducing opioid prescribing in this specialty has been challenging due to limited comprehensive research.

TITLE: Patient Preferences for Carpal Tunnel Release Education: A Comparison of Education Materials from Popular Healthcare Websites and ChatGPT.

Introduction: ChatGPT has been increasingly utilized to create, simplify, and revise hand surgery patient education materials. While significant research has examined the quality and readability of ChatGPT-derived hand surgery patient education, the patient perspective has not previously been evaluated. This study compared patient reported clarity and readability grades as well as patient preferences for carpal tunnel surgery educational information from medical education websites and ChatGPT.