How do Rates of Return to Sports Following Direct Anterior Approach Total Hip Arthroplasty Compare to Other Approaches? A Systematic Review and Meta-analysis.

Background: There is a paucity of literature analyzing data for return to sport (RTS) and return to work (RTW) in the setting of direct anterior approach (DAA) total hip arthroplasty (THA).

Objective: The aims of this systematic review are to identify existing literature and to aggregate rates of RTS/RTW following DAA THA in a meta-analysis.

Methods: A query of major databases yielded 1819 initial studies.

Double-level osteotomy (DLO) for varus deformity results in over a decade of mean survival without compromising subsequent total knee arthroplasty function at a mean 26-year follow-up.

Purpose: Double-level osteotomies (DLOs) have shown promising results for knee joint preservation, however, most ultimately progress in terms of degenerative disease resulting in conversion to total knee arthroplasty (TKA). Therefore, the purpose of this study was to examine the time to TKA conversion, long-term clinical outcomes and revision rates of patients who have undergone TKA after prior ipsilateral DLO.

Methods: Patients who underwent simultaneous or staged DLO and subsequently underwent conversion to TKA at a single academic institution from 1997 to 2022 were evaluated.

Comminuted Suprasyndesmotic Ankle Fractures are Associated with a High Rate of Anterolateral Plafond Involvement.

Objectives: This study aimed to identify the rate at which the anterolateral tibial plafond is affected in comminuted suprasyndesmotic ankle fractures (AO/OTA 44C2) and to assess how its involvement affects clinical outcomes.

Methods: Design: Retrospective review.

Setting: Level 1 Trauma Center.

Traumatic Disruption of Profunda Femoris Artery Branch Following Treatment of an Intertrochanteric Hip Fracture With a Cephalomedullary Nail.

Surgical management of intertrochanteric hip fractures is a common surgery with low rates of intraoperative complications. Vascular injuries are exceptionally rare when placing an intramedullary nail without open reduction. There are very few reported cases of direct arterial injury and active bleed at the level of the distal interlocking screw following closed reduction and intramedullary nailing of a hip fracture.

Excision of Intra-articular Knee Heterotopic Ossification Using a 70° Arthroscope.

Heterotopic ossification is ectopic lamellar bone formation within soft tissue and can result in significant functional limitations. There are multiple underlying etiologies of HO including musculoskeletal trauma and traumatic brain injury. Intra-articular HO of the knee is rare and is typically located within the cruciate ligaments.

Motor Examination of the Brachial Plexus.

Serial physical examination is often required in the evaluation of brachial plexus injuries. (Noland, 2019) A comprehensive evaluation that includes a thorough history, electrodiagnostic evaluation, and imaging studies, in addition to physical examination, can provide valuable information about the location of the lesion, prognosis for recovery, and whether surgical intervention is necessary. After brachial plexus reconstruction, physical examinations are also performed to document clinical improvement and identify any residual issues.

Guided Growth to Treat Anterolateral Tibial Bowing Associated with Congenital Pseudarthrosis of the Tibia.

Background: Anterolateral tibial bowing associated with congenital tibial pseudarthrosis occurs often in patients with neurofibromatosis type 1 and results from the inability of the fractured bone to unite, leading to persistent nonunion, abnormal bone growth, and further bowing of the tibia. Current surgical and nonsurgical approaches demonstrate persistent nonunion or refracture, often resulting in amputation.

Methods: This report describes the management of 3 patients with anterolateral tibial bowing and NF1 who underwent distal tibia-guided growth.

Single-use versus reusable rhinolaryngoscopes for inpatient otorhinolaryngology consults: Resident and patient experience.

Objectives: Single-use rhinolaryngoscopes were brought to market in 2019 as an alternative to traditional reusable scopes and have garnered interest across settings given portability and potential cost advantages. While single-use was previously evaluated compared to traditional devices, the overall impact to the consult experience for both users and patients has not been captured.

Methods: Eighteen residents performed consults with both single-use and reusable rhinolaryngoscope systems on alternating weeks.

How are Oral Antibiotics Being Used in Total Joint Arthroplasty? A Review of the Literature.

While the role and benefit of perioperative intravenous (IV) antibiotics in patients undergoing total joint arthroplasty (TJA) is well-established, oral antibiotic use in TJA remains a controversial topic with wide variations in practice patterns. With this review, we aimed to better educate the orthopedic surgeon on when and how oral antibiotics may be used most effectively in TJA patients, and to identify gaps in the literature that could be clarified with targeted research. Extended oral antibiotic prophylaxis (EOAP) use in high-risk primary, aseptic revision, and exchange TJA for infection may be useful in decreasing periprosthetic joint infection (PJI) rates.

Acute postoperative and rehabilitation care managed in a virtual hybrid hospital-at-home after a total knee arthroplasty: A case report.

Key Clinical Messages: This case report demonstrates a virtual hybrid hospital-at-home program can provide inpatient-level postoperative and rehabilitative care after total knee arthroplasty to a medically complex patient in the comfort of their own home.

Abstract: Advanced Care at Home combines virtual providers with in-home care delivery. We report a case of virtual postoperative and rehabilitative care in a medically complex patient who underwent a total knee arthroplasty.

Video Analysis of 26 Cases of Second ACL Injury Events in Collegiate and Professional Athletes.

Background: Significant effort has gone into the identification and quantification of the underlying mechanisms of primary ACL injury. Secondary ACL injury is observed in approximately 1/4 to 1/3 of athletes who return to sport following ACL reconstruction. However, little has been done to evaluate the mechanisms and playing circumstances surrounding these repeat injuries.

Epidural bupivacaine administration after infiltration of liposomal bupivacaine for transversalis fascia plane block: A case report.

Extended-release liposomal bupivacaine is frequently used in surgical infiltration for postoperative pain control. The manufacturer recommends against subsequent local anesthetics within 96 hours. We administered epidural bupivacaine one day after local liposomal bupivacaine infiltration for staged hemipelvectomy without symptoms of LAST.

Brd4 Inactivation Increases Adenoviral Delivery of BMP2 for Paracrine Stimulation of Osteogenic Differentiation as a Gene Therapeutic Concept to Enhance Bone Healing.

Bromodomain (BRD) proteins are histone code interpreters that recognize acetylated lysines and link the dynamic state of chromatin with the transcriptional machinery. Here, we demonstrate that ablation of the Brd4 gene in primary mouse bone marrow-derived mesenchymal stem cells via a conditional Brd4 allele suppresses osteogenic lineage commitment. Remarkably, loss of Brd4 function also enhances expression of genes in engineered adenoviral vectors, including Cre recombinase and green fluorescent protein (GFP).

Primary Elbow Osteoarthritis: Evaluation and Management.

Most patients with primary osteoarthritis of the elbow report a history of heavy lifting with the affected upper extremity . Conservative treatment, including activity modifications, nonsteroidal anti-inflammatory drugs and the occasional intraarticular corticosteroid injection, may provide adequate pain relief in earlier stages . When surgery is required, and despite the presence of cartilage wear, many patients with primary elbow osteoarthritis experience substantial pain improvement with joint preserving procedures .

Effect of Lidocaine on Viability and Gene Expression of Human Adipose-derived Mesenchymal Stem Cells: An in vitro Study.

Objective: To assess the biologic effects of lidocaine on the viability, proliferation, and function of human adipose tissue-derived mesenchymal stromal/stem cells (MSCs) in vitro.

Methods: Adipose-derived MSCs from three donors were exposed to lidocaine at various dilutions (2 mg/mL to 8 mg/mL) and exposure times (0.5 to 4 hours).

Recurrent myxoinflammatory fibroblastic sarcoma: a case report.

Myxoinflammatory fibroblastic sarcoma is a rare sarcoma which typically presents in the extremities and is treated by definitive surgery. In recurrent disease, the reported utilization of radiotherapy is increasing, and more modern techniques such as intensity-modulated radiotherapy may be improving long-term outcomes.

Phylogenetics and biogeography of the two-wing flyingfish (Exocoetidae: ).

Two-wing flyingfish (.) are widely distributed, epipelagic, mid-trophic organisms that feed on zooplankton and are preyed upon by numerous predators (e.g.

The beginnings of Orthopedic Surgery at the Mayo Clinic: A Review of the First Orthopedic Patients who Presented Over 100 Years Ago.

Background: Formalized training in the specialty of orthopedic surgery began at the Mayo Clinic nearly 100 years ago, and treatment of patients with musculoskeletal injuries and disease began even earlier. A robust historical patient database provides the opportunity for review of the first recorded orthopedic cases at our institution, which date back to 1907.

Methods: The first 400 sequential medical charts of the Mayo Clinic's patient record database were comprehensively reviewed in order to identify the first documented orthopedic cases.

Analysis of fluid movement in skeletal muscle using fluorescent microspheres.

Introduction: Regional variability in interstitial fluid pressure confounds use of intramuscular pressure measurement to assess muscle force. It is hypothesized that interstitial flow is dependent on intramuscular pressure. The goal of this study was to assess the feasibility of using fluorescent microspheres to evaluate movement of interstitial fluid in skeletal muscle.

Utility of modular implants in primary total hip arthroplasty.

Most surgeons believe that some level of modularity has a valuable role to play in primary total hip arthroplasty. However, all modular junctions carry some risk and recent problems with taper tribocorrosion have elevated concerns. These problems suggest that more rigorous preclinical testing should be undertaken before new types of modularity are widely used.