Tips and tricks to avoid implant failure in proximal femur fractures treated with cephalomedullary nails: a review of the literature.

Objective: To describe the surgical aspects potentially contributing to hardware failure of cephalomedullary nails.

Data Sources: A search of the Embase, PubMed (MEDLINE), Web of Science, and the Cochrane library for reports of hardware failures after intramedullary fixation of proximal femur fractures. Issues of cut out and cut through phenomena related to technique were excluded.

Cost-Effectiveness of Preoperative Spinal Imaging Before Total Hip Arthroplasty.

Background: The risk of instability, dislocation, and revision following total hip arthroplasty (THA) is increased in patients with abnormal spinopelvic mobility. Seated and standing lateral lumbar spine imaging can identify patients with stiff/hypermobile spine (SHS) to guide interventions such as changes in acetabular cup placement or use of a dual-mobility hip construct aimed at reducing dislocation risk.

Methods: A Markov decision model was created to compare routine preoperative spinal imaging (PSI) to no screening in patients with and without SHS.

Predictors of acromial and scapular stress fracture after reverse shoulder arthroplasty: a study by the ASES Complications of RSA Multicenter Research Group.

Background: Acromial (ASF) and scapular spine (SSF) stress fractures are well-recognized complications of reverse shoulder arthroplasty (RSA), but much of the current data are derived from single-center or single-implant studies with limited generalizability. This study from the American Shoulder and Elbow Surgeons (ASES) Complications of Reverse Shoulder Arthroplasty Multicenter Research Group determined the incidence of ASF/SSF after RSA and identified preoperative patient characteristics associated with their occurrence.

Method: Fifteen institutions including 21 ASES members across the United States participated in this study.

Process Mapping Total Knee Arthroplasty: A Comparison of Instrument Designs.

Background: Total knee arthroplasty (TKA) is commonly performed with proprietary, manual instrumentation provided by the surgical implant manufacturer. Registry studies and meta-analysis, with few outliers, have consistently shown similar functional outcomes and implant survival after TKA regardless of implant manufacturer, implant design, or surgical technique. We hypothesized that process mapping could identify areas for improvement in TKA instrumentation.

Nociceptin is present in synovial fluid of patients undergoing total knee arthroplasty.

Background: Osteoarthritis is a mechanical abnormality characterized by chronic joint pain associated with degeneration of the articular cartilage, synovitis, and local inflammation, leading to loss of function and pain. A connection exists between the peripheral nervous system and inflammatory joint degeneration. The process by which inflammation is influenced by the nervous system is known as neuroinflammation.

Demographic Distribution of Foot and Ankle Surgeries Among Orthopaedic Surgeons and Podiatrists: A 10-Year Database Retrospective Study.

Background: Foot and ankle surgeries in the United States (US) are currently performed by orthopaedic surgeons or podiatrists with specialty surgical training. With the trend in healthcare now placing increased emphasis on quality and standardizing patient care, this study aimed to characterize the distribution, volume, and trends of certain foot and ankle surgeries performed in the US by both orthopaedic surgeons and podiatrists.

Materials And Methods: A retrospective analysis was performed using the Marketscan Claims Database (Truven Health Analytics, Ann Arbor, Michigan) which covers most privately insured patients under the age of 65 in the USA from 2005 to 2014.

The Financial Implications of the Removal of Total Knee Arthroplasty From the Medicare Inpatient-Only List.

Background: Centers for Medicare and Medicaid Services removed total knee arthroplasties (TKAs) from the Inpatient-Only list on January 1, 2018, which meant TKAs could be performed on a hospital outpatient basis. We sought to understand (1) what the financial implications have been for hospitals, (2) to what extent financial incentives have influenced the adoption of outpatient TKAs across hospitals, (3) whether adoption of outpatient TKAs has impacted the success of hospitals with managing post-acute care (PAC) spend, and (4) the financial implications to Medicare of the adoption of outpatient TKAs.

Methods: We used national patient-level Medicare fee-for-service Part A claims data (100% sample) from January 2018 through June 2019 to calculate the inpatient and outpatient TKA payment rate for each hospital, and the distribution in these payments across the country.

Economic Impact of Outpatient Medicare Total Knee Arthroplasty at a Tertiary Care Academic Medical Center.

Background: In January 2018, the Center for Medicare and Medicaid Services (CMS) removed total knee arthroplasty (TKA) from the inpatient-only list. This impacted hospital reimbursement, Comprehensive Joint Replacement (CJR) bundle volumes, and bundle performance. We describe these impacts at an academic teaching hospital.

Three-dimensional Bioprinting for Bone and Cartilage Restoration in Orthopaedic Surgery.

Notable shortcomings exist in the currently available surgical options for reconstruction of bone and articular cartilage defects. Three-dimensional (3D) printing incorporating viable cells and extracellular matrix, or 3D bioprinting, is an additive manufacturing tissue engineering technique that can be used for layer-by-layer fabrication of highly complex tissues such as bone and cartilage. Because of the scalability of 3D bioprinting, this technology has the ability to fabricate tissues in clinically relevant volumes and addresses the defects of varying sizes and geometries.

Do clinical outcomes correlate with bone density after open reduction and internal fixation of tibial plateau fractures.

Introduction: The operative management of tibial plateau fractures in elderly patients has historically led to inconsistent results, and these clinical outcomes were thought to be associated with poor bone quality often in elderly patients. The goal of this study was to investigate the relationship between bone density and subjective clinical outcome scores after open reduction and internal fixation of tibial plateau fractures.

Materials And Methods: This is a retrospective cohort study from a single-surgeon conducted at an Academic, Level 1 Trauma Center.

Dimensional analysis of the distal phalanx with consideration of distal interphalangeal joint arthrodesis using a headless compression screw.

Background: Headless compression screws have been used for arthrodesis of the distal interphalangeal joint with good clinical results. However, some distal phalanges are too small, thus precluding their use, or increasing complication rates.

Methods: In order to validate our digital measurements, radiographs of five cadaveric hands were obtained.

Evaluation and treatment of chronic hand conditions.

Hand and wrist problems are frequently the cause of patients' complaints in the primary care setting. Common problems include hand numbness, pain, loss of motion, or unexplained masses in the hand. Many problems can be successfully managed or treated with nonoperative measures.

Nail and skin disorders of the foot.

Disorders of the dermis and the nails on the feet are common. Despite the simplicity of the skin and nail disorders of the foot, they can be debilitating and impact the patient's ability to ambulate and perform activities of daily living. Diagnosis in most cases is confirmed on physical examination alone.