Comparison of the mechanical properties and anchoring performance of polyvinylidene fluoride and polypropylene barbed sutures for tendon repair.

Polyvinylidene fluoride (PVDF) has been considered as an alternative suture material to replace polypropylene (PP) due to its superior biocompatibility and mechanical properties, but it has never been examined for use in barbed sutures, particularly for tendon repair. This study fabricated size 2-0 PVDF and PP bidirectional barbed sutures and compared their mechanical properties and anchoring performance in patellar tendons. The mechanical properties were evaluated via tensile testing, and the anchoring performance of the barbed sutures was assessed by a tendon suture pullout test.

Use of Cannabis Does Not Decrease Opioid Consumption in Patients Who Underwent Total Joint Arthroplasty.

Background: The primary purpose of this study was to determine if cannabis use decreases narcotic consumption in patients undergoing total joint arthroplasty (TJA).

Material And Methods: Forty-six patients undergoing a primary unilateral TJA, who self-reported the use of cannabis, were prospectively enrolled and completed this study between July 2015 and November 2019. This cohort was prospectively matched to patients who did not report cannabis use.

In-Office Needle Arthroscopy: A Systematic Review of Indications and Clinical Utility.

Purpose: This review explores the current literature regarding both the clinical indications and utility of minimally invasive in-office needle arthroscopy (IONA) relative to conventional imaging modalities.

Methods: In compliance with R-AMSTAR (Revised Assessment of Multiple Systematic Reviews) and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines, 3 databases (MEDLINE, Embase, and PubMed) were searched in July 2018, in addition to the conference abstract databases of 5 prominent meetings between 2013 and 2018, for studies using IONA for diagnostic purposes. Study quality was assessed with the Methodological Index for Non-Randomized Studies (MINORS) criteria.

Postoperative Blood Salvage and Autotransfusion for Adult Spinal Deformity: A Randomized Controlled Trial.

Study Design: Randomized controlled trial.

Objective: The aim of this study was to determine whether postoperative blood salvage and autotransfusion versus traditional closed suction drainage reduces the rate of homologous blood transfusions in patients undergoing surgery for adult spinal deformity.

Summary Of Background Data: The use of intraoperative blood salvage has become commonplace in spine surgery; however, the collection and reinfusion of blood drained from the wound postoperatively have not been employed routinely because of increased cost and questionable benefit.

Transient osteoporosis of the hip after bariatric surgery.

Transient osteoporosis is a rare manifestation of acute hip pain which typically resolves with weight-bearing restrictions and pain management. Our case report presents a patient who experienced atraumatic right hip pain a few weeks after an uncomplicated bariatric surgery and was diagnosed with transient osteoporosis of the hip. Her condition resolved after weeks of protected weight-bearing restrictions and nonsteroidal anti-inflammatories.

Return to Play and In-Game Performance Statistics Among Pitchers After Ulnar Collateral Ligament Reconstruction of the Elbow: A Systematic Review.

Background: Injury to the ulnar collateral ligament of the elbow is relatively common among baseball pitchers. Ulnar collateral ligament reconstruction (UCLR) has revolutionized the management of this injury, allowing a greater proportion of pitchers to return to play.

Purpose: To assess the return to play and in-game performance specific to baseball pitchers who have undergone primary UCLR.

Return to sport following arthroscopic Bankart repair: a systematic review.

Hypothesis And Background: The purpose of this systematic review was to determine the return-to-sport rate following arthroscopic Bankart repair, and it was hypothesized that patients would experience a high rate of return to sport.

Methods: The MEDLINE, Embase, and PubMed databases were searched by 2 reviewers, and the titles, abstracts, and full texts were screened independently. The inclusion criteria were English-language studies investigating arthroscopic Bankart repair in patients of all ages participating in sports at all levels with reported return-to-sport outcomes.

Midterm Prospective Comparative Analysis of 2 Hard-on-Hard Bearing Total Hip Arthroplasty Designs.

Introduction: Hard-on-hard (HoH) bearing surfaces in total hip arthroplasty (THA) are commonly utilized in younger patients and may decrease mechanical wear compared to polyethylene bearing surfaces. To our knowledge, no study has prospectively compared the 2 most common HoH bearings, ceramic-on-ceramic (CoC) and metal-on-metal (MoM) THA.

Materials And Methods: We prospectively enrolled 40 patients to undergo an MoM THA and 42 patients to undergo a CoC THA utilizing the same acetabular component.

Comparative Evaluation of Surgical Procedures with Clinical Equipoise: the Unique Perspective of Our Hand Therapy Colleagues.

Background: There are several accepted surgical treatment options available for carpal tunnel syndrome, thumb carpometacarpal joint (CMC), osteoarthritis (OA), and wrist degenerative joint disease.

Questions/purposes: We sought to obtain the views and preferences from a cohort of certified hand therapists (CHT) and hypothesized that this source may identify differences in procedures that are otherwise widely believed to have clinical equipoise.

Methods: Five hundred twelve CHTs were surveyed regarding their experience, volume, and referral base along with their subjective assessments and preferences regarding open versus endoscopic carpal tunnel release (CTR), various surgical procedures for CMC OA, and proximal row carpectomy (PRC) versus 4-corner fusion (4-CF).

Direct Anterior Hip Replacement Does Not Pose Undue Radiation Exposure Risk to the Patient or Surgeon.

Background: The fluoroscopically assisted direct anterior approach for total hip arthroplasty has gained interest in recent years. One of the perceived advantages is the use of fluoroscopy to aid in the positioning of implants. The purpose of this study was to measure the radiation entrance surface dose to anatomically important areas of both patients and surgeons during direct anterior approach total hip arthroplasty.

Lumbar computed tomography scans are not appropriate surrogates for bone mineral density scans in primary adult spinal deformity.

OBJECTIVE The authors examined the correlation between lumbar spine CT Hounsfield unit (HU) measurements and bone mineral density measurements in an adult spinal deformity (ASD) population. METHODS Patients with ASD were identified in the records of a single institution. Lumbar CT scans were reviewed, and the mean HU measurements from L1-4 were recorded.

Porous-Coated Metaphyseal Sleeves for Severe Femoral and Tibial Bone Loss in Revision TKA.

Background: Metaphyseal bone loss is commonly encountered in revision total knee arthroplasty (TKA). Anderson Orthopaedic Research Institute types 2 and 3 defects generally require some form of metaphyseal fixation or augmentation. This study evaluates the midterm results of stepped, porous-coated metaphyseal sleeves in revision TKA in the setting of severe bone loss.

Acetabular Reconstruction With the Medial Protrusio Technique for Complex Primary and Revision Total Hip Arthroplasties.

Background: In the setting of acetabular deficiency during total hip arthroplasty (THA), the medial protrusio technique (MPT) allows for increased component coverage while avoiding excessive component abduction or elevation of the hip center. The technique involves controlled reaming through the medial acetabular wall while maintaining the continuity of the anterior and posterior columns. The purpose of this study is to analyze the results of the largest reported series to date of primary and revision THAs using the MPT.

Adolescent Idiopathic Scoliosis: Update on Bracing, Surgical Techniques, and Patient Safety.

The primary goal in the management of adolescent idiopathic scoliosis is to prevent the progression of spinal deformity either with the use of a brace or with surgery. The goals of surgery, if indicated, are to correct the spinal deformity safely and to preserve overall spinal balance and as many motion segments as possible, which maximizes the long-term health of a patient's spine. Recently, tremendous advances have been made in the surgical techniques that are used to correct adolescent idiopathic scoliosis, and improved tools have allowed surgeons to perform spinal deformity surgery as safely and with as few complications as possible.

Implant Design and Effects on Patellofemoral Crepitus.

 Patellofemoral crepitus is a known complication of posterior stabilized (PS) total knee arthroplasty (TKA). This study compared the incidence of patellofemoral crepitus between two femoral components designs.  Between January 2005 and August 2010, 1,120 patients with complete 2-year follow-up had a PS TKA with two different prosthetic designs (group A, 553 patients; group B, 567 patients).

Femoral Implant Design Modification Decreases the Incidence of Patellar Crepitus in Total Knee Arthroplasty.

Background: Patellar crepitus is a complication most commonly seen in patients implanted with a posterior-stabilized total knee arthroplasty (TKA). Recently, design changes in the patellofemoral geometry and the intercondylar box ratio have been optimized in newer TKA designs. A comparative study was performed to analyze the incidence of patellar crepitus between a historical vs modern TKA design.

Fracture of a spline of the femoral stem in an ingrown modular hip implant.

Introduction: Physiologic strain patterns of the femur are altered by the bending stiffness of the implant as well as the loading pattern of the implant itself. The Savish Range of Motion (S-ROM) femoral stem has been designed with flutes (to decrease distal material) and with a coronal slot (to decrease stiffness).

Materials: The purpose of this case report is to briefly discuss design characteristics of femoral stems and their relationship to thigh pain as well as to describe the only report in the literature of a fracture of the anterior spline of a S-ROM prosthesis at the coronal slot.

Lumbar Radiculopathy Confounded: Total Knee Arthroplasty Diminishes the Patellar Tendon Reflex.

Study Design: Patellar tendon reflexes were elicited among patients who had had a unilateral total knee replacement, those planned for unilateral total knee replacement, and a cohort of controlled patients. Patellar tendon reflex (PTR) response was measured with surface electromyography.

Objective: The aim of this study was to determine if total knee arthroplasty significantly alters the PTR.

Inter- and intra-observer agreement of femoroacetabular impingement (FAI) parameters comparing plain radiographs and advanced, 3D computed tomographic (CT)-generated hip models in a surgical patient cohort.

Purpose: The purpose of our study was to investigate whether advanced, 3D computed tomographic (CT)-generated hip models improves inter-and intra-observer agreement when compared to plain radiographs in identifying femoroacetabular impingement (FAI) morphology.

Methods: Eight consecutive patients who underwent surgery for FAI pathology were selected for this study. Preoperative CT scan image data were used to create high resolution, 3D hip reconstruction models.

Neuromuscular fatigue alters postural control and sagittal plane hip biomechanics in active females with anterior cruciate ligament reconstruction.

Background: Females with history of anterior cruciate ligament (ACL) injury and subsequent ligament reconstruction are at high risk for future ACL injury. Fatigue may influence the increased risk of future injury in females by altering lower extremity biomechanics and postural control.

Hypothesis: Fatigue will promote lower extremity biomechanics and postural control deficits associated with ACL injury.

Extra-articular hip impingement: a systematic review examining operative treatment of psoas, subspine, ischiofemoral, and greater trochanteric/pelvic impingement.

Purpose: Extra-articular hip impingement can be the result of psoas impingement (PI), subspine impingement (SSI), ischiofemoral impingement (IFI), and greater trochanteric/pelvic impingement (GTPI). Symptoms may be due to bony abutment or soft-tissue irritation, and often, it is a challenge to differentiate among symptoms preoperatively. Currently, the clinical picture and diagnostic criteria are still being refined for these conditions.

Intermediate and long-term follow-up of total shoulder arthroplasty for the management of postcapsulorrhaphy arthropathy.

Background: The purpose of this study was to evaluate the subjective and objective outcomes in patients undergoing total shoulder arthroplasty for treatment of postcapsulorrhaphy arthropathy (CA) and compare them with outcomes in patients undergoing total shoulder arthroplasty for primary glenohumeral osteoarthritis (OA).

Methods: Total shoulder arthroplasty was used to treat 25 consecutive CA patients (25 shoulders) at our institution; of these, 22 patients were available for follow-up. An age-matched cohort of 19 consecutive patients (20 shoulders) who were treated with total shoulder arthroplasty for primary glenohumeral OA was compared with the CA group.

Proximal humerus and humeral shaft nonunions.

The rate of nonunion is estimated to be 1.1% to 10% following closed treatment of proximal humerus fracture and 5.5% following closed treatment of humeral shaft fracture.

Hemostasis with a bipolar sealer during surgical correction of adolescent idiopathic scoliosis.

Study Design: Retrospective before-after comparison study.

Objective: The primary aim of this study was to evaluate the effectiveness of a radiofrequency-based bipolar hemostatic sealer during surgical correction of adolescent idiopathic scoliosis (AIS).

Summary Of Background Data: Spinal reconstructive surgery is commonly associated with excessive blood loss.

Classic bladder exstrophy: orthopaedic surgical considerations.

Classic bladder exstrophy is an embryologic malformation that results in complex deficiency of the anterior midline, with urogenital and skeletal manifestations. Urogenital reconstruction is a challenging procedure that can be facilitated by closure of the bony pelvic ring by an orthopaedic team. Surgical options include a multiyear staged approach and the single-stage complete repair for exstrophy.