Early postoperative pain is similar after arthroscopic rotator cuff repair vs. short-stay shoulder arthroplasty: a prospective study.

Background: One of the barriers to counseling patients for shoulder arthroplasty (TSA) is the anticipated pain after surgery. This can be contrasted with the common perception of arthroscopic rotator cuff repair (RCR) surgery being less painful because of the less invasive nature of the procedure. We conducted a prospective study comparing postoperative pain levels and narcotic consumption after TSA to those after RCR.

Microbiology, Treatment, and Postoperative Outcomes of Gram-Negative Prosthetic Joint Infections-A Systematic Review of the Literature.

Introduction: Gram-negative prosthetic joint infections (PJIs) represent 10% to 25% of all PJIs and are associated with worse outcomes than gram-positive infections. We sought to assess the microbiology, surgical treatment, and outcomes of patients with gram-negative PJIs.

Methods: A systematic review using the PubMed and Embase databases was conducted.

Evaluating the Efficacy of a Thermoresponsive Hydrogel for Delivering Anti-Collagen Antibodies to Reduce Posttraumatic Scarring in Orthopedic Tissues.

Excessive posttraumatic scarring in orthopedic tissues, such as joint capsules, ligaments, tendons, muscles, and peripheral nerves, presents a significant medical problem, resulting in pain, restricted joint mobility, and impaired musculoskeletal function. Current treatments for excessive scarring are often ineffective and require the surgical removal of fibrotic tissue, which can aggravate the problem. The primary component of orthopedic scars is collagen I-rich fibrils.

Republication of "Open Repair of Acute Achilles Tendon Ruptures: Is the Incidence of Clinically Significant Wound Complications Overestimated?".

Background: Conflicting evidence exists regarding the optimal management of acute Achilles tendon ruptures. Operative repair is thought to afford patients a lower risk of rerupture, albeit at a higher overall risk of wound complications.

Methods: A retrospective chart review of 369 consecutive patients undergoing open repair of acute Achilles tendon ruptures performed by a single foot and ankle fellowship-trained orthopedic surgeon was undertaken.

Extracellular Targets to Reduce Excessive Scarring in Response to Tissue Injury.

Excessive scar formation is a hallmark of localized and systemic fibrotic disorders. Despite extensive studies to define valid anti-fibrotic targets and develop effective therapeutics, progressive fibrosis remains a significant medical problem. Regardless of the injury type or location of wounded tissue, excessive production and accumulation of collagen-rich extracellular matrix is the common denominator of all fibrotic disorders.

Profibrotic behavior of fibroblasts derived from patients that develop posttraumatic shoulder stiffness.

Background And Aims: Arthrofibrosis is a severe scarring condition characterized by joint stiffness and pain. Fundamental to developing arthrofibrotic scars is the accelerated production of procollagen I, a precursor of collagen I molecules that form fibrotic deposits in affected joints. The procollagen I production mechanism comprises numerous elements, including enzymes, protein chaperones, and growth factors.

Extensor carpi ulnaris tendon pathology and ulnar styloid bone marrow edema as diagnostic markers of peripheral triangular fibrocartilage complex tears on wrist MRI: a case-control study.

Objectives: To evaluate extensor carpi ulnaris (ECU) tendon pathology and ulnar styloid process bone marrow edema (BME) as diagnostic MRI markers for peripheral triangular fibrocartilage complex (TFCC) tears.

Methods: One hundred thirty-three patients (age range 21-75, 68 females) with wrist 1.5-T MRI and arthroscopy were included in this retrospective case-control study.

Arthroscopically Assisted Acromioclavicular and Coracoclavicular Reconstruction with a Looped Braided Polyester Suture Band and Buckle Device.

Acromioclavicular (AC) joint injuries occur with a traumatic load to the lateral aspect of the shoulder and account for 9% of all shoulder girdle injuries. Rockwood classified AC joint injuries as type I though type VI, based on severity of injury, radiographic findings, and reducibility of the AC joint. Type I and II injuries are typically managed nonoperatively, whereas type IV, V, and VI are managed operatively to address the significant soft tissue disruption, persistent AC joint instability, and apical shoulder deformation.

Staged Bilateral Total Knee Arthroplasty: When Should the Second Knee be Replaced?

Background: Bilateral total knee arthroplasty (BTKA) under the same anesthesia (simultaneous) or staged are options for patients with end-stage arthritis of the knee that carries advantages and limitations. Not all patients are candidates for simultaneous BTKA, and therefore, surgeons prefer to stage the two TKAs. The optimal safe interval between two TKAs is not known.

Mechanisms of reducing joint stiffness by blocking collagen fibrillogenesis in a rabbit model of posttraumatic arthrofibrosis.

Posttraumatic fibrotic scarring is a significant medical problem that alters the proper functioning of injured tissues. Current methods to reduce posttraumatic fibrosis rely on anti-inflammatory and anti-proliferative agents with broad intracellular targets. As a result, their use is not fully effective and may cause unwanted side effects.

Perioperative Pain Management in Ambulatory and Inpatient Shoulder Surgery.

»: Acetaminophen is an effective addition to a multimodal pain regimen; however, evidence to support intravenous versus oral administration requires further evaluation.

»: While nonsteroidal anti-inflammatory drugs are a valuable addition to a multimodal pain strategy, concerns regarding their effect on healing after certain procedures (i.e.

Outcomes of chronic distal biceps reconstruction with tendon grafting: a matched comparison with primary repair.

Background: The purpose of this analysis was to analyze outcomes of distal biceps reconstruction with soft tissue allograft in the setting of chronic, irreparable distal biceps ruptures. The outcomes of these cases were then compared with a matched cohort of distal biceps ruptures that were able to be repaired primarily.

Methods: Retrospective review of an institutional elbow surgery database was conducted.

Outcomes of open reduction and internal fixation of proximal humerus fracture dislocations.

Introduction: Proximal humeral fracture with associated glenohumeral dislocation (PHFD) is a challenging clinical problem. Outcomes of open reduction and internal fixation (ORIF) of these injuries have not been widely reported. The purpose of this analysis is to report our experience with ORIF of PHFD.

Collagen-rich deposit formation in the sciatic nerve after injury and surgical repair: A study of collagen-producing cells in a rabbit model.

Introduction: Posttraumatic scarring of peripheral nerves produces unwanted adhesions that block axonal growth. In the context of surgical nerve repair, the organization of the scar tissue adjacent to conduits used to span the gap between the stumps of transected nerves is poorly understood. The goal of this study was to elucidate the patterns of distribution of collagen-rich scar tissue and analyze the spatial organization of cells that produce fibrotic deposits around and within the conduit's lumen.

The Effects of Patient Occupation, Hobbies, and Body Mass Index on Kneeling after Total Knee Arthroplasty.

A common patient concern after total knee arthroplasty (TKA) is the ability to kneel. Kneeling may have a substantial impact on the patients' ability to perform many activities of daily living, occupations, and hobbies. The purpose of this study was to quantify the percentage of patients able to kneel after TKA after 2 years and to evaluate preoperative patient characteristics that influence the patient's perceived ability to kneel after TKA such as obesity, occupation, and hobbies.

Outcomes of shoulder arthroplasty following axillary lymph node dissection.

Introduction: Shoulder arthroplasty with previous axillary lymph node dissection historically has unsatisfactory outcomes. We analyzed outcomes of primary shoulder arthroplasty in patients with previous axillary lymph node dissection.

Methods: Thirty-two primary shoulder arthroplasties after prior axillary lymph node dissection were performed.

Intraoperative povidone-iodine irrigation for infection prevention.

Although prevention of infection following arthroplasty requires a multifaceted approach, the use of intraoperative irrigation is an important component of any protocol. Recent clinical practice guidelines from the Centers for Disease Control, World Health Organization, and International Consensus Meeting on Musculoskeletal Infection advocate the use of a dilute povidone-iodine solution prior to wound closure. Our experience suggests that this practice is safe, inexpensive, and easily implemented.

Outcomes of Bilateral Shoulder Arthroplasties: A Comparison of Bilateral Total Shoulder Arthroplasties and Bilateral Reverse Shoulder Arthroplasties.

Background: The purpose of this study was to compare outcomes of patients who underwent bilateral total shoulder arthroplasties (TSAs) for osteoarthritis (OA) versus bilateral reverse shoulder arthroplasties (RSAs) for cuff tear arthropathy (CTA).

Methods: Inclusion criteria were patients who underwent bilateral TSAs for OA or bilateral RSAs for CTA with at least 2 years of follow-up. Twenty-six TSA patients (52 shoulders) were matched 2 to 1 with 13 RSA patients (26 shoulders) by sex, age at first surgery, and time between surgeries.

Failure to restore the calcar and locking screw cross-threading predicts varus collapse in proximal humerus fracture fixation.

Background: Varus collapse is a common failure mode of proximal humerus fracture (PHF) fixation. The purpose of this study was to analyze predictors of varus collapse of PHF after open reduction, internal fixation (ORIF).

Methods: All patients who underwent ORIF of a PHF from January 2008 to July 2018 were identified.

The impact of cholesterol deposits on the fibrillar architecture of the Achilles tendon in a rabbit model of hypercholesterolemia.

Background: Increased tendon pain and tendon damage is a significant complication related to hyperlipidemia. Unlike the well-established pathogenesis associated with increased serum concentrations of total cholesterol, triglycerides, and low-density lipoprotein in atherosclerotic cardiovascular disease, the role of hyperlipidemia in promoting tendon damage remains controversial and requires mechanistic clarity.

Methods: In this study, we analyzed the consequences of hypercholesterolemia on the integrity of the collagen-based architecture of the Achilles tendon.

Failure of Anatomic Total Shoulder Arthroplasty with Revision to another Anatomic Total Shoulder Arthroplasty.

Background: While outcomes of primary anatomic total shoulder arthroplasty (aTSA) are generally favorable, results after revision procedures are less reliable. This study examines the functional outcomes, complications, and implant survival in patients who underwent revision of aTSA to aTSA.

Methods: Patients who underwent revision aTSA were identified from 2008-2015.

Novel mutation in Teneurin 3 found to co-segregate in all affecteds in a multi-generation family with developmental dysplasia of the hip.

DDH is a debilitating condition characterized by incomplete formation of the acetabulum leading to dislocation of the hip, suboptimal joint function and accelerated wear of the articular cartilage resulting in early onset crippling arthritis of the hip in 20-40 year olds. Current diagnostic tests in newborns using physical manipulation of the femur or ultrasound either under or over-diagnose this condition. Developing an accurate, cost effective diagnostic test is a goal of this study.

The effect of an orthopedic specialty hospital on operating room efficiency in shoulder arthroplasty.

Background: Operating room (OR) time is a major cost to the health care system. Therefore, increasing OR efficiency to save time may be a cost-saving tool. This study analyzed OR efficiency in shoulder arthroplasty at an orthopedic specialty hospital (OSH) and a tertiary referral center (TRC).

Outcomes of Shoulder Arthroplasty Performed for Postinfectious Arthritis.

Background: The purpose of this study was to evaluate the functional outcomes, infection rate, and complications associated with shoulder arthroplasty for sequelae of prior septic arthritis.

Methods: This is a retrospective cohort study of 17 patients who underwent shoulder arthroplasty for sequelae of septic arthritis. Patients were analyzed for patient-reported outcomes, complications, and reoperations.