An Update in Complication Rates Associated With Anterior Lumbar Surgery: A Systematic Review and Meta-Analysis.

Study Design: Systematic Review and meta-analysis.

Objective: To conduct an updated systematic review and meta-analysis of complications associated with different anterior fusion techniques/approaches and adjuvant resources (i.e.

OrthoPass: Long-term Outcomes following Implementation of an Orthopaedic Patient Handoff Template.

Standardized handoff tools improve communication and patient care; however, their widespread use in surgical fields is lacking. OrthoPass, an orthopaedic adaptation of I-PASS, was developed in 2019 to address handoff concerns and demonstrated sustained improvements across multiple handoff domains over an 18-month period. We sought to characterize the longitudinal effect and sustainability of OrthoPass within a single large residency program 3.

Inpatient opioid use varies by construct length among laminoplasty versus laminectomy and fusion patients.

Background: Laminoplasty (LP) and laminectomy and fusion (LF) are utilized to achieve decompression in patients with symptomatic degenerative cervical myelopathy (DCM). Comparative analyses aimed at determining outcomes and clarifying indications between these procedures represent an area of active research. Accordingly, we sought to compare inpatient opioid use between LP and LF patients and to determine if opioid use correlated with length of stay.

Elliptical Humeral Head Implants in Anatomic Total Shoulder Arthroplasty.

Humeral implants for anatomic total shoulder arthroplasty and hemiarthroplasty have typically used spherical humeral heads that have a uniform diameter and radius of curvature. However, the native humeral head has a more elliptical morphology, which has spurred interest in nonspherical implant designs. Cadaveric studies indicate that the native humeral head diameter is 10% longer in the superior-inferior plane than the anterior-posterior plane and has a radius of curvature that is approximately 8% greater.

Shoulder Arthrodesis.

Shoulder arthrodesis is an end-stage, salvage procedure for the glenohumeral joint and can provide a pain-free, stable shoulder with varying levels of function. Common indications include brachial plexus injury, chronic instability with rotator cuff and deltoid dysfunction, and failed shoulder arthroplasty. Multiple techniques are described, including intra-articular and extra-articular arthrodeses.

Editorial Commentary: Hydrogen Peroxide in the Perioperative Skin Preparation is a No Brainer for Shoulder Surgery (Despite Imperfect Data).

Although the clinical impact of positive cultures at the time of primary shoulder surgery remain unknown, much effort has been placed on identifying agents for skin preparation that reduce Cutibacterium acnes skin colonization. Although several randomized controlled trials of hydrogen peroxide use as part of the skin preparation exist, they are plagued by small sample sizes that lead to inadequate power or statistical fragility. Despite the lack of perfect data, our clinical experience and break-even analyses indicate value to routine use of hydrogen peroxide as part of the perioperative skin preparation prior to shoulder surgery.

Prosthetic Bearing Surfaces in Anatomic and Reverse Total Shoulder Arthroplasty.

Total shoulder arthroplasty (TSA) and reverse TSA have provided an effective treatment for glenohumeral osteoarthritis; however, longevity of the procedure may be limited by osteolysis and polyethylene wear. In TSA, glenoid component failure occurs through several mechanisms, the most common being aseptic loosening and polyethylene wear. Newer bearing surfaces such as highly cross-linked ultra-high-molecular-weight polyethylene, vitamin E processing, ceramic heads, and pyrolytic carbon surfaces have shown improved wear characteristics in biomechanical and some early clinical studies.

What is the clinical impact of positive cultures at the time of primary total shoulder arthroplasty?

Background: Cultures taken at the time of primary shoulder arthroplasty are commonly positive for Cutibacterium acnes. Despite our limited understanding of the clinical implication of deep tissue inoculation from dermal colonization, significant efforts have been made to decolonize the shoulder prior to surgery. The purpose of this study is to determine differences in clinical outcomes based on culture positivity at the time of primary shoulder arthroplasty.

Techniques for lower trapezius tendon transfer for the management of irreparable posterosuperior rotator cuff tears.

Irreparable posterosuperior rotator cuff tears are a challenging treatment problem. Several tendon transfers have been described for the treatment of irreparable tears. Recently the lower trapezius (LT) tendon transfer has grown in popularity.

Differential rates of intravascular uptake and pain perception during lumbosacral epidural injection among adults using a 22-gauge needle versus 25-gauge needle: a randomized clinical trial.

Background: Inadvertent intravascular injection has been suggested as the most probable mechanism behind serious neurological complications during transforaminal epidural steroid injections. Authors believe a smaller gauge needle may lead to less intravascular uptake and less pain. Theoretically, there is less chance for a smaller gauge needle to encounter a blood vessel during an injection compared to a larger gauge needle.

Treatment of elbow periprosthetic joint infection: a systematic review of clinical outcomes.

Background: Periprosthetic joint infection (PJI) of the elbow is a relatively common complication after total elbow arthroplasty (TEA), and its treatment is frequently variable. Few articles have provided direct comparisons of outcomes, making it difficult to draw conclusions from the available literature. This systematic review synthesizes the English-language literature on elbow PJI to quantify treatment outcomes.