Patient-Reported Outcomes After Periacetabular Osteotomy Versus Hip Arthroscopy for Borderline Acetabular Dysplasia Are Both Favorable: A Systematic Review.

Purpose: To compare patient populations and outcomes in studies treating borderline hip dysplasia (BHD) with either hip arthroscopy or periacetabular osteotomy (PAO).

Methods: We conducted a literature review according to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines to identify studies published after 2014 that reported patient-reported outcome measures (PROMs) after hip arthroscopy or PAO for BHD. Preoperative demographic characteristics, radiographic variables, operative findings, procedures, postoperative outcomes, and complications were recorded.

Functional Outcomes After Nonoperative Management in Older Adult Low-Energy Stable and Unstable Ankle Fractures: A Retrospective Review of 158 Patients.

Background: There is ongoing debate regarding the optimal management of older adult ankle fractures. The purpose of this study was to describe baseline characteristics and functional outcomes including complications in older adult patients receiving nonoperative treatment for low-energy ankle fracture and compare the outcomes of those with unstable vs stable fracture patterns.

Methods: Patients aged ≥65 from January 2012 to March 2019 that sustained an ankle fracture were identified.

Frustrations in Providing Orthopaedic Trauma Care: An OTA Member Survey Study.

Objectives: To determine sources of frustration for surgeons and how they might affect job satisfaction within the orthopaedic trauma community.

Methods: A 25-question survey regarding potential common causes of frustration, operating room (OR) utilization, and career satisfaction was electronically distributed to the Orthopaedic Trauma Association (OTA) membership.

Results: Four hundred seventy-one surgeons participated in the survey (response rate 27.

A Simple Clinical Predictive Model for Arthroscopic Mobility of Osteochondritis Dissecans Lesions of the Knee.

Background: Osteochondritis dissecans (OCD) of the knee is a focal idiopathic alteration of subchondral bone and/or its precursor with risk for instability and disruption of adjacent cartilage. Treatment options focused on preventing premature osteoarthritis vary depending on multiple patient and lesion characteristics, including lesion mobility.

Purpose: To differentiate lesion mobility before arthroscopy using a multivariable model that includes patient demographic characteristics and physical examination findings.

Advanced Neuromuscular Training Differentially Changes Performance on Visuomotor Reaction Tests and Single-leg Hop Tests in Patients with ACL Reconstruction.

Background: Advanced neuromuscular training prepares patients with anterior cruciate ligament reconstruction (ACLR) for sport participation. Return-to-sport testing often includes single-leg hop tests, yet combining motor and cognitive tasks (i.e.

Autograft and Allograft Anterior Cruciate Ligament Reconstruction in Patients Older Than 40 Years Have Similar Short-Term Patient-Reported Outcomes With Greater Rates of Anterior Cruciate Ligament Graft Failure in Patients Who Receive Allograft.

Purpose: To evaluate short-term patient-reported outcomes (PROs) in patients aged 40 years and older after primary anterior cruciate ligament reconstruction (ACLR) between patients who received allograft or autograft. Secondary aims included assessing the effect of preexisting osteoarthritis on short-term PROs.

Methods: A retrospective review of an ambulatory surgery center's electronic medical record was conducted for patients who underwent primary ACLR between 2009 and 2022.

Three-dimensional analysis of age and sex differences in femoral head asphericity in asymptomatic hips in the United States.

Background: The sphericity of the femoral head is a metric used to evaluate hip pathologies and is associated with the development of osteoarthritis and femoral-acetabular impingement.

Aim: To analyze the three-dimensional asphericity of the femoral head of asymptomatic pediatric hips. We hypothesized that femoral head asphericity will vary significantly between male and female pediatric hips and increase with age in both sexes.

Hypothalamic-pituitary-ovarian axis suppression is common among women during US Army Basic Combat Training.

Objective: Less than half of servicewomen report loss of menses during initial military training. However, self-reported menstrual status may not accurately reflect hypothalamic-pituitary-ovarian (HPO) axis suppression and may underestimate reproductive health consequences of military training. Our aim was to characterise HPO axis function during US Army Basic Combat Training (BCT) in non-hormonal contraceptive-using women and explore potential contributors to HPO axis suppression.

Functional testing following isolated meniscus repair may help to identify patients who need additional physical therapy prior to a return to activity.

Objectives: Functional testing (FT), commonly used to evaluate dynamic knee function and provide objective information about how well a patient, has progressed in rehabilitation following an anterior cruciate ligament (ACL) reconstruction. The purpose of the study was to determine whether a functional test could be used as an assessment tool for return to activity following isolated meniscus repair.

Methods: The results of FT completed between 80 and 150 days post-operation (representing 4-months post-operative) in isolated meniscal repair patients were analysed for the involved limb, uninvolved limb, and limb symmetry index (LSI).

Limb Length Discrepancy After Intraosseous Line Malpositioning: A Case Report.

Case: We will present the case of a 6-year-old girl who presented with a 3-cm limb length discrepancy after intraosseous line placement at age 14 months without other known history of trauma or infection to account for the growth arrest. Imaging revealed a left proximal tibial physeal bar amenable to surgical resection with autologous lipotransfer. At 10 months postoperatively, physical examination and imaging demonstrated a stable 3-cm leg length discrepancy with an interval increase in the length of the left tibia in proportion to the growth of the right side with an increase in valgus alignment that will continue to be monitored and addressed as indicated.

Early Versus Delayed Definitive Fixation Relative to Fasciotomy Closure in High-Energy Tibial Plateau Fractures With Compartment Syndrome.

Objectives: To evaluate the timing of definitive fixation of tibial plateau fractures relative to fasciotomy closure with regard to alignment and articular reduction.

Design: Retrospective case series.

Setting: Four Level I trauma centers.

Use of Social Media in Orthopaedic Surgery Training and Practice: A Systematic Review.

Background: Social media use has grown across healthcare delivery and practice, with dramatic changes occurring in response to the coronavirus (COVID-19) pandemic. The purpose of this study was to conduct a comprehensive systematic review to determine the current landscape of social media use by (1) orthopaedic surgery residencies/fellowship training programs and (2) individual orthopaedic surgeons and the change in use over time.

Methods: We searched 3 electronic databases (PubMed, MEDLINE, and Embase) from their inception to April 2022 for all studies that analyzed the use of social media in orthopaedic surgery.

Foot and Ankle Bone Marrow Edema Assessment in Long Distance Runners.

Background: The clinical significance of foot and ankle bone marrow edema (BME) is poorly understood.

Methods: Magnetic resonance imaging (MRI) and the visual analog scale (VAS) pain scores were collected for 17 runners who participated in the Twin Cities Marathon, immediately postmarathon and at a 6-week follow-up. Bone marrow edema lesions were classified using lesion frequency, anatomical location, and grading scale change to calculate a BME score for each affected bone.

An MCL internal brace can withstand cyclic fatigue loading and produce a valgus load to failure similar to that of intact knees.

Purpose: The purpose of this study is to report on the biomechanical durability and strength of an MCL internal brace construct. The null hypothesis is that there will be no difference between this construct and the intact MCL in terms of deflection during fatigue testing and the ultimate failure load.

Methods: Eight cadaver knees were used.

MCL internal brace does not fully recapitulate normal MCL function in valgus stress.

Purpose: The null hypothesis is that there would be no difference in medial gapping under valgus load between the intact MCL and the ruptured MCL with an internal brace in place.

Methods: Eight pairs of cadaver knees were used (16 knees). Alternating sides, one knee from each pair was used for one of two "internal brace" constructs.

Are Canadian orthopaedic surgeons and American orthopaedic surgeons on par? A Canadian practice survey of orthopaedic traumatologists.

Objectives: The purpose of this study was to obtain information on Canadian orthopaedic trauma surgeon practices and salary demographics. It was hypothesized that most of the practicing surgeons recognize specific practice aspects (compensation, call schedule, operating room availability, and provided support staff) as key factors in employment opportunity evaluation.

Design: Cross-sectional survey study.

Creative bracing: A descriptive overview of an alternative technique for non-operative fracture management of frail older adults.

As the world population ages, a higher proportion of older and frailer patients will sustain fragility fractures. Considering their depleted physiologic reserve and potentially different goals of care at their stage in life, these patients; especially those enrolled in hospice care, with profound dementia, or at end-of-life care; may not benefit from traditional surgical methods of fracture care. Non-operative treatment using standard immobilization or casting techniques in older and frailer patients can still render them susceptible to complications and adverse events.

A quality improvement project addressing the underreporting of delirium in hip fracture patients.

Introduction: After discovering a low incidence of delirium for hip fracture patients at our institution, we evaluated if this was due to underreporting and, if so, where process errors occurred.

Methods: Hip fracture patients aged ≥60 with a diagnosis of delirium were identified. Chart-Based Delirium Identification Instrument (CHART-DEL) identified missed diagnoses of delirium.

Outcomes After Revision Fixation With Cement Augmentation for Failed Intertrochanteric Fracture Fixation in Older Adult Patients.

Introduction: Intertrochanteric (IT) fractures that fail fixation are traditionally treated with arthroplasty, introducing significant risk of morbidity and mortality in frail older adult patients. Revision fixation with cement augmentation is a relatively novel technique that has been reported in several small scale international studies. Here we report a clinical series of 22 patients that underwent revision fixation with cement augmentation for IT fracture fixation failure.

CT and Functional Outcomes of Primarily Ligamentous and Combined Ligamentous-Bony Lisfranc Injuries: A Retrospective Review.

Lisfranc injuries have been rising in incidence and can cause significant and lasting morbidity. There is no consensus on the optimal surgical treatment for these injuries, be they primarily ligamentous or combined (bony and ligamentous). No study has ever followed Lisfranc injury patients postoperatively using advanced imaging.

Physeal-Sparing Anterior Cruciate Ligament Reconstruction with Iliotibial Band Autograft in the Skeletally Immature Knee.

Conventional adult anterior cruciate ligament reconstruction techniques are controversial in skeletally immature patients due to the risk of iatrogenic physeal damage and potential growth disturbance. The physeal-sparing, combined intra- and extra-articular anterior cruciate ligament reconstruction using an autogenous iliotibial band was developed to mitigate this risk in prepubescent, skeletally immature patients, with excellent functional outcomes and a low revision rate. This article describes the surgical details of this reproducible reconstruction technique.

Comparison of Orthosis Management Failure Rates for Mallet Injuries.

Purpose: A closed mallet injury is a common finger injury involving terminal extensor tendon avulsion from its insertion on the distal phalanx. Nonsurgical treatment with continuous extension orthosis fabrication is the preferred treatment. Our purpose was to report the failure rates of orthotic management by digit and investigate other factors that contribute to failure.

Establishing Sustainable Arthroscopy Capacity in Low- and Middle-Income Countries (LMICs) through High-Income Country/LMIC Partnerships: A Qualitative Analysis.

Unlabelled: Disparities exist in treatment modalities, including arthroscopic surgery, for orthopaedic injuries between high-income countries (HICs) and low- and middle-income countries (LMICs). Arthroscopy training is a self-identified goal of LMIC surgeons to meet the burden of musculoskeletal injury. The aim of this study was to determine the necessary "key ingredients" for establishing arthroscopy centers in LMICs in order to build capacity and expand training in arthroscopy in lower-resource settings.