Genetic Biomarker Prevalence Is Similar in Fecal Immunochemical Test Positive and Negative Colorectal Cancer Tissue.

Background: Fecal immunochemical test (FIT) screening detects most asymptomatic colorectal cancers. Combining FIT screening with stool-based genetic biomarkers increases sensitivity for cancer, but whether DNA biomarkers (biomarkers) differ for cancers detected versus missed by FIT screening has not been evaluated in a community-based population.

Aims: To evaluate tissue biomarkers among Kaiser Permanente Northern California patients diagnosed with colorectal cancer within 2 years after FIT screening.

Basic Hip Arthroscopy: Anatomic Establishment of Arthroscopic Portals Without Fluoroscopic Guidance.

Hip arthroscopy has gained popularity in recent years for diagnostic and therapeutic hip preservation management. This article details the establishment of arthroscopic portals of the hip, specifically the anterolateral and modified anterior portals without fluoroscopic guidance. The anterolateral portal is established anatomically, and the modified anterior portal is then established under arthroscopic guidance.

Arthroscopic Bullet Removal From the Central and Peripheral Compartments of the Hip Joint.

Recent advances in hip arthroscopy offer an approach for treating an uncommon but highly disabling injury from intra-articular missile injury to the hip. Hip arthroscopy affords the patient the benefit of minimally invasive surgery while allowing for the diagnosis and treatment of concomitant pathology, which may be either acute, from the trauma of the missile, or chronic. We present a technique for the removal of projectiles from the central and peripheral compartments of the hip joint.

Evidence-Based Workflows for Thyroid and Parathyroid Surgery.

A need exists to reduce care variations by standardizing the practice of thyroid and parathyroid surgery. During the course of a year, a task force developed algorithms representing decision points and workflows based on American Thyroid Association guidelines and three internal studies of surgical practices in the Northern and Southern California Regions of Kaiser Permanente conducted in collaboration with Health Information Technology Transformation & Analytics (HITTA).

Cyclists Have Greater Chondromalacia Index Than Age-Matched Controls at the Time of Hip Arthroscopy.

Purpose: To evaluate the clinical symptoms and intraoperative pathology associated with hip pain in the cyclist compared with a matched hip arthroscopy surgical group.

Methods: In an institutional review board-approved study, we retrospectively reviewed a prospective database of 1,200 consecutive hip arthroscopy patients from 2008 to 2015. Adult patients were identified who reported cycling as a major component of their activity.

Arthroscopic Management of Hip Chondral Defects: A Systematic Review of the Literature.

Purpose: To critically evaluate the evidence for arthroscopic management of chondral defects in the hip through a systematic literature review.

Methods: A systematic literature review was performed to identify all articles addressing the arthroscopic management of chondral defects about the hip. Case reports, open techniques, and those associated with osteonecrosis were excluded.

Tissue engineering and the future of hip cartilage, labrum and ligamentum teres.

As the field of hip arthroscopy continues to evolve, the biological understanding of orthopaedic tissues, namely articular cartilage, labral fibro-cartilage and the ligamentum teres continues to expand. Similarly, the need for biological solutions for the pre-arthritic and early arthritic hip continues to be a challenge for the sports medicine surgeon and hip arthroscopist. This article outlines existing biological and tissue-engineering technologies, some being used in clinical practice and other technologies being developed, and how these biological and tissue-engineering principals may one day influence the practice of hip arthroscopy.

Basic Hip Arthroscopy: Supine Patient Positioning and Dynamic Fluoroscopic Evaluation.

Hip arthroscopy serves as both a diagnostic and therapeutic tool for the management of various conditions that afflict the hip. This article reviews the basics of hip arthroscopy by demonstrating supine patient positioning, fluoroscopic evaluation of the hip under anesthesia, and sterile preparation and draping. Careful attention to detail during the operating theater setup ensures adequate access to the various compartments of the hip to facilitate the diagnosis of disease and treatment with minimally invasive arthroscopy.

The power of the National Surgical Quality Improvement Program--achieving a zero pneumonia rate in general surgery patients.

The National Surgical Quality Improvement Program (NSQIP) of the American College of Surgeons provides risk-adjusted surgical outcome measures for participating hospitals that can be used for performance improvement of surgical mortality and morbidity. A surgical clinical nurse reviewer collects 135 clinical variables including preoperative risk factors, intraoperative variables, and 30-day postoperative mortality and morbidity outcomes for patients undergoing major surgical procedures. A report on mortality and complications is prepared twice a year.

Equal kinematics between central anatomic single-bundle and double-bundle anterior cruciate ligament reconstructions.

Purpose: The purpose of this study was to compare the kinematics of a central anatomic single-bundle anterior cruciate ligament (ACL) reconstruction with a double-bundle ACL reconstruction by use of hamstring grafts and anatomic tunnel placement.

Methods: Anterior tibial translation and rotation were measured with a computer navigation system in 8 pairs of fresh-frozen cadaveric knees by use of a 133-N anterior force, an internal and external torque of 10 Nm, and an anterior force (133 N) combined with an internal rotation torque (10 Nm). Tests were performed at 30 degrees and 60 degrees of flexion with the ACL intact, the ACL transected, and after reconstruction of one side of a pair with either a single or a double-bundle construct.

Mid-diaphyseal fibular fractures with syndesmotic disruption: should we plate the fibula?

Background: The treatment of mid-diaphyseal fibula fractures with syndesmotic disruption is controversial. The purpose of this study was to compare the biomechanical properties of 2 fixation constructs.

Materials And Methods: Eight pairs of human cadaveric legs were divided into two groups, both of which had midshaft fibular osteotomies and disruption of all ligamentous support up to the osteotomy level.