Medicine and Health Sciences Commons^™

Anterior Talofibular Ligament Abnormality On Routine Magnetic Resonance Imaging Of The Ankle, Patrick Kane, Md, David Pedowitz, Md, Adam C C. Zoga, Md, Steven M. Raikin, Md

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The anterior talo­fibular ligament (ATFL) extends from the anteroinferior border of the ­fibula to the talar neck. Primary restraint to ankle inversion in plantar‑exion. Injury (acute or chronic) can be diagnosed with physical exam, stress X-Rays, ultrasound or magnetic resonance imaging (MRI).

Purpose:

MRI abnormalities in asymptomatic individuals known in other areas of orthopaedics (shoulder and spine). Purpose of our study: determine the prevalence of ATFL abnormalities found on MRI in asymptomatic individuals. Asymptomatic individuals - those undergoing MRI for pathology unrelated to lateral ankle trauma, instability, or inversion injuries.

Is Further Treatment Necessary For Patellar Crepitus After Total Knee Arthroplasty?, Bo-Hyun Hwang, Md, Chang-Hyun Nam, Md, Kwang-Am Jung, Md, Alvin Ong, Md, Su-Chan Lee, Md

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Introduction:

• Posterior-stabilized (PS) TKA that sacrifice the cruciate ligaments improves pain and function in patients with advanced osteoarthritis.
• Patellar crepitus appears to be due to a spectrum of peripatellar fibrosynovial formations and is usually encountered after PS-TKA, which uniquely has an intercondylar box to accept the tibial post.
• Symptoms of patellar crepitus occur most commonly during terminal knee extension and occur usually from 3 to 9 months after PS-TKA, and in some cases, this phenomenon is symptomatic enough to warrant an arthroscopic procedure or open arthrotomy.
• The development of patellar crepitus after PS-TKA appears related to many factors such as …

Postoperative Urinary Retention (Pour): What Are The Risk Factors?, Eric H. Tischler, Ba, Camilo Restrepo, Md, Jennifer Oh, Ba, Mitchell Maltenfort, Phd, Javad Parvizi, Md, Frcs

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Introduction

Total hip arthroplasty (THA) is a successful procedure alleviating pain in patients with debilitating arthritis. Postoperative urinary retention (POUR) is a common complication following surgery and is managed with intermittent or continued urinary catheterization. POUR has been estimated in retrospective literature to be on the order of 5% – 70% of surgical cases with early catheter removal or without a catheter. At our institution, and based on a Level 1 study here, urinary catheter is not used routinely in patients undergoing THA under regional anesthesia. The purpose of this study was to evaluate the incidence of POUR and risk …

A Clinical Decision Support Tool To Predict The Risk Of Failure In Patients With Femoroacetabular Impingement Undergoing Hip Preservation Surgery, Claudio Diaz-Ledezma, Md, Mitchell Maltenfort, Phd, Lesley Walinchus, Bs, Benjamin Hendy, Bs, Thomas Novack, Bs, Javad Parvizi, Md, Frcs

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In modern orthopaedics, risk prediction scores can help discriminate between ideal and poor candidates for a specifi­c therapeutic intervention. We consider these tools useful during the process of shared medical decision-making1. To our knowledge, such a strategy has never been explored in the ­field of hip preservation surgery.

The aim of our study is to generate a clinical decision support tool to predict risk of failure after hip preservation surgery among patients with femoroacetabular impingement (FAI).

Cost Benefit Analysis Of Athletic Team Coverage By An Orthopaedic Practice, Brandon Eck, Bs, Fotios Tjoumakaris, Md, Matthew Pepe, Md, Kevin Freedman, Md, Katherine Bagnato, Atc, Bradford Tucker, Md

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Introduction

- Coverage of high school football by an orthopaedic practice is considered standard of care in many localities.

- Taking time away from an orthopaedic practice to provide on ­field athletic care has potential advantages and disadvantages.

- To this date, the economic value of this endeavor has never been investigated.

- Purpose: to perform a cost/benefi­t analysis of local high school sports coverage by an orthopaedic sports medicine practice.

High Variability In Outcomes Of Two-Stage Exchange To Treat Periprosthetic Joint Infection, Benjamin Zmistowski, Bs, Paul Lichstein, Md, Aaron H Carter, Md, Joshua J. Minori, Do, Javad Parvizi, Md

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Introduction:

Periprosthetic joint infection (PJI) is a challenging condition to manage with sobering morbidity and mortality.1,2 Treatment options range from simple irrigation and debridement with prosthetic retention to explantation and placement of a temporary cement spacer. Indictations for each option are unclear and non-uniform despite signi­cant efforts to understand the management outcomes. Until recently, a uniform de­nition of success was unavailable, thus clouding the discussion of treatment options. Two-stage exchange is currently considered the “gold-standard” in North America, yet an appropriate understanding of the actual success and ancillary effects of treatment is needed. With the advantage of an expert opinion …

Threshold For Synovial Cell Count And Neutrophil Differential In Diagnosis Of Periprosthetic Knee Infection: A Multi-Institutional Study, Benjamin Zmistowski, Bs, Carlos Higuera, Md, Jane Liu, Ba, Wael Barsoum, Md, Joseph Mendelis, Ba, Craig Della Valle, Md, Javad Parvizi, Md

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Introduction:

Synovial fl­uid analysis is an important tool in the work-up of suspected periprosthetic joint infection (PJI). Yet, there is confl­icting guidance for the analysis of synovial fl­uid aspiration, including a lack of uniform thresholds for white blood cell (WBC) count and neutrophil percentage (PMN%)1-3. Therefore, a multi-institutional study was undertaken to reassess these thresholds, compare preoperative versus intraoperative sample collection, and assess variation in results between institutions.

Risk Factors For Surgical Site Infection Following Total Joint Arthroplasty, Mohammad Rasouli, Md, Camilo Restrepo, Md, Mitchell Maltenfort, Phd, James J. Purtill, Md, Javad Parvizi, Md

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Surgical Site Infection (SSI) after total joint arthroplasty (TJA) is a rare but devastating complication1. In spite of improvement in the prevention of SSI, these infections are still a signi­ficant cause of morbidity in surgical patients2. Management of Hospital Acquired infections (HAI) including SSI poses a huge economic burden on healthcare3. As part of the mission to reduce the burden of HAI, the Centers for Disease Control and Prevention (CDC) has issued guidelines for the prevention of SSI that are currently being updated4. In addition, CDC requires all hospitals to report HAI through the National Healthcare Safety Network (NHSN) surveillance …