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Orthopedics

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Full-Text Articles in Medicine and Health Sciences

Optimum Anatomic Socket Position And Sizing For The Direct Anterior Approach: Impingement And Instability, N. Mercer, E. Hawkins, L. Menken, A. Deshmukh, P. Rathod, J. A. Rodriguez Jan 2019

Optimum Anatomic Socket Position And Sizing For The Direct Anterior Approach: Impingement And Instability, N. Mercer, E. Hawkins, L. Menken, A. Deshmukh, P. Rathod, J. A. Rodriguez

Journal Articles

© 2019 A comprehensive strategy is important for ensuring reproducible and safe acetabular component sizing and positioning. Presented here is our approach for anatomic acetabular component positioning in direct anterior total hip arthroplasty. This strategy has evolved with our understanding of the ramifications of socket sizing and positioning on instability and impingement. Data collected by a single surgeon (J.A.R.) between 2009 and 2011 influenced our current paradigm. We compare the sizing and positioning parameters of the anterior and posterior approach, thus demonstrating how the 2 are different. By highlighting these differences, we hope to provide a clear, defined approach ...


A Nationwide Comparative Analysis Of Medical Complications In Fibromyalgia Patients Following Total Knee Arthroplasty, T. Moore, N. Sodhi, A. Kalsi, R. M. Vakharia, J. O. Ehiorobo, H. K. Anis, K. Dushaj, V. Papas, G. Scuderi, M. A. Mont, +2 Additional Authors Jan 2019

A Nationwide Comparative Analysis Of Medical Complications In Fibromyalgia Patients Following Total Knee Arthroplasty, T. Moore, N. Sodhi, A. Kalsi, R. M. Vakharia, J. O. Ehiorobo, H. K. Anis, K. Dushaj, V. Papas, G. Scuderi, M. A. Mont, +2 Additional Authors

Journal Articles

No abstract provided.


Impact Of A Resident-Guided Rounding Initiative On The Hospital Consumer Assessment Of Healthcare Providers And Systems Survey Scores In Orthopaedic Surgery Inpatients., E. Stapleton, N. Frane, J. Lentz, K. Yngstrom, C. Healy, R. Cohn, G. Katsigiorgis Jan 2019

Impact Of A Resident-Guided Rounding Initiative On The Hospital Consumer Assessment Of Healthcare Providers And Systems Survey Scores In Orthopaedic Surgery Inpatients., E. Stapleton, N. Frane, J. Lentz, K. Yngstrom, C. Healy, R. Cohn, G. Katsigiorgis

Journal Articles

No abstract provided.


Cost-Effectiveness Analysis Of Needle Arthroscopy Versus Magnetic Resonance Imaging In The Diagnosis And Treatment Of Meniscal Tears Of The Knee, N. Amin, L. Mcintyre, T. Carter, J. Xerogeanes, J. Voigt Jan 2019

Cost-Effectiveness Analysis Of Needle Arthroscopy Versus Magnetic Resonance Imaging In The Diagnosis And Treatment Of Meniscal Tears Of The Knee, N. Amin, L. Mcintyre, T. Carter, J. Xerogeanes, J. Voigt

Journal Articles

© 2019 The Authors Purpose: To determine whether needle arthroscopy (NA) compared with magnetic resonance imaging (MRI) in the diagnosis and treatment of meniscal tears is cost-effective when evaluated over a 2-year period via patient-reported outcomes. The hypothesis is that improved diagnostic accuracy with NA would lead to less costly care and similar outcomes. Methods: A Markov model/decision tree analysis was performed using TreeAge Pro 2017 software. Patients were evaluated for degenerative and traumatic damage to the lateral/medial meniscus. Assumed sensitivities and specificities were derived from the medical literature. The direct costs for care were derived from the 2017 ...


Implementation And Validation Of The 2013 Caprini Score For Risk Stratification Of Arthroplasty Patients In The Prevention Of Venous Thrombosis, E. S. Krauss, A. Segal, M. A. Cronin, N. Dengler, M. L. Lesser, S. Ahn, J. A. Caprini Jan 2019

Implementation And Validation Of The 2013 Caprini Score For Risk Stratification Of Arthroplasty Patients In The Prevention Of Venous Thrombosis, E. S. Krauss, A. Segal, M. A. Cronin, N. Dengler, M. L. Lesser, S. Ahn, J. A. Caprini

Journal Articles

© The Author(s) 2019. Appropriate chemoprophylaxis choice following arthroplasty requires accurate patient risk assessment. We compared the results of our prospective department protocol to the Caprini risk assessment model (RAM) retrospectively in this study group. Our goal was to determine whether the department protocol or the Caprini score would identify venous thromboembolism (VTE) events after total joint replacement. A secondary purpose was to validate the 2013 Caprini RAM in joint arthroplasty and determine whether patients with VTE would be accurately identified using the Caprini score. A total of 1078 patients met inclusion criteria. A Caprini score of 10 or greater ...


Quantifying The Impact Of Patient-Specific Factors And Disease Severity On Clinical Decision Making In Cuff Tear Arthropathy: A Case-Based Survey, A. P. Schumaier, Y. H. Bedeir, J. S. Dines, K. Kenter, L. V. Gulotta, D. M. Dines, B. M. Grawe Jan 2019

Quantifying The Impact Of Patient-Specific Factors And Disease Severity On Clinical Decision Making In Cuff Tear Arthropathy: A Case-Based Survey, A. P. Schumaier, Y. H. Bedeir, J. S. Dines, K. Kenter, L. V. Gulotta, D. M. Dines, B. M. Grawe

Journal Articles

© 2019, The Author(s). Background: Rotator cuff tears are a common cause of disability. Some patients with massive and irreparable tears can develop cuff tear arthropathy (CTA), which makes management more challenging. Questions/Purposes: We sought to examine how orthopedists determine treatment for patients with CTA. Specifically, we investigated (1) the effect of patient age, symptoms, activity level, range of motion, and radiographic findings on the decision making of shoulder specialists and (2) the observer reliability of the Seebauer and Hamada grading systems. Methods: Five shoulder surgeons were each sent 108 simulated patient cases. Each simulated patient had a different ...


A 6-Year Trends Analysis Of Infections After Revision Total Hip Arthroplasty, P. A. Gold, L. J. Garbarino, N. Sodhi, H. K. Anis, J. O. Ehiorobo, S. M. Kurtz, J. R. Danoff, V. J. Rasquinha, C. A. Higuera, M. A. Mont Jan 2019

A 6-Year Trends Analysis Of Infections After Revision Total Hip Arthroplasty, P. A. Gold, L. J. Garbarino, N. Sodhi, H. K. Anis, J. O. Ehiorobo, S. M. Kurtz, J. R. Danoff, V. J. Rasquinha, C. A. Higuera, M. A. Mont

Journal Articles

No abstract provided.


The Effect Of Operative Time On In-Hospital Length Of Stay In Revision Total Knee Arthroplasty, L. J. Garbarino, P. A. Gold, N. Sodhi, H. K. Anis, J. O. Ehiorobo, S. Boraiah, J. R. Danoff, V. J. Rasquinha, C. A. Higuera-Rueda, M. A. Mont Jan 2019

The Effect Of Operative Time On In-Hospital Length Of Stay In Revision Total Knee Arthroplasty, L. J. Garbarino, P. A. Gold, N. Sodhi, H. K. Anis, J. O. Ehiorobo, S. Boraiah, J. R. Danoff, V. J. Rasquinha, C. A. Higuera-Rueda, M. A. Mont

Journal Articles

No abstract provided.


Full-Body Radiographic Analysis Of Postoperative Deviations From Age-Adjusted Alignment Goals In Adult Spinal Deformity Correction And Related Compensatory Recruitment., P. G. Passias, C. M. Jalai, B. G. Diebo, D. L. Cruz, G. W. Poorman, A. J. Buckland, L. M. Day, J. H. Oren, T. J. Errico, V. Lafage, +8 Additional Authors Jan 2019

Full-Body Radiographic Analysis Of Postoperative Deviations From Age-Adjusted Alignment Goals In Adult Spinal Deformity Correction And Related Compensatory Recruitment., P. G. Passias, C. M. Jalai, B. G. Diebo, D. L. Cruz, G. W. Poorman, A. J. Buckland, L. M. Day, J. H. Oren, T. J. Errico, V. Lafage, +8 Additional Authors

Journal Articles

Background: Full-body stereographs for adult spinal deformity (ASD) have enhanced global deformity and lower-limb compensation associations. The advent of age-adjusted goals for classic ASD parameters (sagittal vertical axis, pelvic tilt, spino-pelvic mismatch [PI-LL]) has enabled individualized evaluation of successful versus failed realignment, though these remain to be radiographically assessed postoperatively. This study analyzes pre- and postoperative sagittal alignment to quantify patient-specific correction against age-adjusted goals, and presents differences in compensation in patients whose postoperative profile deviates from targets.

Methods: Single-center retrospective review of ASD patients ≥ 18 years with biplanar full-body stereographic x-rays. Inclusion: ≥ 4 levels fused, complete baseline and early ...


Can Weakness In End-Range Plantar Flexion After Achilles Tendon Repair Be Prevented?, K. F. Orishimo, S. Schwartz-Balle, T. F. Tyler, M. P. Mchugh, B. B. Bedford, S. J. Lee, S. J. Nicholas Jan 2018

Can Weakness In End-Range Plantar Flexion After Achilles Tendon Repair Be Prevented?, K. F. Orishimo, S. Schwartz-Balle, T. F. Tyler, M. P. Mchugh, B. B. Bedford, S. J. Lee, S. J. Nicholas

Journal Articles

Background: Disproportionate end-range plantar flexion weakness, decreased passive stiffness, and inability to perform a heel rise on a decline after Achilles tendon repair are thought to reflect increased tendon compliance or tendon lengthening. Since this was first noted, we have performed stronger repairs and avoided stretching into dorsiflexion for the first 12 weeks after surgery.

Hypothesis: Using stronger repairs and avoiding stretching into dorsiflexion would eliminate end-range plantar flexion weakness and normalize passive stiffness.

Study Design: Case series; Level of evidence, 4.

Methods: Achilles repairs with epitendinous augmentation were performed on 18 patients. Plantar flexion torque, dorsiflexion range of motion ...


Long Head Of Biceps Tendon Management: A Survey Of The American Shoulder And Elbow Surgeons, K. T. Corpus, G. H. Garcia, J. N. Liu, D. M. Dines, S. J. O’Brien, J. S. Dines, S. A. Taylor Jan 2018

Long Head Of Biceps Tendon Management: A Survey Of The American Shoulder And Elbow Surgeons, K. T. Corpus, G. H. Garcia, J. N. Liu, D. M. Dines, S. J. O’Brien, J. S. Dines, S. A. Taylor

Journal Articles

© 2017, Hospital for Special Surgery. Background:: Management of symptomatic long head of biceps tendon (LHBT) pathology remains a source of debate. Questions/Purposes:: The purpose of this study was to identify consensus trends for the treatment of LHBT pathology among specialists. Methods:: A survey was distributed to members of the American Shoulder and Elbow Society (ASES), consisting of three sections—demographics, case scenarios, and general LHBT pathology management. Cases presented common clinical scenarios, and surgeons reported their management preferences. Consensus responses were defined as > 50% of participants giving a single response. Results:: One hundred and forty-two of 417 (34%) surgeons ...


Revision Total Shoulder Arthroplasty Is Associated With Increased Thirty-Day Postoperative Complications And Wound Infections Relative To Primary Total Shoulder Arthroplasty, V. Boddapati, M. C. Fu, W. W. Schairer, L. V. Gulotta, D. M. Dines, J. S. Dines Jan 2018

Revision Total Shoulder Arthroplasty Is Associated With Increased Thirty-Day Postoperative Complications And Wound Infections Relative To Primary Total Shoulder Arthroplasty, V. Boddapati, M. C. Fu, W. W. Schairer, L. V. Gulotta, D. M. Dines, J. S. Dines

Journal Articles

© 2017, Hospital for Special Surgery. Background: With an increasing volume of primary total shoulder arthroplasties (TSA), the number of revision TSA cases is expected to increase as well. However, the postoperative medical morbidity of revision TSA has not been clearly described. Questions/Purposes: The purpose of this study was to determine the rate of postoperative complications following revision TSA, relative to primary TSA. In addition, we sought to identify independent predictors of complications, as well as to compare operative time and postoperative length of stay between primary and revision TSA. Methods: Patients who underwent primary/revision TSA between 2005 and ...


Septic Arthritis After Anterior Cruciate Ligament Reconstruction: Clinical And Functional Outcomes Based On Graft Retention Or Removal, B. R. Waterman, W. Arroyo, E. J. Cotter, M. A. Zacchilli, E. S. Garcia, B. D. Owens Jan 2018

Septic Arthritis After Anterior Cruciate Ligament Reconstruction: Clinical And Functional Outcomes Based On Graft Retention Or Removal, B. R. Waterman, W. Arroyo, E. J. Cotter, M. A. Zacchilli, E. S. Garcia, B. D. Owens

Journal Articles

© 2018, © The Author(s) 2018. Background: There remains a debate over whether to retain the index anterior cruciate ligament (ACL) graft in the setting of septic arthritis. Purpose: To evaluate and compare clinical outcomes for the treatment of septic arthritis after ACL reconstruction (ACLR) in those with and without early graft retention. Study Design: Case series; Level of evidence, 4. Methods: The Military Health System was queried for all ACLR procedures performed between 2007 and 2013. Inclusion criteria required active military status, primary ACLR with secondary septic arthritis, and minimum 24-month surveillance. Demographic, clinical, and surgical variables were evaluated using ...


Tranexamic Acid Increases Early Perioperative Functional Outcomes After Total Knee Arthroplasty., M. J. Grosso, D. P. Trofa, J. R. Danoff, T. R. Hickernell, T. Murtaugh, A. Lakra, J. A. Geller Jan 2018

Tranexamic Acid Increases Early Perioperative Functional Outcomes After Total Knee Arthroplasty., M. J. Grosso, D. P. Trofa, J. R. Danoff, T. R. Hickernell, T. Murtaugh, A. Lakra, J. A. Geller

Journal Articles

Background: The purpose of this study was to investigate the influence of tranexamic acid (TXA) on functional outcomes in the immediate postoperative period after total knee arthroplasty (TKA). We hypothesized that the known benefits of TXA would confer measurable clinical improvements in physical therapy (PT) performance, decrease pain, and decrease hospital length of stay (LOS).

Methods: We retrospectively analyzed 560 TKA patients, including 280 consecutive patients whose surgery was performed before the initiation of a standardized TXA protocol and the first 280 patients who received TXA after protocol initiation. Outcome measurements included postoperative changes in hemoglobin and hematocrit, LOS, pain ...


Epidemiology Of Injuries In Tennis Players, M. C. Fu, T. S. Ellenbecker, P. A. Renstrom, G. S. Windler, D. M. Dines Jan 2018

Epidemiology Of Injuries In Tennis Players, M. C. Fu, T. S. Ellenbecker, P. A. Renstrom, G. S. Windler, D. M. Dines

Journal Articles

© 2018, Springer Science+Business Media, LLC, part of Springer Nature. Purpose of review: To review the recent literature regarding the epidemiology of tennis injuries at all levels of play, and to discuss recent findings in injury surveillance by the Association of Tennis Professionals (ATP). Recent findings: Following the release of a consensus statement in 2009 calling for standardized documentation and analysis of tennis-related injuries, multiple studies have been published describing longitudinal injury incidences at Grand Slam tournaments and the Davis Cup. Recent efforts by the ATP have further elucidated injury patterns on tour. There have also been recent high-quality studies ...


Arthroscopic Knotless Rotator Cuff Repair: Factors Associated With Construct Selection And Recent Trends From A Manual Review Of 1617 Cases, S. S. Shah, A. Shah, V. Chadayammuri, M. Mcgill, N. Wei, D. V. Tuckman, N. A. Sgaglione Jan 2018

Arthroscopic Knotless Rotator Cuff Repair: Factors Associated With Construct Selection And Recent Trends From A Manual Review Of 1617 Cases, S. S. Shah, A. Shah, V. Chadayammuri, M. Mcgill, N. Wei, D. V. Tuckman, N. A. Sgaglione

Journal Articles

© 2018 Prof. PK Surendran Memorial Education Foundation Purpose: Our aim was to identify predictors of construct selection and recent trends for arthroscopic knotless rotator cuff repair (RCR). Methods: A manual review of 1617 operative reports was performed. Results: A medium-sized tear had a threefold increase in odds of single row (SR) knotless repair (OR, 6.91; p = 0.009) versus SR knotted (OR, 3.05; p = 0.003). Generalist orthopaedic surgeons were 79% less likely to perform SR knotless repairs versus sports medicine trained specialists (p < 0.001). Conclusion: There was a significant increase from 2009 to 2016 in SR knotless and double row medial row knotless constructs contrasting the declining use of the SR knotted technique.


A New Method For Calculating Femoral Anterior Cortex Point Location And Its Effect On Component Sizing And Placement, M. R. Mahfouz, E. E. A. Fatah, L. Bowers, G. Scuderi Jan 2015

A New Method For Calculating Femoral Anterior Cortex Point Location And Its Effect On Component Sizing And Placement, M. R. Mahfouz, E. E. A. Fatah, L. Bowers, G. Scuderi

Journal Articles

Variation in anterior femoral cortex morphology can cause improper component placement and alignment. When surgical inaccuracies occur, the mechanical properties of the distal femur may be altered, which could result in lower surgical success rates and an increased chance of postoperative complications. The purpose of the study is to come up with a reproducible computational algorithm to simulate what the surgeon does in the operating room. This method could help in surgical preplanning, patient-specific instruments, and implant design. From there, we evaluated (1) the angular difference between reference alignment axes; and (2) whether the location of the anterior cortex point ...


Multirater Agreement Of The Causes Of Anterior Cruciate Ligament Reconstruction Failure: A Radiographic And Video Analysis Of The Mars Cohort, M. J. Matava, R. A. Arciero, K. M. Baumgarten, J. A. Hannafin, B. S. Miller, C. W. Nissen, T. N. Taft, B. R. Wolf, E. B. Hershman, R. W. Wright, +3 Additional Authors Jan 2015

Multirater Agreement Of The Causes Of Anterior Cruciate Ligament Reconstruction Failure: A Radiographic And Video Analysis Of The Mars Cohort, M. J. Matava, R. A. Arciero, K. M. Baumgarten, J. A. Hannafin, B. S. Miller, C. W. Nissen, T. N. Taft, B. R. Wolf, E. B. Hershman, R. W. Wright, +3 Additional Authors

Journal Articles

BACKGROUND: Anterior cruciate ligament (ACL) reconstruction failure occurs in up to 10% of cases. Technical errors are considered the most common cause of graft failure despite the absence of validated studies. Limited data are available regarding the agreement among orthopaedic surgeons regarding the causes of primary ACL reconstruction failure and accuracy of graft tunnel placement. HYPOTHESIS: Experienced knee surgeons have a high level of interobserver reliability in the agreement about the causes of primary ACL reconstruction failure, anatomic graft characteristics, and tunnel placement. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 3. METHODS: Twenty cases of revision ACL reconstruction were ...


Patient Expectations And Long-Term Outcomes In Rheumatoid Arthritis Patients: Results From The Sara (Silicone Arthroplasty In Rheumatoid Arthritis) Study, K. C. Chung, K. W. Nellans, P. B. Burns, E. F. S. Wilgis, F. D. Burke, D. A. Fox, H. M. Kim Jan 2015

Patient Expectations And Long-Term Outcomes In Rheumatoid Arthritis Patients: Results From The Sara (Silicone Arthroplasty In Rheumatoid Arthritis) Study, K. C. Chung, K. W. Nellans, P. B. Burns, E. F. S. Wilgis, F. D. Burke, D. A. Fox, H. M. Kim

Journal Articles

Little evidence exists to understand the influence of patient expectations on outcomes for silicone metacarpophalangeal arthroplasty (SMPA). The purpose of this paper is to compare long-term treatment outcome experiences regarding hand function/appearance for a surgical and nonsurgical cohort of rheumatoid arthritis (RA) patients and contrast them to expectations at baseline. This sample is part of a larger multicenter prospective cohort study of RA patients enrolled from 2004 to 2008. A total of 169 RA patients with severe deformities at the metacarpophalangeal (MCP) joints were recruited in the original study. Expectations for SMPA were collected at enrollment. A follow-up patient-reported ...


Cruciate-Retaining Tka Is An Option In Patients With Prior Patellectomy, K. R. Reinhardt, S. J. Huffaker, T. S. Thornhill, R. D. Scott Jan 2015

Cruciate-Retaining Tka Is An Option In Patients With Prior Patellectomy, K. R. Reinhardt, S. J. Huffaker, T. S. Thornhill, R. D. Scott

Journal Articles

The recommendation for using posterior-stabilized (PS) implants in patellectomy patients undergoing total knee arthroplasty (TKA) is based on older case series with heterogeneous patient populations. The use of cruciate-retaining implants in these patients has not been evaluated with more contemporary implant designs. The purpose of this study was to evaluate the survivorship and functional outcomes (Knee Society score, presence of an extensor lag, and range of motion) of cruciate-retaining (CR) TKA in patients with prior patellectomy. Between 1986 and 2012, we performed 27 CR TKAs in 25 patients after patellectomy. Of those, 23 CR TKAs in 21 patients were available ...


Association Of Meniscal Status, Lower Extremity Alignment, And Body Mass Index With Chondrosis At Revision Anterior Cruciate Ligament Reconstruction, R. H. Brophy, A. K. Haas, L. J. Huston, S. K. Nwosu, R. W. Wright, E. Hershman Jan 2015

Association Of Meniscal Status, Lower Extremity Alignment, And Body Mass Index With Chondrosis At Revision Anterior Cruciate Ligament Reconstruction, R. H. Brophy, A. K. Haas, L. J. Huston, S. K. Nwosu, R. W. Wright, E. Hershman

Journal Articles

BACKGROUND: Knees undergoing revision anterior cruciate ligament reconstruction (rACLR) have a high prevalence of articular cartilage lesions. HYPOTHESIS: The prevalence of chondrosis at the time of rACLR is associated with meniscal status and lower extremity alignment. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Data from the prospective Multicenter ACL Revision Study (MARS) cohort were reviewed to identify patients with preoperative lower extremity alignment films. Lower extremity alignment was defined by the weightbearing line (WBL) as a percentage of the tibial plateau width, while the chondral and meniscal status of each weightbearing compartment was recorded at the time of ...


Coping With Congenital Hand Differences, L. E. Franzblau, K. C. Chung, N. Carlozzi, A. Y. T. Chin, K. W. Nellans, J. F. Waljee Jan 2015

Coping With Congenital Hand Differences, L. E. Franzblau, K. C. Chung, N. Carlozzi, A. Y. T. Chin, K. W. Nellans, J. F. Waljee

Journal Articles

Background: Although functional outcomes following reconstruction for congenital hand differences are frequently described, much less is known regarding children's ability to cope with the psychosocial effects of these conditions. The authors qualitatively explored stress and coping mechanisms among children following reconstructive surgery for congenital hand differences. Methods: Forty patients and their parents participated in semistructured interviews examining children's stress related to hand functioning and appearance, emotional responses to stress, and coping strategies. Interviews were audiotaped, transcribed, and analyzed thematically. A consensus taxonomy for classifying content evolved from comparisons of coding by two reviewers. Themes expressed by participants were ...


Minimally Invasive Knee Arthroplasty: An Overview, A. J. Tria, G. R. Scuderi Jan 2015

Minimally Invasive Knee Arthroplasty: An Overview, A. J. Tria, G. R. Scuderi

Journal Articles

Minimally invasive surgery (MIS) for arthroplasty of the knee began with surgery for unicondylar knee arthroplasty (UKA). Partial knee replacements were designed in the 1970s and were amenable to a more limited exposure. In the 1990s Repicci popularized the MIS for UKA. Surgeons began to apply his concepts to total knee arthroplasty. Four MIS surgical techniques were developed: quadriceps sparing, mini-mid vastus, mini-subvastus, and mini-medial parapatellar. The quadriceps sparing technique is the most limited one and is also the most difficult. However, it is the least invasive and allows rapid recovery. The mini-midvastus is the most common technique because it ...


Systemic Lupus Erythematosus Is Not A Risk Factor For Poor Outcomes After Total Hip And Total Knee Arthroplasty, U. H. Shah, L. A. Mandl, C. Mertelsmann-Voss, Y. Y. Lee, M. M. Alexiades, M. P. Figgie, S. M. Goodman Jan 2015

Systemic Lupus Erythematosus Is Not A Risk Factor For Poor Outcomes After Total Hip And Total Knee Arthroplasty, U. H. Shah, L. A. Mandl, C. Mertelsmann-Voss, Y. Y. Lee, M. M. Alexiades, M. P. Figgie, S. M. Goodman

Journal Articles

OBJECTIVES: Historically, arthroplasty in systemic lupus erythematosus (SLE) patients has been less successful than for patients with osteoarthritis (OA). It is not known if SLE remains an independent risk factor for poor arthroplasty outcomes or if other factors, such as avascular necrosis (AVN), continue to play a role. METHODS: A case-control study using data from a single-institution arthroplasty registry compared SLE total hip arthroplasty (THA) and total knee arthroplasty (TKA) with OA controls matched by age, gender and presence of AVN. Baseline, two-year administrative and self-report data, and diagnosis leading to arthroplasty were evaluated. RESULTS: A total of 54 primary ...


Minimally Invasive Scoliosis Surgery: A Novel Technique In Patients With Neuromuscular Scoliosis, V. Sarwahi, T. Amaral, S. Wendolowski, R. Gecelter, M. Gambassi, C. Plakas, B. Liao, S. Kalantre, C. Katyal Jan 2015

Minimally Invasive Scoliosis Surgery: A Novel Technique In Patients With Neuromuscular Scoliosis, V. Sarwahi, T. Amaral, S. Wendolowski, R. Gecelter, M. Gambassi, C. Plakas, B. Liao, S. Kalantre, C. Katyal

Journal Articles

Minimally invasive surgery (MIS) has been described in the treatment of adolescent idiopathic scoliosis (AIS) and adult scoliosis. The advantages of this approach include less blood loss, shorter hospital stay, earlier mobilization, less tissue disruption, and relatively less pain. However, despite these significant benefits, MIS approach has not been reported in neuromuscular scoliosis patients. This is possibly due to concerns with longer surgery time, which is further increased due to more levels fused and instrumented, challenges of pelvic fixation, size and number of incisions, and prolonged anesthesia. We modified the MIS approach utilized in our AIS patients to be implemented ...


Platelet-Rich Plasma And Other Cellular Strategies In Orthopedic Surgery, P. N. Williams, G. Moran, J. P. Bradley, N. S. Elattrache, J. S. Dines Jan 2015

Platelet-Rich Plasma And Other Cellular Strategies In Orthopedic Surgery, P. N. Williams, G. Moran, J. P. Bradley, N. S. Elattrache, J. S. Dines

Journal Articles

The use of biologics in the treatment of musculoskeletal disease has become increasingly more common as research studies continue to provide further elucidation of their mechanisms in healing. Platelet-rich plasma, patches, growth factors, and stem cells are among the many biologics under active investigation and have varying levels of success in augmenting surgical or nonoperative interventions. However, the limitations of these treatments exist, and clear guidelines for their indications and application have yet to be established. Well-designed clinical trials will help determine the appropriate future use of biologics to ensure consistent outcomes.


Pregabalin And Pain After Total Knee Arthroplasty: A Double-Blind, Randomized, Placebo-Controlled, Multidose Trial, J. T. Yadeau, Y. Lin, D. J. Mayman, E. A. Goytizolo, M. M. Alexiades, D. E. Padgett, K. G. Fields, A. K. Goon, J. Curren, G. H. Westrich, +4 Additional Authors Jan 2015

Pregabalin And Pain After Total Knee Arthroplasty: A Double-Blind, Randomized, Placebo-Controlled, Multidose Trial, J. T. Yadeau, Y. Lin, D. J. Mayman, E. A. Goytizolo, M. M. Alexiades, D. E. Padgett, K. G. Fields, A. K. Goon, J. Curren, G. H. Westrich, +4 Additional Authors

Journal Articles

BACKGROUND: Pregabalin may reduce postoperative pain and opioid use. Higher doses may be more effective, but may cause sedation and confusion. This prospective, randomized, blinded, placebo-controlled study tested the hypothesis that pregabalin reduces pain at 2 weeks after total knee arthroplasty, but increases drowsiness and confusion. METHODS: Patients (30 per group) received capsules containing pregabalin (0, 50, 100, or 150 mg); two capsules before surgery, one capsule twice a day until postoperative day (POD) 14, one on POD15, and one on POD16. Multimodal analgesia included femoral nerve block, epidural analgesia, oxycodone-paracetamol, and meloxicam. The primary outcome was pain with flexion ...


Comorbid Profile Rather Than Age Determines Hip Fracture Mortality In A Nonagenarian Population, A. Graver, S. Merwin, L. Collins, N. Kohn, A. Goldman Jan 2015

Comorbid Profile Rather Than Age Determines Hip Fracture Mortality In A Nonagenarian Population, A. Graver, S. Merwin, L. Collins, N. Kohn, A. Goldman

Journal Articles

BACKGROUND: In light of poor outcomes with nonoperative management of hip fractures, orthopedic surgeons are faced with difficult decisions about which patients are too ill or too old for surgical treatment. QUESTIONS/PURPOSES: This study sought to investigate if patients over 90 years had different preoperative laboratory, clinical, and injury characteristics than younger patients with the same injury. We compared our cohort with previously published data. We wished to identify if there were pre-injury risk factors associated with 30-day mortality, which could be modified to enhance postoperative outcomes. METHODS: This is a retrospective review of 198 operatively managed hip fractures ...


Shoulder Arthroplasty: Return To Sport, M. M. Khair, J. S. Dines, D. M. Dines Jan 2015

Shoulder Arthroplasty: Return To Sport, M. M. Khair, J. S. Dines, D. M. Dines

Journal Articles

CONTEXT: Increasingly, total shoulder arthroplasty is being performed not only to treat the pain associated with glenohumeral arthritis but also to return patients to the level of activity and function they enjoyed prior to the development of arthritis. While return to sport and activity have been studied in the total knee and total hip replacement literature, it is only relatively recently that the same focus has been placed on total shoulder replacements. EVIDENCE ACQUISITION: PubMed database from the years 2000 to 2014. All studies relevant to shoulder arthroplasty and return to sport were included in the review. STUDY DESIGN: Clinical ...


Biologics In Achilles Tendon Healing And Repair: A Review, E. Shapiro, D. Grande, M. Drakos Jan 2015

Biologics In Achilles Tendon Healing And Repair: A Review, E. Shapiro, D. Grande, M. Drakos

Journal Articles

Injuries of the Achilles tendon are relatively common with potentially devastating outcomes. Healing Achilles tendons form a fibrovascular scar resulting in a tendon which may be mechanically weaker than the native tendon. The resulting strength deficit causes a high risk for reinjury and other complications. Treatments using biologics aim to restore the normal properties of the native tendon and reduce the risk of rerupture and maximize tendon function. The purpose of this review was to summarize the current findings of various therapies using biologics in an attempt to improve the prognosis of Achilles tendon ruptures and tendinopathies. A PubMed search ...