Orthopedics Commons^™

Arthroscopic Treatment Of Shoulder Stiffness With Rotator Cuff Repair Yields Similar Outcomes To Isolated Rotator Cuff Repair, Parker L. Brush, Adrian Santana, Ruchir Nanavati, Gregory R. Toci, Tariq Z. Issa, Daniel J. Fletcher, Joshua Hornstein

Rothman Institute Papers

Purpose To compare patient-reported and surgical outcome measures in patients with and without secondary shoulder stiffness (SSS) undergoing rotator cuff repair (RCR).

Methods Patients undergoing rotator cuff repair from 2014 to 2020 with complete patient-reported outcome measures (PROMs) by the short-form 12 survey (SF-12) were retrospectively reviewed to identify if operative intervention for SSS was performed alongside the RCR. Those patients with operative intervention for SSS were propensity matched to a group without prior intervention for stiffness by age, sex, laterality, body mass index, diabetes mellitus status, and the presence of a thyroid disorder. The groups were compared by rotator …

Utility Of Seated Lateral Radiographs In The Diagnosis And Classification Of Lumbar Degenerative Spondylolisthesis, Tariq Z. Issa, Yunsoo Lee, Emily Berthiaume, Mark J. Lambrechts, Caroline Zaworski, Qudratallah S. Qadiri, Henley Spracklen, Richard Padovano, Jackson Weber, John J. Mangan, Jose A, Canseco, Barrett I. Woods, I. David Kaye, Alan S. Hilibrand, Christopher K. Kepler, Alexander R. Vaccaro, Gregory D. Schroeder, Joseph K. Lee

Rothman Institute Papers

STUDY DESIGN: Retrospective cohort study.

PURPOSE: Our goal was to determine which radiographic images are most essential for degenerative spondylolisthesis (DS) classification and instability detection.

OVERVIEW OF LITERATURE: The heterogeneity in DS requires multiple imaging views to evaluate vertebral translation, disc space, slip angle, and instability. However, there are several restrictions on frequently used imaging perspectives such as flexion-extension and upright radiography.

METHODS: We assessed baseline neutral upright, standing flexion, seated lateral radiographs, and magnetic resonance imaging (MRI) for patients identified with spondylolisthesis from January 2021 to May 2022 by a single spine surgeon. DS was classified by Meyerding and …

Enough Is Enough: Salvage Procedures In Severe Periprosthetic Joint Infection, Yves Gramlich, Javad Parvizi

Rothman Institute Papers

Background

In severe cases of periprosthetic joint infection involving negative host-dependent factors, individual-based decisions between a curative therapy vs. salvage procedure are necessary. We aimed to review salvage procedures in severe periprosthetic joint infection cases, where a gold standard of a curative two-stage exchange can no longer be achieved. The options of knee arthrodesis, amputation, persistent fistula (stable drainage), or a debridement, antibiotics, and implant retention procedure in late-onset cases are discussed, including lifelong antibiotic suppression alone.

Methods

We focused on known salvage procedures for severe periprosthetic joint infection of the hip and knee, such as amputation, arthrodesis, antibiotic …

Validation Of The Hierarchical Nature Of The Ao Spine Sacral Classification And The Development Of The Sacral Ao Spine Injury Score, Brian A. Karamian, Gregory D. Schroeder, Mark J. Lambrechts, Jose A. Canseco, Emiliano N. Vialle, Frank Kandziora, Lorin M. Benneker, Rajasekaran Shanmuganathan, F. Cumhur Öner, Klaus J. Schnake, Christopher K. Kepler, Alexander R. Vaccaro

Rothman Institute Papers

STUDY DESIGN: Global cross-sectional survey.

OBJECTIVE: The objective of this study was to validate the hierarchical nature of the AO Spine Sacral Classification System and develop an injury scoring system.

SUMMARY OF BACKGROUND DATA: Although substantial interobserver and intraobserver reliability of the AO Spine Sacral Classification System has been established, the hierarchical nature of the classification has yet to be validated.

METHODS: Respondents numerically graded each variable within the classification system for severity. Based on the results, a Sacral AO Spine Injury Score (AOSIS) was developed.

RESULTS: A total of 142 responses were received. The classification exhibited a hierarchical Injury …

Bibliometric Analysis Of Spinopelvic Alignment In Total Hip Arthroplasty, Samantha Harrer, Justin A. Magnuson, Gregory R. Toci, Andrew M. Star, Arjun Saxena

Rothman Institute Papers

INTRODUCTION: Postoperative dislocation of unclear etiology remains a concern after total hip arthroplasty (THA). Interest is growing in the importance of spinopelvic alignment on stability in THA. The purpose of this study was to analyze publication trends, areas of interest, and future research direction of spinopelvic alignment in THA.

METHODS: Articles on the topic of spinopelvic alignment in THA published between 1990 and 2022 were obtained through Web of Science Core Collection of Clarivate Analytics (WSCCA). Results were screened by title, abstract, and full text. The inclusion criterion was English-language peer-reviewed journal publications on the clinical topic of spinopelvic alignment …

Diagnosis Of Periprosthetic Joint Infection: The Utility Of Biomarkers In 2023, Mehmet Kursat Yilmaz, Ahmad Abbaszadeh, Saad Tarabichi, Ibrahim Azboy, Javad Parvizi

Rothman Institute Papers

Periprosthetic joint infection (PJI) is a rare yet devastating complication following total joint arthroplasty (TJA). Early and accurate diagnosis of PJI is paramount in order to maximize the chances of successful treatment. However, we are yet to identify a single “gold standard” test for the diagnosis of PJI. As a result, the diagnosis of PJI is often challenging. Currently, the 2018 ICM definition of PJI is the only validated diagnostic criteria available. This article will review the importance of serum and synovial biomarkers in the diagnosis of PJI. In addition, it will provide a brief overview of the emerging modalities …

Reasons For Transfer And Subsequent Outcomes Among Patients Undergoing Elective Spine Surgery At An Orthopedic Specialty Hospital, Tristan B. Fried, Yunsoo Lee, Jeremy C. Heard, Nicholas S. Siegel, Tariq Z. Issa, Mark J. Lambrechts, Caroline Zaworski, Jasmine Wang, Taylor D'Amore, Amit Syal, Charles Lawall, John J. Mangan, Jose A. Canseco, Barrett I. Woods, Alan S. Hilibrand, Alex R. Vaccaro, Christopher K. Kepler, Gregory D. Schroeder

Rothman Institute Papers

Objective:

To evaluate the reasons for transfer as well as the 90-day outcomes of patients who were transferred from a high-volume orthopedic specialty hospital (OSH) following elective spine surgery.

Materials and Methods:

All patients admitted to a single OSH for elective spine surgery from 2014 to 2021 were retrospectively identified. Ninety-day complications, readmissions, revisions, and mortality events were collected and a 3:1 propensity match was conducted.

Results:

Thirty-five (1.5%) of 2351 spine patients were transferred, most commonly for arrhythmia (n = 7; 20%). Thirty-three transferred patients were matched to 99 who were not transferred, and groups had similar rates …

Osteoporosis In The Setting Of Shoulder Arthroplasty: A Narrative Review, Mohammad Daher, Mohamad Fares, Peter Boufadel, Akshay Khanna, Ziad Zalaquett, Joseph A. Abboud

Rothman Institute Papers

Patients who undergo shoulder surgery are frequently affected by osteoporosis and osteopenia, and the prevalence of this association is expected to increase due to the growing number of elderly individuals undergoing these procedures. It may be advisable to conduct a preoperative DXA scan for orthopedic surgical candidates at high risk, to detect those who could benefit from early intervention and avoid any related adverse events. Some of these complications include periprosthetic fractures, infection, subsequent fragility fractures, and have an all-cause revision arthroplasty at 2 years post-op. Some studies analyzed the beneficence of antiresorptive medications pre-operatively but the latter did not …

The Dome Technique For Managing Massive Anterosuperior Medial Acetabular Bone Loss In Revision Total Hip Arthroplasty: Short-Term Outcomes, Tyler J. Humphrey, Colin M. Baker, P. M. Courtney, Wayne G. Paprosky, Hany S. Bedair, Neil P. Sheth, Christopher M. Melnic

Rothman Institute Papers

PURPOSE: The dome technique is a technique used in performance of revision total hip arthroplasty (THA) involving intraoperative joining of two porous metal acetabular augments to fill a massive anterosuperior medial acetabular bone defect. While excellent outcomes were achieved using this surgical technique in a series of three cases, short-term results have not been reported. We hypothesized that excellent short-term clinical and patient reported outcomes could be achieved with use of the dome technique.

MATERIALS AND METHODS: A multicenter case series was conducted for evaluation of patients who underwent revision THA using the dome technique for management of Paprosky 3B …

Intracept Technique At Adjacent Levels To Fusions With Pedicle Screws, David Stolzenberg, Paul Kitei, David Tran, Ryan Pfeifer

Rothman Institute Papers

No abstract provided.

A Comparison Of Radiographic Alignment Between Bilateral And Unilateral Interbody Cages In Patients Undergoing Transforaminal Lumbar Interbody Fusion, Mark J. Lambrechts, Jeremy Heard, Nicholas D. D'Antonio, John Bodnar, Gregory Schroeder, Evan Bloom, Jose Canseco, Barrett Woods, Ian David Kaye, Mark Kurd, Jeffrey Rihn, Alan Hilibrand, Gregory D. Schroeder, Alex R. Vaccaro, Christopher Kepler

Rothman Institute Papers

Study Design

Purpose:

Overview of Literature

Methods:

Incidence, Risk Factors, And Outcomes Of Incidental Durotomy During Lumbar Spine Decompression With Or Without Fusion, Gregory Toci, Mark James Lambrechts, Tariq Issa, Brian A. Karamian, Nicholas Siegel, Nicholas D'Antonio, Jose Canseco, Mark Kurd, Barrett Woods, Ian D. Kaye, Alan Hilibrand, Christopher K. Kepler, Alexander Vaccaro, Gregory Schroeder

Rothman Institute Papers

STUDY DESIGN: Retrospective cohort study.

PURPOSE: The primary objective of this study was to determine the incidence and risk factors for incidental durotomies during lumbar decompression surgeries. In addition, we aimed to determine the changes in patient-reported outcome measures (PROMs) based on incidental durotomy status.

OVERVIEW OF LITERATURE: There is limited literature investigating the affect of incidental durotomy on patient reported outcome measures. While the majority of research does not suggest differences in complications, readmission, or revision rates, many studies rely on public databases, and their sensitivity and specificity for identifying incidental durotomies is unknown.

METHODS: Patients undergoing lumbar decompression …

Treatment Of Angular Deformity And Limb Length Discrepancy With A Retrograde Femur Magnetic Intramedullary Nail: A Fixator-Assisted, Blocking Screw Technique, Erik J. Geiger, Adam D Geffner, S Robert Rozbruch, Austin T Fragomen

Rothman Institute Papers

Background: Fixator-assisted nailing techniques that incorporate magnetic internal lengthening nails (MILNs) permit acute deformity correction and then gradual limb lengthening without needing postoperative external fixators.

Purposes: We sought to investigate the safety and accuracy of a fixator-assisted, blocking screw technique using retrograde MILNs for the correction of LLD and limb malalignment.

Methods: Forty-one patients (13 patients with genu varum and 28 patients with genu valgum) with LLD treated with fixator-assisted, blocking screw retrograde MILN reconstruction were included. Preoperative LLD, mechanical axis deviation, and joint orientation angles were compared with values at the end of treatment, and bone healing indices were …

Inpatient Opioid Use Varies By Construct Length Among Laminoplasty Versus Laminectomy And Fusion Patients, Harry M. Lightsey, Peter J. Georgakas, Matthew H. Lindsey, Caleb M. Yeung, Joseph H. Schwab, Harold A. Fogel, Stuart H. Hershman, Daniel G. Tobert, Kevin M. Hwang

Rothman Institute Papers

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.

METHODS: Sociodemographic information, surgical and hospitalization data, and medication administration records were abstracted for patients >18 years of age who underwent LP or LF for DCM in the Mass General Brigham (MGB) health system between 2017 and …

Publication Rates Of Abstracts Presented Across 6 Major Spine Specialty Conferences, Tariq Z. Issa, Yunsoo Lee, Mark J. Lambrechts, Christopher Reynolds, Ryan Cha, James Kim, Jose A. Canseco, Alex R. Vaccaro, Christopher K. Kepler, Gregory D. Schroeder, Alan S. Hilibrand

Rothman Institute Papers

Background: Although scientific researchers aim to present their projects at academic conferences as a step toward publication, not all projects mature to become a peer-reviewed manuscript. The publication rate of meetings can be utilized to assess the quality of presented research. Our objective was to evaluate the contemporary publication rate of abstracts presented at spine conferences.

Methods: We reviewed annual meeting programs of North American Spine Society (NASS), Scoliosis Research Society (SRS), International Meeting on Advanced Spine Techniques (IMAST), Spine Global Spine Congress (GSC), Lumbar Spine Research Society (LSRS), and Cervical Spine Research Society (CSRS) from 2017 to 2019. Abstracts …

Does Prehabilitation Before Surgery Affect Return To Sport In Baseball Pitchers With Partial Ulnar Collateral Ligament Tears?, Kourtney Snigar, Ryan W. Paul, Joshua M. Spada, Usman Zareef, Anya Hall, Brandon J. Erickson, Michael G. Ciccotti, Stephen J. Thomas

Rothman Institute Papers

BACKGROUND: Purposeful rehabilitation before surgery (prehabilitation) has been researched and implemented in the treatment of anterior cruciate ligament tears. However, it is unclear whether prehabilitation would affect outcomes for baseball pitchers with partial ulnar collateral ligament (UCL) tears.

PURPOSE/HYPOTHESIS: The purpose of this study was to determine whether baseball pitchers with partial UCL tears who completed ≥4 weeks of prehabilitation (prehab group) have different return to play (RTP) outcomes than pitchers with 0 to 3 weeks of preoperative physical therapy (no prehab group). We hypothesized that pitchers in the prehab group would have similar RTP rates compared with pitchers in …

Differences In The Academic Attributes Of Matched And Unmatched Orthopaedic Surgery Residency Applicants Are Narrowing, Suleiman Y. Sudah, Nareena Imam, Francis Sirch, Allen D. Nicholson, Surena Namdari, Mariano E. Menendez

Rothman Institute Papers

Background: Orthopaedic surgery remains one of the most competitive residency specialties, with the number of applicants outpacing the availability of residency positions each year. The purpose of this study was to analyze present-day orthopaedic surgery match data, identify differences between matched and unmatched applicants, and compare our findings to previous trends.

Methods: Applicant data from the National Resident Matching Program from 2016 to 2022 were analyzed. The number of matched and unmatched US allopathic senior orthopaedic applicants relative to the number of available positions was used to determine respective match rates. Performance metrics and applicant characteristics were compared by match …

Prevention Of Surgical Site Infection: A Ten-Step Approach, Saad Tarabichi, Javad Parvizi

Rothman Institute Papers

Surgical site infection (SSI) is a common cause of morbidity and mortality in patients undergoing surgery. Similarly, periprosthetic joint infection (PJI), is a major cause of failure after total joint arthroplasty (TJA). As the annual volume of TJA procedures is projected to rise, so will the rate of subsequent SSI and PJI. Currently, prevention has been identified as the single most important strategy for combating SSI/PJI. Hence, the present article will serve as a summary of an evidence-based ten-step approach for SSI/PJI prevention that may help orthopedic surgeons with their infection prevention strategies.

Effect Of Drain Duration And Output On Perioperative Outcomes And Readmissions After Lumbar Spine Surgery, Brian A. Karamian, Parth Kothari, Gregory R. Toci, Mark J. Lambrechts, Jose A. Canseco, Jennifer Mao, Raj Narayan, Sammy Alfonsi, Francis Sirch, Nadim Kheir, Nicholas Semenza, Barrett I. Woods, Jeffrey A. Rihn, Mark Kurd, Kris Radcliff, I David Kaye, Alan S. Hilibrand, Christopher K. Kepler, Alex R. Vaccaro, Gregory D. Schroeder

Rothman Institute Papers

Study design: Single-center retrospective cohort.

Purpose: To compare surgical outcomes of patients based on lumbar drain variables relating to output and duration.

Overview of literature: The use of drains following lumbar spine surgery, specifically with respect to hospital readmission, postoperative hematoma, postoperative anemia, and surgical site infections, has been controversial.

Methods: Patients aged ≥18 years who underwent lumbar fusion with a postoperative drain between 2017 and 2020 were included and grouped based on hospital readmission status, last 8-hour drain output (<40 mL cutoff), or drain duration (2 days cutoff). Total output of all drains, total output of the primary drain, drain duration in days, drain output per day, last 8-hour output, penultimate 8-hour output, and last 8-hour delta (last 8-hour output subtracted by penultimate 8-hour output) were collected. Continuous and categorical data were compared between groups. Multivariate logistic regression analysis and receiver operating characteristic (ROC) analysis were performed to determine whether drain variables can predict hospital readmission, postoperative blood transfusions, and postoperative anemia. Alpha was 0.05.

Results: Our cohort consisted of 1,166 patients with 111 (9.5%) hospital readmissions. Results of regression analysis did not identify …

Serotonin Reuptake Inhibitor Increases Pseudarthrosis Rates In Anterior Cervical Discectomy And Fusions, Mark J. Lambrechts, Nicholas D. D'Antonio, Gregory R R. Toci, Brian A. Karamian, Josuhu Pezzulo, Dominic Farronato, Jose Canseco, Ian David Kaye, Barrett Woods, Jeffrey A. Rihn, Mark Kurd, Joseph K. Lee, Md, Alan S. Hilibrand, Christopher K. Kepler, Alexander R. Vaccaro, Gregory D. Schroeder

Rothman Institute Papers

STUDY DESIGN: Retrospective cohort.

PURPOSE: To determine (1) the effects of serotonin reuptake inhibitors in pseudarthrosis rates after anterior cervical decompression and fusion (ACDF) and (2) to identify patient-reported outcome measures in patients taking serotonin reuptake inhibitors.

OVERVIEW OF LITERATURE: Recent literature suggests that selective serotonin reuptake inhibitors (SSRIs) may inhibit fracture healing via downregulation of osteoblast differentiation. Spinal fusion supplementation with osteoblast-rich substances enhances spinal fusion, thus SSRIs may be detrimental.

METHODS: Patients with 1-year postoperative dynamic cervical spine radiographs following ACDF were grouped into serotonin reuptake inhibitor prescriptions (SSRI, serotonin-norepinephrine reuptake inhibitor [SNRI], or tricyclic antidepressant [TCA]) and …

Evaluation And Treatment Of Postoperative Periprosthetic Humeral Fragility Fractures, Evangeline F. Kobayashi, Surena Namdari, Mara Schenker, George S. Athwal, Jaimo Ahn

Rothman Institute Papers

Postoperative periprosthetic humeral shaft fractures represent a growing and difficult complication to treat given the aging patient population and associated bone loss. Determining the best treatment option is multifactorial, including patient characteristics, fracture pattern, remaining bone stock, and implant stability. Possible treatment options include nonoperative management with bracing or surgical intervention. Nonoperative treatment has been shown to have higher nonunion rates, thus should only be selected for a specific patient population with minimally displaced fractures or those that are unfit for surgery. Surgical management is recommended with prosthetic loosening, fracture nonunion, or failure of nonoperative treatment. Surgical options include open …

Direct Anterior Versus Direct Lateral Hip Approach In Total Hip Arthroplasty With The Same Perioperative Protocols One Year Post Fellowship Training, Asim M. Makhdom, William J. Hozack

Rothman Institute Papers

BACKGROUND: Variable results have been reported regarding the clinical outcomes in Total hip arthroplasty (THA) based on the surgical approach. The aim of this study is to compare the clinical outcomes between Direct anterior (DA) and direct lateral (DL) approaches in THA when performed immediately after fellowship training.

METHODS: During the 1st year of practice, all consecutive patients who underwent THA via DA and DL hip approaches were retrospectively investigated. Patients' demographics, diagnosis, American society of Anesthesiology (ASA) score, route of anesthesia, length of hospital stay (LOS), leg length discrepancy (LLD), radiographic parameters, operative time, number of opioids refills postoperatively, …

Nationwide Results Of Microorganism Antigen Testing As A Component Of Preoperative Synovial Fluid Analysis., Krista O'Shaughnessey Toler, Pearl Ravindra Paranjape, Alex Mclaren, Brett Levine, Alvin Ong, Carl Deirmengian

Rothman Institute Papers

BACKGROUND: Antigen immunoassays to detect synovial fluid (SF) microorganisms have recently been made available for clinical use. The purpose of this study was to determine the sensitivity and specificity of an SF microorganism antigen immunoassay detection (MID) panel, evaluate the panel's capability to detect microorganisms in the setting of culture-negative periprosthetic joint infection (PJI), and determine diagnostic predictive values of the MID panel for PJI.

METHODS: This study included 67,441 SF samples obtained from a hip or knee arthroplasty, from 2,365 institutions across the United States, submitted to 1 laboratory for diagnostic testing. All data were prospectively compiled and then …

Surgeon Estimations Of Acetabular Cup Orientation Using Intraoperative Fluoroscopic Imagining Are Unreliable., Parker L Brush, Adrian Santana, Gregory R Toci, Eric Slotkin, Michael Solomon, Tristan Jones, Arjun Saxena

Rothman Institute Papers

BACKGROUND: Accurate acetabular cup orientation is associated with decreased revision rates and improved outcomes of primary total hip arthroplasty. This study assesses surgeon's ability to estimate both the acetabular component inclination and anteversion angles via intraoperative fluoroscopy (IF) images.

METHODS: We surveyed orthopedic surgeons to estimate acetabular component inclination and anteversion based on 20 IF images of total hip arthroplasty through a direct anterior approach. Postoperative computed-tomography scans were used to calculate the true inclination and anteversion component angles. The absolute difference between the true and estimated values was calculated to determine the mean and standard deviation of the survey …

Open Posterior Reduction And Stabilization Of Ao Spine C3 Sacral Fractures, Philipp Kobbe, Gregory D. Schroeder, Klaus J. Schnake, Lorin M. Benneker, Mark Lambrechts, Frank Hildebrand, Richard M. Sellei

Rothman Institute Papers

AO Spine C3 sacral fractures are defined by separation of the spine including S1 from the pelvic ring and are usually result of a high-energy injury. Besides their high biomechanical instability and high rate of associated neurological impairment, these fractures are often extremely difficult to reduce due to severe bony impaction and dislocation. Additional difficulties in management of these fractures arise from only a thin-layer of soft-tissue coverage overlying the injured area.

Analysis Of Orthopaedic In-Training Examination Trauma Questions: 2017 To 2021, Lilah Fones, Daryl C. Osbahr, Daniel E. Davis, Andrew M. Star, Atif K. Ahmed, Arjun Saxena

Rothman Institute Papers

INTRODUCTION: The Orthopaedic In-Training Examination (OITE) is a multiple-choice examination developed by the American Academy of Orthopaedic Surgeons annually since 1963 to assess orthopaedic residents' knowledge. This study's purpose is to analyze the 2017 to 2021 OITE trauma questions to aid orthopaedic residents preparing for the examination.

METHODS: The 2017 to 2021 OITEs on American Academy of Orthopaedic Surgeons' ResStudy were retrospectively reviewed to identify trauma questions. Question topic, references, and images were analyzed. Two independent reviewers classified each question by taxonomy.

RESULTS: Trauma represented 16.6% (204/1,229) of OITE questions. Forty-nine percent of trauma questions included images (100/204), 87.0% (87/100) …

Associating Outcomes After Hip Arthroscopy With Patient Resilience, Patrick F Szukics, Peters Otlans, Matthew Meade, Jeffrey Lynch, John P. Salvo

Rothman Institute Papers

Background: Higher patient resilience has been shown to be associated with improved patient-reported outcome measures (PROMs) at 6 months after hip arthroscopy.

Purpose: To examine the relationship between patient resilience and PROMs at minimum 2 years after hip arthroscopy.

Study design: Cross-sectional study; Level of evidence, 3.

Methods: Included were 89 patients (mean age, 36.9 years; mean follow-up, 4.6 years). Patient demographics, surgical details, and preoperative International Hip Outcome Tool-12 (iHOT-12) and visual analog scale (VAS) pain scores were collected retrospectively. Postoperative variables were collected via a survey and included the Brief Resilience Scale (BRS), Patient Activation Measure-13 (PAM-13), Pain …

One-Stage Synovectomies Result In Improved Short-Term Outcomes Compared To Two-Stage Synovectomies Of Diffuse-Type Tenosynovial Giant Cell Tumor (D-Tgct) Of The Knee: A Multicenter, Retrospective, Cohort Study, Geert Spierenburg, Floortje G M Verspoor, Jay S Wunder, Anthony M Griffin, Peter C Ferguson, Matthew T Houdek, David M King, Richard Boyle, Robert Lor Randall, Steven W Thorpe, Jacob I Priester, Erik J Geiger, Lizz Van Der Heijden, Nicholas M Bernthal, Bart H W B Schreuder, Hans Gelderblom, Michiel A J Van De Sande

Rothman Institute Papers

Diffuse-type tenosynovial giant cell tumors' (D-TGCTs) intra- and extra-articular expansion about the knee often necessitates an anterior and posterior surgical approach to facilitate an extensive synovectomy. There is no consensus on whether two-sided synovectomies should be performed in one or two stages. This retrospective study included 191 D-TGCT patients from nine sarcoma centers worldwide to compare the postoperative short-term outcomes between both treatments. Secondary outcomes were rates of radiological progression and subsequent treatments. Between 2000 and 2020, 117 patients underwent one-stage and 74 patients underwent two-stage synovectomies. The maximum range of motion achieved within one year postoperatively was similar (flexion …

Analyses Of Orthopaedic Surgery Residency Interviews, Alexander J Adams, Matthew Sherman, James J. Purtill

Rothman Institute Papers

Interviews are a critical component of orthopaedic surgery residency selection for both the applicant and the program. Some institutions no longer report Alpha Omega Alpha (AOA) designation or class rank, and US Medical Licensing Examination (USMLE) Step 1 recently switched to pass/fail scoring. During the coronavirus disease 2019 (COVID-19) pandemic, all Accreditation Council for Graduate Medical Education programs conducted virtual interviews and subinternship rotations were restricted. These changes offer significant challenges to the residency match process. The purpose of this study was to examine the residency applicant interview and ranking process at a large urban academic university setting. We hypothesized …

Total Hip Arthroplasty In The Setting Of Post-Traumatic Arthritis Following Acetabular Fracture: A Systematic Review, Conor S O'Driscoll, Martin S Davey, Andrew J Hughes, John M O'Byrne, Michael Leonard, Brendan J O'Daly

Rothman Institute Papers

Background: Acetabular fractures are frequently associated with post-traumatic arthritis (PTA), for which total hip arthroplasty (THA) has emerged as the established procedure. The purpose of this systematic review is to report the patient outcomes, complications, and implant survival of delayed THA for patients with PTA following acetabular fracture.

Methods: A systematic review was performed in December 2021 as per Preferred Reporting Items for Systematic Review and Meta-Analysis Guidelines to identify all studies reporting outcomes of delayed THA performed for PTA with a history of acetabular fracture. From an initial screen of 893 studies, 29 studies which met defined inclusion criteria …