Cerebral Oxygenation in the Sitting Position Is Not Compromised During Spontaneous or Positive-Pressure Ventilation
ConclusionsThere were no signs of inadequate brain perfusion during general anesthesia using paralytic agents. Positive-pressure ventilation with moderate hypotension in the sitting position does not endanger patients, in the context of moderate hypercapnia and hemodynamic support using ephedrine or epinephrine. (Source: HSS Journal)
Source: HSS Journal - November 9, 2018 Category: Orthopaedics Source Type: research
Scaphoid Fracture Repair Does Not Significantly Diminish Short-Term Participation in the National Football League
ConclusionsAthletes with a history of scaphoid repair are not at significant risk for diminished participation during their first season in the NFL. (Source: HSS Journal)
Source: HSS Journal - November 5, 2018 Category: Orthopaedics Source Type: research
Improvement in Residents ’ Attitudes Toward Individuals with Substance Use Disorders Following an Online Training Module on Stigma
ConclusionResidents ’ attitudes toward individuals with SUDs improved after taking an online training module. This is encouraging, as studies have shown that attitudes toward individuals with SUDs tend to decline during residency training and negatively affect patient care. Larger studies are needed to determine if s uch online modules can improve attitudes of other groups of clinicians, result in sustained change over time, and improve patient outcomes. (Source: HSS Journal)
Source: HSS Journal - November 1, 2018 Category: Orthopaedics Source Type: research
A Novel Mobile Phone Text Messaging Platform Improves Collection of Patient-Reported Post-operative Pain and Opioid Use Following Orthopedic Surgery
ConclusionsThis application of a widely available technology can improve the measurement of post-operative patient-reported outcomes. Such data can in turn be used in the development of strategies to reduce post-operative opioid use. The adoption of novel technologies at a patient level will play a key role in combating the opioid epidemic. (Source: HSS Journal)
Source: HSS Journal - October 22, 2018 Category: Orthopaedics Source Type: research
Correction to: Patient and Surgeon Expectations Prior to Anterior Cruciate Ligament Reconstruction
The degree of author Hassan Ghomrawi was listed incorrectly in the original article. It is correct here. (Source: HSS Journal)
Source: HSS Journal - October 19, 2018 Category: Orthopaedics Source Type: research
Use of a Prescription Drug-Monitoring Program by Emergency and Surgical Prescribers: Results of a Hospital Survey
ConclusionAcute-care prescribers at our institution are universally aware of the opioid epidemic, but efficient and useful tools for identifying at-risk patients are lacking. Our prescribers desired an alert system integrated into the EMR to highlight targeted risk factors. (Source: HSS Journal)
Source: HSS Journal - October 17, 2018 Category: Orthopaedics Source Type: research
Opioid-Free Total Knee Arthroplasty? Local Infiltration Analgesia Plus Multimodal Blood-Loss Prevention Make it Possible
AbstractOpioids have been widely used in the USA for pain control after total knee arthroplasty (TKA). However, adverse effects, especially the possibility of addiction, have increased interest in opioid-free pain management after surgery. We therefore sought to review current pain management protocols after TKA, focusing especially on opioid-free alternatives. We reviewed the literature on pain management after TKA using Medline (PubMed), through June 30, 2018, using the keywords “TKA” and “analgesia.” We found 388 articles but chose to analyze the 34 that presented high-quality (levels I and II) evidence. Local i...
Source: HSS Journal - October 15, 2018 Category: Orthopaedics Source Type: research
Carbon-Fiber-Reinforced Polymer Intramedullary Nails Perform Poorly in Long-Bone Surgery
ConclusionsThe use of the CFR polymer IM nail was associated with loss of fixation and nonunion after surgeries that have traditionally healed uneventfully. The increased elasticity of the CFR polymer allows for more motion at the osteotomy/fracture interface than the stiffer titanium counterparts, exposing long-bone osteotomies to delayed union and nonunion, a finding seen with CFR polymer plates. The overwhelmingly poor early results of this device applied to a long-bone deformity practice have led these authors to abandon the use of this implant. (Source: HSS Journal)
Source: HSS Journal - October 12, 2018 Category: Orthopaedics Source Type: research
Damage to or Injury of the Distal Semitendinosus Tendon During Sporting Activities: A Systematic Review
ConclusionIsolated, complete distal semitendinosus tears and avulsions remain infrequently reported during sporting activities and, in this review, occurred predominantly during non-contact activity. Athletes treated conservatively were found to return to sport more quickly, although additional studies are needed to determine the clinical relevance of treatment option, tear location, and concurrent injuries. (Source: HSS Journal)
Source: HSS Journal - October 11, 2018 Category: Orthopaedics Source Type: research
Institutional Guidelines Can Decrease the Amount of Opioids Prescribed After Total Joint Replacement
ConclusionAn institutional guideline for opioid prescribing after total joint arthroplasty significantly reduced the number of pills prescribed to patients without causing a significant increase in the number of phone calls to the service. (Source: HSS Journal)
Source: HSS Journal - October 1, 2018 Category: Orthopaedics Source Type: research
A New Preoperative Planning Technique Can Reduce Radiation Exposure During the Performance of Medial Opening-Wedge High Tibial Osteotomy
ConclusionsThis new preoperative planning technique achieves similar accuracy of the lateral bone hinge when compared to current methods but exposes the patient, surgeon, and staff to significantly less intraoperative radiation. (Source: HSS Journal)
Source: HSS Journal - October 1, 2018 Category: Orthopaedics Source Type: research
Has Tranexamic Acid in Total Knee Arthroplasty Made Tourniquet Use Obsolete?
AbstractThe application of tranexamic acid (TXA) in total joint arthroplasty has dramatically improved peri-operative blood management. In light of these benefits, a study by Huang et al., “Intravenous and Topical Tranexamic Acid Alone Are Superior to Tourniquet Use for Primary Total Knee Arthroplasty,” evaluates the need for continued use of the intra-operative tourniquet, which remains a routine practice with documented benefits and adverse effects. This review evaluates the stu dy’s design and critically interprets its findings for clinical practice. Through a prospective, randomized trial, Huang et al. demonstrat...
Source: HSS Journal - October 1, 2018 Category: Orthopaedics Source Type: research
Isokinetic Strength Testing Following Intramedullary Nailing of Tibial Shaft Fractures Predicts Time to Recovery and Return of Muscle Strength in the Injured Extremity: A Prospective Case Series
ConclusionsPatients exhibited equal strength between their healthy and injured legs at 12 months after surgery. Improvement in strength occurred to a greater extent between 3 and 6 months after surgery than between 6 and 12 months. Plantar flexion appeared to improve more rapidly than dorsal extension. (Source: HSS Journal)
Source: HSS Journal - October 1, 2018 Category: Orthopaedics Source Type: research
Scapular Body Fracture in the Athlete: A Systematic Review
ConclusionScapular body fractures in athletes occur primarily from muscle contraction against a resisted force in the upper extremity during contact sports. Unlike non-sporting fractures, these fractures usually involve low-energy mechanisms without associated injury and conservative treatment is usually successful. (Source: HSS Journal)
Source: HSS Journal - October 1, 2018 Category: Orthopaedics Source Type: research
Point-of-care Ultrasonography in Orthopedic Management of Hemophilia: Multiple Uses of an Effective Tool
This article reviews the literature on the uses of POC-US in hemophilia, including early diagnosis of joint damage, differential diagnosis of articular pain, follow-up of joint injury, and guidance for both arthrocentesis and intra-articular injection. Studies show that for patients with hemophilia, POC-US enhances diagnostic accuracy and targeted treatments. Further research is required into the most efficient use of POC-US and the training needed to develop clinicians ’ skills. The attributes of POC-US should be understood more fully to enable its widespread application. (Source: HSS Journal)
Source: HSS Journal - October 1, 2018 Category: Orthopaedics Source Type: research
