ACL Deficiency Increases Forces on the Medial Femoral Condyle and the Lateral Meniscus with Applied Rotatory Loads
Conclusions:
ACL sectioning increased the net forces carried by the lateral meniscus and medial femoral condyle—and the anterior shear and lateral shear forces, respectively—in response to multiplanar valgus and internal rotation torque.
Clinical Relevance:
These loading patterns provide a biomechanical rationale for clinical patterns of intra-articular derangement such as lateral meniscal injury and osseous remodeling of the medial compartment seen with ACL insufficiency. (Source: JBJS)
Source: JBJS - October 18, 2016 Category: Orthopaedics Authors: McDonald, L. S., Boorman-Padgett, J., Kent, R., Stone, K., Wickiewicz, T. L., Pearle, A. D., Imhauser, C. W. Tags: Basic Science, Sports Medicine Scientific Articles Source Type: research
Ponseti Treatment of Rigid Residual Deformity in Congenital Clubfoot After Walking Age
Conclusions:
Ponseti treatment with TATT, which was performed in 88% of the feet, was effective, and satisfactory results were achieved in 84% of the feet. At the time of follow-up, no patient showed an abnormal gait, all feet were plantigrade and flexible, but 2 feet (2.9%) had relapsed.
Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. (Source: JBJS)
Source: JBJS - October 18, 2016 Category: Orthopaedics Authors: Dragoni, M., Farsetti, P., Vena, G., Bellini, D., Maglione, P., Ippolito, E. Tags: Pediatrics Scientific Articles Source Type: research
Safety and Outcomes of Inpatient Compared with Outpatient Surgical Procedures for Ankle Fractures
Conclusions:
In patients with closed fractures and minimal comorbidities, outpatient ORIF was associated with reduced risk of select 30-day medical morbidity and no difference in surgical morbidity, reoperations, and readmissions relative to inpatient. Factors unaccounted for when creating matched cohorts may impact our results. Our findings lend reassurance to surgeons who defer admission for low-risk patients.
Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. (Source: JBJS)
Source: JBJS - October 18, 2016 Category: Orthopaedics Authors: Qin, C., Dekker, R. G., Blough, J. T., Kadakia, A. R. Tags: Foot & Ankle, Trauma Scientific Articles Source Type: research
Five-Year Survival of 20,946 Unicondylar Knee Replacements and Patient Risk Factors for Failure: An Analysis of German Insurance Data
Conclusions:
Apart from known risk factors, this study showed a significant negative influence of obesity, depression, and complicated diabetes on the 5-year unicondylar knee replacement survival rate. Surgical indications and preoperative patient counseling should consider these findings.
Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence. (Source: JBJS)
Source: JBJS - October 18, 2016 Category: Orthopaedics Authors: Jeschke, E., Gehrke, T., Günster, C., Hassenpflug, J., Malzahn, J., Niethard, F. U., Schräder, P., Zacher, J., Halder, A. Tags: Knee Scientific Articles Source Type: research
Meaningful Thresholds for the Volume-Outcome Relationship in Total Knee Arthroplasty
Conclusions:
Our study supports the use of SSLR analysis of ROC curves for risk-based volume stratification in total knee arthroplasty volume-outcomes research. SSLR analysis established meaningful volume definitions for low, medium, high, and very high-volume total knee arthroplasty surgeons and hospitals. This should help patients, surgeons, hospitals, and policymakers to make decisions with regard to the optimal delivery of total knee arthroplasty.
Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. (Source: JBJS)
Source: JBJS - October 18, 2016 Category: Orthopaedics Authors: Wilson, S., Marx, R. G., Pan, T.-J., Lyman, S. Tags: Knee Scientific Articles Source Type: research
Erratum
(Source: JBJS)
Source: JBJS - October 18, 2016 Category: Orthopaedics Tags: Erratum Source Type: research
Goals and Challenges of Identifying Asymptomatic Pseudotumors in Patients Treated with Total Hip Arthroplasty: Commentary on an article by Young-Min Kwon, MD, PhD, et al.: "Asymptomatic Pseudotumors in Patients with Taper Corrosion of a Dual-Taper Modular Femoral Stem: MARS-MRI and Metal Ion Study"
(Source: JBJS)
Source: JBJS - October 18, 2016 Category: Orthopaedics Authors: Incavo, S. J. Tags: Hip Commentary and Perspective Source Type: research
Should Only the Highest-Volume Surgeons and Centers Be Doing Primary Total Knee Arthroplasty?: Commentary on an article by Sean Wilson, BA, et al.: "Meaningful Thresholds for the Volume-Outcome Relationship in Total Knee Arthroplasty"
(Source: JBJS)
Source: JBJS - October 18, 2016 Category: Orthopaedics Authors: Giori, N. J. Tags: Knee Commentary and Perspective Source Type: research
P-Hacking in Orthopaedic Literature: A Twist to the Tail
Conclusions:
P-hacking is an evolving phenomenon that threatens to jeopardize the evidence-based practice of medicine. Although our results show that there is good evidential value for orthopaedic literature published in our top journals, there is some evidence of p-hacking of which authors and readers should be wary. (Source: JBJS)
Source: JBJS - October 18, 2016 Category: Orthopaedics Authors: Bin Abd Razak, H. R., Ang, J.-G. E., Attal, H., Howe, T.-S., Allen, J. C. Tags: Ethics in Practice Source Type: research
Inconsistencies Between Physician-Reported Disclosures at the AAOS Annual Meeting and Industry-Reported Financial Disclosures in the Open Payments Database
Conclusions:
In this sample, there was a 35% rate of inconsistency between physician-reported financial relationships for presenters at the AAOS Annual Meeting and industry-reported relationships published in the Open Payments database. (Source: JBJS)
Source: JBJS - October 18, 2016 Category: Orthopaedics Authors: Hannon, C. P., Chalmers, P. N., Carpiniello, M. F., Cvetanovich, G. L., Cole, B. J., Bach, B. R. Tags: The Orthopaedic Forum Source Type: research
A Prospective Evaluation of Opioid Utilization After Upper-Extremity Surgical Procedures: Identifying Consumption Patterns and Determining Prescribing Guidelines
Conclusions:
In this large, prospective evaluation of postoperative opioid consumption, we found that patients are being prescribed approximately 3 times greater opioid medications than needed following upper-extremity surgical procedures. We have provided general prescribing guidelines, and we recommend that surgeons carefully examine their patients’ opioid utilization and consider customizing their opioid prescriptions on the basis of anatomic location and procedure type to prescribe the optimal amount of opioids while avoiding dissemination of excess opioids. (Source: JBJS)
Source: JBJS - October 18, 2016 Category: Orthopaedics Authors: Kim, N., Matzon, J. L., Abboudi, J., Jones, C., Kirkpatrick, W., Leinberry, C. F., Liss, F. E., Lutsky, K. F., Wang, M. L., Maltenfort, M., Ilyas, A. M. Tags: Elbow, Hand & Wrist, Shoulder The Orthopaedic Forum Source Type: research
Coagulation Profile of Patients with Adolescent Idiopathic Scoliosis Undergoing Posterior Spinal Fusion
Conclusions:
The stress of posterior spinal fusion induces a hypercoagulable state in patients with adolescent idiopathic scoliosis. Over the first 2 hours of a surgical procedure, varying degrees of fibrinolysis develop. Platelets and coagulation factors are not depleted. Our data support the use of antifibrinolytic therapy for patients with adolescent idiopathic scoliosis. (Source: JBJS)
Source: JBJS - October 18, 2016 Category: Orthopaedics Authors: Bosch, P., Kenkre, T. S., Londino, J. A., Cassara, A., Yang, C., Waters, J. H. Tags: Pediatrics, Spine Scientific Articles Source Type: research
Whats Important: The Unhappy Patient
(Source: JBJS)
Source: JBJS - October 4, 2016 Category: Orthopaedics Authors: Light, T. R. Tags: The Orthopaedic Forum Source Type: research
Developing a Clinically Representative Model of Periprosthetic Joint Infection
The poor treatment outcomes for periprosthetic joint infection (PJI) reflect the limited understanding that currently exists regarding the pathogenesis of this devastating clinical problem.
Current animal models of PJI are limited in their translational nature primarily because of their inability to recreate the periprosthetic environment.
A greater mechanistic understanding of the musculoskeletal and immune systems of small animals, such as mice and rats, provides a more robust platform for modeling and examining the pathogenesis of PJI.
A clinically representative PJI model must involve an implant that recreates th...
Source: JBJS - October 4, 2016 Category: Orthopaedics Authors: Carli, A. V., Ross, F. P., Bhimani, S. J., Nodzo, S. R., Bostrom, M. P. G. Tags: Basic Science, Hip, Infection, Knee Current Concepts Review Source Type: research
Microstructural and Mechanical Properties of the Posterior Cruciate Ligament: A Comparison of the Anterolateral and Posteromedial Bundles
Conclusions:
The PCL has relatively homogenous microstructural and mechanical properties, with few differences between the anterolateral and posteromedial bundles. This finding suggests that distinct functions of the PCL bundles result primarily from size and anatomical location rather than from differences in these properties.
Clinical Relevance:
These properties of the PCL can be used to assess the utility of graft choices and operative techniques for PCL reconstruction and may partly explain limited differences in the outcomes of single-bundle compared with double-bundle reconstruction techniques for the PCL. (Source: JBJS)
Source: JBJS - October 4, 2016 Category: Orthopaedics Authors: Wright, J. O., Skelley, N. W., Schur, R. P., Castile, R. M., Lake, S. P., Brophy, R. H. Tags: Basic Science, Sports Medicine Scientific Articles Source Type: research
