Breast Radiation Exposure in Female Orthopaedic Surgeons
Conclusions:
Breast radiation exposure is higher in a C-arm lateral projection compared with an anteroposterior projection. Higher dose-equivalent rates were observed for the UOQ compared with the LIQ of the breast and for aprons that were too small or too large, although these differences did not reach significance. Factors that may reduce radiation exposure include lead protection of appropriate size and distancing the axilla from the patient and x-ray tube.
Clinical Relevance:
Increased breast cancer prevalence has been reported for female orthopaedic surgeons. The UOQ of the breast may be at risk for intraoperative ra...
Source: JBJS - November 1, 2016 Category: Orthopaedics Authors: Valone, L. C., Chambers, M., Lattanza, L., James, M. A. Tags: Basic Science Scientific Articles Source Type: research
Reverse Total Shoulder Arthroplasty without Bone-Grafting for Severe Glenoid Bone Loss in Patients with Osteoarthritis and Intact Rotator Cuff
Conclusions:
RTSA without bone-grafting and with medialization of the baseplate in patients with osteoarthritis and severe glenoid bone loss resulted in significant improvement in pain and function with reliable short-term implant survivorship and may be a good alternative to anatomical TSA. Longer follow-up is needed to determine the relative advantages and disadvantages. This was an "off-label" indication for this device.
Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. (Source: JBJS)
Source: JBJS - November 1, 2016 Category: Orthopaedics Authors: McFarland, E. G., Huri, G., Hyun, Y. S., Petersen, S. A., Srikumaran, U. Tags: Shoulder Scientific Articles Source Type: research
Cost Analysis of Ceramic Heads in Primary Total Hip Arthroplasty
Conclusions:
The ability to recoup the initial increased expenditure of ceramic heads through a diminished lifetime revision cost is dependent on the price premium for ceramic and the age of the patient. A wholesale switch to ceramic bearings regardless of age or cost differential may result in an economic burden to the health system.
Level of Evidence:
Economic and decision analysis, Level III. See Instructions for Authors for a complete description of levels of evidence. (Source: JBJS)
Source: JBJS - November 1, 2016 Category: Orthopaedics Authors: Carnes, K. J., Odum, S. M., Troyer, J. L., Fehring, T. K. Tags: Hip Scientific Articles Source Type: research
The Wear Rate of Highly Cross-Linked Polyethylene in Total Hip Replacement Is Not Increased by Large Articulations: A Randomized Controlled Trial
Conclusions:
The wear rate of a larger 36-mm metal-on-XLPE articulation between 1 and 3 years following primary total hip arthroplasty was low and no greater than that of a 28-mm articulation. However, before a 36-mm metal-on-XLPE articulation is widely recommended, particularly in young active patients, long-term wear rates and association between wear and periprosthetic osteolysis should be determined.
Level of Evidence:
Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence. (Source: JBJS)
Source: JBJS - November 1, 2016 Category: Orthopaedics Authors: Howie, D. W., Holubowycz, O. T., Callary, S. A. Tags: Hip Scientific Articles Source Type: research
Quality of Reduction Influences Outcome After Locked-Plate Fixation of Proximal Humeral Type-C Fractures
Conclusions:
Anatomical fracture reduction with a locked plate significantly improved the clinical outcome of unstable and displaced proximal humeral fractures involving the anatomical neck.
Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. (Source: JBJS)
Source: JBJS - November 1, 2016 Category: Orthopaedics Authors: Schnetzke, M., Bockmeyer, J., Porschke, F., Studier-Fischer, S., Grützner, P.-A., Guehring, T. Tags: Shoulder, Trauma Scientific Articles Source Type: research
Development of a Prognostic Survival Algorithm for Patients with Metastatic Spine Disease
Conclusions:
We identified risk factors associated with survival that should be considered in prognostication. Performance of the boosting algorithm and nomogram were comparable on the testing data sets. However, the nomogram is easier to apply and therefore more useful to aid surgical decision-making.
Level of Evidence:
Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence. (Source: JBJS)
Source: JBJS - November 1, 2016 Category: Orthopaedics Authors: Paulino Pereira, N. R., Janssen, S. J., van Dijk, E., Harris, M. B., Hornicek, F. J., Ferrone, M. L., Schwab, J. H. Tags: Oncology, Spine Scientific Articles Source Type: research
The Appropriate Variable to Compare Wear in Total Hip Prostheses: Commentary on an article by Donald W. Howie, MBBS, FRACS, PhD, et al.: "The Wear Rate of Highly Cross-Linked Polyethylene in Total Hip Replacement Is Not Increased by Large Articulations. A Randomized Controlled Trial"
(Source: JBJS)
Source: JBJS - November 1, 2016 Category: Orthopaedics Authors: Burstein, A. H. Tags: Hip Commentary and Perspective Source Type: research
Proximal Humeral Fractures: Is Some Varus Acceptable?: Commentary on an article by Marc Schnetzke, MD, et al.: "Quality of Reduction Influences Outcome After Locked-Plate Fixation of Proximal Humeral Type-C Fractures"
(Source: JBJS)
Source: JBJS - November 1, 2016 Category: Orthopaedics Authors: Flatow, E. L. Tags: Shoulder, Trauma Commentary and Perspective Source Type: research
How Many Orthopaedic Surgeons Does It Take to Write a Manuscript?: A Vignette-Based Discussion of Authorship in Orthopaedic Surgery
Discussion of authorship criteria prior to the initiation of clinical research investigations is a standard that must be met. The International Committee of Medical Journal Editors (ICMJE) guidelines provide a framework for this discussion and should be reviewed by all authors prior to publication. Modifications to published authorship guidelines may be necessary to address some of the scenarios identified here that are not adequately addressed by the existing guidelines. (Source: JBJS)
Source: JBJS - November 1, 2016 Category: Orthopaedics Authors: Agel, J., DeCoster, T. A., Swiontkowski, M. F., Roberts, C. S. Tags: The Orthopaedic Forum Source Type: research
Outcomes of Spinal Fusion for Cervical Kyphosis in Children with Neurofibromatosis
Conclusions:
Anteroposterior surgery provided better correction of cervical kyphosis than posterior spinal fusion in children with NF1. Erosion of vertebral bodies continued during the postoperative follow-up period in all patients who had presented with dysplastic changes preoperatively. The cervical spine should be screened in all children with NF1. Fusion should include at least 6 levels to prevent junctional kyphosis.
Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. (Source: JBJS)
Source: JBJS - November 1, 2016 Category: Orthopaedics Authors: Helenius, I. J., Sponseller, P. D., Mackenzie, W., Odent, T., Dormans, J. P., Asghar, J., Rathjen, K., Pahys, J. M., Miyanji, F., Hedequist, D., Phillips, J. H. Tags: Pediatrics, Spine Scientific Articles Source Type: research
Whats New in Shoulder and Elbow Surgery
(Source: JBJS)
Source: JBJS - October 18, 2016 Category: Orthopaedics Authors: Chamberlain, A. M., Namdari, S., Keener, J. D. Tags: Elbow, Shoulder Specialty Update Source Type: research
Primary Linked Semiconstrained Total Elbow Arthroplasty for Rheumatoid Arthritis: A Single-Institution Experience with 461 Elbows Over Three Decades
Conclusions:
Elbow arthroplasty using a cemented linked semiconstrained elbow arthroplasty provides satisfactory clinical results in the treatment of RA with a reasonable rate of survivorship free of mechanical failure at 20 years. Although bushing wear was identified on radiographs in approximately one-fourth of the patients, revision for isolated bushing wear was uncommon.
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: Sanchez-Sotelo, J., Baghdadi, Y. M. K., Morrey, B. F. Tags: Elbow Scientific Articles Source Type: research
Asymptomatic Pseudotumors in Patients with Taper Corrosion of a Dual-Taper Modular Femoral Stem: MARS-MRI and Metal Ion Study
Conclusions:
The prevalence of asymptomatic taper-corrosion-related pseudotumors on MARS-MRI in this study demonstrated that the absence of symptoms does not exclude the presence of adverse local tissue reactions. Elevated cobalt levels and cobalt/chromium ratios were associated with the presence of pseudotumors in asymptomatic and symptomatic patients. Cross-sectional imaging such as MARS-MRI is indicated for patients with elevated metal-ion levels. A longitudinal study is required to determine whether asymptomatic patients with taper-corrosion-related pseudotumors will develop symptoms with time.
Level of Evidence:
Ther...
Source: JBJS - October 18, 2016 Category: Orthopaedics Authors: Kwon, Y.-M., Khormaee, S., Liow, M. H. L., Tsai, T.-Y., Freiberg, A. A., Rubash, H. E. Tags: Hip Scientific Articles Source Type: research
Surgical Outcome and Prognostic Analysis of Transoral Atlantoaxial Reduction Plate System for Basilar Invagination: A Voxel-Based Morphometry Study
Conclusions:
We found that the odontoid descent distance predicted the craniocervical volume improvement rate following TARP procedures in patients with basilar invagination, and we believe that both can serve as predictors of surgical efficacy. We believe that planning the odontoid descent distance preoperatively may help to improve the efficacy of TARP operations.
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: Wei, G., Shi, C., Wang, Z., Xia, H., Yin, Q., Wu, Z. Tags: Spine Scientific Articles Source Type: research
Contamination of the Surgical Field with Propionibacterium acnes in Primary Shoulder Arthroplasty
Conclusions:
P. acnes is a common contaminant of the surgical field in primary shoulder arthroplasty. The subdermal layer may be the source of this contamination, and the prevalence of P. acnes in the surgical wound may be due to the surgeon’s manipulation with gloves and instruments. Our findings are consistent with those regarding the increased rates of P. acnes bacterial load and intraoperative growth in male patients compared with female patients.
Clinical Relevance:
P. acnes is likely to be spread throughout the surgical field from the subdermal layer via soft-tissue handling by the surgeon and instruments. Str...
Source: JBJS - October 18, 2016 Category: Orthopaedics Authors: Falconer, T. M., Baba, M., Kruse, L. M., Dorrestijn, O., Donaldson, M. J., Smith, M. M., Figtree, M. C., Hudson, B. J., Cass, B., Young, A. A. Tags: Shoulder Scientific Articles Source Type: research
