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Management of Athletic Turf Toe Using Biologics
Turf toe is a common injury in a variety of different athletes, especially those involved in contact sports played on rigid surfaces. It is caused by a hyperextension injury to the hallux metatarsophalangeal joint resulting in attenuation or tearing of the plantar capsular ligamentous complex. Treatment generally consists of nonoperative measures such as rest, ice, nonsteroidal anti-inflammatory drugs, taping, a stiff-sole shoe, walking boot, or casting. There has been a recent increase in the use of biologics, such as platelet-rich plasma and autologous conditioned plasma for the treatment of a variety of orthopaedic cond...
Source: Operative Techniques in Orthopaedics - March 1, 2016 Category: Orthopaedics Authors: Aaron V. Mares, Ryan Schreiter, Carola F. van Eck, Robert Blanc, Volker Musahl Source Type: research

Small Molecules Alone or in Combination to Treat Joint Disease and Progress Toward Gene Therapy
The field of biologics for joint disease, specifically articular cartilage injury and osteoarthritis, is one that has stimulated much excitement in the area of orthopaedics. The deficit of growth factors and anticatabolics in joint disease is now a well-recognized problem; however, unraveling the mystery associated with appropriate dose and timing of administration and when these molecules might have their most therapeutic benefits would be the subject of study for decades to come. Further, the technique of how these proteins are enhanced in the joint to result in the greatest influence remains in question. (Source: Operat...
Source: Operative Techniques in Orthopaedics - March 1, 2016 Category: Orthopaedics Authors: Laurie R. Goodrich, C. Wayne McIlwraith Source Type: research

Current State for Clinical Use of Stem Cells and Platelet-Rich Plasma
In the management of common orthopaedic pathology involving tendons, ligaments, bone, and articular cartilage, the application of small molecules and biologic compounds has expanded greatly in the past decade. In particular, the use of platelet-rich plasma (PRP) and stem cells has gained significant attention for potential therapeutic augmentation of healing, modulation of inflammatory cascades, and pain modulation. Despite the increase in clinical application and interest, there has been a paucity of high level of evidence studies supporting the use of these biologic agents. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - March 1, 2016 Category: Orthopaedics Authors: Jason P. Zlotnicki, Jonathan Watson, Ben B. Rothrauff, Carola F. Van Eck, Volker Musahl Source Type: research

Editorial Board
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Source: Operative Techniques in Orthopaedics - March 1, 2016 Category: Orthopaedics Source Type: research

Table of Contents
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Source: Operative Techniques in Orthopaedics - March 1, 2016 Category: Orthopaedics Source Type: research

Contributors
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Source: Operative Techniques in Orthopaedics - March 1, 2016 Category: Orthopaedics Source Type: research

The Treatment of Open Fractures
Patients with open fractures often present with severe soft-tissue injuries, bony injuries, and contamination that requires prompt treatment. Classifying the severity of injury is important for diagnostic and treatment purposes, including administering antibiotic prophylaxis, providing emergency room management, and executing timely surgical intervention. Surgery is performed to minimize contamination, eliminate necrotic and devascularized tissue, provide biological stabilization of the trauma-induced zone of tissue necrosis, and mechanically stabilize the soft-tissues and bone. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - January 27, 2016 Category: Orthopaedics Authors: Andrew R. Evans Source Type: research

Treatment of Chronic Bone Infection
The treatment of chronic osteomyelitis depends on the obstinate persistence of the offending micro-organism(s) and often results in long-term patient disability causing remarkable costs to the health care system. Difficulties of treating chronic osteomyelitis derive from biofilm-forming pathogens that resist the host immunologic defense and antimicrobial substances, and the need to treat osseous defects that result from the disease itself and eventual previous interventions. Established surgical techniques require multiple costly operations with extended periods of disablement and impairment of the patients, sometimes maki...
Source: Operative Techniques in Orthopaedics - January 26, 2016 Category: Orthopaedics Authors: Heinz Winkler, Peter Haiden Source Type: research

Treatment of Chronic Bone Infections
The treatment of chronic osteomyelitis (COM) depends on the obstinate persistence of the offending microorganism(s), and can result in long-term patient disability that increases costs to the health care system. Difficulties of treating COM derive from biofilm-forming pathogens that resist the host immunological defense and other antimicrobial substances, and the need to treat osseous defects that result from the disease itself. Established surgical techniques require multiple costly operations with extended periods of disablement and impairment of the patients, sometimes making the therapy worse than the disease. (Source:...
Source: Operative Techniques in Orthopaedics - January 26, 2016 Category: Orthopaedics Authors: Heinz Winkler Source Type: research

Postoperative Spine Infections: Prevention and Treatment
Several patient-related risk factors for postoperative spine infections exist. Those modifiable risk factors, such as malnutrition and glucose control, should be optimized prior to surgery with the hopes of lessening any associated infection risk. Furthermore, other operative variables, like antibiotic administration, should also be closely monitored. However, postoperative infections will always remain inevitable. Prompt diagnosis and proper treatment is key to reducing any associated morbidity for the patient. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - January 11, 2016 Category: Orthopaedics Authors: Jesse E. Bible, William F. Donaldson Source Type: research

Operative Treatment of Infections in the Foot and Ankle
Treatment of infections of the foot and ankle, similar to other areas of orthopaedics, often require operative treatment to remove infected tissue and bone, and potentiate the effectiveness of antibiotic management. Due to the presence of patient comorbidities such as diabetes and peripheral vascular disease, a seemingly minor infection can result in major morbidity and even mortality in the foot and ankle patient. In this article, we focus on the general principles of irrigation and debridement for treating foot and/or ankle infections, and discuss treatment strategies for septic ankle arthritis and periprosthetic ankle j...
Source: Operative Techniques in Orthopaedics - January 11, 2016 Category: Orthopaedics Authors: Patrick S. Buckley, Steven M. Raikin Source Type: research

The Diagnosis and Management of Periprosthetic Joint Infections of the Shoulder
Periprosthetic joint infection of the shoulder is a rare complication of shoulder arthroplasty that can have a profound effect on a patient's clinical outcome and function. The diagnosis and management of these infections is challenging, largely due to the unique microbiome of the shoulder. While current treatment strategies are based upon the infection literature in hip and knee arthroplasty, there is little evidence to support their effectiveness in the shoulder. Although there continues to be innovations in the diagnosis and treatment of this unique joint infection, improving the understanding of periprosthetic joint in...
Source: Operative Techniques in Orthopaedics - January 8, 2016 Category: Orthopaedics Authors: Jia-Wei Kevin Ko, Surena Namdari Source Type: research

Periprosthetic Joint Infection Treatment in Total Hip and Knee Arthroplasty
The cumulative incidence of periarticular joint infection is about 1.2%, and there are multiple ways to surgically manage these patients. Arthroscopy is not recommended due to poor outcomes of high infection recurrence. Open debridement and irrigation shows a success rate of about 65%, and this technique should only be considered during the very early stages of infection. For definitive treatment, one-stage or two-stage exchange arthroplasty is recommended, and the success rate after single-stage revision and two-stage revision is about 93% and 86%, respectively. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - January 8, 2016 Category: Orthopaedics Authors: R. Becker, M. Clauss, N. Rotigliano, M.T. Hirschmann Source Type: research

Introduction
Infections are deadly. Hospital acquired infections affect over 700,000 individuals in the United States each year and have high morbidity and mortality rates. While the U.S. Department of Health and Human Services has undertaken initiatives to decrease the rate of infections, our battle against infection continues. Infection has been likened to cancer, as they stimulate similar immunologic responses and severely compromise patient outcomes. Moreover, 1 out of 6 cancers stem from infectious causes that can be prevented or treated. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - January 8, 2016 Category: Orthopaedics Authors: Antonia F. Chen Source Type: research

Treating Orthopaedic Infections in Pediatric Patients
Pediatric musculoskeletal infections represent a wide spectrum of diseases and pose a treatment challenge for the orthopaedic surgeon. Prompt and accurate diagnosis and treatment are of utmost importance to prevent long-term sequelae and often require a multidisciplinary approach. Staphylococcus aureus is still reported as the most common causative organism of infection, with an increase in the number of methicillin-resistant Staphylococcus aureus infections in more recent years. Treatment consists of a combination of surgical debridement and antibiotics. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - January 8, 2016 Category: Orthopaedics Authors: Verena M. Schreiber, Kenneth D. Illingworth, William Timothy Ward Source Type: research