Pub Date : 2023-12-08DOI: 10.1097/bco.0000000000001250
Yaw Adu, Gracie R. Baum, Justin G. Harder, Cameron T. Cox, Brendan J MacKay
{"title":"Jumpy stump syndrome treated by targeted muscle reinnervation (TMR): a case report and review of the literature","authors":"Yaw Adu, Gracie R. Baum, Justin G. Harder, Cameron T. Cox, Brendan J MacKay","doi":"10.1097/bco.0000000000001250","DOIUrl":"https://doi.org/10.1097/bco.0000000000001250","url":null,"abstract":"","PeriodicalId":10732,"journal":{"name":"Current Orthopaedic Practice","volume":"7 2","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138589754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-08DOI: 10.1097/bco.0000000000001249
M. A. Rowley, J. R. Allen, William Newton, Charles Daly
Latent Dirichlet Allocation is an artificial intelligence model which processes text into topics, and has had broad application in medicine, political science, and engineering. As the orthopedic hand literature continues to grow, such technology may have value in efficiently conducting identifying trends and conducting systematic reviews. The purpose of this study is to demonstrate the use of Latent Dirichlet Allocation and machine learning to review literature and summarize the past 21 yr of hand surgery research. All original research articles published in the Journal of Hand Surgery (American), Journal of Hand Surgery (European), Hand, Journal of Bone and Joint Surgery (JBJS), Clinical Orthopaedics and Related Research (CORR), Journal of the American Academy of Orthopaedic Surgeons (JAAOS) and Plastic and Reconstructive Surgery (PRS) from 2000-2021 were analyzed using Latent Dirichlet Allocation, generating 50 topics which were then ranked by popularity and trended over the previous 21 yr. Research article abstracts totaling 11,501 from 2000-2020 were extracted and analyzed to create 50 topics. This is the first study of its kind to utilize machine learning models for reviewing the hand surgery literature. Machine learning possesses the ability to rapidly process a large body of test and assess the current state of research and trends or research topics, which can aid clinicians and researchers in time-intensive tasks to provide clues that will promote areas of further study.
潜狄利克雷分配是一种将文本处理成主题的人工智能模型，在医学、政治学和工程学等领域有着广泛的应用。随着骨科手部文献的持续增长，这种技术可能在有效地进行趋势识别和进行系统回顾方面具有价值。本研究的目的是展示使用潜在狄利克雷分配和机器学习来回顾文献并总结过去21年的手外科研究。使用Latent Dirichlet Allocation对2000-2021年发表在Journal of Hand Surgery(美国)、Journal of Hand Surgery(欧洲)、Hand、Journal of Bone and Joint Surgery (JBJS)、Clinical orthopotic and Related research (CORR)、Journal of American Academy of Orthopaedic Surgeons (JAAOS)和Plastic and reconstruction Surgery (PRS)上的所有原创研究文章进行分析。生成50个主题，然后根据过去21年的受欢迎程度和趋势进行排名。提取并分析2000-2020年共11,501篇研究文章摘要，以创建50个主题。这是同类研究中首次利用机器学习模型来回顾手外科文献。机器学习具有快速处理大量测试并评估当前研究状态和趋势或研究主题的能力，这可以帮助临床医生和研究人员在时间密集型任务中提供线索，从而促进进一步研究领域。
{"title":"Machine learning review of hand surgery literature","authors":"M. A. Rowley, J. R. Allen, William Newton, Charles Daly","doi":"10.1097/bco.0000000000001249","DOIUrl":"https://doi.org/10.1097/bco.0000000000001249","url":null,"abstract":"\u0000 \u0000 Latent Dirichlet Allocation is an artificial intelligence model which processes text into topics, and has had broad application in medicine, political science, and engineering. As the orthopedic hand literature continues to grow, such technology may have value in efficiently conducting identifying trends and conducting systematic reviews. The purpose of this study is to demonstrate the use of Latent Dirichlet Allocation and machine learning to review literature and summarize the past 21 yr of hand surgery research.\u0000 \u0000 \u0000 \u0000 All original research articles published in the Journal of Hand Surgery (American), Journal of Hand Surgery (European), Hand, Journal of Bone and Joint Surgery (JBJS), Clinical Orthopaedics and Related Research (CORR), Journal of the American Academy of Orthopaedic Surgeons (JAAOS) and Plastic and Reconstructive Surgery (PRS) from 2000-2021 were analyzed using Latent Dirichlet Allocation, generating 50 topics which were then ranked by popularity and trended over the previous 21 yr.\u0000 \u0000 \u0000 \u0000 Research article abstracts totaling 11,501 from 2000-2020 were extracted and analyzed to create 50 topics.\u0000 \u0000 \u0000 \u0000 This is the first study of its kind to utilize machine learning models for reviewing the hand surgery literature. Machine learning possesses the ability to rapidly process a large body of test and assess the current state of research and trends or research topics, which can aid clinicians and researchers in time-intensive tasks to provide clues that will promote areas of further study.\u0000","PeriodicalId":10732,"journal":{"name":"Current Orthopaedic Practice","volume":"48 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138588399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-30DOI: 10.1097/bco.0000000000001246
Gabriel J. Barclay, A. Saxena, Venkataraghavan Ramamoorthy, Mukesh Roy, S. Appunni, M. Doke, Md Ashfaq Ahmed, Zhenwei Zhang, Yanjia Zhang, M. Rubens
COVID-19 pandemic has significantly affected orthopedic surgery, resulting in postponements and cancellations. The aim of this study is to determine the possible effects of COVID-19 on the number of total hip arthroplasty (THA) hospitalizations and hospital outcomes using a large database. We conducted a retrospective analysis of data gathered and stored in the California State Inpatient Database (SID) during 2019 and 2020. All THA hospitalizations ≥18 yr that occurred in 2019 and 2020 and COVID-19 hospitalizations that occurred in 2020 were used for the analysis. The primary outcomes of the study were trends in THA hospitalizations between 2019 and 2020. Secondary outcomes were mortality, surgical, medical, and other complications, and prolonged length of stay. A total of 36,760 and 20,243 THA hospitalizations occurred during 2019 and 2020, respectively. Trends in THA hospitalizations during 2019 and 2020 showed that the rates of these hospitalizations were substantially lower throughout 2020. Logistic regression analysis showed that the odds of mortality (odds ratio [OR], 2.77; 95% CI, 1.38-5.53), surgical complications (OR,1.61; 95% CI, 1.36-1.89), medical complications (OR,1.27; 95% CI, 1.20-1.33), other complications (OR,1.42; 95% CI, 1.19-1.69), and prolonged length of stay (OR,1.10; 95% CI, 1.05-1.16) were significantly higher during 2020. Our findings show that during COVID-19 pandemic THA hospitalizations were prioritized based on case severity. By the end of 2020 THA hospitalizations did not steeply decrease in numbers compared to the advent of the pandemic, indicating that orthopedic surgeons and other healthcare professionals functioned optimally even during the COVID-19 pandemic.
{"title":"Impact of COVID-19 on total hip arthroplasty: results from California state inpatient database","authors":"Gabriel J. Barclay, A. Saxena, Venkataraghavan Ramamoorthy, Mukesh Roy, S. Appunni, M. Doke, Md Ashfaq Ahmed, Zhenwei Zhang, Yanjia Zhang, M. Rubens","doi":"10.1097/bco.0000000000001246","DOIUrl":"https://doi.org/10.1097/bco.0000000000001246","url":null,"abstract":"COVID-19 pandemic has significantly affected orthopedic surgery, resulting in postponements and cancellations. The aim of this study is to determine the possible effects of COVID-19 on the number of total hip arthroplasty (THA) hospitalizations and hospital outcomes using a large database. We conducted a retrospective analysis of data gathered and stored in the California State Inpatient Database (SID) during 2019 and 2020. All THA hospitalizations ≥18 yr that occurred in 2019 and 2020 and COVID-19 hospitalizations that occurred in 2020 were used for the analysis. The primary outcomes of the study were trends in THA hospitalizations between 2019 and 2020. Secondary outcomes were mortality, surgical, medical, and other complications, and prolonged length of stay. A total of 36,760 and 20,243 THA hospitalizations occurred during 2019 and 2020, respectively. Trends in THA hospitalizations during 2019 and 2020 showed that the rates of these hospitalizations were substantially lower throughout 2020. Logistic regression analysis showed that the odds of mortality (odds ratio [OR], 2.77; 95% CI, 1.38-5.53), surgical complications (OR,1.61; 95% CI, 1.36-1.89), medical complications (OR,1.27; 95% CI, 1.20-1.33), other complications (OR,1.42; 95% CI, 1.19-1.69), and prolonged length of stay (OR,1.10; 95% CI, 1.05-1.16) were significantly higher during 2020. Our findings show that during COVID-19 pandemic THA hospitalizations were prioritized based on case severity. By the end of 2020 THA hospitalizations did not steeply decrease in numbers compared to the advent of the pandemic, indicating that orthopedic surgeons and other healthcare professionals functioned optimally even during the COVID-19 pandemic.","PeriodicalId":10732,"journal":{"name":"Current Orthopaedic Practice","volume":"48 14","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139203811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-28DOI: 10.1097/BCO.0000000000001248
J. Weinreb, Tyler J. Pease, Ryan A. Smith, Anthony K. Chiu, Eugene Y. Koh, Steven C. Ludwig, Daniel L. Cavanaugh
{"title":"Osteotomy via the prone transpsoas approach for lateral interbody fusion of the lumbar spine","authors":"J. Weinreb, Tyler J. Pease, Ryan A. Smith, Anthony K. Chiu, Eugene Y. Koh, Steven C. Ludwig, Daniel L. Cavanaugh","doi":"10.1097/BCO.0000000000001248","DOIUrl":"https://doi.org/10.1097/BCO.0000000000001248","url":null,"abstract":"","PeriodicalId":10732,"journal":{"name":"Current Orthopaedic Practice","volume":"213 1","pages":"27 - 32"},"PeriodicalIF":0.3,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139226144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-16DOI: 10.1097/bco.0000000000001247
Fernando A. Huyke-Hernández, Stephen A. Doxey, Lily J. Qian, Brian P. Cunningham
Orthopaedic surgery residency program ranking and leadership can influence applicant and program decision-making. The study objective was to evaluate the relationship between program rankings and characteristics of their leadership. The Accreditation Council for Graduate Medical Education, Doximity, and program-specific websites were queried, identifying 193 programs and 426 leaders for analysis. Leadership positions evaluated included: Chairs, Vice Chairs, Program Directors, and Assistant Program Directors. Residency programs were categorized into tiers based on 2022-2023 Doximity reputation ranking. Program ranking was stratified as follows: Tier 1 (rank 1-50, highest-ranking programs), Tier 2 (rank 51-100), Tier 3 (rank 101-150), and Tier 4 (rank 151-201, lowest-ranking programs). Leaders were described according to demographics, training, research productivity, and experience. A total of 426 leaders at 193 programs were included. The average number of leadership positions per program was 2.2±1.0. Higher-tier programs had more leadership positions and were more likely to have chairpeople (P<0.001). They also had a larger proportion of women leaders (P=0.023), although only 11.2% of leaders overall were women. Residency training outside the US did not vary across tiers (P=0.881). Higher-tier leaders were more likely to complete fellowship (P<0.001) and specialize in pediatrics, oncology, and spine (P<0.032), although trauma was the most common specialty among leaders regardless of ranking. Program rank correlated strongly with program size (number of residents) (r2=−0.69) and weakly with leadership h-index (r2=−0.33) and research documents (r2=−0.40). Rank did not correlate with years in practice (r2=0.06), years until attaining a leadership position (r2=0.06), or years in present leadership position (r2=0.07). Program ranking correlated with the number of leaders and residents, as well as research productivity, but not with years of experience or training within the US. Top-tier programs have a higher proportion of women leaders, although the overall number is still low.
{"title":"Orthopaedic surgery residency program ranking and the current state of leadership: what are the characteristics of the leaders in the “Top-tier” programs?","authors":"Fernando A. Huyke-Hernández, Stephen A. Doxey, Lily J. Qian, Brian P. Cunningham","doi":"10.1097/bco.0000000000001247","DOIUrl":"https://doi.org/10.1097/bco.0000000000001247","url":null,"abstract":"Orthopaedic surgery residency program ranking and leadership can influence applicant and program decision-making. The study objective was to evaluate the relationship between program rankings and characteristics of their leadership. The Accreditation Council for Graduate Medical Education, Doximity, and program-specific websites were queried, identifying 193 programs and 426 leaders for analysis. Leadership positions evaluated included: Chairs, Vice Chairs, Program Directors, and Assistant Program Directors. Residency programs were categorized into tiers based on 2022-2023 Doximity reputation ranking. Program ranking was stratified as follows: Tier 1 (rank 1-50, highest-ranking programs), Tier 2 (rank 51-100), Tier 3 (rank 101-150), and Tier 4 (rank 151-201, lowest-ranking programs). Leaders were described according to demographics, training, research productivity, and experience. A total of 426 leaders at 193 programs were included. The average number of leadership positions per program was 2.2±1.0. Higher-tier programs had more leadership positions and were more likely to have chairpeople (P<0.001). They also had a larger proportion of women leaders (P=0.023), although only 11.2% of leaders overall were women. Residency training outside the US did not vary across tiers (P=0.881). Higher-tier leaders were more likely to complete fellowship (P<0.001) and specialize in pediatrics, oncology, and spine (P<0.032), although trauma was the most common specialty among leaders regardless of ranking. Program rank correlated strongly with program size (number of residents) (r2=−0.69) and weakly with leadership h-index (r2=−0.33) and research documents (r2=−0.40). Rank did not correlate with years in practice (r2=0.06), years until attaining a leadership position (r2=0.06), or years in present leadership position (r2=0.07). Program ranking correlated with the number of leaders and residents, as well as research productivity, but not with years of experience or training within the US. Top-tier programs have a higher proportion of women leaders, although the overall number is still low.","PeriodicalId":10732,"journal":{"name":"Current Orthopaedic Practice","volume":"5 2","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139269565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-13DOI: 10.1097/bco.0000000000001245
Ana Paula Fontes, Rui Miguel Cintra, Luís Filipe Gomes, João Paulo Sousa
Background: This study aimed to know which variables most contribute to the functioning acquired in the third month using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and a multivariate analysis through classification and regression tree (CRT), comparing the conventional instrumentation (CI), and patient-specific instrumentation (PSI). Methods: This is an observational and retrospective study. The sample consisted of 252 patients, 68 receiving CI (27.0%) and 184 receiving PSI (73.0%). The functional variables of the study were: knee pain, passive flexion and extension, gait distance and the domains of the WOMAC index. Results: The CRT method identified that the only explanatory variable that contributed to the highest functioning in the CI group (13.2 in the WOMAC) was pain in the third month with a value ≤2.5 in the visual analog scale (VAS). In the PSI group, the variable that best explained functioning was pain in the first postoperative month (VAS ≤4.5), with the best functional result (2.8 in WOMAC) referring to the patients who walked >320.5 m in the 6-minute walk test in the first month and who had flexion of >112.5 in the third month. Conclusions: Feeling pain is the variable with the most significant explanatory power for the results achieved in functioning at the third month, regardless of the arthroplasty instrumentation employed. Moving the knee in higher flexion ranges and obtaining higher mean values of gait speed also positively influences functioning in patients subjected to PSI.
{"title":"Feel, move, or walk? Which has a greater contribution to functioning in total knee arthroplasty? A comparative study between two instrumentations based on a classification and regression tree","authors":"Ana Paula Fontes, Rui Miguel Cintra, Luís Filipe Gomes, João Paulo Sousa","doi":"10.1097/bco.0000000000001245","DOIUrl":"https://doi.org/10.1097/bco.0000000000001245","url":null,"abstract":"Background: This study aimed to know which variables most contribute to the functioning acquired in the third month using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and a multivariate analysis through classification and regression tree (CRT), comparing the conventional instrumentation (CI), and patient-specific instrumentation (PSI). Methods: This is an observational and retrospective study. The sample consisted of 252 patients, 68 receiving CI (27.0%) and 184 receiving PSI (73.0%). The functional variables of the study were: knee pain, passive flexion and extension, gait distance and the domains of the WOMAC index. Results: The CRT method identified that the only explanatory variable that contributed to the highest functioning in the CI group (13.2 in the WOMAC) was pain in the third month with a value ≤2.5 in the visual analog scale (VAS). In the PSI group, the variable that best explained functioning was pain in the first postoperative month (VAS ≤4.5), with the best functional result (2.8 in WOMAC) referring to the patients who walked >320.5 m in the 6-minute walk test in the first month and who had flexion of >112.5 in the third month. Conclusions: Feeling pain is the variable with the most significant explanatory power for the results achieved in functioning at the third month, regardless of the arthroplasty instrumentation employed. Moving the knee in higher flexion ranges and obtaining higher mean values of gait speed also positively influences functioning in patients subjected to PSI.","PeriodicalId":10732,"journal":{"name":"Current Orthopaedic Practice","volume":"53 38","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134993792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-09DOI: 10.1097/bco.0000000000001244
Elan Karlin, Ji Won Lee, Kavya Sanghavi, Henry Boucher
Background: Robotic assisted (RA) total hip arthroplasty (THA) may provide improved precision and accuracy; however, contention remains on whether RA THA provides better patient outcomes than conventional THA. This study compares short-term clinical outcomes, complication rates, and operative times between these two groups. Methods: We retrospectively reviewed charts for demographic data, comorbidities, operating time, revisions, and complications of patients who underwent RA and conventional THA. Patient-reported outcomes were collected via OBERD database at the following timepoints: preoperatively, 6-month, 1-year, and 2-year postoperatively. Descriptive statistics and mixed multivariate regression analyses were used to analyze data. Results: Two hundred ten patients were included (n=149 conventional, n=61 RA). Patients with RA THAs were younger than those with conventional THAs (59 years, IQR: 53-66 and 64 years, IQR: 58-71; P =.002). The operative time was longer for the RA compared to the conventional group (106 minutes, IQR: 92-120 and 92 minutes, IQR: 82-109, respectively, P =< .001). There was no statistically significant difference in SF-12 mental scores, SF-12 physical scores, or OHS between RA and conventional THA at different timepoints. Additionally, there was no statistically significant difference in complication and revision rates between the two groups. Conclusion: Our findings demonstrated that there were no statistically significant differences in patient-reported outcomes between the RA versus conventional THA groups. Furthermore, our findings suggest a lack of significant differences in complication or revision rates. Surgeons performing robot-assisted surgeries for hip replacements can reasonably expect patient outcomes that are, at a minimum, as successful as the conventional counterparts.
{"title":"Patient outcomes of conventional versus robot assisted total hip arthroplasty","authors":"Elan Karlin, Ji Won Lee, Kavya Sanghavi, Henry Boucher","doi":"10.1097/bco.0000000000001244","DOIUrl":"https://doi.org/10.1097/bco.0000000000001244","url":null,"abstract":"Background: Robotic assisted (RA) total hip arthroplasty (THA) may provide improved precision and accuracy; however, contention remains on whether RA THA provides better patient outcomes than conventional THA. This study compares short-term clinical outcomes, complication rates, and operative times between these two groups. Methods: We retrospectively reviewed charts for demographic data, comorbidities, operating time, revisions, and complications of patients who underwent RA and conventional THA. Patient-reported outcomes were collected via OBERD database at the following timepoints: preoperatively, 6-month, 1-year, and 2-year postoperatively. Descriptive statistics and mixed multivariate regression analyses were used to analyze data. Results: Two hundred ten patients were included (n=149 conventional, n=61 RA). Patients with RA THAs were younger than those with conventional THAs (59 years, IQR: 53-66 and 64 years, IQR: 58-71; P =.002). The operative time was longer for the RA compared to the conventional group (106 minutes, IQR: 92-120 and 92 minutes, IQR: 82-109, respectively, P =< .001). There was no statistically significant difference in SF-12 mental scores, SF-12 physical scores, or OHS between RA and conventional THA at different timepoints. Additionally, there was no statistically significant difference in complication and revision rates between the two groups. Conclusion: Our findings demonstrated that there were no statistically significant differences in patient-reported outcomes between the RA versus conventional THA groups. Furthermore, our findings suggest a lack of significant differences in complication or revision rates. Surgeons performing robot-assisted surgeries for hip replacements can reasonably expect patient outcomes that are, at a minimum, as successful as the conventional counterparts.","PeriodicalId":10732,"journal":{"name":"Current Orthopaedic Practice","volume":" 22","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135292275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-08DOI: 10.1097/bco.0000000000001239
Gabriel I. Onor, William L. Johns, Neel Patel, Sean Wilson, Ralph Cook, Michael C. Ciccotti, Christopher C. Dodson
Anterior cruciate ligament (ACL) repair has become increasingly popular in recent years as an option for management of ACL rupture. Though arthroscopic reconstruction has long been the gold standard, there may be a role for repair in appropriately selected patient populations and tear patterns. Recent industry-driven advances in techniques and available instrumentation for ACL repair have regenerated interest. Proponents of ACL repair highlight the maintenance of native tissues allowing for retained proprioception, lack of need for graft usage or harvest, and the potential for accelerated rehabilitation postoperatively as compared to ACL reconstruction. Short-term and early mid-term ACL repair studies have demonstrated encouraging results; however, the authors remain in favor of ACL reconstruction at this time given a dearth of long-term outcomes following ACL repair.
{"title":"Reconstruction vs. repair: a review of recent trends and controversies for management of ACL rupture","authors":"Gabriel I. Onor, William L. Johns, Neel Patel, Sean Wilson, Ralph Cook, Michael C. Ciccotti, Christopher C. Dodson","doi":"10.1097/bco.0000000000001239","DOIUrl":"https://doi.org/10.1097/bco.0000000000001239","url":null,"abstract":"Anterior cruciate ligament (ACL) repair has become increasingly popular in recent years as an option for management of ACL rupture. Though arthroscopic reconstruction has long been the gold standard, there may be a role for repair in appropriately selected patient populations and tear patterns. Recent industry-driven advances in techniques and available instrumentation for ACL repair have regenerated interest. Proponents of ACL repair highlight the maintenance of native tissues allowing for retained proprioception, lack of need for graft usage or harvest, and the potential for accelerated rehabilitation postoperatively as compared to ACL reconstruction. Short-term and early mid-term ACL repair studies have demonstrated encouraging results; however, the authors remain in favor of ACL reconstruction at this time given a dearth of long-term outcomes following ACL repair.","PeriodicalId":10732,"journal":{"name":"Current Orthopaedic Practice","volume":" 23","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135340594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-06DOI: 10.1097/bco.0000000000001243
Solangel Rodriguez-Materon, Christopher W. Hodgkins
{"title":"Traumatic rupture of the flexor hallucis brevis tendon. Case report and review of the literature","authors":"Solangel Rodriguez-Materon, Christopher W. Hodgkins","doi":"10.1097/bco.0000000000001243","DOIUrl":"https://doi.org/10.1097/bco.0000000000001243","url":null,"abstract":"","PeriodicalId":10732,"journal":{"name":"Current Orthopaedic Practice","volume":"22 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135679343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-06DOI: 10.1097/bco.0000000000001242
Islam Sameeh, Yamen Safwat, Mohammed Khalid Saleh
Background: Associated fractures of the acetabulum and pelvic ring represent considerable percentage of polytrauma victims. These types of injuries are different from isolated acetabular or pelvic injuries regarding injury severity scores, haemodynamic status, blood transfusion requirements, and higher mortality rates up to 13%. Both Letournel and Matta have definitively shown that anatomic reduction of the fracture is the most influential factor predictive of clinical outcome. The ability of obtaining anatomical reduction is affected by age, fracture pattern, associated injuries, patient general condition, timing to surgery and complications. Design: Retrospective cohort study. Methods: It is a retrospective study among 24 patients performed in Zagazig university hospitals between May 2017 and February 2019. Matta scoring system was used to quantify the radiological outcome of both acetabular and pelvic components while, both Majeed and Merle d’Aubigné were used for clinical grading at the final follow up. Timing to surgery was found to affect the quality of reduction significantly. Results: We divided our cases into 2 groups; First group including the patients underwent operative management from day 0 to day 10 which include 18 cases and Second group including the patients underwent operative management from day 11 to day 21 which include 6 cases and we will observe if there is a correlation between the preoperative delay and Matta scoring for both acetabular and pelvic components. Among the operatively managed acetabular fracture There was significant association between preoperative delay and Matta scoring system for acetabular component ( P <0.05) Among the operatively managed pelvic ring injuries There was significant association between preoperative delay and Matta scoring system for pelvic component ( P <0.05). Conclusion: The quality of reduction can be controlled by controlling the time to surgery after optimization of the general condition of the patient and controlling the local complications. In our study the earlier to operate on both components within the first 10 days after initial trauma the better to get anatomical reduction.
背景:髋臼和骨盆环相关骨折在多发外伤患者中占相当大的比例。这些类型的损伤在损伤严重程度评分、血流动力学状况、输血要求和高达13%的高死亡率方面不同于孤立的髋臼或骨盆损伤。Letournel和Matta都明确表明，骨折解剖复位是预测临床结果的最重要因素。获得解剖复位的能力受年龄、骨折类型、相关损伤、患者一般情况、手术时机和并发症的影响。设计:回顾性队列研究。方法:对2017年5月至2019年2月在扎加齐格大学附属医院就诊的24例患者进行回顾性研究。Matta评分系统用于量化髋臼和骨盆部位的放射学结果，而在最后随访时使用Majeed和Merle d ' aubign进行临床分级。发现手术时机对复位质量有显著影响。结果:我们将病例分为两组;第一组包括从0天到10天接受手术治疗的患者，包括18例;第二组包括从11天到21天接受手术治疗的患者，包括6例，我们将观察术前延迟与髋臼和骨盆成分的Matta评分之间是否存在相关性。在手术处理的髋臼骨折中，术前延迟与髋臼成分Matta评分系统有显著相关性(P <0.05)。在手术处理的骨盆环损伤中，术前延迟与骨盆成分Matta评分系统有显著相关性(P <0.05)。结论:优化患者全身情况，控制局部并发症，控制手术时间，可控制复位质量。在我们的研究中，创伤后10天内越早对两个部位进行手术，解剖复位效果越好。
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