Journal of surgical orthopaedic advances最新文献

The objective of this study was to delineate a model for management of developmental dysplasia of the hip (DDH) treatment that incorporates hip ultrasound with objective/predicative parameters at key decision-making times. Hip sonograms of 74 infants (59 females, 15 males; 141 hips) with DDH were retrospectively reviewed. Hip sonographic score (HSS; ranges 0-10) was developed to reflect hip status based on sonographic position, stability, and morphology. Analysis on different management groups (i.e., no treatment, successful treatment, and failed treatment) showed that the trend of HSS is helpful in predicting course of the disease and determining effectiveness of treatment. A model for the management of DDH that utilizes an HSS and frequency schedule for hip sonography that is aligned with times of critical treatment decisions is proposed. This model illustrates how hip sonography can bring added value when timed to guide critical treatment decisions. (Journal of Surgical Orthopaedic Advances 32(1):047-054, 2023).

The purpose of the study was to (1) assess the prevalence of comorbidities and (2) compare demographics of surgically and non-surgically treated distal humerus fracture patients. Retrospective review of data from a national database was performed. The primary outcome was comorbidities; the secondary outcome was demographic trends between treatment groups. Distal humerus fractures are associated with cerebrovascular disease, dementia, diabetes mellitus, heart disease, hyperlipidemia, hypertension, hypothyroidism, kidney disease, liver disease, and lung disease. Those undergoing surgery are more likely to be obese, under the age of 40 years, female, Medicare recipients with fewer comorbidities, who reside in a rural setting, and who seek care at urban/teaching hospitals within the Southern United States. They are also more likely to have a shorter hospital stay, to be discharged to home, and to have improved survival. (Journal of Surgical Orthopaedic Advances 32(1):017-022, 2023).

The Coronavirus disease 2019 (COVID-19) pandemic has strained many healthcare systems. Google Trends is a tool that provides information on online interest in selected keywords and topics over time. The purpose of this study is to describe the effect of the COVID-19 pandemic on online interest in elective shoulder pathology. Online search pattern data were obtained via Google Trends from November 2019 to November 2020 using the search terms 'orthopedic surgery' and 'shoulder pathology' search terms. Relative search volume index (SVI) graphs were generated from this data and the 7-day average of new COVID-19 cases in the United States. Orthopaedic surgery and shoulder pathology search trends decreased during March 2020 with a sudden rise in the 7-day average of new COVID-19 cases. After March 2020, orthopaedic surgery and shoulder pathology search terms approached pre-COVID-19 pandemic values despite continued increases in the 7-day average of new COVID-19 cases. (Journal of Surgical Orthopaedic Advances 32(1):014-016, 2023).

Obesity and malnutrition are modifiable risk factors associated with increased postoperative complications following total knee arthroplasty (TKA). Obesity is paradoxically associated with malnutrition. Previous studies have only evaluated the impact of body mass index (BMI) and hypoalbuminemia separately in relation to postoperative TKA outcomes and have attempted to compare the impact of these modifiable risk factors. Our study seeks to establish if increased BMI and decreased albumin levels have a compounding effect on postoperative outcomes. A retrospective analysis was conducted using the 2011-2014 American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) dataset. This study reaffirmed that increased BMI and low albumin levels are associated with increased postoperative complications following TKA. Moreover, this study demonstrated that they do not have a compounding effect, but rather only help predict outcomes when analyzed individually. (Journal of Surgical Orthopaedic Advances 32(2) 114-117, 2023).

Instability remains a challenge after total hip arthroplasty (THA). We have previously utilized a monofilament polypropylene mesh to reconstruct the posterior capsule for unstable THA. This study identified 24 hips that underwent mesh reconstruction of the posterior capsule for instability. Survivorship was 70.8% at mean 6.5 years (range 6 weeks-20.1 years). Six patients underwent re-operation, and one patient had the mesh removed. Of eight hips, five (62.5%) with a history of prior revision re-dislocated, while only 2/16 hips (12.5%) with no previous revision history re-dislocated (p = 0.02). Posterior capsule reconstruction with polypropylene mesh has reasonable mid-term survivorship in this challenging population. (Journal of Surgical Orthopaedic Advances 32(2):092-096, 2023).

In order to evaluate postoperative function and failure rates among younger patients undergoing hemiarthroplasty for humeral head avascular necrosis (AVN), data from patients < 40 years treated between December 2008 - January 2018 was retrospectively analyzed. Pain was assessed preoperatively and at final follow up using a visual analogue scale (VAS). The American Shoulder and Elbow Surgeons (ASES) standardized assessment, single assessment numeric evaluation (SANE) score, and patient satisfaction were assessed at final follow up, as well as surgical revision rates. In total, eight shoulders were included in the final analysis, with a follow up of 6.6 + 3.6 years. Analysis indicated a statistical improvement in VAS pain (p = 0.001), while comparison of postoperative function between surgical and non-surgical limbs did not demonstrate statistical differences in SANE or ASES averages (p > 0.05). At final follow up, 25% of patients expressed dissatisfaction; however, there were no cases of revision surgery. In conclusion, younger patients undergoing hemiarthroplasty for humeral head AVN experienced pain improvement and no revisions at short-to-mid-term follow up, but one-in-four indicated dissatisfaction. Level of evidence: IV, case series. (Journal of Surgical Orthopaedic Advances 32(2):118-121, 2023).