Pub Date : 2022-01-01DOI: 10.2106/jbjs.jopa.22.00020
C. Bishop, Allegra Hackman
{"title":"Distal Tibial Physeal Fracture in an 11-Year-Old Girl","authors":"C. Bishop, Allegra Hackman","doi":"10.2106/jbjs.jopa.22.00020","DOIUrl":"https://doi.org/10.2106/jbjs.jopa.22.00020","url":null,"abstract":"","PeriodicalId":93583,"journal":{"name":"Journal of orthopedics for physician assistants","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67753922","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 : 2021-12-16DOI: 10.2106/JBJS.JOPA.21.00026
C. M. Davis, David C. Beck
Ankylosing spondylitis (AS) is an inflammatory condition that is challenging to diagnose, especially early in its clinical course. Delays in recognizing, diagnosing, and properly classifying cases of AS allow for ongoing clinical progression, which can result in avoidable pain, debilitation, and other negative impacts on quality of life and participation in life and society to the fullest. In this review article, we present background information about AS, as well as diagnostic tools and other guidance for physician assistants and other health care providers to aid in its early detection and appropriate classification to facilitate impactful treatment.
{"title":"Axial Spondyloarthritis","authors":"C. M. Davis, David C. Beck","doi":"10.2106/JBJS.JOPA.21.00026","DOIUrl":"https://doi.org/10.2106/JBJS.JOPA.21.00026","url":null,"abstract":"Ankylosing spondylitis (AS) is an inflammatory condition that is challenging to diagnose, especially early in its clinical course. Delays in recognizing, diagnosing, and properly classifying cases of AS allow for ongoing clinical progression, which can result in avoidable pain, debilitation, and other negative impacts on quality of life and participation in life and society to the fullest. In this review article, we present background information about AS, as well as diagnostic tools and other guidance for physician assistants and other health care providers to aid in its early detection and appropriate classification to facilitate impactful treatment.","PeriodicalId":93583,"journal":{"name":"Journal of orthopedics for physician assistants","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42733696","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 : 2021-12-06DOI: 10.2106/jbjs.jopa.21.00028
S. G. Connell
Background: Patients undergoing total knee arthroplasty (TKA) tend to do very well; however, there is still a percentage of the population who will remain dissatisfied despite a successful surgery. Orthopaedic surgeons do not currently recommend mental health evaluations or support as standard of care when discussing TKA. The objective was to determine the role of orthopaedic surgeons and mental health referrals or recommendations. Methods: A quantitative retrospective study was performed on TKA patients in 2019 by 2 high-volume joint surgeons. A survey was sent through e-mail asking demographic questions and questions specific to coping skills and feelings of pain, fear, anger, or anxiety, which is referred to as mental health in this study. The response rate was 41% with n = 110 participants. Descriptive statistics was used to show the data trends. Results: Most of the people reported that seeing a counselor or therapist would not have been helpful with TKA recovery, with many feeling that they did not need support in this area. Women reported more difficulty with coping skills and were more responsive to seeing a counselor or therapist if recommended by their surgeon. Eighty-three percent of the 60- to 79-year-olds felt that orthopaedic surgeons should make referrals or provide resources for mental health support. Conclusion: The results show that more evidence is needed to determine the role of which orthopaedic surgeons play when it comes to mental health recommendations and referrals.
{"title":"Mental Health and Total Knee Arthroplasty","authors":"S. G. Connell","doi":"10.2106/jbjs.jopa.21.00028","DOIUrl":"https://doi.org/10.2106/jbjs.jopa.21.00028","url":null,"abstract":"Background: Patients undergoing total knee arthroplasty (TKA) tend to do very well; however, there is still a percentage of the population who will remain dissatisfied despite a successful surgery. Orthopaedic surgeons do not currently recommend mental health evaluations or support as standard of care when discussing TKA. The objective was to determine the role of orthopaedic surgeons and mental health referrals or recommendations. Methods: A quantitative retrospective study was performed on TKA patients in 2019 by 2 high-volume joint surgeons. A survey was sent through e-mail asking demographic questions and questions specific to coping skills and feelings of pain, fear, anger, or anxiety, which is referred to as mental health in this study. The response rate was 41% with n = 110 participants. Descriptive statistics was used to show the data trends. Results: Most of the people reported that seeing a counselor or therapist would not have been helpful with TKA recovery, with many feeling that they did not need support in this area. Women reported more difficulty with coping skills and were more responsive to seeing a counselor or therapist if recommended by their surgeon. Eighty-three percent of the 60- to 79-year-olds felt that orthopaedic surgeons should make referrals or provide resources for mental health support. Conclusion: The results show that more evidence is needed to determine the role of which orthopaedic surgeons play when it comes to mental health recommendations and referrals.","PeriodicalId":93583,"journal":{"name":"Journal of orthopedics for physician assistants","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48311286","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 : 2021-12-01DOI: 10.2106/JBJS.JOPA.21.00027
Alexandra Meekin, Cody A. Sasek
Knee osteoarthritis (KOA) is a musculoskeletal disorder that causes progressive degeneration of the articular cartilage leading to pain and loss of function. Conservative treatment focuses on symptomatic relief with analgesics and nonsteroidal anti-inflammatory drugs. Mesenchymal stem cells (MSCs) have immunosuppressive and anti-inflammatory properties that aim to modify the disease process. Patients find improvement in function and pain after MSC therapy. MSC treatment stabilizes the cartilage, but there is no definitive regeneration. MSC therapy could be a treatment option for those wanting to stop or delay the disease process. This article reviews the current literature on the use of MSC therapy for patients with KOA.
{"title":"Stem-Cell Therapy for the Treatment of Knee Osteoarthritis","authors":"Alexandra Meekin, Cody A. Sasek","doi":"10.2106/JBJS.JOPA.21.00027","DOIUrl":"https://doi.org/10.2106/JBJS.JOPA.21.00027","url":null,"abstract":"Knee osteoarthritis (KOA) is a musculoskeletal disorder that causes progressive degeneration of the articular cartilage leading to pain and loss of function. Conservative treatment focuses on symptomatic relief with analgesics and nonsteroidal anti-inflammatory drugs. Mesenchymal stem cells (MSCs) have immunosuppressive and anti-inflammatory properties that aim to modify the disease process. Patients find improvement in function and pain after MSC therapy. MSC treatment stabilizes the cartilage, but there is no definitive regeneration. MSC therapy could be a treatment option for those wanting to stop or delay the disease process. This article reviews the current literature on the use of MSC therapy for patients with KOA.","PeriodicalId":93583,"journal":{"name":"Journal of orthopedics for physician assistants","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49113676","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 : 2021-10-13DOI: 10.2106/JBJS.JOPA.21.00015
Stanislav Avshalumov, Nicholas Frane, Erik J. Stapleton, Zachary Aberman, I. Bandovic, Alex Wicker
Introduction: The supercapsular percutaneously assisted total hip (SuperPATH) approach and technique are a relatively new minimally invasive procedure for total hip replacement. The theoretical benefits include muscle sparing, no hip precautions, smaller incision, decrease in blood loss, and a relative familiar approach for joint surgeons. The aim of our study was to assess the early results and learning curve using the SuperPATH technique. Methods: A retrospective cohort analysis of the first 28 SuperPATH hip replacements by a single surgeon was performed. The learning curve was assessed by evaluating the results of 2 groups of 14 cases grouped in order in which they were performed. Group 1 was comprised of the first 14 cases, and group 2 of the last 14 cases. Primary measures included operative time and blood loss as surrogates of technical improvement. Secondary measures recorded were length of stay, acetabular component inclination angle, postoperative leg length discrepancy, and intraoperative complications. Descriptive statistics were used to describe the patient cohort, and comparative testing was performed to determine differences between the groups. Statistical significance was defined as p < 0.05. Results: The duration of the operative procedure between the first 14 cases and the last 14 cases was statistically significant (p = 0.045), 162.85 and 142.67 minutes, respectively. The length of stay was also statistically significant (p = 0.020) between the 2 groups, 3.5 and 2.5 days, respectively. There was no difference between the groups for blood loss, acetabular inclination angle, and leg length discrepancy. Conclusions: This study found a gradual decrease in operative time without plateau between the 2 groups, suggesting that operative time will continue to decrease in the future. Future research will include an extended follow-up of the study group to determine longer-term outcomes and complications. Furthermore, a larger sample size will be needed to determine when the learning curve levels off for this procedure. Level of Evidence: Level IV.
{"title":"SuperPATH Total Hip Arthroplasty","authors":"Stanislav Avshalumov, Nicholas Frane, Erik J. Stapleton, Zachary Aberman, I. Bandovic, Alex Wicker","doi":"10.2106/JBJS.JOPA.21.00015","DOIUrl":"https://doi.org/10.2106/JBJS.JOPA.21.00015","url":null,"abstract":"Introduction: The supercapsular percutaneously assisted total hip (SuperPATH) approach and technique are a relatively new minimally invasive procedure for total hip replacement. The theoretical benefits include muscle sparing, no hip precautions, smaller incision, decrease in blood loss, and a relative familiar approach for joint surgeons. The aim of our study was to assess the early results and learning curve using the SuperPATH technique. Methods: A retrospective cohort analysis of the first 28 SuperPATH hip replacements by a single surgeon was performed. The learning curve was assessed by evaluating the results of 2 groups of 14 cases grouped in order in which they were performed. Group 1 was comprised of the first 14 cases, and group 2 of the last 14 cases. Primary measures included operative time and blood loss as surrogates of technical improvement. Secondary measures recorded were length of stay, acetabular component inclination angle, postoperative leg length discrepancy, and intraoperative complications. Descriptive statistics were used to describe the patient cohort, and comparative testing was performed to determine differences between the groups. Statistical significance was defined as p < 0.05. Results: The duration of the operative procedure between the first 14 cases and the last 14 cases was statistically significant (p = 0.045), 162.85 and 142.67 minutes, respectively. The length of stay was also statistically significant (p = 0.020) between the 2 groups, 3.5 and 2.5 days, respectively. There was no difference between the groups for blood loss, acetabular inclination angle, and leg length discrepancy. Conclusions: This study found a gradual decrease in operative time without plateau between the 2 groups, suggesting that operative time will continue to decrease in the future. Future research will include an extended follow-up of the study group to determine longer-term outcomes and complications. Furthermore, a larger sample size will be needed to determine when the learning curve levels off for this procedure. Level of Evidence: Level IV.","PeriodicalId":93583,"journal":{"name":"Journal of orthopedics for physician assistants","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46696037","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 : 2021-10-08DOI: 10.2106/JBJS.JOPA.21.00020
John P. Bryan
Preoperative anxiety has been shown to have widespread adverse effects on perioperative care. Total joint arthroplasty (TJA) in the presence of preoperative anxiety has been shown to negatively affect outcomes, although performance objectives have been obtained. Limited research has been conducted using qualitative methodology to define the concerns related to preoperative anxiety as they relate to TJA. This qualitative study aimed to identify the preoperative concerns of patients leading up to their TJA. Twenty-one patients scheduled for TJA were interviewed the night before their scheduled surgery in a public hospital. Thematic analysis identified 4 main sources of preoperative anxiety: recovery period, surgical complications, outcomes, and hospital period. Accompanying these themes were multiple subthemes reflecting succinct concerns patients have. These themes echo previous literature and identify broader concerns around the recovery period and outcomes. As the number of TJAs increases, this research may benefit existing and ever-evolving future preoperative TJA educational programs. In addition, this research may suggest the further development of interventions aimed at reducing preoperative anxiety in TJA.
{"title":"Concerns Related to Preoperative Anxiety in the Total Joint Arthroplasty Patient","authors":"John P. Bryan","doi":"10.2106/JBJS.JOPA.21.00020","DOIUrl":"https://doi.org/10.2106/JBJS.JOPA.21.00020","url":null,"abstract":"Preoperative anxiety has been shown to have widespread adverse effects on perioperative care. Total joint arthroplasty (TJA) in the presence of preoperative anxiety has been shown to negatively affect outcomes, although performance objectives have been obtained. Limited research has been conducted using qualitative methodology to define the concerns related to preoperative anxiety as they relate to TJA. This qualitative study aimed to identify the preoperative concerns of patients leading up to their TJA. Twenty-one patients scheduled for TJA were interviewed the night before their scheduled surgery in a public hospital. Thematic analysis identified 4 main sources of preoperative anxiety: recovery period, surgical complications, outcomes, and hospital period. Accompanying these themes were multiple subthemes reflecting succinct concerns patients have. These themes echo previous literature and identify broader concerns around the recovery period and outcomes. As the number of TJAs increases, this research may benefit existing and ever-evolving future preoperative TJA educational programs. In addition, this research may suggest the further development of interventions aimed at reducing preoperative anxiety in TJA.","PeriodicalId":93583,"journal":{"name":"Journal of orthopedics for physician assistants","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46694476","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 : 2021-09-09DOI: 10.2106/JBJS.JOPA.21.00017
D. Cloutier
The purpose of this study is to offer readers a brief overview of prolotherapy and common indications in an orthopaedic setting including Achilles tendinitis, lateral epicondylitis, plantar fasciitis, sacroiliac joint pain, and knee arthritis. This study briefly summarizes the study results and injection protocols used in each study to help guide practitioners who are considering using prolotherapy in their practice.
{"title":"Prolotherapy","authors":"D. Cloutier","doi":"10.2106/JBJS.JOPA.21.00017","DOIUrl":"https://doi.org/10.2106/JBJS.JOPA.21.00017","url":null,"abstract":"The purpose of this study is to offer readers a brief overview of prolotherapy and common indications in an orthopaedic setting including Achilles tendinitis, lateral epicondylitis, plantar fasciitis, sacroiliac joint pain, and knee arthritis. This study briefly summarizes the study results and injection protocols used in each study to help guide practitioners who are considering using prolotherapy in their practice.","PeriodicalId":93583,"journal":{"name":"Journal of orthopedics for physician assistants","volume":"9 1","pages":"e21.00017"},"PeriodicalIF":0.0,"publicationDate":"2021-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67753228","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 : 2021-08-27DOI: 10.2106/JBJS.JOPA.21.00005
Ryan D. Clement
Three-dimensional printing (3DP) is also referred to as additive manufacturing or rapid prototyping. During its evolution, it was designed to create prototypes/models for industries in a more economically and timely manner in respect to conventional mass production. It was created to change from the normal industrial casting or machining of the products in mass numbers to a more tailored/customized product. 3DP in orthopaedics started out printing anatomic models and then evolved into printing surgical cutting guides and jigs. Today, in orthopaedics, we print patient-specific implants. This article will be a brief overview of the available 3DP methods, the process, materials, applications in orthopaedics, and an orthopaedic case example of printed materials.
{"title":"An Overview to Three-Dimensional Printing Process and Creating a Custom Orthopaedic Medical Device","authors":"Ryan D. Clement","doi":"10.2106/JBJS.JOPA.21.00005","DOIUrl":"https://doi.org/10.2106/JBJS.JOPA.21.00005","url":null,"abstract":"Three-dimensional printing (3DP) is also referred to as additive manufacturing or rapid prototyping. During its evolution, it was designed to create prototypes/models for industries in a more economically and timely manner in respect to conventional mass production. It was created to change from the normal industrial casting or machining of the products in mass numbers to a more tailored/customized product. 3DP in orthopaedics started out printing anatomic models and then evolved into printing surgical cutting guides and jigs. Today, in orthopaedics, we print patient-specific implants. This article will be a brief overview of the available 3DP methods, the process, materials, applications in orthopaedics, and an orthopaedic case example of printed materials.","PeriodicalId":93583,"journal":{"name":"Journal of orthopedics for physician assistants","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45117663","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}
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