Prevalence of Risk Factors for Adverse Spinopelvic Mobility in Total Hip Arthroplasty
The aim of this study was to identify spinopelvic risk variables relevant to hip arthroplasty surgeons, as well patient risk factors for pathologic spinopelvic movement and anterior dislocation. In this study, 46% of patients had spinopelvic disease. Adverse spinopelvic mobility is found in half of THA patients with no specific risk factor, highlighting need to screen all patients preoperatively.
Multimodal Analgesic Management for Lumbar Decompression Surgery in the Ambulatory Setting
Largest ASC study examined lumbar decompression operations with no specific 23-hour surveillance (499 patients). It was found that lumbar decompression surgery can be performed in an ASC with proper patient selection, surgical technique, and multimodal analgesia. This treatment is safe in the ASC setting due to its low VAS and low postoperative complications.
Acute vs. Delaying Reverse Total Shoulder Arthroplasty Treatment of Proximal Humeral Fracture
This study aims to understand how the time of RTSA treatment influences results by comparing the revision rate, surgical and medical complications, and costs between acute and delayed RTSA. Delayed RTSA for proximal humeral fractures causes more 1-year revisions and dislocations than acute RTSA. Delaying RTSA may lead to more surgery and worse outcomes.
Higher Preoperative NarxCare Scores Linked to Adverse Outcomes After Primary Total Hip Arthroplasty
The study aimed to identify a preoperative NCS threshold for poor outcomes, a link between preoperative NCS and LOS, discharge disposition, 90-day readmission, and reoperation rates following initial THA. Higher NCS was linked to longer LOS, 90-day readmission, & reduced probabilities of home release. NCS of 300 may be utilised to identify people at risk for THA complications.
Fragility Fracture of the Upper Extremity and Foot or Ankle Should Be Considered Sentinel Events
This study aimed to examine patient demographics, bone disease severity, prior fracture frequency, and osteoporosis treatment frequency by anatomic location of fragility fracture. Fragility fractures of the foot/ankle occur in people with less severe metabolic bone disease and should be referred for bone health evaluation.
Periprosthetic Femur Fracture Risk: Influenced by Stem Choice, Not Surgical Approach
This study's goal is to assess the 90-day relative risk of PFF based on method and stem type. PFF is a prevalent cause of failure after total hip arthroplasty (THA). Based on their single-center experience, collared stems and fit-and-fill stems lower the risk of periprosthetic fracture within 90 days. A female's age and BMI below 25 increase PFF risk. No anaesthesia reduced fracture rates.
Association between Femoral Stem Type and the Risk of Aseptic Revision following Hemiarthroplasty
In the treatment of displaced femoral neck fractures in the elderly, uncemented hemiarthroplasty had higher risk of aseptic revision than cemented hemiarthroplasty. Aseptic revision risk was assessed with three uncemented hemiarthroplasty stem designs. Uncemented stem designs have higher incidence of aseptic revision than cemented fixation.
Knee Arthroscopy Prior to Revision TKA linked with Increased Revision for Stiffness
The study aimed to evaluate the impact of knee arthroscopy on outcomes of subsequent TKA revision surgery. This cohort matched analysis found patients who had prior knee arthroscopy were likely to need revision TKA than individuals who received revision TKA without prior knee arthroscopy. Patients who had prior knee arthroscopy within 6 months had a higher risk of needing revision.
Continuous Passive Motion vs. Physical Therapy after Arthroscopic Release of Elbow Contracture
Following surgical contracture release, CPM was faster & better than PT in postoperative elbow rehabilitation. This was reflected in improved 6-week & 3-month ROM, as well as a reduced median time to attain their primary post-operative goal & improved 1-year ROM. These findings suggest more contractures benefit with CPM as they regained maximal recovery at 1 year.
Long Cervical Fusions: Are Multiple Segmental Plates Less Likely to Fail than a Single Long Plate?
Multilevel anterior cervical discectomy & fusion (ACDF) is commonly used for neuro-compressive pathology. Separated segmental anterior fixation maintains its stiffness effectively at caudal aspect of the construct than long single plate fixation.The validated model of biochemical performances of cervical spine fixation will enhance ability to optimize constructs & reduce risk of fractures.
Non-Narcotic Total Joint Arthroplasty Using an Alternative to Opioids Multimodal Pain Protocol
An opioid-free, multimodal pain management pathway is safe and effective for TJA patients and does not affect length of stay, 90-day complication rates, ED visits, or readmission rates. To properly understand how to adopt an opioid-free approach in total joint arthroplasty, future research will need to include randomised trials.
Arthroscopic Latarjet: In Vitro Evidence to Avoid Complications with the Trans-Pec Medial Portal
To avoid difficulties in the arthroscopic Bankart-Bristow-Latarjet surgery, the medial trans-pec major (East) portal can be used safely. To palpable tip of coracoid process, portal placement should be 45-50 mm distal and 30-35 mm medial. The portal medial to the coracoid gives excellent surgical access without compromising critical neurovascular pathways.
Safety Profile of Recombinant Human Bone Morphogenetic Protein 2 in Spinal Fusion Surgery
The session described use of recombinant human bone morphogenetic protein (rhBMP) in spinal fusion but remained controversial. The prior observational studies have shown conflicting conclusions regarding rhBMP safety and effectivenes. This large observational study states that rhBMP is found to be safe and effective as compared to non-BMP usage in spinal fusion with low infections.
Scoliosis Team & Standardized Surgery Improve Adolescent Idiopathic Scoliosis Surgery Outcomes
A retrospective review showed that standardization of the perioperative approach for AIS correction with a dedicated team significantly reduced blood loss, surgical time, and length of stay. These results were seen as the team continued to refine the protocol and its reproducibility is demonstrated by its capacity to enhance perioperative outcomes across multiple institutions.
The Incidence of Osteochondral Lesions after Ankle Fractures: A Systematic Review
In the study, OCLs were found in up to 45% of patients suffering from an ankle fracture at 3 years of follow up after initial trauma. The talus was found to be the location with the highest incidence of posttraumatic OCLs. Rotational type ankle fractures reported a higher percentage of OCLs compared to other ankle fracture types.
Arthroplasty vs. Internal Fixation for the Treatment of Minimally Displaced Femoral Neck Fractures
Arthroplasty be the optimal treatment for displaced femoral neck fracture management. For minimally displaced femoral neck fractures, internal fixation remains the preferred approach.The study suggests arthroplasty may reduce the risk of mortality & reoperation compared to internal fixation. This finding is counter to many surgical practices, but consistent with a mounting body of evidence.
Failure of Conservative Management in the Treatment of Calcific Tendinitis of the Shoulder
Shoulder calcific tendinitis results in 7% of shoulder discomfort and is caused by calcium deposits in the rotator cuff tendons. Physical therapy and corticosteroid injections are the first line treatments. If that doesn't work, arthroscopy is considered. The size of the lesion may influence the efficacy of conservative treatment. Preoperative planning and discussion should be included.
Optimal Fixation of the Capitellar Fragment in Distal Humerus Fractures
The study determined if orthogonal or parallel plate position provides superior fixation of the separate capitellar fragment often present in intraarticular distal humerus fractures. It was found that orthogonal plating would provide stiffer fixation as well as screw trajectories perpendicular to the fracture plane by a posterolateral plate compared to a parallel plate construct.
Reduced Fluoroscopy, Radiation Dose, and Surgical Time with Dedicated Spine Radiology Technologist
The purpose of this study was to investigate the fluoroscopy time and radiation exposure during pediatric spine surgery using a DRT with extensive experience in spine operating rooms compared to all other radiology technologists. It was found that the use of DRT was independently associated with a significant reduction in total fluoroscopy time, radiation exposure, total surgical time, and EBL.
Latissimus Dorsi, Pectoralis Major, and Pectoralis Minor Transfers in SCC Deficient Shoulders
Pma and Pmi transfers are less successful in generating internal rotational moment arms than LD. The transplanted LD can also generate internal rotational moment arms and mimics the subscapularis biomechanical features. Both the Pma and LD transfers had significantly reduced adducting moment arms, which clinically may result in decreased adduction.
