New JAAOS Deputy Editors and JAAOS Mentorship Consortium Sounds From the Training Room

Levine, William N. MD

doi : 10.5435/JAAOS-D-21-00691

September 15, 2021 - Volume 29 - Issue 18 - p 767-769

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Surgical Tips and Tricks for Distal Femur Plating

Lee, Christopher MD; Brodke, Dane MD; Gurbani, Ajay MD

doi : 10.5435/JAAOS-D-20-01221

September 15, 2021 - Volume 29 - Issue 18 - p 770-779

Distal femur fractures are challenging fractures to treat, with nonunion rates as high as 22%. Precontoured locking plates have mitigated some earlier causes of failure, while introducing new challenges. The recognition of troublesome injury patterns and appropriate preoperative planning can avoid common pitfalls. Adjunctive techniques, including the use of a radiolucent triangle, an external fixator, unicortical plates, and crossing K-wires, can assist with fracture reduction and maintenance. It is important to understand the common pitfalls involved with distal femur plating and to consider a wide array of techniques to combat these challenges.

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Spinopelvic Biomechanics and Total Hip Arthroplasty: A Primer for Clinical Practice

Heckmann, Nathanael D. MD; Lieberman, Jay R. MD

doi : 10.5435/JAAOS-D-20-00953

September 15, 2021 - Volume 29 - Issue 18 - p e888-e903

Abnormal spinopelvic motion from spine pathology is associated with inferior outcomes after total hip arthroplasty, including inferior patient-reported outcomes, increased rates of instability, and higher revision rates. Identifying these high-risk patients preoperatively is important to conduct the appropriate workup and formulate a surgical plan. Standing and sitting lateral spinopelvic radiographs are able to identify and quantify abnormal spinopelvic motion. Depending on the type of spinopelvic deformity, some patients may require increased anteversion, increased offset, and large diameter heads or dual mobility articulations to prevent dislocation. This review article will provide the reader with practical information that can be applied to patients regarding the terminology, pathophysiology, evaluation, and management of total hip arthroplasty patients with spinopelvic pathology.

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The Use of Metaphyseal Cones and Sleeves in Revision Total Knee Arthroplasty

Siddiqi, Ahmed DO, MBA; Chen, Antonia F. MD, MBA; Piuzzi, Nicolas S. MD; Kelly, Michael A. MD

doi : 10.5435/JAAOS-D-20-01431

September 15, 2021 - Volume 29 - Issue 18 - p e904-e920

The burden of revision total knee arthroplasty (rTKA) is expected to increase with the rise in the number of TKA procedures being performed yearly. Management of bone loss during rTKA is challenging and necessitates appropriate surgical planning. Metaphyseal cones and sleeves have emerged as an increasing popular option for addressing metaphyseal femoral and tibial bone loss when performing rTKA. Understanding what cones and sleeves are commercially available and when to use them are critical parts of preoperative evaluation and planning. The purpose of this comprehensive review was to present different design philosophies, types of manufacturing, clinical outcomes, and the versatility and interchangeability of varying cones and sleeves with different TKA revision systems.

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Survivorship of the Hip Joint After Acetabulum Fracture

Preston, Gordon DO; Heimke, Isabella M. BA; Heindel, Koan DO; Scarcella, Nicholas R. MD; Furdock, Ryan MD; Vallier, Heather A. MD

doi : 10.5435/JAAOS-D-20-00517

September 15, 2021 - Volume 29 - Issue 18 - p 781-788

The purposes of this study were to determine the rate of failure of the hip joint after acetabulum fracture and to identify risk factors.

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Trend and Economic Implications of Implant Selection in the Treatment of Intertrochanteric Hip Fractures: A Review of the American Board of Orthopaedic Surgery Database From 2007 to 2017

Smith, Lauren MD; Albersheim, Melissa MD; Blaschke, Breanna L. BA; Parikh, Harsh R. MPH; Solfelt, David A. MD; Van Heest, Ann E. MD; Cunningham, Brian P. MD

doi : 10.5435/JAAOS-D-20-00470

September 15, 2021 - Volume 29 - Issue 18 - p 789-795

Intertrochanteric (IT) fractures are estimated to burden the healthcare system six billion dollars annually. Previous studies have documented a trend of early-career orthopaedic surgeons favoring intramedullary nails (IMNs) for these fractures, despite multiple randomized controlled trials demonstrating no evidence for improved patient outcomes when compared with sliding hip screws (SHSs). The purpose of this study was to report the trend of implant utilization for IT fracture fixation from 2007 to 2017.

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Evaluation of International Normalized Ratio Thresholds for Complications in Hip Fractures Treated With Intramedullary Nailing: Analysis of 15,323 Cases

Du, Jerry Y. MD; Trivedi, Nikunj N. MD; Joseph, Noah M. MD, MS; Sivasundaram, Lakshmanan MD; Lapite, Isaac BS; Vallier, Heather A. MD; Ochenjele, George MD

doi : 10.5435/JAAOS-D-19-00643

September 15, 2021 - Volume 29 - Issue 18 - p 796-804

In hip fracture patients with elevated international normalized ratios (INRs), the risks of delaying surgery for correction of INR are controversial. We examined the association of (1) preoperative INR values and (2) surgical delay with postoperative complications after intramedullary nailing of hip fractures.

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Incidence and Management of Articular Impaction in Geriatric Olecranon Fractures

Wadhwa, Harsh BS; Goodnough, L. Henry MD, PhD; Finlay, Andrea K. PhD; DeBaun, Malcolm R. MD; Campbell, Sean T. MD; Hecht, Garin MD; Lucas, Justin F. MD; Bishop, Julius A. MD; Gardner, Michael J. MD

doi : 10.5435/JAAOS-D-20-01293

September 15, 2021 - Volume 29 - Issue 18 - p 805-810

Olecranon fractures are common in the elderly. Articular impaction is encountered occasionally, but the incidence and outcomes after treatment of this injury pattern have not been well characterized.

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Comparison of Patient Demographics and Patient-Related Risk Factors for Infections After Primary Total Hip Arthroplasty for Acetabular Fractures

Ciminero, Matthew L. MD; Golub, Ivan J. MD; Mannino, Angelo MD; Vakharia, Rushabh M. MD; Cannada, Lisa K. MD; Kang, Kevin K. MD

doi : 10.5435/JAAOS-D-20-01056

September 15, 2021 - Volume 29 - Issue 18 - p e921-e931

In the proper age group, there is evidence that total hip arthroplasty (THA) has superior outcomes for the treatment of acetabular fractures compared with open reduction and internal fixation. Studies comparing patient demographics and identifying risk factors for either surgical site infections (SSIs) or periprosthetic joint infections (PJIs) are limited. Therefore, the purpose of this study was to (1) compare baseline demographics of patients who did and did not develop infections and (2) identify risk factors associated with developing either SSIs or PJIs.

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A Simple Initiative to Decrease Time to Antibiotic Prophylaxis for Open Fractures Is Durable After 2 Years

Goodman, Avi D. MD; Modest, Jacob M. MD; Johnson, Joey P. MD; Hayda, Roman A. MD

doi : 10.5435/JAAOS-D-20-00075

September 15, 2021 - Volume 29 - Issue 18 - p e932-e939

A simple antibiotic prophylaxis initiative can effectively decrease the time to antibiotic administration for patients with open fractures. We aim to determine whether adherence to the protocol decreased over time without active input from the orthopaedic trauma team.

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