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Is Immobilization Necessary for Early Return to Work Following Distal Biceps Repair Using a Cortical Button Technique?
Bergman, Joseph W. MD, PEng, FRCSC1,2; Silveira, Anelise PT, MScRS3; Chan, Robert MD, MSc, FRCSC1,2; Lapner, Michael MD, FRCSC1,2; Hildebrand, Kevin A. MD, FRCSC4; Le, Ian L.D. MD, FRCSC4; Sheps, David M. MD, MSc, MBA, FRCSC1,2; Beaupre, Lauren A. PT, PhD3,*,a; Lalani, Aleem MD, FRCSC1,2,*
doi : 10.2106/JBJS.20.02047
October 6, 2021 - Volume 103 - Issue 19 - p 1763-1771
Improvements in surgical fixation to repair distal biceps tendon ruptures have not fully translated to earlier postoperative mobilization; it is unknown whether earlier mobilization affords earlier functional return to work. This parallel-arm randomized controlled trial compared the impact of early mobilization versus 6 weeks of postoperative immobilization following distal biceps tendon repair.
Ineffective Communication: The Uninformed Injured Worker
Vanderhooft, Jan Eric MD, FAAOS1,a
doi : 10.2106/JBJS.21.00182
October 6, 2021 - Volume 103 - Issue 19 - p 1772-1776
Effective communication has been demonstrated to impact patient health outcomes, specifically in improving symptom resolution, safety, function, and emotional well-being, and to lower malpractice claims. I hypothesized that the communication process with patients with Workers’ Compensation is inadequate.
Molecular and Clinical Elucidation of the Mechanism of Action of Steroids in Idiopathic Carpal Tunnel Syndrome
Yamanaka, Yoshiaki MD, PhD1,a; Tajima, Takafumi MD, PhD1; Tsujimura, Yoshitaka MD1; Kosugi, Kenji MD1; Mano, Yosuke MD1; Zenke, Yukichi MD, PhD1; Hachisuka, Akiko MD, PhD2; Aoki, Takatoshi MD, PhD3; Sakai, Akinori MD, PhD1
doi : 10.2106/JBJS.20.02096
October 6, 2021 - Volume 103 - Issue 19 - p 1777-1787
Carpal tunnel steroid injection is a nonoperative intervention for the treatment for idiopathic carpal tunnel syndrome (CTS). The antifibrotic, anti-inflammatory, and antiedematous properties of steroids account for their therapeutic effects in the context of CTS; however, their relative contribution has not been clarified.
Comparative Analysis of Serial Union Patterns After Opening-Wedge High Tibial Osteotomy with and without Bone-Void Fillers
Kim, Seong Chan MD1; Kim, Dong Hyun MD1; Lee, Jae Ik MD1; Kim, Tae Woo MD, PhD2; Lee, Yong Seuk MD, PhD1,a
doi : 10.2106/JBJS.20.00778
October 6, 2021 - Volume 103 - Issue 19 - p 1788-1797
Opening-wedge high tibial osteotomy produces opening gaps; however, there is little consensus on bone graft necessity and the material that would produce a superior union. The purposes of the present study were (1) to compare the serial union patterns associated with various bone-void fillers, (2) to determine whether bone-void filler is necessary to achieve bone union of the opening gap, and (3) to determine whether bone union is different according to the correction degree during opening-wedge high tibial osteotomy.
Stepped Augmented Glenoid Component in Anatomic Total Shoulder Arthroplasty for B2 and B3 Glenoid Pathology
Iannotti, Joseph P. MD, PhD1,a; Jun, Bong-Jae PhD2; Derwin, Kathleen A. PhD2; Ricchetti, Eric T. MD1
doi : 10.2106/JBJS.20.01420
October 6, 2021 - Volume 103 - Issue 19 - p 1798-1806
Posterior glenoid bone loss is commonly associated with primary glenohumeral osteoarthritis. Surgical management of bone loss in anatomic total shoulder arthroplasty (aTSA) remains controversial. We studied the use of a stepped augmented glenoid component for management of Walch B2 and B3 glenoids and compared the radiographic and clinical outcomes at short-term follow-up with those achieved with a non-augmented component of the same design in Walch A1 glenoids.
Lower 1-Year Postoperative Mortality After Acetabular Versus Proximal Femoral Fractures in Elderly Patients
Stetzelberger, Vera M. MD1,2,a; Brouze, Iris F. MD1; Steppacher, Simon D. MD2; Bastian, Johannes D. MD2; Schwab, Joseph M. MD3; Tannast, Moritz MD1,2
doi : 10.2106/JBJS.20.01805
October 6, 2021 - Volume 103 - Issue 19 - p 1807-1816
Geriatric acetabular fractures are becoming more common due to demographic changes. Compared with proximal femoral fractures, surgical treatment is more complex and often does not allow full-weight-bearing. The aims of this study were to compare operatively treated acetabular and proximal femoral fractures with regard to (1) cumulative 1-year mortality, (2) perioperative complications, and (3) predictive factors associated with a higher 1-year mortality.
Comparison of Outcomes by Reconstructive Strategy in Patients with Prostheses for Proximal Femoral Focal Deficiency
Floccari, Lorena V. MD1; Jeans, Kelly A. MS2,a; Herring, John A. MD2; Johnston, Charles E. MD2; Karol, Lori A. MD3
doi : 10.2106/JBJS.20.02001
October 6, 2021 - Volume 103 - Issue 19 - p 1817-1825
The present study compares prosthetic treatment options for proximal femoral focal deficiency in terms of gait analysis, oxygen consumption, and patient-reported outcomes.
Midterm Results of Primary Exeter Cemented Stem in a Select Patient Population
Gausden, Elizabeth B. MD, MPH1; Abdel, Matthew P. MD2; Mabry, Tad M. MD2; Berry, Daniel J. MD2; Trousdale, Robert T. MD2; Sierra, Rafael J. MD2,a
doi : 10.2106/JBJS.20.01829
October 6, 2021 - Volume 103 - Issue 19 - p 1826-1833
Most North American surgeons predominantly use uncemented stems in primary total hip arthroplasties (THAs) and reserve cemented stems for selected older patients and those with poor bone quality. However, data on this “selective use” strategy for cemented stems in the population at risk for periprosthetic fracture and implant loosening are limited. The purpose of this study was to describe implant survivorship, complications, and radiographic results of a specific collarless, polished, tapered cemented stem (Exeter; Stryker) used selectively in a predominantly elderly population undergoing primary THA.
High Failure Rates of a Unilateral Posterior Peri-Apical Distraction Device (ApiFix) for Fusionless Treatment of Adolescent Idiopathic Scoliosis
Stadhouder, Agnita MD1,a; Holewijn, Roderick M. MD, PhD2; Haanstra, Tsjitske M. PhD3; van Royen, Barend J. MD, PhD1; Kruyt, Moyo C. MD, PhD4; de Kleuver, Marinus MD, PhD5
doi : 10.2106/JBJS.20.02176
October 6, 2021 - Volume 103 - Issue 19 - p 1834-1843
Conventional surgical treatment for adolescent idiopathic scoliosis (AIS) consists of correction of the spinal deformity with rigid spinal instrumentation and fusion. Less-invasive and fusionless surgery could potentially improve patient outcomes. The purpose of the present study was to evaluate the efficacy of a recently U.S. Food and Drug Administration (FDA)-approved posterior peri-apical self-distracting device (ApiFix) that is designed to gradually correct the deformity without spinal fusion.
The Effect of Supramalleolar Osteotomy without Marrow Stimulation for Medial Ankle Osteoarthritis
Lim, Jung-Won MD1; Eom, Joon-Sang MD2; Kang, Sung Jin MD1; Lee, Dong-Oh MD3; Kang, Hwa Jun MD4; Jung, Hong-Geun MD, PhD1,a
doi : 10.2106/JBJS.20.00502
October 6, 2021 - Volume 103 - Issue 19 - p 1844-1851
The effect of supramalleolar osteotomy without a bone marrow-stimulating procedure for articular cartilage regeneration in the ankle joint remains unknown. We investigated whether supramalleolar osteotomy yielded favorable clinical and radiographic outcomes. We also evaluated the joint tissue appearance after supramalleolar osteotomy without a bone marrow-stimulating procedure with use of second-look arthroscopy and its correlation with the outcome.
The Hip-Spine Challenge
Chavarria, Joseph C. MD1; Douleh, Diana G. MD1; York, Philip J. MD2,a
doi : 10.2106/JBJS.20.01728
October 6, 2021 - Volume 103 - Issue 19 - p 1852-1860
The proper diagnosis and treatment of patients with concurrent hip and spine pathological processes can be challenging because of the substantial overlap in symptomatology.
What’s Important: Retirement, Viewed 2 Years Later
Weiland, Andrew J. MD1,a
doi : 10.2106/JBJS.21.00593
October 6, 2021 - Volume 103 - Issue 19 - p 1861-1862
Causal Language in Observational Orthopaedic Research
Varady, Nathan H. SB1; Feroe, Aliya G. BA1; Fontana, Mark Alan PhD2; Chen, Antonia F. MD, MBA1,a
doi : 10.2106/JBJS.20.01921
October 6, 2021 - Volume 103 - Issue 19 - p e76
With the increasing availability of large clinical registries and administrative data sets, observational (i.e., nonexperimental) orthopaedic research is being performed with increased frequency. While this research substantially advances our field, there are fundamental limitations to what can be determined through a single observational study. Avoiding overstatements and misstatements is important for the sake of accuracy, particularly for ensuring that clinical care is not inadvertently swayed by how an observational study is written up and described. We have noticed that causal language is frequently misused in observational orthopaedic research—that is, language that says or implies that 1 variable definitively causes another, despite the fact that causation can generally only be determined with randomization. In this data-backed commentary, we examine the prevalence of causal language in a random sample of 400 observational orthopaedic studies; we found that causal language was misused in 60% of them. We discuss the implications of these results and how to report observational findings more accurately: the word “association” (and its derivatives) can almost always replace or reframe a causal phrase.
“What We Have Here Is a Failure to Communicate”
Talmage, James Byron MD1,a
doi : 10.2106/JBJS.21.00721
October 6, 2021 - Volume 103 - Issue 19 - p e77
What Actually Happens After One Injects a Steroid into the Carpal Tunnel of a Patient?
Slater, Robert R. Jr. MD1,a
doi : 10.2106/JBJS.21.00725
October 6, 2021 - Volume 103 - Issue 19 - p e78
Bridging the Gap. Is Augmentation Necessary During Opening-Wedge High Tibial Osteotomy?
Angeline, Michael MD1,a
doi : 10.2106/JBJS.21.00722
October 6, 2021 - Volume 103 - Issue 19 - p e79
