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What’s New in Orthopaedic Rehabilitation
Cleland, Travis L. DO1; Gharib, Mahmood MD2; Williams, Reed MD, RMSK3; Jain, Nitin B. MD, MPH3
doi : 10.2106/JBJS.21.00868
November 17, 2021 - Volume 103 - Issue 22 - p 2063-2069
Rapidly Destructive Hip Disease Following Intra-Articular Corticosteroid Injection of the Hip
Okike, Kanu MD, MPH1,a; King, Ryan K. BA2; Merchant, Jason C. MD3; Toney, Eugene A. MD1; Lee, Gregory Y. MD1; Yoon, Hyo-Chun MD, PhD3
doi : 10.2106/JBJS.20.02155
November 17, 2021 - Volume 103 - Issue 22 - p 2070-2079
While recent reports have suggested that hip corticosteroid injections can hasten joint degeneration, there are few published data on the topic. The purpose of the present study was to evaluate for an association between corticosteroid injection and rapidly destructive hip disease (RDHD) and to determine the rate of, and risk factors for, occurrence.
Three-Year Rates of Reoperation and Revision Following Mobile Versus Fixed-Bearing Total Ankle Arthroplasty
Assal, M. MD1,2; Kutaish, H. MD1,2,a; Acker, A. MD1; Hattendorf, J. PhD3,4; Lübbeke, A. MD, DSc2,5; Crevoisier, X. MD6
doi : 10.2106/JBJS.20.02172
November 17, 2021 - Volume 103 - Issue 22 - p 2080-2088
Currently, the implants utilized in total ankle arthroplasty (TAA) are divided between mobile-bearing 3-component and fixed-bearing 2-component designs. The literature evaluating the influence of this mobility difference on implant survival is sparse. The purpose of the present study was therefore to compare the short-term survival of 2 implants of similar design from the same manufacturer, surgically implanted by the same surgeons, in fixed-bearing or mobile-bearing versions.
Complications of Hardware Removal
Kellam, Patrick J. MD1,a; Harrast, John PhD2; Weinberg, Maxwell BS1; Martin, David F. MD3; Davidson, Nathan P. MD1; Saltzman, Charles L. MD1
doi : 10.2106/JBJS.20.02231
November 17, 2021 - Volume 103 - Issue 22 - p 2089-2095
While hardware removal may improve patient function, the procedure carries risks of unexpected outcomes. Despite being among the most commonly performed orthopaedic procedures, scant attention has been given to its complication profile.
Fewer Adverse Events Following Outpatient Compared with Inpatient Unicompartmental Knee Arthroplasty
Hur, Edward S. MD1; Serino, Joseph MD1; Bohl, Daniel D. MD, MPH1; Della Valle, Craig J. MD1; Gerlinger, Tad L. MD1,a
doi : 10.2106/JBJS.20.02157
November 17, 2021 - Volume 103 - Issue 22 - p 2096-2104
Unicompartmental knee arthroplasty (UKA) is a common procedure for unicompartmental knee arthritis, often resulting in pain relief and improved function. The demand for total knee arthroplasty in the U.S. is projected to grow 85% between 2014 and 2030, and the volume of UKA procedures is growing 3 to 6 times faster than that of total knee arthroplasty. The purpose of the present study was to examine the safety of outpatient and inpatient UKA and to investigate changes over time as outpatient procedures were performed more frequently.
The Impact of Surgical Site Infection on Patient Outcomes After Open Posterior Instrumented Thoracolumbar Surgery for Degenerative Disorders
Urquhart, Jennifer C. PhD1; Gurr, Kevin R. MD1,2,3; Siddiqi, Fawaz MD1,2,3; Rasoulinejad, Parham MD1,2,3; Bailey, Christopher S. MD, MSc1,2,3,a
doi : 10.2106/JBJS.20.02141
November 17, 2021 - Volume 103 - Issue 22 - p 2105-2114
Few reports in the literature have described the long-term outcome of postoperative infection from the patient perspective. The aim of the present study was to determine if complicated surgical site infection (SSI) affects functional recovery and surgical outcomes up to 2 years after posterior instrumented thoracolumbar surgery for the treatment of degenerative disorders.
Outcomes of Bulk Fresh Osteochondral Allografts for Cartilage Restoration in the Knee
Daud, Anser BSc, MD(C)1; Safir, Oleg A. MD, FRCSC2; Gross, Allan E. MD, FRCSC2; Kuzyk, Paul R.T. MD, MASc, FRCSC2,a
doi : 10.2106/JBJS.20.00350
November 17, 2021 - Volume 103 - Issue 22 - p 2115-2125
Symptomatic osteochondral defects of the knee in young patients can cause substantial disability and predispose to osteoarthritis. Fresh osteochondral allografts (FOCAs) are a treatment option for such defects. With our institution having one of the longest-running FOCA programs, we investigated the long-term outcomes of bulk FOCA in the knee, focusing on graft survivorship, function, complications, and reoperation.
Prevalence of Trochlear Dysplasia and Associations with Patellofemoral Pain and Instability in a Skeletally Mature Population
DeVries, Clarabelle A. MD1; Bomar, James D. MPH1; Pennock, Andrew T. MD1,a
doi : 10.2106/JBJS.20.01624
November 17, 2021 - Volume 103 - Issue 22 - p 2126-2132
Patellar instability among adolescents has an incidence of 29 to 43 per 100,000 per year. Trochlear dysplasia has been found in up to 85% of those with recurrent patellar instability. The prevalence of trochlear dysplasia in the general population has not yet been defined. The purpose of the present study was to determine the prevalence of trochlear dysplasia as defined by ultrasound in a skeletally mature population and to characterize associations of trochlear dysplasia with a history of patellofemoral instability or pain.
Patient Perspectives on the Cost of Hand Surgery
Wahl, Elizabeth P. MD1; Huber, Joel PhD2; Richard, Marc J. MD1; Ruch, David S. MD1; Mithani, Suhail K. MD1; Pidgeon, Tyler S. MD1,a
doi : 10.2106/JBJS.20.02195
November 17, 2021 - Volume 103 - Issue 22 - p 2133-2140
Health-care expenditures in the U.S. are continually rising, prompting providers, patients, and payers to search for solutions to reduce costs while maintaining quality. The present study seeks to define the out-of-pocket price that patients undergoing hand surgery are willing to pay, and also queries the potential cost-cutting measures that patients are most and least comfortable with. We hypothesized that respondents would be less accepting of higher out-of-pocket costs.
Use of Lesser Trochanter Profile as a Rotational Alignment Guide in Intramedullary Nailing for Femoral Shaft Fracture
Ju, Baruenchan MD1,*; Moon, Young Jae MD, PhD2,*; Lee, Kwang-Bok MD, PhD3,a
doi : 10.2106/JBJS.21.00105
November 17, 2021 - Volume 103 - Issue 22 - p e89
Malrotation after nailing of femoral shaft fractures occurs in about 25% of cases. It can cause substantial functional problems. The lesser trochanter (LT) profile has been used to assess rotational alignment. However, the extent to which the LT profile is symmetrical between limbs, whether the LT profile varies as a function of age or sex, and the efficacy of the LT profile technique remain unknown. The purpose of this study was to determine if there was a significant side-to-side length difference in the LT profile (LTD) according to age and sex.
In Older Adults with 3- or 4-Part Dislocated Proximal Humeral Fractures, Reverse Shoulder Arthroplasty Improved Anterior Elevation and Constant Score, but Not DASH Scores, Quality of Life, or Radiographic Outcomes Compared with Hemiarthroplasty
Li, Xinning MD; Associate Professor of Orthopaedic Surgery1
doi : 10.2106/JBJS.21.01006
November 17, 2021 - Volume 103 - Issue 22 - p 2142
In TKA, Lower Versus Higher Tourniquet Inflation Pressures Reduced Postoperative Pain at the Tourniquet Inflation Site and Surgical Site at 24 and 48 Hours and 2 Weeks
Figueroa, David MD1
doi : 10.2106/JBJS.21.01008
November 17, 2021 - Volume 103 - Issue 22 - p 2143
In Frozen Shoulder, US-Guided Versus Blind Administration of Intra-Articular Corticosteroid Injections Increased Accuracy of Injections but Did Not Improve Clinical Outcomes at 12 Weeks
Balazs, CDR George C. MD, MC, USN1
doi : 10.2106/JBJS.21.01007
November 17, 2021 - Volume 103 - Issue 22 - p 2144
Addressing Smoking in Musculoskeletal Specialty Care
Thayer, Logan S. BS1; Tiffany, Elizabeth M. MD2; Carreira, Dominic S. MD1,a
doi : 10.2106/JBJS.21.00108
November 17, 2021 - Volume 103 - Issue 22 - p 2145-2152
Physicians who advise patients to quit smoking substantially improve cessation rates, but cessation counseling is currently underperformed.
Transition to Independent Research Funding Among National Institutes of Health K Grant Awardees at Departments of Orthopaedic Surgery
Silvestre, Jason MD1,a; Hines, Shawn M. MD2; Chang, Benjamin MD, FACS3; Ahn, Jaimo MD, PhD, FACS4
doi : 10.2106/JBJS.20.01754
November 17, 2021 - Volume 103 - Issue 22 - p e90
The National Institutes of Health (NIH) supports mentored research career development awards (K awards) to increase the pipeline of independently funded scientists. This study analyzed the portfolio of K grants that were awarded to orthopaedic surgery departments and characterized the factors that were associated with successful transition to independent NIH research funding, including R01 grants.
A Call for a Standardized Approach to Reporting Patient-Reported Outcome Measures
Orr, Melissa N. BS1; Klika, Alison K. MS1; Gagnier, Joel J. PhD, ND, MSc2,3; Bhandari, Mohit MD, PhD, FRCSC4; Piuzzi, Nicolas S. MD1,a
doi : 10.2106/JBJS.21.00030
November 17, 2021 - Volume 103 - Issue 22 - p e91
A shift toward a value-driven health-care model has made prospective collection of patient-reported outcome measures (PROMs) inextricably tied to measuring the success of orthopaedic surgery and patient satisfaction. While progress has been made in optimizing the utilization of PROM data, including establishing appropriate PROMs for a procedure and determining the clinical importance of unique tools, if these PROMs are not accurately analyzed and reported, a proportion of patients who do not reach the clinical thresholds may go unnoticed. Furthermore, parameters are unclear for setting a statistically and clinically important PROM threshold along with a minimum period for follow-up data collection.
Primum Non Nocere: Is It Really True with Corticosteroid Hip Injections?: Commentary on an article by Kanu Okike, MD, MPH, et al.: “Rapidly Destructive Hip Disease Following Intra-Articular Corticosteroid Injection of the Hip”
Hernigou, Philippe MD1,a
doi : 10.2106/JBJS.21.00797
November 17, 2021 - Volume 103 - Issue 22 - p e92
Inching Closer to the End of the Debate Between Fixed Versus Mobile-Bearing Total Ankle Arthroplasty: Commentary on an article by M. Assal, MD, et al.: “Three-Year Rates of Reoperation and Revision Following Mobile Versus Fixed-Bearing Total Ankle Arthroplasty. A Cohort of 302 Patients Treated with 2 Implants of Similar Design”
Coetzee, J. Chris MD, FAAOS1,a
doi : 10.2106/JBJS.21.00739
November 17, 2021 - Volume 103 - Issue 22 - p e93
