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What’s New in Musculoskeletal Tumor Surgery
Rose, Peter S. MD1,a
doi : 10.2106/JBJS.21.00935
December 15, 2021 - Volume 103 - Issue 24 - p 2251-2260
A Simple Algorithmic Approach Allows the Safe Use of Cephalosporin in “Penicillin-Allergic” Patients without the Need for Allergy Testing
Goh, Graham S. MD1,*; Shohat, Noam MD1,2,*; Austin, Matthew S. MD1,a
doi : 10.2106/JBJS.21.00027
December 15, 2021 - Volume 103 - Issue 24 - p 2261-2269
Patients who report a penicillin allergy are often given second-line antibiotic prophylaxis during total joint arthroplasty (TJA), with only a minority of patients undergoing additional consultations and allergy testing. In an effort to increase the use of cephalosporin prophylaxis in TJA, the present study aimed to assess the effectiveness of a simple, protocol-driven penicillin allergy screening program without the need for additional work-up.
A Matched Comparison of the Long-Term Outcomes of Cemented and Cementless Total Knee Replacements
Mohammad, Hasan R. MBChB, MRes(Dist), MRCS(Eng), DPhil(Oxon)1,2,a; Judge, Andrew BSc, MSc, PhD1,2; Murray, David W. MD, FRCS1
doi : 10.2106/JBJS.21.00179
December 15, 2021 - Volume 103 - Issue 24 - p 2270-2280
Total knee replacements (TKRs) can be implanted with or without the use of cement. It is currently uncertain how cemented and cementless TKRs compare overall and in different age groups of the population in the long term.
The Influence of Postoperative Coronal Alignment on Tibial Migration After Total Knee Arthroplasty in Preoperative Varus and Valgus Knees
Hasan, Shaho MD1,a; Kaptein, Bart L. MSc, PhD1; Nelissen, Rob G.H.H. MD, PhD1; van Hamersveld, Koen T.1; Toksvig-Larsen, Sören MD, PhD2,3; Marang-van de Mheen, Perla J. PhD4
doi : 10.2106/JBJS.20.01659
December 15, 2021 - Volume 103 - Issue 24 - p 2281-2290
Orthopaedic surgeons aim for mechanical alignment when performing total knee arthroplasty (TKA) as malalignment is associated with loosening. Loosening may be predicted by migration as measured with radiostereometric analysis (RSA), but previous RSA studies on postoperative alignment have shown contradictory results and have been limited to cemented implants and small numbers of patients. Therefore, we performed a secondary analysis of 10 previously published randomized controlled trials (RCTs) to compare migration between postoperative in-range and out-of-range cemented and uncemented TKA implants among patients with a preoperative varus or valgus knee.
Should Pertrochanteric and Subtrochanteric Fractures Be Treated with a Short or Long Intramedullary Nail?
Viberg, Bjarke PhD1,2,3,a; Eriksen, Lasse1,2; Højsager, Katia D.1; Højsager, Frederik D.1,2; Lauritsen, Jens PhD1; Palm, Henrik DmSci4,5; Overgaard, Søren PhD, DmSci1,6
doi : 10.2106/JBJS.20.01904
December 15, 2021 - Volume 103 - Issue 24 - p 2291-2298
The purpose of the present multicenter cohort study was to compare the rates of reoperation in elderly patients with pertrochanteric and subtrochanteric fractures that had been treated with a short or long intramedullary nail.
Measurable Thoracic Motion Remains at 1 Year Following Anterior Vertebral Body Tethering, with Sagittal Motion Greater Than Coronal Motion
Buyuk, Abdul Fettah MD1; Milbrandt, Todd A. MD, MS1; Mathew, Smitha E. MBBS1; Larson, A. Noelle MD1,a
doi : 10.2106/JBJS.20.01533
December 15, 2021 - Volume 103 - Issue 24 - p 2299-2305
Anterior vertebral body tethering is an alternative to fusion surgery for the treatment of adolescent idiopathic scoliosis (AIS) that is purported to preserve spinal motion. There is limited information regarding the measurable motion that is maintained over the instrumented levels following thoracic anterior vertebral body tethering surgery in humans. The purpose of the present study was to assess radiographic spinal motion 1 year after anterior vertebral body tethering.
Does Implant Selection Affect Patient-Reported Outcome Measures After Primary Total Hip Arthroplasty?
Campbell, Andrew MD1; Emara, Ahmed K. MD1; Klika, Alison MS1; Piuzzi, Nicolas S. MD1,a; The Cleveland Clinic OME Arthroplasty Group
doi : 10.2106/JBJS.20.01931
December 15, 2021 - Volume 103 - Issue 24 - p 2306-2317
Total hip arthroplasty (THA) is a reliable operation, but it is critical that orthopaedic surgeons characterize which surgical factors influence patient-reported outcomes. The purpose of this study was to determine whether implant selection at the time of THA affects the odds of having (1) inadequate improvement according to patient-reported pain, function, and activity; (2) failure to achieve a substantial clinical benefit (SCB) with respect to pain; or (3) failure to achieve a patient-acceptable symptomatic state (PASS) according to pain and function.
Orthopaedic Trauma Research Priorities in Latin America
Roberts, Heather J. MD1; MacKechnie, Madeline C. MA1; Shearer, David W. MD, MPH1; Segovia Altieri, Julio MD2; de la Huerta, Fernando MD3; Rio, Marcelo W. MD4; Sánchez Valenciano, Carlos MD5; Miclau, Theodore MD1,a; the ACTUAR Study Group
doi : 10.2106/JBJS.21.00271
December 15, 2021 - Volume 103 - Issue 24 - p 2318-2323
Despite a substantial burden of musculoskeletal injury, orthopaedic trauma studies in Latin America are lacking. The purpose of the present study was to identify research priorities among orthopaedic trauma surgeons in Latin America.
Does a Medial Malleolar Osteotomy or Posteromedial Approach Provide Greater Surgical Visualization for the Treatment of Talar Body Fractures?
Magnusson, Erik A. MD1,a; Telfer, Scott PhD1; Jackson, Madeleine MD1; Githens, Michael F. MD1
doi : 10.2106/JBJS.21.00299
December 15, 2021 - Volume 103 - Issue 24 - p 2324-2330
Surgical management of talar body fractures is influenced by soft-tissue condition and fracture pattern. Two common surgical approaches for the treatment of talar body fractures are the medial malleolar osteotomy (MMO) and the posteromedial approach (PMA). The purpose of this study was to compare the observable talar body surface area with the MMO and the PMA. We hypothesized that visualization following a PMA improves with distraction and distraction with a gastrocnemius recession.
Minimum Clinically Important Difference
Karhade, Aditya V. MD, MBA1,2; Bono, Christopher M. MD1; Schwab, Joseph H. MD, MS1; Tobert, Daniel G. MD1,a
doi : 10.2106/JBJS.21.00773
December 15, 2021 - Volume 103 - Issue 24 - p 2331-2337
As the Patient-Reported Outcomes Measurement Information System (PROMIS) is increasingly utilized in orthopaedic research and clinical practice, there is not a consensus regarding the minimum clinically important difference (MCID) calculation.
Freddie H. Fu, MD 1951-2021
doi : 10.2106/JBJS.21.01211
December 15, 2021 - Volume 103 - Issue 24 - p 2340
Strategies for Effective Implementation of Patient-Reported Outcome Measures in Arthroplasty Practice
Franklin, Patricia D. MD, MBA, MPH1,a; Bond, Christina P. MS, FACHE2; Rothrock, Nan E. PhD1; Cella, David PhD1
doi : 10.2106/JBJS.20.02072
December 15, 2021 - Volume 103 - Issue 24 - p e97
Patient-reported outcome measures (PROMs) will be an important component of real-world evidence, but best practices for capture and integration are not yet defined. While digital tools support patients, clinicians, and researchers to collect PROMs, PROM capture in clinical care remains challenging. We synthesized PROM implementation strategies that are successfully used by hundreds of arthroplasty surgeons and early PROM-adopter clinical systems. This information can guide health systems that are preparing to implement PROMs to inform clinical care, drive quality-improvement activities, and support reporting for payer-sponsored incentives. Specific information is included to guide each step in the implementation process, including selecting PROMs, redesigning office procedures, programming of information technology, and informing interpretation and clinical use. While no one solution exists for successful PROM implementation in total hip and total knee replacement, referred to as total joint replacement, these guidelines can inform optimal PROM deployment and the capture of complete PROM data. In addition, we outline future research that is needed to define methods for optimal patient engagement, technology infrastructure, and operational systems to seamlessly integrate PROM collection in clinical care.
Strategies for Recruiting and Retaining Women and Minorities in Orthopaedics
Gerull, Katherine M. MD1; Salles, Arghavan MD, PhD2; Porter, Scott E. MD, MBA3; Braman, Jonathan P. MD, MHA4,a
doi : 10.2106/JBJS.21.00016
December 15, 2021 - Volume 103 - Issue 24 - p e98
Despite considerable attention being paid to the lack of diversity in orthopaedic surgery over the last decade, there has been very little actual change in the racial and gender demographics. This article discusses mechanisms for improving the diversity of interested programs, including reviewing potential barriers to racial and gender-based diversity programs.
A Common Sense Approach to Concerns About Direct Allergy or Allergic Crossover with Penicillin
Vail, Thomas Parker MD1,a
doi : 10.2106/JBJS.21.00876
December 15, 2021 - Volume 103 - Issue 24 - p e99
To Cement or Not to Cement: Have We Answered the Question?
Carli, Alberto V. MD, MSC1,a
doi : 10.2106/JBJS.21.00939
December 15, 2021 - Volume 103 - Issue 24 - p e100
