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What’s New in Pediatric Orthopaedics
Andras, Lindsay M. MD1,a; Whitlock, Patrick W. MD, PhD2; Abousamra, Oussama MD1
doi : 10.2106/JBJS.21.01430
February 16, 2022 - Volume 104 - Issue 4 - p 299-306
Clinical Outcome Differences in the Treatment of Impending Versus Completed Pathological Long-Bone Fractures
Groot, Olivier Q. MD1,2,a; Lans, Amanda MD1,2; Twining, Peter K. BA1; Bongers, Michiel E.R. MD1,3; Kapoor, Neal D. MS1; Verlaan, Jorrit-Jan MD, PhD2; Newman, Erik T. MD1; Raskin, Kevin A. MD1; Lozano-Calderon, Santiago A. MD, PhD1; Janssen, Stein J. MD, PhD3; Schwab, Joseph H. MD, MS1
doi : 10.2106/JBJS.21.00711
February 16, 2022 - Volume 104 - Issue 4 - p 307-315
The outcome differences following surgery for an impending versus a completed pathological fracture have not been clearly defined. The purpose of the present study was to assess differences in outcomes following the surgical treatment of impending versus completed pathological fractures in patients with long-bone metastases in terms of (1) 90-day and 1-year survival and (2) intraoperative blood loss, perioperative blood transfusion, anesthesia time, duration of hospitalization, 30-day postoperative systemic complications, and reoperations.
Extent of Preoperative Medial Meniscal Extrusion Influences Intermediate-Term Outcomes After Medial Opening-Wedge High Tibial Osteotomy
Yang, Hong-Yeol MD1; Kwak, Woo-Kyoung MD1; Lee, Chang-Hyun MD1; Kang, Joon-Kyoo MD1; Song, Eun-Kyoo MD, PhD1; Seon, Jong-Keun MD, PhD1,a
doi : 10.2106/JBJS.21.00456
February 16, 2022 - Volume 104 - Issue 4 - p 316-325
The purpose of the present study was to determine the relationship between preoperative medial meniscal extrusion, as classified according to magnetic resonance imaging (MRI), and medial opening-wedge high tibial osteotomy outcomes at intermediate-term follow-up.
PLAN and AM-PAC “6-Clicks” Scores to Predict Discharge Disposition After Primary Total Hip and Knee Arthroplasty
Hadad, Matthew J. MD1; Orr, Melissa N. BS1; Emara, Ahmed K. MD1; Klika, Alison K. MS1; Johnson, Joshua K. DPT, PhD2,3; Piuzzi, Nicolas S. MD1,a
doi : 10.2106/JBJS.21.00503
February 16, 2022 - Volume 104 - Issue 4 - p 326-335
Determination of the appropriate post-discharge disposition after total hip (THA) and knee (TKA) arthroplasty is a challenging multidisciplinary decision. Algorithms used to guide this decision have been administered both preoperatively and postoperatively. The purpose of this study was to simultaneously evaluate the predictive ability of 2 such tools—the preoperatively administered Predicting Location after Arthroplasty Nomogram (PLAN) and the postoperatively administered Activity Measure for Post-Acute Care (AM-PAC) “6-Clicks” basic mobility tools—in accurately determining discharge disposition after elective THA and TKA.
Emergency Department Stress Radiographs of Lateral Compression Type-1 Pelvic Ring Injuries Are Safe, Effective, and Reliable
DeKeyser, Graham J. MD1,a; Kellam, Patrick J. MD1; Haller, Justin M. MD1; Higgins, Thomas F. MD1; Marchand, Lucas S. MD1; Rothberg, David L. MD1
doi : 10.2106/JBJS.21.00737
February 16, 2022 - Volume 104 - Issue 4 - p 336-344
Occult instability of lateral compression type-1 (LC1) pelvic ring injuries may be determined with a fluoroscopic stress examination under anesthesia (EUA) performed in the operating room. We hypothesized that LC1 injuries, similar to some fractures of the extremities, could be radiographically stressed for stability in the emergency department (ED). Our primary objective was to determine if stress examination of LC1 fractures could be safely and accurately performed in the ED and could be tolerated by patients.
Defining the Patient Acceptable Symptom State for the HOOS JR and KOOS JR After Primary Total Joint Arthroplasty
Kunze, Kyle N. MD1; Fontana, Mark A. PhD2,3; MacLean, Catherine H. MD, PhD2,4; Lyman, Stephen PhD5; McLawhorn, Alexander S. MD, MBA1,a
doi : 10.2106/JBJS.21.00550
February 16, 2022 - Volume 104 - Issue 4 - p 345-352
It is essential to quantify an acceptable outcome after total joint arthroplasty (TJA) in order to understand quality of care. The purpose of this study was to define patient acceptable symptom state (PASS) thresholds for the Knee injury and Osteoarthritis Outcome Score, Joint Replacement (KOOS JR) and the Hip disability and Osteoarthritis Outcome Score, Joint Replacement (HOOS JR) after TJA.
Pathoanatomy of the Anterolateral Tibial Fragment in Ankle Fractures
Rammelt, Stefan MD, PhD1,a; Bartoní?ek, Jan MD, PhD2; Kroker, Livia MD1
doi : 10.2106/JBJS.21.00167
February 16, 2022 - Volume 104 - Issue 4 - p 353-363
The anterior distal tibial tubercle provides attachment to the anterior tibiofibular syndesmosis. It may be considered a fourth, or anterior, malleolus (AM). Fractures of the AM may extend into the tibial incisura and tibial plafond. The purpose of this study was to analyze the pathoanatomy of AM fractures and associated ankle injuries.
A Clinical Risk Model for Surgical Site Infection Following Pediatric Spine Deformity Surgery
Matsumoto, Hiroko PhD1,2,a; Larson, Elaine L. PhD2,3; Warren, Shay I. MD4; Hammoor, Bradley T. MS1; Bonsignore-Opp, Lisa BS1; Troy, Michael J. BS5; Barrett, Kody K. MD6; Striano, Brendan M. MD7; Li, Gen PhD8; Terry, Mary Beth PhD2; Roye, Benjamin D. MD, MPH1; Lenke, Lawrence G. MD1; Skaggs, David L. MD, MMM9; Glotzbecker, Michael P. MD10; Flynn, John M. MD7; Roye, David P. MD1; Vitale, Michael G. MD, MPH1
doi : 10.2106/JBJS.21.00751
February 16, 2022 - Volume 104 - Issue 4 - p 364-375
Despite tremendous efforts, the incidence of surgical site infection (SSI) following the surgical treatment of pediatric spinal deformity remains a concern. Although previous studies have reported some risk factors for SSI, these studies have been limited by not being able to investigate multiple risk factors at the same time. The aim of the present study was to evaluate a wide range of preoperative and intraoperative factors in predicting SSI and to develop and validate a prediction model that quantifies the risk of SSI for individual pediatric spinal deformity patients.
In Patients with Periprosthetic Joint Infection Treated with Surgery, Antibiotic Therapy for 6 Versus 12 Weeks After Surgery Increased Persistent Infection at 2 Years
Parvizi, Javad MD, FRCS1
doi : 10.2106/JBJS.21.01433
February 16, 2022 - Volume 104 - Issue 4 - p 376
In Mason Type-2 Radial Head Fracture, Surgical and Nonsurgical Treatment Did Not Differ for Functional Outcomes at 12 Months
O’Driscoll, Shawn MD, PhD1; Rojas-Lievano, Jorge MD, MSc2
doi : 10.2106/JBJS.21.01483
February 16, 2022 - Volume 104 - Issue 4 - p 377
In Recurrent Anterior Shoulder Instability with a Hill-Sachs Lesion, Adding Arthroscopic Infraspinatus Remplissage to Arthroscopic Bankart Repair Reduced Recurrent Instability and Revision Surgery but Did Not Improve Shoulder-Related Quality of Life at 24 Months
Mohtadi, Nick MD, MSc, FRCSC, DipSportMed1
doi : 10.2106/JBJS.21.01482
February 16, 2022 - Volume 104 - Issue 4 - p 378
Adult Soft-Tissue Sarcomas of the Extremities
Bickels, Jacob MD1,a; Malawer, Martin M. MD2
doi : 10.2106/JBJS.21.00196
February 16, 2022 - Volume 104 - Issue 4 - p 379-389
Soft-tissue sarcomas (STS) in adults comprise a heterogeneous group of tumors of mesenchymal origin that share similar biological patterns of local tumor growth and metastatic dissemination.
What’s Important: A Christian, a Muslim, and a Jew…
Giammattei, Frank MD1,a
doi : 10.2106/JBJS.21.00907
February 16, 2022 - Volume 104 - Issue 4 - p 390-391
Training the New Generations of Orthopaedic Surgery Residents
Sarac, Nikolas J. MD1; Vajapey, Sravya P. MD, MBA1; Bosse, Michael J. MD2; Ly, Thuan V. MD3,a
doi : 10.2106/JBJS.21.00533
February 16, 2022 - Volume 104 - Issue 4 - p e10
Most of the current orthopaedic residents are considered Millennials (born between 1981 and 1996) and are often trained by attending surgeons who are from Generation X (born between 1965 and 1980) or the Baby Boomer generation (born between 1946 and 1964). The Generation X orthopaedic surgeons were largely trained by Baby Boomers who were very demanding of their trainees and expected excellence. The Baby Boomers had been inspired, mentored, and trained by the Greatest Generation (born between 1901 and 1927). Baby Boomers took nothing for granted and nothing was given to them on a silver platter. Generation X was trained under these premises and was expected to abide by similar values. Regarding the next generation of residents, current faculty hope to instill the same qualities that had been instilled in them during their training. This value transference sometimes presents a challenge because of the differences in attitudes and perspectives that may exist between Millennial residents and their predecessors regarding work-life balance, teaching styles, the regulation of duty hours, and feedback assessments. These differences require an evolution in the methods of surgical education to optimize the educational benefit and ensure good will and rapport between the generations. Trainees and faculty alike have a responsibility to understand each other’s differences and come together to ensure that knowledge, experience, values, and skill sets are effectively passed on to a new generation of orthopaedic surgeons.
Industry Payments Among Appropriate Use Criteria Voting Panels
Acuña, Alexander J. BS1; Jella, Tarun K. MPH1; Barksdale, Edward M. III BS1; Samuel, Linsen T. MD, MBA1; Kamath, Atul F. MD1,a
doi : 10.2106/JBJS.21.00150
February 16, 2022 - Volume 104 - Issue 4 - p e11
Although multiple studies have consistently demonstrated that orthopaedic surgeons receive greater transfers of value than other specialties, the industry payments of providers who are involved in the formation of practice guidelines have not been thoroughly explored. Therefore, the purpose of our analysis was to evaluate the industry payments of the authors of the Appropriate Use Criteria (AUC) from the American Academy of Orthopaedic Surgeons (AAOS).
Objective Assessment Scores and the Development of Efficient Health-Care Systems in Arthroplasty
Meena, Amit MBBS, MS, DNB1,a
doi : 10.2106/JBJS.21.01255
February 16, 2022 - Volume 104 - Issue 4 - p e12
Consider Emergency Department Stress Examinations on Lateral Compression Type-1 Pelvic Ring Injuries with Complete Sacral Fractures
Crist, Brett D. MD1
doi : 10.2106/JBJS.21.01367
February 16, 2022 - Volume 104 - Issue 4 - p e13
The Role of Content Experts in Appropriate Use Criteria
Roberts, Karl C. MD, FAAOS1; Chen, Antonia F. MD, MBA, FAAOS2,a; Quinn, Robert MD, FAAOS3
doi : 10.2106/JBJS.21.01136
February 16, 2022 - Volume 104 - Issue 4 - p e14
Expression of Concern
doi : 10.2106/JBJS.EOC.20.00196
February 16, 2022 - Volume 104 - Issue 4 - p e15
