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What’s New in Limb Lengthening and Deformity Correction
Georgiadis, Andrew G. MD1,2,a; Morrison, Stewart G. MBBS, FRACS3,4; Dahl, Mark T. MD1,2
doi : 10.2106/JBJS.21.00584
August 18, 2021 - Volume 103 - Issue 16 - p 1467-1472
Clinical, Functional, and Physical Activity Outcomes 5 Years Following the Treatment Algorithm of the Delaware-Oslo ACL Cohort Study
Pedersen, Marie PT, MS1,a; Grindem, Hege PT, PhD2,3; Johnson, Jessica L. PT, PhD4,5; Engebretsen, Lars MD, PhD2,6; Axe, Michael J. MD5,7; Snyder-Mackler, Lynn PT, ScD*,4,5; Risberg, May Arna PT, PhD1,6,*
doi : 10.2106/JBJS.20.01731
August 18, 2021 - Volume 103 - Issue 16 - p 1473-1481
Anterior cruciate ligament (ACL) injuries can be treated with or without ACL reconstruction (ACLR), and more high-quality studies evaluating outcomes after the different treatment courses are needed. The purpose of the present study was to describe and compare 5-year clinical, functional, and physical activity outcomes for patients who followed our decision-making and treatment algorithm and chose (1) early ACLR with preoperative and postoperative rehabilitation, (2) delayed ACLR with preoperative and postoperative rehabilitation, or (3) progressive rehabilitation alone. Early ACLR was defined as that performed ?6 months after the preoperative rehabilitation program, and late ACLR was defined as that performed >6 months after the preoperative rehabilitation program.
Reconstruction for Chronic ACL Tears with or without Anterolateral Structure Augmentation in Patients at High Risk for Clinical Failure
Chen, Jiebo MD1,*; Xu, Caiqi MD1,*; Cho, Eunshinae BM1; Huangfu, Xiaoqiao MD1; Zhao, Jinzhong MD1,a
doi : 10.2106/JBJS.20.01680
August 18, 2021 - Volume 103 - Issue 16 - p 1482-1490
The purpose of this trial was to determine whether anterior cruciate ligament reconstruction (ACLR) with anterolateral structure augmentation (ALSA) would result in better clinical outcomes in patients with a high risk of clinical failure.
One Versus 3-Week Immobilization Period for Nonoperatively Treated Proximal Humeral Fractures
Mart?nez, Raquel MD1; Santana, Fernando MD, PhD2; Pardo, Albert MD2,a; Torrens, Carlos MD, PhD2
doi : 10.2106/JBJS.20.02137
August 18, 2021 - Volume 103 - Issue 16 - p 1491-1498
There is no consensus on the duration of immobilization for nonoperatively treated proximal humeral fractures (PHFs). The main objective of the study was to determine the differences in pain between PHFs that were treated nonoperatively with 3-week immobilization and those treated with 1-week immobilization.
Total Shoulder Arthroplasty Is Cost-Effective Compared with Hemiarthroplasty
Lapner, Peter MD, FRCSC1,2,a; Kumar, Srishti MSc3,b; van Katwyk, Sasha MSc3,4,c; Thavorn, Kednapa PhD1,2,3,4,5,d
doi : 10.2106/JBJS.20.00678
August 18, 2021 - Volume 103 - Issue 16 - p 1499-1509
Although outcome studies generally demonstrate the superiority of a total shoulder arthroplasty (TSA) over a hemiarthroplasty (HA), comparative cost-effectiveness has not been well studied. From a publicly funded health-care system’s perspective, this study compared the costs and quality-adjusted life-years (QALYs) in patients who underwent TSA with those in patients who underwent HA.
Venous Tumor Thrombus in Primary Bone Sarcomas in the Pelvis
Liang, Haijie MD1; Guo, Wei MD, PhD1,a; Tang, Xiaodong MD1; Yang, Rongli MD1; Yan, Taiqiang MD1; Yang, Yi MD1; Ji, Tao MD1; Sun, Xin MD1; Xie, Lu MD1; Xu, Jie MD1
doi : 10.2106/JBJS.20.00569
August 18, 2021 - Volume 103 - Issue 16 - p 1510-1520
Few investigations of venous tumor thrombus (VTT) in primary pelvic bone sarcomas are available. We aimed to identify the prevalence, associated factors, and prognosis of VTT across different types of pelvic sarcomas and to propose an algorithm for management.
Correlation Between Patient-Reported Outcome Measures and Health Insurance Provider Types in Patients with Hip Osteoarthritis
Greene, Brady D. BS1; Lange, Jeffrey K. MD1; Heng, Marilyn MD, MPH2; Melnic, Christopher M. MD3; Smith, Jeremy T. MD1,a
doi : 10.2106/JBJS.20.02246
August 18, 2021 - Volume 103 - Issue 16 - p 1521-1530
Patient-reported outcome measures (PROMs) are frequently utilized to assess patient perceptions of health and function. Numerous factors influence self-reported physical and mental health outcome scores. The purpose of this study was to examine if an association exists between insurance payer type and baseline PROM scores in patients diagnosed with hip osteoarthritis.
Dose-Dependent Early Postoperative Opioid Use Is Associated with Periprosthetic Joint Infection and Other Complications in Primary TJA
Chung, Brian C. BS1; Bouz, Gabriel J. MD1; Mayfield, Cory K. MD1; Nakata, Haley MD1; Christ, Alexander B. MD1; Oakes, Daniel A. MD1; Lieberman, Jay R. MD1; Heckmann, Nathanael D. MD1,a
doi : 10.2106/JBJS.21.00045
August 18, 2021 - Volume 103 - Issue 16 - p 1531-1542
Opioids are commonly prescribed for postoperative pain following total joint arthroplasty. Despite widespread use, few studies have examined the dose-dependent effect of perioperative opioid use on postoperative complications following total hip arthroplasty (THA) and total knee arthroplasty (TKA). Therefore, we examined the dose-dependent relationship between opioid use and postoperative complications following primary THA and TKA.
The Relationship of Olecranon Apophyseal Ossification and Sanders Hand Scores with the Timing of Peak Height Velocity in Adolescents
Greene, Janelle D. MD1; Yu, Kristin BS1; Li, Don T. PhD1; Furdock, Ryan J. MD2; Li, Eric1; Liu, Raymond W. MD2; Cooperman, Daniel R. MD1
doi : 10.2106/JBJS.20.01856
August 18, 2021 - Volume 103 - Issue 16 - p 1543-1551
The onset of peak height velocity (PHV) guides the timing of interventions in the growing child. The purpose of the present study was to validate the Diméglio olecranon grading system and to compare these scores with the Risser/triradiate closure (TRC), proximal humerus, and Sanders hand scores.
A BMP/Activin A Chimera Induces Posterolateral Spine Fusion in Nonhuman Primates at Lower Concentrations Than BMP-2
Seeherman, Howard J. PhD, VMD1,a; Wilson, Christopher G. PhD2; Vanderploeg, Eric J. PhD2; Brown, Christopher T. MA2; Morales, Pablo R. DVM3; Fredricks, Douglas C. BS4; Wozney, John M. PhD5
doi : 10.2106/JBJS.20.02036
August 18, 2021 - Volume 103 - Issue 16 - p e64
Supraphysiologic bone morphogenetic protein (BMP)-2 concentrations are required to induce spinal fusion. In this study, a BMP-2/BMP-6/activin A chimera (BV-265), optimized for BMP receptor binding, delivered in a recombinant human collagen:CDHA [calcium-deficient hydroxyapatite] porous composite matrix (CM) or bovine collagen:CDHA granule porous composite matrix (PCM), engineered for optimal BV-265 retention and guided tissue repair, was compared with BMP-2 delivered in a bovine absorbable collagen sponge (ACS) wrapped around a MASTERGRAFT Matrix (MM) ceramic-collagen rod (ACS:MM) in a nonhuman primate noninstrumented posterolateral fusion (PLF) model.
In Patients with Sanders Type 2 Calcaneal Fractures, the Sinus Tarsi and Extensile Lateral Approaches Did Not Differ for Wound Complications
Berkes, Marschall B. MD1
doi : 10.2106/JBJS.21.00684
August 18, 2021 - Volume 103 - Issue 16 - p 1553
In Acute Closed Tibial Shaft Fractures, Surgery with the Taylor Spatial Frame Versus Reamed Intramedullary Nailing Did Not Differ for Quality of Life or Pain at 2 Years
Russell, George V. MD, MBA1
doi : 10.2106/JBJS.21.00682
August 18, 2021 - Volume 103 - Issue 16 - p 1554
In Primary Frozen Shoulder, Arthroscopic Capsular Release Improved Function and Reduced Pain Compared with Manipulation Under Anesthesia or Early Physiotherapy with Steroid Injection at 1 Year, but Changes Were Not Clinically Important
O’Donnell, Evan A. MD1
doi : 10.2106/JBJS.21.00683
August 18, 2021 - Volume 103 - Issue 16 - p 1555
Venous Thromboembolic Prophylaxis After Total Hip and Knee Arthroplasty
Lieberman, Jay R. MD1,a; Bell, Jennifer A. MD1
doi : 10.2106/JBJS.20.02250
August 18, 2021 - Volume 103 - Issue 16 - p 1556-1564
The selection of an agent for prophylaxis against venous thromboembolism (VTE) is a balance between efficacy and safety. The goal is to prevent symptomatic VTE while limiting the risk of bleeding.
What’s Important: Narrative Reflections After Orthopaedic Surgery
Biglino, Giovanni BEng, PhD1,2,a
doi : 10.2106/JBJS.20.01641
August 18, 2021 - Volume 103 - Issue 16 - p 1565-1566
COVID-19: Impact on Orthopaedic Graduate Medical Education in the U.S.
Van Heest, Ann MD, FAOA1,a; Brandt, Aaron M. MD2,b; Dyer, George MD3,c; Homer, Cole J. BS1,d; Murray, Peter M. MD4,e
doi : 10.2106/JBJS.20.01948
August 18, 2021 - Volume 103 - Issue 16 - p e65
The COVID-19 crisis has challenged the U.S. health-care system in a variety of ways, including how we teach and train orthopaedic surgery residents and fellows. During the spring of 2020, the cessation of all elective surgical procedures and the diminished number of outpatient visits challenged graduate medical education. While residency programs in less affected areas may not have had to make many dramatic adjustments, some of those located in pandemic hotspots had to redirect trainees from orthopaedic rotations to COVID-19 units. No matter the region, the time that trainees have spent in rotations has been altered, and absences have occurred due to quarantines. This symposium summarizes the impact of restrictions related to the COVID-19 pandemic on residency and fellowship programs from the perspectives of the Accreditation Council for Graduate Medical Education (ACGME), a program director, and a graduating resident. Although new opportunities for virtual curricula, virtual surgical simulation, and virtual interviews have been innovated, residency programs and residents report primarily a negative effect from the pandemic due to decreased surgical volumes and the limitation of patient-care experiences. Ultimately, program directors have an obligation to the program, the trainee, and the general public to graduate only those residents and fellows who are truly prepared to practice independently; they have the responsibility of making the final decision regarding graduation. The COVID-19 pandemic has continued to underscore the need for competency-based medical education. Assessing competency includes evaluation of the knowledge, the operative skills, the nonoperative patient-care skills, and the professional behavior of each and every individual graduating from orthopaedic residency and fellowship training programs. A hybrid model for time and competency-based training, with established national standards not only for accreditation for our training programs but also for board certification of our graduating residents, was enhanced by the COVID-19 pandemic and is highlighted in this symposium.
Insurance Type and Patient-Reported Outcome Measures: Can Insurance Type Be a Good Proxy for Risk Stratification?
Sterling, Robert S. MD, FAAOS, FAOA1,a
doi : 10.2106/JBJS.21.00660
August 18, 2021 - Volume 103 - Issue 16 - p e66
The Dangers of Opioids: More Than Just Addiction
Hamilton, William G. MD1,a
doi : 10.2106/JBJS.21.00523
August 18, 2021 - Volume 103 - Issue 16 - p e67
Erratum: Changes in 24-Hour Physical Activity Patterns and Walking Gait Biomechanics After Primary Total Hip Arthroplasty
doi : 10.2106/JBJS.ER.20.01679
August 18, 2021 - Volume 103 - Issue 16 - p e68
