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9 ± .3 to 8.4 ± .2;
= .0003; arthroscopic 5.9 ± .3 to 8.4 ± .2;
= .0001). After using the simulator, participants felt more strongly that VR simulation is a valuable training modality (
= .0025), that simulation should be a mandatory part of orthopaedics and surgical training (
= .0001 and
= .0001), and that access to VR simulators improves the quality of surgical training (
= .0024).
These results demonstrate that exposure to VR arthroscopic simulation increased medical students' interest in orthopaedics, surgery, and arthroscopy, without the need for direct supervision. Following VR simulator use, students reported they were more likely to engage with training opportunities, including arthroscopic and endoscopic surgery.
Understanding factors that stimulate interest in orthopaedic surgery may help programs attract the broadest pool of potential trainees.
Understanding factors that stimulate interest in orthopaedic surgery may help programs attract the broadest pool of potential trainees.
To compare the suture slippage on a hamstring tendon graft prepared with a modified finger-trap device (SPEEDTRAP) with one prepared with Krackow stitch during graft passage through the tibial tunnel in ACL reconstruction.
Thirty-eight patients underwent anatomic triple-bundle anterior cruciate ligament reconstruction with 2 femoral and 3 tibial tunnels. After semitendinosus tendon was cut in half to make 2 grafts, the free ends of the proximal membranous portion (posterolateral [PL] graft) were prepared together with 2 sutures (1) one SPEEDTRAP and one Krackow stitch for 20 cases (group A) and (2) double Krackow stitches on both sides for 18 cases (group B). Then, the PL graft was dye-marked at the proximal suture of SPEEDTRAP in group A and Krackow suture in group B and was inserted into the joint via tibial tunnel ahead of the loop side. The distance between the mark on the graft and the proximal suture of SPEEDTRAP or Krackow stitch was measured under arthroscopy after graft fixation at femur. Slippage was defined as 1 mm and more of distance between the mark and the proximal suture.
Slippage was observed in 16 cases for SPEEDTRAP and in 2 for Krackow suture in group A, whereas one case showed slippage in group B. The slippage distance was 4.0 ± 2.9 mm for SPEEDTRAP and 0.2 ± 0.5 mm for Krackow stitch in group A (
< .001), whereas it was 0.1 ± 0.2 mm for double Krackow stitch in group B, showing a significant difference from SPEEDTRAP suture (
<.001).
At the time of PL graft passage through the tibial tunnel in anterior cruciate ligament reconstruction, there was significantly less slippage observed with the Krackow stitch compared with the SPEEDTRAP stitch.
Level IV, therapeutic case series.
Level IV, therapeutic case series.
To evaluate the 1-year outcomes of a small patient series following open gluteus medius/minimus repair with human dermal allograft incorporated into the repair construct using a double-row repair.
Data from consecutive patients undergoing a superior gluteal reconstruction for massive, irreparable abductor tendon tears with severe tendon loss and atrophy by a single fellowship trained surgeon from January 2018 to May 2019 were collected and analyzed. Baseline demographic data and magnetic resonance imaging were collected preoperatively. Clinical outcomes including Hip Outcome Score-Activities of Daily Living (HOS-ADL), HOS-Sports Subscale (HOS-SS), modified Harris hip score (mHHS), international Hip Outcome Score-12 (iHOT-12), visual analog scale (VAS) pain, and VAS satisfaction were recorded at 1-year postoperatively.
A total of 8 patients underwent open superior gluteal reconstruction for severe hip abductor deficiency. The mean age and body mass index were 62.6 ± 7.3 years and 29.6 ± 5.3 kg/m
, respectively. The majority of patients were female (N= 7, 87.5%). Three (37.5%) patients had undergone previous endoscopic gluteus medius repair and presented for revision surgery. All patients had full-thickness tears with gluteus medius and gluteus minimus involvement. Patients were evaluated at an average of 11.5 ± 1.7 months from the initial surgical intervention and reported a mean HOS-ADL of 82.9 ± 24.3, HOS-SS of 73.2 ± 37.3, mHHS of 83.6 ± 17.1, iHOT-12 of 63.9 ± 27.4, VAS Pain of 30.0 ± 23.1, and VAS Satisfaction of 87.1 ± 17.0. There was no evidence of retears in this patient cohort as defined by physical examination findings and/or corroborating magnetic resonance imaging.
Superior gluteal reconstruction for massive, irreparable abductor tendon tears with severe tendon loss and atrophy is a technique that demonstrates promising 1-year postoperative outcomes in both primary and revision patients.
Level IV, therapeutic case series.
Level IV, therapeutic case series.
To assess the quantity of morselized cartilage that can be harvested from the non-load-bearing portion of the talus for immediate reimplantation.
Non-load-bearing talar cartilage was harvested from 5 cadaveric specimens using a standard arthroscopic approach. Cartilage was separated from the talus in maximum dorsiflexion at the junction of the talar head and neck, grasped, and morselized into a graft using a cartilage particulator. The volume of reclaimed cartilage was measured, and the extrapolated area of coverage was compared to average osteochondral lesions of the talus previously reported.
The total yield of cartilage graft following processing that was obtained from 5 ankle joints ranged from 0.3 mL to 2.1 mL with a mean volume of 1.3 ± 0.7 mL, yielding a theoretical 13.2 ± 7.1 cm
coverage with a 1-mm monolayer. While the average size of osteochondral lesions of the talus is difficult to estimate, they may range from 0.5 cm
to 3.7 cm
according to the literature.
This study validated that it is possible to harvest sufficient amount of cartilage for an autologous morselized cartilage graft via a single-stage, single-site surgical and processing technique to address most talar articular cartilage defects.
Particulated cartilage autografts have shown promise in surgical management of cartilage defects. A single-site, single-staged procedure that uses a patient's autologous talar cartilage from the same joint has the potential to reduce morbidity associated with multiple surgical sites, multistaged procedure, or nonautologous tissue in ankle surgery.
Particulated cartilage autografts have shown promise in surgical management of cartilage defects. A single-site, single-staged procedure that uses a patient's autologous talar cartilage from the same joint has the potential to reduce morbidity associated with multiple surgical sites, multistaged procedure, or nonautologous tissue in ankle surgery.
We evaluate the incidence of heterotopic ossification (HO) development with nonsteroidal anti-inflammatory drug (NSAID) prophylaxis in patients after open and arthroscopic hip preservation surgery.
A retrospective review identified patients who underwent hip preservation surgery at a single institution within the past 3 years. Patients who underwent hip arthroscopy with or without periacetabular osteotomy (PAO) or femoral osteotomy (FO) were included. Those who did not receive 3-month postoperative radiographs were excluded. PARP inhibitor The incidence and Brooker classification (BC) of HO in patients taking Naproxen or another NSAID (meloxicam, celecoxib, indomethacin, or aspirin alone) was assessed using AP radiographs available from 3-, 6-, and 12-month follow-up appointments. Univariate analysis was conducted to compare numerical means and categorical data (significance level
= .05).
A total of 328 hips (284 patients) were included. All patients received hip arthroscopy, while 71 patients (21.6%) received concurrent periacetabular osteotomy (PAO;
= 65) or femoral osteotomy (FO;
= 6). Overall, 276 hips (84.4%) received Naproxen for HO prophylaxis. In total, 5 of 328 hips (1.5%) developed HO (4, BC I; 1, BC III). The rate of HO development was significantly higher in males versus females (4 of 121 (3.31%) vs 1 of 207 (.48%),
= .0441). All 5 patients received arthroscopic cam resection and labral repair, and 1 patient also received PAO. Three patients in the Naproxen group (.91%) developed HO, which was not statistically different from those taking a different NSAID (.61%,
= .1797).
The incidence of HO development was low with NSAID prophylaxis after hip preservation surgery.
The incidence of HO development was low with NSAID prophylaxis after hip preservation surgery.
The purpose of this study is to analyze the Instagram practices of current orthopaedic surgeons and the components associated with highest reach and interactions.
The top 25 orthopaedic surgeon Instagram profiles using the hashtag #ortho were ranked by the number of followers. Account information regarding followers, posts, engagement percentage, average likes, average comments, average video view, average video likes, average video comments, and estimated cost per post was recorded using social media marketing tools. An analysis of each Instagram profiles' top 10 posts, based on number of likes, was conducted. A coding framework was developed to categorized posting strategies utilized.
Twenty-five Instagram accounts and 250 Instagram posts were included in the analysis. Accounts with increased engagement rating had a significantly greater number of likes and video views. When examining post characteristics that influenced the number of likes a post generated, posts that elicited negative emotions receitent, and contribute to the social media presence of orthopaedic surgery.
Orthopaedic surgeons have an opportunity to connect with colleagues, patients, and interested viewers through social media platforms in order to enhance their practice, disseminate educational content, and contribute to the social media presence of orthopaedic surgery.
We sought to determine the rate of return to play (RTP) in baseball players following arthroscopic elbow debridement for the management of the symptomatic elbow.
A retrospective case series with prospectively collected data via questionnaire was conducted on all baseball players who underwent an arthroscopic elbow debridement, from July, 15, 2004 to November 1, 2017. A postoperative questionnaire was released at an average 7.25 year follow-up. Data collected included age, gender, laterality, preoperative diagnosis, range of motion, duration and characterization of symptoms, visual analog scale (VAS) pain score, complications, level of play, and RTP.
Follow-up data were available on 18 baseball players. Average age was 19.7 years (range 16-24). Seventeen were pitchers, and 1 was a catcher. Level of play included 12 collegiate athletes, 2 high school athletes, 2 recreational athletes, 1 minor league athletes, and 1 major league athlete. Rate of RTP was 61% (11/18) with 6 returning to a greater level and 5 to an equal level. The length of time to RTP following surgery was most commonly within 6-8 months (44.4%, 8/18). Mean VAS pain score improved from 6.9 to 0.75 (
= <.001). 27.8% (5/18) had repeat surgery secondary to recurrent/persistent stiffness or heterotopic ossification. 77.8% (14/18) of patients rated their final outcome as either "very satisfied" (9/18), or "satisfied" (5/18).
Pain can reliably be relieved following arthroscopic elbow debridement in baseball players. Although patient satisfaction may be high, patients do not always return to their previous level of play. Patients must be counseled on the risk of limited postoperative athletic capacity before the time of surgery.
Level IV, therapeutic case series.
Level IV, therapeutic case series.
Homepage: https://www.selleckchem.com/products/nesuparib.html
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