Publisher: American Academy of Orthopaedic Surgeons   (Total: 1 journals)   [Sort by number of followers]

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J. of the American Academy of Orthopaedic Surgeons     Hybrid Journal   (Followers: 13, SJR: 1.41, CiteScore: 3)
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Journal of the American Academy of Orthopaedic Surgeons
Journal Prestige (SJR): 1.41
Citation Impact (citeScore): 3
Number of Followers: 13  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1067-151X - ISSN (Online) 1940-5480
Published by American Academy of Orthopaedic Surgeons Homepage  [1 journal]
  • Ultrasound Examination Techniques for Elbow Injuries in Overhead Athletes
    • Authors: Hultman; Kristi L.; Goldman, Brian H.; Nazarian, Levon N.; Ciccotti, Michael G.
      Abstract: imageElbow pain is a frequent complaint among overhead athletes. Standard evaluation of the elbow uses history and physical examination, with radiographic imaging and MRI aiding in the confirmation of diagnosis. Musculoskeletal ultrasonography (US) provides dynamic, functional assessment of tendons and ligaments in the elbow, allowing the visualization of structures under stress and motion. Stress US offers the ability to detect injuries to the ulnar collateral ligament by measuring changes in joint space under stress. The freedom of dynamic imaging means results are dependent on the skill of the US operator to obtain the most accurate and complete evaluation. US is cost efficient and portable, allowing for quick examination at the point of care. This article provides a technique guide for sports medicine specialists performing US examination of the elbow.
      PubDate: Mon, 15 Mar 2021 00:00:00 GMT-
       
  • Artificial Intelligence for the Orthopaedic Surgeon: An Overview of
           Potential Benefits, Limitations, and Clinical Applications
    • Authors: Makhni; Eric C.; Makhni, Sonya; Ramkumar, Prem N.
      Abstract: imageArtificial intelligence (AI), along with its subset technology machine learning, has transformed numerous industries through newfound efficiencies and supportive decision-making. These technologies have similarly begun to find application within United States healthcare, particularly orthopaedics. Although these modalities have the potential to similarly transform health care, there exist limitations that must also be recognized and understood. Unfortunately, most clinicians do not have an understanding of the fundamentals of AI and therefore may have challenges in contextualizing its impact in modern healthcare. The purpose of this review was to provide an overview of the key concepts of AI and machine learning with the orthopaedic surgeon in mind. The review further highlights the potential benefits and limitations of AI, along with an overview of its applications, in orthopaedics.
      PubDate: Mon, 15 Mar 2021 00:00:00 GMT-
       
  • Patella Fractures: Approach to Treatment
    • Authors: Hargett; Damayea I.; Sanderson, Brent R.; Little, Milton T.M.
      Abstract: imagePatellar fracture morphology varies based on the mechanism of injury. Most fractures are either a result of direct impact or through an indirect eccentric extensor contraction injury. Each fracture pattern requires appropriate preoperative planning and individualization of the fixation method. Displaced fractures affect the extension apparatus, and often require surgical fixation. Surgical treatment is recommended in fractures with any of the following features: articular step-off> 2 mm,> 3 mm of fracture displacement, open fractures, and displaced fractures affecting the extensor mechanism. Meticulous handling of the soft-tissue envelope is of the utmost importance, given the patella's tenuous blood supply and limited soft-tissue envelope. Incongruent articular surface can result in detrimental long-term effects; therefore, surgical treatment is directed toward anatomic reduction and fixation. The evolution of patellar fracture fixation continues to maximize options to balance rigid fixation with low-profile fixation constructs. Improving functional outcomes, minimizing soft-tissue irritation, and limiting postoperative complications are possible by using the therapeutic principles of rigid anatomical fixation and meticulous soft-tissue handling.
      PubDate: Mon, 15 Mar 2021 00:00:00 GMT-
       
  • The Application of All-arthroscopic Technique to Deep Osteochondral
           Lesions in the Talus With Scaffold and Autograft Bone Taken From the
           Tibial Plafond
    • Authors: Akmese; Ramazan; Ertan, Mehmet Batu; Özyildiran, Mustafa
      Abstract: imageOsteochondral lesions in the talus are frequently seen disorders that can cause chronic ankle pain. Surgical treatment is determined by the size and location of the lesion. The microfracture procedure and additional application of scaffold technique have gained popularity for the treatment of small osteochondral defects. However, these techniques may be insufficient and have poor outcomes in deep lesions. Therefore, several different invasive surgical techniques that require the malleolar osteotomy have been described. Problems associated with the invasive surgical intervention may be seen such as reduction loss in the osteotomy site, delayed union or nonunion, permanent pain, and/or swelling. We describe a new all-arthroscopic technique for the treatment of deep talus osteochondral lesions using an autologous bone graft taken from the tibial plafond region together with a chitosan-based noncellular scaffold.
      PubDate: Mon, 15 Mar 2021 00:00:00 GMT-
       
  • Avascular Necrosis of the Talus
    • Authors: Parekh; Selene G.; Kadakia, Rishin J.
      Abstract: imageTalar osteonecrosis results from trauma to the fragile blood supply to the talus. Many etiologies exist that can cause talar osteonecrosis, with the most common being talar neck fractures. Patients with talar osteonecrosis frequently present with progressive ankle pain and limited range of motion. Treatment strategy depends primarily on the stage of disease. Conservative care in the form of medications and bracing treatment can be beneficial for patients with low functional status and early disease stages. Surgical options also exist for early disease without talar collapse that can potentially preserve the tibiotalar joint. Once talar collapse develops, surgical treatment is move invasive and typically involves an arthrodesis or talus arthroplasty. Although some treatment guidelines exist based on the disease stage, talar osteonecrosis is a complex problem, and treatment strategy should always be determined on a case-by-case basis carefully examining all clinical aspects.
      PubDate: Mon, 15 Mar 2021 00:00:00 GMT-
       
  • Incidental Durotomy in Lumbar Spine Surgery; Risk Factors, Complications,
           and Perioperative Management
    • Authors: Hassanzadeh; Hamid; Bell, Joshua; Bhatia, Manminder; Puvanesarajah, Varun
      Abstract: imageIncidental durotomy (ID) can occur in up to 14% of all lumbar spine surgeries. The risk of this complication is markedly higher among elderly patients with advanced spinal pathology. In addition, revision cases and other more invasive procedures increase the risk of ID. When unrepaired, IDs can increase the risk of developing meningitis and can lead to the formation of cerebrospinal fluid fistulas and pseudomeningoceles. Intraoperative recognition and repair are essential to ID management, although repair techniques vary considerably. Although primary suture repair is considered the “benchmark,” indirect repair alone has shown comparable outcomes. Given the concern for infection after ID, many have indicated for prolonged prophylactic antibiotic regimens. However, there is little clinical evidence that this is necessary after adequate repair. The addition of subfascial drains have been shown to promote wound healing and early ambulation, whereas no consensus on duration of indwelling drains exists and such management is largely case dependent. Early ambulation after surgery has not shown to be associated with increased risk of further ID complications and decreases rehabilitation time, length of stay, and risk of venous thromboembolism. However, there remains a role for conservation mobilization protocols in more severe cases where notable symptoms are observed.
      PubDate: Mon, 15 Mar 2021 00:00:00 GMT-
       
  • The Impact of Unguided Trauma Simulation Practice on Novice Performance: A
           Randomized Controlled Trial
    • Authors: Wang; Kevin C.; Bernardoni, Eamon D.; Cotter, Eric J.; Levine, Brett R.; Frank, Rachel M.
      Abstract: imageIntroduction: The purpose of this investigation was to determine the impact of simulator practice on task completion time, radiation use, success rate, and overall quality in a simulation of placing a distal locking screw.Methods: This was a prospective, randomized control trial with one-to-one randomization and parallel group design. Twenty-eight volunteer novice trainees (medical and premedical students) participated. Using the TraumaVision Virtual Reality Simulator (Swemac, Sweden), subjects performed locking screw placement using the “perfect circle” technique. All subjects underwent a pretest and posttest on the simulator. The simulator group completed three additional simulator training sessions. The primary outcome variables were simulator-collected task completion time, success rate, radiation exposure time, and overall score.Results: No notable difference existed between groups for pretest completion time, radiation use, success rate, or overall score. No notable difference in posttest radiation use or overall procedure score was found between groups. A significant difference existed in posttest total completion time (trained = 251.2 ± 103.4; control = 497.3 ± 223.1; P = 0.001) and success rate (64.3% versus 100%; P = 0.041) between groups. In addition, a significant difference existed in variance between groups for completion time (P = 0.029).Conclusions: These findings suggest that independent simulator practice leads to improved speed and success rates; however, radiation use and overall score do not improve in the same manner. The design of simulator-based curriculum must be tailored to specific educational objectives and ultimately validated in the clinical setting.
      PubDate: Mon, 15 Mar 2021 00:00:00 GMT-
       
  • The Impact of Subspecialty Fellows on Orthopaedic Resident Surgical
           Experience: A Multicenter Study of 51,111 Cases
    • Authors: Jiang; Sam Y.; Carlock, Kurtis D.; Campbell, Sean T.; Vorhies, John S.; Gardner, Michael J.; Leucht, Philipp; Bishop, Julius A.
      Abstract: imageIntroduction: Meaningful participation in surgery is important for orthopaedic resident education. This study aimed to quantify the effect of fellows on resident surgical experience. We hypothesized that as fellowship programs expanded, resident caseload would decrease, whereas “double-scrubbed” cases would increase.Methods: This multicenter retrospective study included 9 years of surgical caselog data from two orthopaedic residency programs. Six subspecialty services on which fellow number varied over time were included (trauma, spine, foot and ankle, adult reconstruction, and hand). Case volume and personnel composition per case were extracted. Statistical analysis was performed with two-sample equal variance Student t-tests.Results: A total of 51,111 cases were assessed. Surgical volume increased across all sites/services over time. Fellow numbers did not affect average resident caseload. However, in years with more fellows, an 11% decrease in one-on-one resident-attending cases (P = 0.002) and a 17% increase in resident-fellow-attending “double-scrubbed” cases was observed (P < 0.001).Discussion: Increasing orthopaedic fellows did not affect resident case volume but resulted in fewer one-on-one cases with the attending and more “double-scrubbed” cases with a fellow. The implications of these findings to resident education require further study, but orthopaedic educators should be aware of these findings to try to maximize educational opportunities.Level of Evidence: Level III
      PubDate: Mon, 15 Mar 2021 00:00:00 GMT-
       
  • The Influence of Exposure in Training to the Open Bankart on the Declining
           Current Use of the Procedure
    • Authors: Neviaser; Robert J.; Parker, Rachel L.; Neviaser, Andrew S.
      Abstract: imageObjective: The purpose of this study was to assess the influence of exposure to the open Bankart during residency and fellowship on the trend toward obsolescence of the procedure. Our hypothesis was that the open Bankart would be used with decreasing frequency and that this would be related to lack of exposure to the procedure during training.Methods: A survey consisting of 10 questions about their experience with the open Bankart procedure in residency, fellowship, and practice, as well as their current usage of it and other operations, was sent to members of the American Shoulder and Elbow Surgeons. Respondents were divided into groups based on the year of completion of training.Results: Statistical analysis of the responses revealed a notable trend of progressively diminished use of the open Bankart by those trained before 2000 compared with those completing training between 2001 and 2017. Ancillary findings included more surgeons using the open Bankart for revision cases than as a primary procedure and many using the Latarjet for patients with less than 15% or even no glenoid bone loss.Conclusion: We concluded that a statistically notable trend of the decreasing use of the open Bankart was observed despite excellent reported outcomes and that its current role is most likely as a revision procedure. Lack of exposure to the operation in training is a major factor in its decline, and this decreasing exposure is self-perpetuating.Level of Evidence: Survey
      PubDate: Mon, 15 Mar 2021 00:00:00 GMT-
       
  • Soft-tissue Sarcoma of the Hand: Patient Characteristics, Treatment, and
           Oncologic Outcomes
    • Authors: Lans; Jonathan; Yue, Kai-Lou C.; Castelein, René M.; Suster, David I.; Nielsen, G. Petur; Chen, Neal C.; Calderon, Santiago A. Lozano
      Abstract: imageIntroduction: The aim of this study was to describe patient characteristics, treatment, and oncologic outcomes of soft-tissue sarcomas (STSs) of the hand.Methods: Sixty-nine STSs of the hand in adult patients treated at a tertiary referral center were retrospectively included. We describe patient and tumor characteristics along with oncologic outcomes.Results: Epithelioid sarcoma (23%) was the most common histologic subtype, followed by synovial sarcoma (15%). Of all tumors, 17 (25%) were grade I, 22 (32%) were grade II, and 30 (44%) were grade III. The 5-year disease-free survival for epithelioid sarcomas was 75% with a disease survival of 100%, along with a metastatic rate of 15%. Of the patients with a synovial sarcoma, 40% developed metastases, and the 5-year disease-free survival was 68% and the 5-year disease survival was 73%.Conclusion: Hand STSs are aggressive tumors with a high metastatic potential. Even with adequate oncologic treatment, long-term clinical follow-up (10 years) in these tumors is advised. The treating surgical oncologist should not be deceived by their smaller size.
      PubDate: Mon, 15 Mar 2021 00:00:00 GMT-
       
  • Letters to the Editor: Effects of Diabetes Mellitus on Functional Outcomes
           and Complications After Torsional Ankle Fracture
    • Authors: Jahansooz; Julia R.
      Abstract: No abstract available
      PubDate: Mon, 15 Mar 2021 00:00:00 GMT-
       
  • Reply to Letter to the Editor: Effects of Diabetes Mellitus on Functional
           Outcomes and Complications After Torsional Ankle Fracture
    • Authors: Vallier; Heather A.; Benedick, Alex
      Abstract: No abstract available
      PubDate: Mon, 15 Mar 2021 00:00:00 GMT-
       
 
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