In NYU Langone Orthopedics Journal Watch, orthopaedic surgeons from NYU Langone Health highlight significant studies in their subspecialty areas and provide commentary on the clinical relevance of this research to everyday practice.
Journal Watch is a collaboration of the International Congress for Joint Reconstruction and the Department of Orthopedics at NYU Langone Health, with content developed exclusively for ICJR.net.
A recently published study suggests that the direct anterior approach is overall associated with more early revisions, in particular for early femoral loosening, compared with the lateral or posterior approach. Larger studies are needed to substantiate this study’s conclusions.
A recently published paper asserts that medical therapy with the monoclonal antibody denosumab should be part of a multimodal treatment strategy for complicated giant cell tumor of the bone.
The results of a recently published study suggest that a more-invasive 2-stage revision may not be necessary for patients with a failed shoulder arthroplasty and multiple positive cultures for a Propionibacterium infection.
A recently published randomized controlled trial demonstrates improved neurologic outcomes in patients treated with total disc replacement versus the gold standard of anterior cervical discectomy and fusion.
The authors of a recently published study hypothesized that clinical and radiographic outcomes would be significantly different in male and female patients undergoing a modified Brostrum procedure. Were they right?
A recent study of adolescents who had surgery for chronic exertional compartment syndrome provides insight into the important differences between adolescent and adult patients - including the timing of surgery following presentation - that could improve outcomes in the younger population.
A recent study examined the effect of surgical volume on 90-day complication rates, 90-day mortality rates, and 2-year revision rates among total knee arthroplasty patients operated on in New York state – valuable information to have in the era of bundled payments.
Dr. Anthony Sapienza reviews the findings of a study of more than 77,000 opioid-naïve adult patients who underwent an elective or trauma-related hand surgery procedure. Which patient factors and which procedures were associated with filling an opioid prescription months after surgery?
A new study shows that patient age and level of gross motor function are important factors in the effectiveness of varus derotational shortening osteotomy alone or with concomitant acetabular osteotomy.
The results of a recently published study challenge the status quo on the timing of return to weight-bearing following open reduction and internal fixation of this common orthopaedic injury.
A recently published study of Medicare patients undergoing knee arthroscopy found that those who received an intraoperative corticosteroid injection were at higher risk for infection. Can this finding be generalized to the typical younger, healthier knee arthroscopy patients?
A recently published study suggests that the time period between intraarticular hip injection and total hip arthroplasty influences the possibility that the patient will develop a periprosthetic joint infection after the joint replacement procedure.
A recently published study demonstrated that CT-based structural rigidity analysis is superior to the traditional Mirels score in predicting which patients are at greatest risk for pathologic fracture.
A subgroup analysis of the SPORT trial identifies patients who are more likely to have a poor outcome and require reoperation following surgical intervention for a diagnosis of lumbar spinal stenosis.
Results of the elegantly designed, well-powered, multi-national FLOW trial provide insights into the type of irrigant and the pressure that should be used when irrigating and debriding an open fracture wound.
A randomized controlled trial compared healing rates in arthroscopic double-row rotator cuff repair with and without the use of leucocyte- and platelet-rich fibrin.
A newly published study shows that compared with hip fracture, an ankle fracture does not appear to be a sentinel event for older patients.
A systematic review and meta-analysis of RCTs adds to the literature on the usefulness of programs to prevent knee injuries in soccer players, showing that these programs most likely aid in preventing ACL injuries.
This single-surgeon study suggests that when adopting the direct anterior approach, the use of this intraoperative imaging may help diminish errors that can occur during the learning curve.
With advances in implant design and materials, more patients can now undergo proximal interphalangeal arthroplasty for arthritis. But more primary procedures means more revisions.
A retrospective review suggests scapular stabilization procedures can improve range of motion and scapular dimensions. However, the clinical significance of improved scapular dimensions is yet to be determined.
A long-term follow-up study by Sanders et al demonstrates that their classification system can reliably predict outcomes of displaced, intraarticular calcaneal fractures. It also raises important issues to address with further research.
But it is not known if this improved visualization is clinically significant. And the use of epinephrine carries the risk of cardiac events.
A recently published multi-center study provides guidance on modifiable risk factors orthopaedic surgeons can address prior to surgery to reduce the chances of patients being readmitted following total hip arthroplasty.
In this study, patients who received topical tranexamic acid plus diluted epinephrine had a significantly lower total blood loss, hidden blood loss, and transfusion rate than patients who received topical tranexamic acid alone.
And unfortunately, many factors associated with readmission and increased length of stay are outside the healthcare provider’s control.
With the advent of bundled payment models, the importance of finding ways to maximize outcomes while decreasing overall cost is more important than ever before.
This study serves as an encouraging step toward improving results and longevity of anatomic total shoulder arthroplasty in patients with osteoarthritis.
The researchers theorized that the graft would act as a reservoir of the antibiotic, which would elute into the knee over a period of time.
The treatment focuses on a gentle reduction maneuver with the aid of the surgeon’s finger tip plus Kirschner wire fixation in situ crossing the physis.
Surgeons should use caution and thoroughly counsel patients who had a previous infected total joint arthroplasty when considering a subsequent joint replacement procedure.
In addition, patients who were allowed immediate weight-bearing in the first 8 weeks reported a significant health-related quality of life versus those who were on the delayed weight-bearing protocol.
This analysis of data from the SPORT study shows surgery has the potential to significantly improve quality of life for older patients without increased surgical risk.
The results of this study will allow hand surgeons to appropriately counsel patients and guide expectations when a scaphocapitate limited wrist fusion is being considered.