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

Comparing the Risk of Early Failure in THA by Surgical Approach

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.
By Omar A. Behery MD MPH, Ajit Deshmukh MD - Posted 24 Sep 2017

A Solution for Reducing Tumor Size in Giant Cell Tumor of the Bone

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.
By Timothy Rapp MD, Vinay K. Aggarwal MD - Posted 11 Sep 2017

Single-Stage Revision in Shoulder Arthroplasty Patients Positive for Propionibacterium

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.
By Kevin Chen MA, Samir Nayyar MD, Timothy G. Reish MD - Posted 20 Mar 2017

A Viable Option for Treating Multilevel Cervical Degenerative Disc Disease

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.
By Yuhang Sun MD, Peter Passias MD, Shaleen Vira MD - Posted 06 Mar 2017

Are There Gender Differences in Outcomes of Surgery for Chronic Ankle Instability?

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?
By Kenneth J. Mroczek MD - Posted 16 Jan 2017

Evaluating Outcomes of Compartment Release for CECS

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.
By Warren K. Young MD - Posted 19 Dec 2016

Does Quantity Equal Quality? The Volume-Outcome Relationship in TKA in the Age of the Bundle

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.
By William J. Long MD FRCSC, Mitchell C. Weiser MD MEng - Posted 21 Nov 2016

Identifying Hand Surgery Patients At Risk for Prolonged Opioid Use

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?
By Anthony Sapienza MD - Posted 24 Oct 2016

Is VDRO Alone Appropriate Treatment for Hip Dysplasia in Cerebral Palsy?

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.
By Olga Solovyova MD - Posted 19 Sep 2016

Weight-Bearing Following ORIF of Unstable Ankle Fractures

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.
By Philipp Leucht MD, Nicole Stevens MD - Posted 06 Aug 2016

Are Corticosteroid Injections Too Risky for Knee Arthroscopy Patients?

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?
By Mehul R. Shah MD - Posted 18 Jul 2016

The Link Between Hip Injections and PJI after THA

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.
Posted 20 Jun 2016

Evaluating Fracture Risk in Metastatic Femoral Lesions

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.
Posted 18 May 2016

Not All Lumbar Stenosis Patients Are Candidates for Surgery

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.
Posted 27 Apr 2016

Wound Irrigation for Open Fractures

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.
Posted 13 Apr 2016

Investigating a Novel Biologic to Enhance Rotator Cuff Repair

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.
Posted 22 Mar 2016

Lower Risk of Death with an Ankle Fracture than with a Hip Fracture

A newly published study shows that compared with hip fracture, an ankle fracture does not appear to be a sentinel event for older patients.
Posted 17 Feb 2016

The Value of Knee Injury Prevention Programs

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.
Posted 18 Jan 2016

A Surgeon’s Transition from Posterior to Direct Anterior Approach

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.
Posted 21 Dec 2015

Outcomes of PIP Joint Arthroplasty

With advances in implant design and materials, more patients can now undergo proximal interphalangeal arthroplasty for arthritis. But more primary procedures means more revisions.
Posted 16 Nov 2015

Does Scapular Stabilization Benefit Children with Obstetric Brachial Plexus Palsy?

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.
Posted 19 Oct 2015

CT-based Classification System Has Prognostic Value for Calcaneal Fractures

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.
Posted 23 Sep 2015

Adding Epi to Irrigation Fluid May Help Visualization in Shoulder Arthroscopy

But it is not known if this improved visualization is clinically significant. And the use of epinephrine carries the risk of cardiac events.
Posted 17 Aug 2015

Which Patients Are at Greatest Risk for Readmission after THA?

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.
Posted 20 Jul 2015

Diluted Epinephrine Injection Helps Reduce Blood Loss in Primary TKA

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.
Posted 19 Jun 2015

Study Identifies Risk Factors for 30-day Readmission in Older Hip Fracture Patients

And unfortunately, many factors associated with readmission and increased length of stay are outside the healthcare provider’s control.
Posted 19 Jun 2015

Reducing PJI Can Have a Big Impact on Costs Associated with THA

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.
Posted 19 Jun 2015

3D Imaging and Templating May Improve Glenoid Positoning in Anatomic TSA

This study serves as an encouraging step toward improving results and longevity of anatomic total shoulder arthroplasty in patients with osteoarthritis.
Posted 19 Jun 2015

Presoaking ACL Grafts with a Vancomycin Solution May Significantly Decrease Infection Rates

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.
Posted 19 Jun 2015

Classic Article: A Treatment Option for SCFE with Good Clinical, Radiographic Outcomes

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.
Posted 18 Jun 2015

Does PJI after TJA Put Patients At Risk for Another PJI after Replacement of a Different Joint?

Surgeons should use caution and thoroughly counsel patients who had a previous infected total joint arthroplasty when considering a subsequent joint replacement procedure.
Posted 18 Jun 2015

Immediate Weight-bearing in Achilles Rupture Treatment Does Not Harm Clinical Outcomes

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.
Posted 18 Jun 2015

Octogenarians Can Benefit from Surgery for Lumbar Stenosis and Degenerative Spondylolisthesis

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.
Posted 18 Jun 2015

In Advanced Kienbock Disease, SCA Improves Grip Strength at the Expense of Wrist ROM

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.
Posted 18 Jun 2015