This study assesses the relationship between the glenoid bone loss size and range of motion, functional outcomes, and complications in high-performance athletes undergoing bone block surgery for ...anterior shoulder instability.
This retrospective study evaluated postoperative outcomes in athletes submitted to bone block surgery for anterior shoulder instability. In 5 years, 41 shoulders underwent the procedure; 20 had bone losses up to 15%, and 21 shoulders presented bone losses ranging from 15% and 25%.
There was no statistically significant difference regarding postoperative complications, new dislocations, and the rate of return to sports. In addition, the quantitative criteria evaluated, i.e., ranges of motion and functional scores, showed no statistically significant difference between groups.
The size of the bone loss per se does not seem to affect functional outcomes and complications from these procedures, which are safe techniques for small and large bone losses.
This study assessed the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of serological tests, synovial fluid markers, microbiological tissue culture, and ...histopathological examination of the periprosthetic membrane in diagnosing periprosthetic knee infection.
This study is prospective, and it includes patients undergoing total knee arthroplasty revision surgery from November 2019 to December 2021. The analysis consisted of serological tests (erythrocyte sedimentation rate ESR, C-reactive protein CRP, and D-dimer), synovial fluid markers (leukocyte and polymorphonuclear cell counts), periprosthetic tissue culture, and histopathological examination of the periprosthetic membrane of all patients.
Sixty-two patients had periprosthetic joint infection (PJI) according to the 2018 International Consensus Meeting criteria (infection group), while 22 subjects had no infection. ESR sensitivity and specificity were 83.6% and 45.4%, respectively. CRP sensitivity and specificity were 64.5% and 100%, whereas D-dimer sensitivity and specificity were 78.9% and 25%, respectively. Leukocyte count sensitivity and specificity were 75.6% and 100%, polymorphonuclear cell count sensitivity and specificity were 33% and 100%, respectively. Periprosthetic tissue culture sensitivity and specificity culture were, respectively, 77.4% and 100%. Histopathological examination sensitivity and specificity were 43.7% and 100%, respectively.
In our study, the total blood cell count in synovial fluid and microbiological cultures of periprosthetic tissues were the most accurate tests for PJI diagnosis. In contrast, polymorphonuclear cell percentage was the least accurate test for PJI diagnosis.
Background:Registries have been created to accrue comprehensive clinical data for evaluation, with purported benefits for clinical governance, public health and scientific investigation. As has been ...the experience internationally, orthopaedic surgeon contribution to data collection for the South African Orthopaedic Registry (SAOR) has been moderate. Due to this response, several awareness initiatives were implemented by the South African Orthopaedic Association (SAOA) to encourage surgeons to engage with SAOR. This study aimed to evaluate the efficacy of these initiatives.Methods: This retrospective study evaluated SAOR’s operational data between 1 August 2019 and 30 June 2022. For each month, the number of new surgeons registering, new patients captured, and new registry pathways initiated were evaluated. These monthly increases were evaluated relative to the implementation of several awareness initiatives. Multiple linear regression was performed to determine if any initiative significantly increased recruitment rates. The Strengthening the Reporting of Observational studies in Epidemiology (STROBE) checklist was used for reporting.Results: Thirty-five months of SAOR operational data were analysed. The cumulative number of surgeons enrolled to use the registry by June 2022 was 108, the number of patients captured 9 992, and the number of pathways initiated 9 585. Thirty-three awareness initiatives of four types took place in the period from January 2021 until June 2022. No interventions increased the recruitment of surgeons. Group promotional sessions and virtual group demonstrations significantly increased the number of patients captured on the registry. Group promotional sessions significantly increased the number of pathways initiated.Conclusion: The SAOR was established in 2019 by the SAOA with the intent to improve orthopaedic practice in South Africa. Several awareness initiatives have been implemented to engage surgeon contributions to the registry, none of which increased enrolment of new surgeons, but some of which increased the number of patients captured and pathways initiated. Ways to improve surgeon engagement with registries should be the focus of future research.Level of evidence: Level 4
Abstract Background context Open laminectomy has been regarded as the standard surgical method up to date in degenerative spinal stenosis or herniation of intervertebral disc. The conventional method ...may lead to instability and provoke chronic lower back pain by scarifying facet joint, posterior ligamentous complex as well as paraspinal muscle. For this reason, the new technique using an endoscope, which could protect soft tissue and facet joint, recently got spotlight. Purpose The aim of this study is to introduce a new spinal surgical technique using a 30-degreed endoscopy through bi- or tri- portals and to report the preliminary result of this technique. Study design retrospective study Methods One hundred five patients who were suffering from neurologic symptoms by degenerative lumbar spine disease were included even after preoperative conservative treatment. Two or three portals were used for each level. One portal was used for viewing, the others, for working of a certain instrument. Unilateral laminotomy was followed by bilateral decompression under 30° endoscopy. Clinical outcomes were analyzed in view of modified-Macnab criteria, Oswestry Disability Index (ODI), Visual analog scale (VAS), and postoperative complications were analyzed. Results The ODI improved from 67.4 ± 11.5 preoperatively to 22.9 ± 12.4 postoperatively. VAS for leg decreased from 7.7 ± 1.5 to 2.4 ± 1.3 at final follow up. Eighty-eight percent of the patients were improved over a level of good based on the Macnab criteria. There were not infection case. Conclusions The 30-degreed endoscopy had the advantages of obtaining a wider view. Full endoscopic decompression using 30-degreed endoscopy allowed satisfactory result clinically and reduction of surgical infection. It could be alternative method of microscopic laminectomy.
The Physician-Payments-Sunshine-Act (PPSA) was introduced in 2010 to provide transparency regarding physician-industry payments by making these payments publicly available. Given potential ethical ...implications, it is important to understand how these payments are being distributed, particularly as the women orthopaedic workforce increases. The purpose of this study was thus to determine the role of gender and academic affiliation in relation to industry payments within the orthopaedic subspecialties.
The PPSA website was used to abstract industry payments to Orthopaedic surgeons. The internet was then queried to identify each surgeon's professional listing and gender. Mann-Whitney U, Chi-square tests, and multivariable regression were used to explore the relationships. Significance was set at a value of P < 0.05.
In total, 22,352 orthopaedic surgeons were included in the study. Payments were compared between 21,053 men and 1299 women, 2756 academic and 19,596 community surgeons, and across orthopaedic subspecialties. Women surgeons received smaller research and non-research payments than men (both, P < 0.001). There was a larger percentage of women in academics than men (15.9% vs 12.1%, P < 0.001). Subspecialties with a higher percentage of women (Foot & Ankle, Hand, and Pediatrics) were also the subspecialties with the lowest mean industry payments (all P < 0.001). Academic surgeons on average, received larger research and non-research industry payments, than community surgeons (both, P < 0.001). Multivariable linear regression demonstrated that male gender (P = 0.006, P = 0.029), adult reconstruction (both, P < 0.001) and spine (P = 0.008, P < 0.001) subspecialties, and academic rank (both, P < 0.001) were independent predictors of larger industry research and non-research payments.
A large proportion of the US orthopaedic surgeon workforce received industry payments in 2014. Academic surgeons received larger payments than community surgeons. Despite having a larger percentage of surgeons in academia, women surgeons received lower payments than their male counterparts. Women also had a larger representation in the subspecialties with the lowest payments.
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