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  • Early outcomes of shoulder arthroplasty according to sex

    HYPOTHESIS: Among patients undergoing shoulder arthroplasty (SA), female patients would have worse outcomes than their male counterparts.
    METHODS: A multicenter prospective cohort of 2364 patients (1365 female and 999 male patients) treated with total SA or reverse total SA from 2007 to 2015 was retrospectively analyzed. Results were assessed using several validated outcome measures and range-of-motion testing. A multivariable analysis identified differences in preoperative values, postoperative values, and preoperative-to-postoperative improvements while adjusting for possible confounders.

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  • Social Media Use for Orthopaedic Surgeons

    Abstract There has been increasing use of social media in recent years by hospitals and health-care providers. Social media can provide an extension of the physician to an online presence and have potential practice-building implications.

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  • Pain After Anatomic Total Shoulder Arthroplasty Versus Reverse Total Shoulder Arthroplasty

    Abstract As anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA) become increasingly common, differences between the 2 procedures are of importance. The purpose of this study was to determine differences in acute pain levels between patients undergoing aTSA and rTSA. Sixty patients undergoing aTSA or rTSA were assessed for participation. The primary outcome was postoperative daily visual analog scale scores, which were initially collected for 4 days postoperatively. Secondary outcomes included opioid consumption, length of stay, and complications. Comparisons between the 2 groups were assessed using a multivariable analysis, which controlled for sex, age, body mass index, and type of anesthetic

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  • Abnormal tibial alignment is a risk factor for lateral meniscus posterior root tears in patients with anterior cruciate ligament ruptures

    PURPOSE: The purpose of this study was to identify if abnormal tibial alignment was a risk factor for lateral meniscus posterior root tears (LMPRT) in patients with acute anterior cruciate ligament (ACL) ruptures.
    METHODS: The medical charts of 200 patients treated for ACL ruptures between 2013 and 2016 were retrospectively reviewed and evaluated. MRI images and reports were assessed for concurrent meniscal tears. Radiographs were reviewed for tibia vara and tibial slope angles and MRI reports identifying lateral root tears were compared to intraoperative reports to determine accuracy. Multiple logistic regression models were constructed to identify potential risk factors for LMPRTs.

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  • Adductor Canal Block Versus Femoral Nerve Block for Pain Control After Anterior Cruciate Ligament Reconstruction: A Prospective Randomized Trial

    BACKGROUND: Femoral nerve block (FNB) is a commonly performed technique that has been proven to provide effective regional analgesia after anterior cruciate ligament (ACL) reconstruction. The adductor canal block (ACB) uses a similar sensory block around the knee while avoiding motor blockade of the quadriceps muscles.
    PURPOSE/HYPOTHESIS: The purpose of our study was to compare the efficacy of FNB versus ACB for pain control after ACL reconstruction. It was hypothesized that there would be no difference in pain levels or opioid requirements between the 2 groups.

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  • Risk Factors for Postoperative Opioid Use in Arthroscopic Meniscal Surgery

    PURPOSE: (1) To evaluate the influence of preoperative opioid use on postoperative consumption after arthroscopic meniscal surgery and (2) to determine preoperative patient factors associated with increased opioid use after meniscal surgery.
    METHODS: We performed a retrospective review of all patients with a primary diagnosis of a meniscal tear at a single institution between August 2013 and February 2017. Patients were classified as opioid nonusers if they had not received any opioid medications in the 3 months before meniscal surgery, as acute users if they received at least 1 opioid prescription within 1 month preceding meniscal surgery, or as chronic users if they received at least 1 opioid prescription within 3 months preceding meniscal surgery.

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  • Nonoperative Treatment of Medial Ulnar Collateral Ligament Injuries in the Throwing Athlete: Indications, Evaluation, and Management

    Abstract Ulnar collateral ligament (UCL) injuries are common in overhead throwing athletes, particularly baseball players. Appropriate diagnosis, treatment, and rehabilitation are important in order for athletes to return to their preinjury condition.

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  • Length of Time Between Anterior Cruciate Ligament Reconstruction and Return to Sport Does Not Predict Need for Revision Surgery in National Football League Players

    PURPOSE: To determine whether the length of time between primary anterior cruciate ligament reconstruction (ACLR) and return to sport (RTS) predicted the need for revision ACLR in National Football League (NFL) athletes.
    METHODS: All NFL players who underwent ACLR from 2009 to 2015 were identified. The date of index ACLR and date of return to NFL regular-season game play after surgery were recorded. The length of time between ACLR and RTS was compared between players who required revision ACLR and those who did not. Correlation coefficients were used to assess whether players who RTS sooner sustained recurrent anterior cruciate ligament injury at an earlier date.

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  • Three-dimensional printing improves osteochondral allograft placement in complex cases

    Abstract The use of three-dimensional (3D) printing has seen a vast expansion over recent years, with an increased application for its use in orthopaedics. This report details the use of 3D printing technology to aid in the treatment of a medial femoral condyle osteochondral defect in a 26-year-old female who had previously undergone a failed autograft procedure. A preoperative computed tomography scan of the knee and chondral defect was used to generate a 3D printed, one-to-one scale replica of the distal femur. This replica was then used to size a patient-specific allograft plug for the osteochondral transplantation procedure.

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  • Proximal Tibiofibular Dislocation Repaired with Syndesmotic Suture Buttons: A Case Report

    INTRODUCTION: Dislocations of the proximal tibiofibular joint (PTFJ) are a relatively rare orthopedic injury. They are often repaired with open reduction internal fixation utilizing a transfixation screw. Limited data are available concerning alternative repair methods.
    CASE REPORT: This report details a 46-year-old male who presented with an open Type IIIA comminuted mid-shaft tibia and segmental fibula fractures after being struck by a car traveling 70mph. Computed tomography confirmed comminuted and displaced tibia and fibula fractures with PTFJ dislocation as well as air tracking through the anterior compartment of the leg communicating with the knee joint.

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