JAAOS

JAAOS, Volume 27, No. 4


Latissimus Dorsi Tendon Rupture

Isolated injury to the latissimus dorsi is rare. Partial tendon tears may be successfully treated nonsurgically. Complete tendon ruptures require surgical repair. Tendon repair can be approached either through an anterior deltopectoral incision with a secondary small posterior axillary incision or through a long posterior axillary incision. Suture anchors can be used to repair the latissimus dorsi to the humeral attachment. Although the literature is limited to single-patient case series, most patients have returned to full athletic activity after surgical repair.

SDCT

      • Subspecialty:
      • Spine

    Cemented Femoral Component Use in Hip Arthroplasty

    Elderly patients undergoing both elective and nonelective hip arthroplasty contribute markedly to health care spending, and the current aging population is likely to require even more resources. Several national joint replacement registries show a lower risk of revision surgery in patients older than 75 years who received cemented femoral components compared with cementless implants for primary total hip arthroplasty. Despite a higher incidence of early periprosthetic femoral fracture, noncemented femoral components are being used with increasing frequency in elderly patients worldwide. Improvements in cementing technique and modifications to cemented stem design over several decades allow surgeons to obtain femoral component fixation in poor-quality bone with a relatively low risk of complications. Achieving durable cemented stem fixation requires the surgeon to understand the basic handling properties of cement, how to prepare the femoral bone, and differences in stem design and surface finish.

    special-propertyvideoSDCT

        • Subspecialty:
        • Adult Reconstruction

      Sideline Management of Nonmusculoskeletal Injuries by the Orthopaedic Team Physician

      Although recognized as the most well-trained providers to address musculoskeletal injuries, many orthopaedic surgeons do not routinely treat patients with nonmusculoskeletal issues in their clinical practice. Nonetheless, when serving as a team physician, an orthopaedic surgeon may need to initiate management of or manage many nonmusculoskeletal issues. Knowing how to accurately diagnose and initiate management of sports-related medical and surgical conditions is an important facet of being an orthopaedic team physician. Common systems that may be involved include the cerebral/neurologic, ocular, dental, respiratory/pulmonary, cardiac, abdominal, and genitourinary systems. Each of these systems has specific pathologic processes and risks related to athletic or sporting participation. Orthopaedic team physicians must have a baseline familiarity with the most common nonmusculoskeletal issues to provide comprehensive quality care to athletes and patients.

      STATUSONLINE-ONLYSDCT

          • Subspecialty:
          • General Orthopaedics

        Optimal Management of Tethered Surgical Drains: A Cadaver Study

        Background: Tethered drains are a complication of drain usage and may result in unintentional retained broken drains, as well as anxiety and uncertainty for the surgeon and the patient. To date, no study has examined the optimal approach for management and removal of tethered drains.

            • Subspecialty:
            • General Orthopaedics

          Elective Total Shoulder Arthroplasty in Octogenarians: A Safe Procedure

          Introduction: There has been a lack of studies investigating the perioperative course of total shoulder arthroplasty (TSA) performed in the increasingly octogenarian (≥80 years old) population in a large sample size. The purpose of this study was to compare perioperative complications between primary TSA performed in octogenarians and that performed in younger populations (<70 and 70 to 79 years old) from the National Surgical Quality Improvement Program database.

              • Subspecialty:
              • Shoulder and Elbow

            Reliability of Proxy-reported Patient-reported Outcomes Measurement Information System Physical Function and Pain Interference Responses for Elderly Patients With Musculoskeletal Injury

            Background: Patient-reported Outcomes Measurement Information System (PROMIS) instruments are useful to evaluate health status, but its use can be challenging for some vulnerable elderly patients, requiring aid from their proxies. Whether the proxies could be accurate informants is unknown. The goal of this study was to compare elderly patients' and their proxies' answers with PROMIS physical function (PF) and pain interference (PI) computer adaptive test for the evaluation of patients' outcomes after musculoskeletal injury. In addition, to correlate patients' reported PF with the Timed Up and Go (TUG) test.

                • Subspecialty:
                • General Orthopaedics

              Incidence of Posteromedial Meniscocapsular Separation and the Biomechanical Implications on the Anterior Cruciate Ligament

              Purpose: To report the incidence of posterior medial meniscocapsular junction (PMCJ) separation in patients with anterior cruciate ligament (ACL) injury and to evaluate its biomechanical effect on the ACL.

                  • Subspecialty:
                  • Adult Reconstruction

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