Norwoodhickey5064

xation in the treatment of limb length discrepancy and deformity of long bones in patients with PFD. This strategy ensures reduced external fixation time and high accuracy of alignment. Intramedullary nails left in situ, especially nails with HA-coating, seem to prevent deformity recurrence and stimulate remodeling in dysplastic fibrous zones. © 2020 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.Limb salvage surgery refers to orthopaedic procedures designed to resect tumors and reconstruct limbs. Improvements in managing malignant bone lesions have led to a dramatic shift in limb salvage procedures. Orthopaedic surgeons now employ four main reconstructive procedures endoprosthesis, autograft, bulk allograft, and allograft prosthetic composite. While each approach has its advantages, each technique is associated with complications. Furthermore, knowledge of procedure specific imaging findings can lead to earlier complication diagnosis and improved clinical outcomes. The aim of this article is to review leading reconstructive options available for limb salvage surgery and present a case series illustrating the associated complications. © 2020 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.Osteochondral allograft transplantation can be an effective way to treat cartilage defects in the knee. The objective of this systematic review was to evaluate available research on the effects of preoperative behavioral evaluation and counseling on the outcomes for patients undergoing orthopaedic surgery with emphasis on osteochondral allograft transplantation in the knee. This systematic review of best current evidence indicates that psychological distress and untreated mental health issues are strongly associated with unfavorable outcomes after treatment of orthopaedic disorders, underscoring the need to incorporate behavioral screening and counseling into a comprehensive patient management protocol that improves outcomes for patients. © 2020 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.Objective To determine the efficacy of DIAM Spinal Stabilization System compared with nonoperative treatment for patients with low back pain and lower lumbar disc degenerative disease. Methods A single center collected prospective outcomes data on 38 patients randomized to an interspinous device or non-operative treatment for symptomatic lumbar degenerative disc disease with treatment crossover allowed at 6 months. Results At all postoperative timepoints out to 2-years, statistically significant improvements in ODI and back pain scores were observed with the interspinous device. Clinically significant improvements (ODI >15-point improvement) were seen in 87.5% of DIAM patients at 2-years postoperatively. A high cross-over rate was noted from the non-operative cohort to the operative group (12 of 15) due to continued pain with nonoperative care. Additionally, 80% of patients receiving the DIAM implant reported a >15-point ODI reduction from pre-surgical scores at 2-year follow-up. Conclusion The DIAM device demonstrates improvement in ODI and Back Pain scores maintained out to a 2-year follow-up timepoint and performed superior to conventional nonoperative treatment regimens commonly used in low back pain. © 2020 Published by Elsevier B.V. on behalf of Professor P K Surendran Memorial Education Foundation.Introduction Whilst closed ankle fracture injuries are common, well characterized and have treatment guidelines derived from the literature, open ankle fractures are rare and are not well studied. The few studies that exist are from the developed First World and these well resourced circumstances are not available in most parts of the world. The purpose of this prospective study was to assess the functional outcomes of open ankle fractures and the factors associated with their outcome in an adult population in rural South Africa. Methods This prospective study was done at a referral hospital in a rural and semi-rural part of South Africa during the study period from January 1, 2013 until April 30, 2019 and was a retrospective chart review of 59 adult patients who sustained open ankle fractures. Pre-, peri- and postoperative factors in the chart review were assessed for each patient. Twenty-one patients were available for follow-up and were reviewed at least 6 months post injury for a functional assessment using the American Orthopedic Foot and Ankle Society Score (AOFAS). Results The average AOFAS was 68,2 out of 100 (fair outcome). The lowest score recorded was 38 (one patient) and the highest score 95 (two patients). Nine patients presented with a poor outcome ( less then 60), six with a fair outcome (60-79), two with a good outcome (80-89) and four with an excellent outcome (90-100). The only significant finding, using a Fisher's exact test, indicated that anatomical reduction of the fracture lead to a fair, good or excellent outcome compared to a non-anatomical reduction leading to a poor functional outcome (p = 0,046). Conclusions Our results showed that open ankle fractures are serious injuries with a very variable outcome when managed in a rural or semi-rural setting and that anatomical reduction is required to achieve an optimal functional outcome. © 2020 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.Purpose The long head of the biceps tendon (LHBT) lesions are frequently associated with partial or complete rotator cuff tears (RCTs), but controversy revolves around their optimal surgical management. Methods Hence this article aims to review the current literature available on the role of biceps surgery in rotator cuff surgery and whether it should be routinely performed in rotator cuff repairs. Results Furthermore, we also discuss the advantages and drawbacks of tenotomy or tenodesis of LHBT in rotator cuff surgery. Conclusion We conclude this article with recommendations for surgeons performing rotator cuff repairs and future research in this area. © 2020 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.Background This study assesses if post-operative outcomes following THA vary by racial groups. Methods A review of the ACS-NSQIP database was performed to compare THA patient outcomes from 2008 to 2016 according to race. Results During the study period, 117,389 THA patients were identified. Blacks were at significantly increased risk of peri-operative complications in comparison to non-Hispanic Whites, including serious medical morbidity (+27%), and prolonged length of stay (+53%). Conclusions Despite multivariate control and propensity-matched analysis of important risk factors, race independently predicts longer operative times and higher rates of discharge to non-home facilities. © 2020 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.Group A streptococcal (GAS) infections have high morbidity and mortality due to toxin production and tissue invasion. We reviewed all orthopaedic GAS infections at our medical centre between January 2017 and April 2019. Median age was 56 years. At least 60% had a body mass index (BMI) of ≥30 kg/m2. Median Charlson comorbidity score was 3 (range 0-7). Clinical cure at 90 days was achieved in only 62%. All 4 patients with underlying orthopaedic hardware were cured. Toxin-neutralizing antibiotics and intravenous immunoglobulin were underutilized. Our review confirms poor outcomes from GAS orthopaedic infections without optimal management. © 2020 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.Introduction Osteoarthritis of the hip is one of the leading causes of disability worldwide. There is lack of agreement among providers and governing agencies regarding the efficacy of hyaluronic acid (HA) for the management of hip osteoarthritis (OA). Therefore, the purpose of this systematic review was to determine how HA administration impacts 1) patient reported outcome measures (PROMs) and 2) rates of conversion to THA. Methods The PubMed, EBSCO host, and Google Scholar electronic databases were queried for all studies published between January 1st, 2000 and January 1st, 2020 that reported on outcomes following HA administration for treatment of hip OA. The following keywords were implemented with AND and OR Boolean operators "hip"; "osteoarthritis"; "arthritis"; "viscosupplementation"; "hyaluronic acid." Our final analysis included 39 studies and reported on a total of 5,864 patients receiving injections of HA. Results All studies reporting on visual analog scale (VAS), patient global assessment, and toeatment modalities in randomized controlled trials with larger sample sizes. © 2020 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.Background The clinical outcome of the medial patellofemoral ligament reconstruction (MPFLR) based on graft length change pattern (length pattern group) was compared with MPFLR based on visual examination combined with palpation (visual/palpation group). Methods Physical findings, patient-reported outcome, and radiographic demonstration were evaluated pre- and postoperatively. Results The length pattern group had significantly lower risk of a positive apprehension test (Odds ratio 0.12, p  less then  0.01), and higher scores in postoperative Lysholm score (p = 0.046) and patient satisfaction (p = 0.036) than The visual/palpation group. Conclusion MPFLR based on graft length change pattern improved on patient-reported outcomes and apprehension test. Level of evidence Level Ⅲ, Retrospective comparative study. © 2020 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.Purpose Reverse shoulder arthroplasty (RSA) as an alternative to hemiarthroplasty (HA) as treatment for proximal humerus fractures has prompted a re-evaluation of utilization trends. Methods Operative treatment for proximal humeral fractures were analyzed using a New York State database. Results After introduction as an ICD-9 code, RSA increased to 39.3% (m = +5.2%/year, r = 0.984). When stratifying by age ≥65, HA decreased to 7.7% (m = -2.8%/year, r = 0.962) while RSA increased to 50.6% (m = +6.4%/year, r = 0.985). Conclusion RSA overtook HA as the arthroplasty procedure of choice for proximal humerus fractures. In patients ≥65, RSA passed ORIF as the most prevalent procedure in 2017. Level of evidence III, Descriptive Epidemiology Study, Large Database Analysis. © 2020 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.Objective To compare two different methods of clinical outcomes documentation and investigate the potential impact of a quality assurance program. Methods Data on primary hip arthroplasties conducted between 2004 and 2014 were prospectively collected and analyzed. Results A total of 262/3395 patients suffered a postoperative complication. A reduction of complication rate was observed between 2010 and 2014. A significant difference between the two documentation methods was found in "cardiovascular complications", "hematoma and postoperative hemorrhage" and "reintervention". Finally, the "normalized length of hospital stay" predicted the occurrence of complications. Conclusion Reduction of the incidence of complications through time may be attributed to accumulated surgical experience. © 2020 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.