JBJS JOPA Image Quiz: A Teenager with Thumb Pain After Hand-First Slide
This month’s Image Quiz from the JBJS Journal of Orthopaedics for Physician Assistants (JOPA) describes the case of a 14-year-old boy with a history of a bifid first metacarpal who injured his thumb while sliding hand-first into a base during a baseball game. Anteroposterior and lateral radiographs of the thumb are shown, and findings from the physical exam are detailed in words and photos.
The Image Quiz reviews the function of and injuries to the ulnar collateral ligament (UCL), including the injury classically described as “skier’s thumb.” Pick the best among four possible next steps in diagnosing and treating this injury.
Tags: first metacarpal, JBJS, JOPA, Orthopaedic, Orthopedic, skier;s thumb, thumb, UCL, ulnar collateral ligament
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My TweetsNeed an update on Spine Surgery?
In the June 19th issue of The Journal, Buchowski and Adogwa present an excellent review of the most recent articles in spine surgery.
The article reviews the best recent data on cervical deformity, myelopathy, patient satisfaction, predictive analytics, disc herniation, and more!
And as always, this edition of "What's New" is open access. You can find it on jbjs.org.
#jbjs #orthopedics #orthopedicsurgery #ortho #orthosurgery #surgery #medicine #spine #spinesurgery #discherniation #spinesurgeon #neurosurgery #backpain #spinecare #evidencebasedmedicine #orthopedicresidency #orthoresidency #medicalschool
Don't miss the June Special on JBJS Virtual Recertification Course 2nd Edition!
All the CME for half the price—Each module includes: pre- and post-test assessments, hour-long video-learning components, presentation slides, post-test evaluation, and citations to relevant literature. Earn 22.5 AMA PRA Category 1 Credits™. Use code VRCSum at checkout to purchase for $499 (regular price $999). Valid on full-module purchases only. Purchase today: https://bit.ly/2u6dn76
What's the data on total knee arthroplasty after high tibial osteotomy? Glad you asked!
In the June 5th issue of The Journal, Chalmers et al. present a retrospective review of TKAs performed in patients who previously underwent HTO. The study included 231 TKAs with a mean follow-up of 8 years (2-17). The average time interval between HTO and TKA was 13 years (0.5-34) and the vast majority received posterior-stabilized designs (93%). At 10 years post-op, survivorship free from aseptic loosening was 97%, survivorship free from any revision was 90%, and survivorship free from any reoperation was 85%. Multi-variant analysis revealed that younger age at the time of conversion to TKA (<60) was the only variable associated with a higher risk of revision (HR=1.05 per year decrease in age). This data demonstrates that contemporary total knee arthroplasty with a cemented prosthesis after high tibial osteotomy can expect excellent long-term durability, with 10-year survivorship free from aseptic loosening of 97%. This article can be found on jbjs.org
#jbjs #orthopedics #orthopedicsurgery #ortho #orthosurgery #surgery #medicine #arthroplasty #revisionarthroplasty #totaljointreplacement #kneereplacement #kneearthroplasty #totalkneearthroplasty #hightibialosteotomy #evidencebasedmedicine #orthopedicresidency #orthoresidency #medicalschool
Masquelet technique for the treatment of critical bone defects.
In the June 5th issue of The Journal, you can find an excellent current concepts review article on Masquelet technique written by Dr. Masquelet and colleagues!
The article reviews the surgical technique in detail, the history and development of the technique by Masquelet, the basic science behind the induced membrane, bone-grafting options, and key tips for success.
The clinical outcomes and patient reported outcomes in the literature is reviewed as well.
Lastly, the article features an FAQ with Masquelet (Table III). Definitely a must-read for any orthopedic surgeon treating bone defects!
You can find this article on jbjs.org in the June 5th issue of The Journal.
#jbjs #orthopedics #orthopedicsurgery #ortho #orthosurgery #surgery #medicine #trauma #orthopedictrauma #traumasurgery #bone #fracture #evidencebasedmedicine #orthopedicresidency #orthoresidency #medicalschool
Patellar tendon, hamstring tendon, or double-bundle ACL reconstruction?
In the June 5th issue of The Journal, Mohtadi et al. present their findings from a randomized control trial evaluating the 5-year outcomes of patients who underwent ACL reconstruction with a patellar tendon, single-bundle quadruple-stranded hamstring, or double-bundle hamstring autografts. A total 315 patients were randomized and completed the 5-year follow up which included Anterior Cruciate Ligament-Quality of Line score, IKDC scores, clinical exam, and reinjury rates.
At 5 years post op, there were no significant differences found in the disease-specific outcome scores across the three treatment groups. Although, a trend towards higher IKDC scores was seen in the patellar tendon group compared to the hamstring and double-bundle groups, this did not reach statistical significance.
Interestingly, there were a higher number of traumatic graft reinjuries seen in the hamstring and double-bundle groups (15% and 16%) compared to the patellar tendon group (4%) and this was statistically significant!
This article can be found at jbjs.org in the June 5th issue of The Journal.
#jbjs #orthopedics #orthopedicsurgery #ortho #orthosurgery #surgery #medicine #sportsmedicine #aclreconstruction #aclinjury #acl #knee #sports #evidencebasedmedicine #orthopedicresidency #orthoresidency #medicalschool
Modified V-Y Turndown Flap Augmentation for Quadriceps Tendon Rupture in TKA.
In the June 5th issue of The Journal, Shi et al. present their experience with using a modfied V-Y turndown flap to augment quadriceps tendon repairs following total knee arthroplasy. Twenty-four tendon ruptures in patients who previously underwent TKA were repaired using this technique by the senior author. Prior to the repair, none of the patients were able to walk independently.
Following repair, 92% of patients reported good or excellent results and 83% of patients achieved the goal of 0-120 degrees of active ROM and returned to pre-rupture activity levels. All patients were able to walk without an assistive device at the time of last follow up.
There were 2 (8%) complications in this series. One patient developed a hematoma and delayed wound healing that resolved with local wound care. The second sustained a re-rupture from a fall at 2 years post-op necessitating revision surgery.
This technique appears to be a reliable and effective treatment option for repairing quadriceps tendon ruptures in TKA without the need for allograft or synthetic material for tendon defects ≤6 cm.
This article can be found at jbjs.org in the June 5th issue of The Journal.
#jbjs #orthopedics #orthopedicsurgery #ortho #orthosurgery #surgery #medicine #jointreplacement #totalkneearthroplasty #TKA #kneereplacement #science #jointreconstruction #arthroplasty #evidencebasedmedicine #orthopedicresidency #orthoresidency #medicalschool
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