Afleveringen
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Variable operating room (OR) staffing reduces efficiency in total joint arthroplasty (TJA). Prior studies show consistent OR teams improve efficiency; however, the impact of a single dedicated team member (DTM) in variable staffing settings is unknown and may be more achievable for a given surgeon. This study evaluated the impact of adding a DTM on OR efficiency and cost.
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The purpose of this study was to provide a detailed summary of current publicly available primary and secondary literature, databases, and websites reporting sports-related injuries among male and female collegiate and professional athletes in the United States of America (U.S.A.) to determine whether gender disparities exist in injury reporting.
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Zijn er afleveringen die ontbreken?
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Orthopaedic surgeons who perform primary total knee arthroplasty (TKA) may often refer more complex patients to specialty-trained arthroplasty surgeons for definitive treatment. While this practice is often appropriate for optimal patient care, these internal referrals may represent a population that is associated with higher baseline risk and worse outcomes. This study aims to identify the risk factors and outcomes associated with primary TKA patients who are referred to subspecialists.
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The recording of the JOEI Zoom "Open Mic" featuring Nirav Amin, MD (moderator), Brian Gilmer, MD, & Oscar Vasquez, MD.
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Orthopedic oncology depends on strong patient-provider relationships and advanced expertise. Patients in this specialized and nuanced field rely on online platforms, such as U.S. News & World Report (USNWR), to guide their decision-making. While these platforms provide insights into patient satisfaction, they may fail to capture critical nuances such as academic background, research focus, and training recency. This study aims to evaluate the influence of U.S. News physician ratings on patient perceptions of orthopedic oncologists and their correlation with professional credentials.
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Resident physician unionization has accelerated across the United States in recent years, reflecting broader changes in healthcare systems, physician expectations, and the economics of medical training. At Thomas Jefferson University Hospitals, residents recently voted to unionize and are currently in the midst of contract negotiations, placing these national conversations directly into the daily lives of trainees across all specialties here. Within orthopedic surgery, these issues carry unique complexity. Orthopedic residency has historically embraced an apprenticeship model deeply rooted in long hours, graduated autonomy, mentorship, and personal sacrifice. Residents are not merely employees performing labor, but trainees undergoing professional and personal development. The emergence of organized labor within residency programs therefore raises challenging questions. Are orthopedic residents primarily learners or workers? Can surgical training maintain its apprenticeship ethos within increasingly contractual labor structures? Which aspects of residency hardship are educationally meaningful versus unnecessarily burdensome? This editorial explores the evolving intersection of unionization and orthopedic residency culture through the lens of modern orthopedic resident trainees at Rothman Orthopedics at Thomas Jefferson University Hospital.
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A few months ago, Dr. Buch called me and asked “Hey Chris, you know cones are expensive. Should we really be using them?” And I thought “that’s a pretty easy question.” We’re using cones all the time! We want to optimize fixation, but did it get me thinking, when should we be using cones in metaphyseal fixation? And what is the evidence? What are the finances behind it? You know really break it down.
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The wide reach and unique short audiovisual nature of TikTok make it a potential modality for disseminating information about orthopaedic surgery to both patients and medical professionals. However, only a few recent studies have assessed the purpose and creators of orthopaedic surgery content on TikTok.
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Lower extremity joint replacement is the second largest inpatient expense to U.S. Centers for Medicaid & Medicare Services (CMS), prompting value-based care experimentation most recently seen in the Bundled Payment for Care Improvement Advanced Model (BPCI-A). BPCI-A tested a new target pricing methodology and welcomed acute care hospital, physician group practice (PGP), and convener participants.
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The recording of The Journal of Orthopaedic Experience & Innovation Zoom "Open Mic" featuring Scott Mabry, MD, Robert Sershon, MD, Charles Taunt, DO, and Ira Kirschenbaum, MD (Moderator).
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Medial patellar instability is a potentially severe ligamentous condition that significantly impairs normal knee function, with most cases due to iatrogenic injury to the lateral soft tissue restraints. Idiopathic causes are exceedingly rare. We present a unique case of a 32-year-old woman with chronic idiopathic medial patellar instability managed with LPFL reconstruction using a semitendinosus allograft. This report contributes to the limited literature on non-iatrogenic medial patellar instability and supports LPFL reconstruction as a viable treatment option.
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Peptide therapies have rapidly entered musculoskeletal and orthopaedic care through direct-to-consumer performance clinics and widespread online promotion. Agents such as BPC-157 and thymosin beta-4 derivatives (TB-500) are increasingly used by patients seeking accelerated recovery, despite uncertain efficacy and limited perioperative safety data.
This scoping review aimed to characterize the available evidence regarding commonly used peptide therapies relevant to musculoskeletal pathology and to examine safety considerations and perioperative implications for orthopaedic surgical patients, with emphasis on total joint arthroplasty (TJA). -
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly prescribed for both glycemic control and weight loss, particularly in patients undergoing total joint arthroplasty. While studies on total hip and knee arthroplasty suggest potential perioperative benefits, the impact of GLP-1 RA use on outcomes following total shoulder arthroplasty (TSA) is unclear. Given the unique biomechanical demands of TSA, rising TSA volumes, and increasing GLP-1 RA use, this systematic review aims to evaluate the current literature on the impact of GLP-1 RA therapy on postoperative outcomes in TSA patients.
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Total knee arthroplasty (TKA) is a treatment option for individuals with symptomatic osteoarthritis who have failed conservative therapy. In this manuscript the authors describe the pathophysiology of post-operative edema and explore the patient dependent factors potentially contributing to lymphatic dysfunction and thus directly influencing the TKA postoperative course. A proposed multimodal perioperative protocol is presented that focuses on identifying limb edema/lymphedema preoperatively, intraoperative technique changes that may decrease swelling post-TKA.
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Thumb carpometacarpal (tCMC) arthritis is a common and debilitating condition for aging people worldwide. Conservative treatments including activity modification, bracing, anti-inflammatory medications, and steroid injections remain the initial treatment of choice. Given the size of the tCMC joint, intra-articular image-guided injections (IGI) may provide more consistent and superior outcomes with comparison to peri-articular anatomic landmark injections (ALI). This study systematically reviews the accuracy and efficacy of intra-articular IGA versus ALI.
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Since the removal of total hip arthroplasty (THA) from the Medicare Inpatient‑Only (IPO) list in 2020, there has been a growing trend towards outpatient procedures. Recent studies have demonstrated equivalent complications and patient-reported outcome measures (PROMs) among inpatient and outpatient THA patients, but existing selection tools primarily emphasize medical comorbidities. This study assessed the value of incorporating preoperative PROMs into clinical-decision making tools to adequately identify patients most suitable for outpatient THA.
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Complex acetabular defects with associated infection as well as multiple revision procedures remain a significant reconstructive challenge due to compromised bone stock, altered anatomy, and increased risk of recurrent infection. Custom triflange implants have been used to restore pelvic stability in severe bone loss; however, conventional metallic constructs may present limitations in previously infected environments, including challenges with imaging assessment and biomechanical load transfer. Patient-specific implants manufactured from Poly Ether Ketone Ketone (PEKK), a high-performance polymer with mechanical properties closer to cortical bone, may offer an alternative reconstructive strategy.
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Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are some of the most commonly performed surgical procedures. Due to the soft tissue damage sustained intraoperatively, pain is a common occurrence which is frequently treated with opioid analgesics. Conventional wisdom still espouses large numbers of opioids for post-op pain relief. However, opioid related adverse events such as addiction, mental status changes, fall risk, and sedation remain a problem. Suzetrigine is a novel non-addictive FDA approved medication to treat acute pain. Lowering opioid use in the early phases of recovery has been shown to reduce long-term opioid use for patients.
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