Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Published in
Clinical Orthopaedics and Related Research®
Volume 474 | Issue 8 | Aug, 2016

Does a Patient-centered Educational Intervention Affect African-American Access to Knee Replacement? A Randomized Trial

Ernest R. Vina MD, MS, Diane Richardson PhD, Elina Medvedeva MS, C. Kent Kwoh MD, Aliya Collier BS, Said A. Ibrahim MD, MPH

A TKA is the most effective and cost-effective surgical option for moderate to severe osteoarthritis (OA) of the knee. Yet, black patients are less willing to undergo knee replacement surgery than white patients. Decision aids help people understand treatment options and consider the personal importance of possible benefits and harms of treatments, including TKA.

Tendon Collagen Crosslinking Offers Potential to Improve Suture Pullout in Rotator Cuff Repair: An Ex Vivo Sheep Study

Roland S. Camenzind MD, Karl Wieser MD, Gion Fessel PhD, Dominik C. Meyer MD, Jess G. Snedeker PhD

The suture-tendon interface is often the weakest link in tendon to bone repair of massive rotator cuff tears. Genipin is a low-toxicity collagen crosslinker derived from the gardenia fruit that has been shown to augment collagen tissue strength and mechanically arrest tendon-tear progression.

Does Degenerative Lumbar Spine Disease Influence Femoroacetabular Flexion in Patients Undergoing Total Hip Arthroplasty?

Christina I. Esposito PhD, Theodore T. Miller MD, Han Jo Kim MD, Brian T. Barlow MD, Timothy M. Wright PhD, Douglas E. Padgett MD, Seth A. Jerabek MD, David J. Mayman MD

Sitting pelvic tilt dictates the proximity of the rim of the acetabulum to the proximal femur and, therefore, the risk of impingement in patients undergoing total hip arthroplasty (THA). Sitting position is achieved through a combination of lumbar spine segmental motions and/or femoroacetabular articular motion in the lumbar-pelvic-femoral complex. Multilevel degenerative disc disease (DDD) may limit spine flexion and therefore increase femoroacetabular flexion in patients having THAs, but this has not been well characterized. Therefore, we measured standing and sitting lumbar-pelvic-femoral alignment in patients with radiographic signs of DDD and in patients with no radiographic signs of spine arthrosis.

The Natural History of Osteoarthritis: What Happens to the Other Hip?

Harlan C. Amstutz MD, Michel J. Le Duff MA

Idiopathic osteoarthritis (OA) is a common diagnosis leading to hip arthroplasty. Patients undergoing unilateral hip arthroplasty often wonder whether their other hip will follow the same path as the one that was operated on, and if so, when? There also are limited data available to predict from AP radiographs which contralateral hips will have OA develop and which will not.

Inaccuracies in the Use of Magnification Markers in Digital Hip Radiographs

Michael J. Archibeck MD, Tamara Cummins RT, Krishna R. Tripuraneni MD, Joshua T. Carothers MD, Cristina Murray-Krezan MS, Mohammad Hattab PhD, Richard E. White MD

With the ubiquity of digital radiographs, the use of digital templating for arthroplasty has become commonplace. Although improved accuracy with digital radiographs and magnification markers is assumed, it has not been shown.

The NLRP3/Caspase-1/Interleukin-1β Axis Is Active in Human Lumbar Cartilaginous Endplate Degeneration

Pan Tang MD, Ren Zhu MD, Wei-Ping Ji MD, Ji-Ying Wang MD, Shuai Chen MD, Shun-Wu Fan MD, Zhi-Jun Hu PhD

Modic changes are the MRI signal changes of degenerative lumbar vertebral endplate and which lead to or accelerate intervertebral disc degeneration. NLRP3, caspase-1, and interleukin-1β (IL-1β) play a pivotal role in the pathogenesis of many inflammatory diseases, such as osteoarthritis. However, the roles of IL-1β and its activators caspase-1 and NLRP3 are unclear in the degenerative endplate.

Is Social Support Associated With Upper Extremity Disability?

Sjoerd P. F. T. Nota MD, Silke A. Spit MD, Thijs C. H. Oosterhoff BSc, Michiel G. J. S. Hageman MD, David C. Ring MD, PhD, Ana-Maria Vranceanu PhD

Pain intensity and disability correlate with psychosocial factors such as depression and pain interference (the degree to which pain interferes with activities of daily living) as much or more than pathophysiology in upper extremity illness. However, other factors like emotional support (perception of being cared for and valued as a person), instrumental support (perception of availability of tangible assistance when needed), positive psychosocial impact (perception and focus on the positive side of a difficult situation, sometimes characterized as posttraumatic growth, benefit-finding, or meaning making), also might be associated with disability in patients with upper extremity orthopaedic illness. This is the first published study, to our knowledge, addressing the potential association of emotional support, instrumental support, and positive psychosocial illness impact with disability in patients with upper extremity illness.

Is Assessment of Femoral Head Perfusion During Modified Dunn for Unstable Slipped Capital Femoral Epiphysis an Accurate Indicator of Osteonecrosis?

Eduardo N. Novais MD, Ernest L. Sink MD, Lauryn A. Kestel BS, Patrick M. Carry BA, João C. M. Abdo MD, Travis C. Heare MD

The modified Dunn procedure, which is an open subcapital realignment through a surgical dislocation approach, has gained popularity for the treatment of unstable slipped capital femoral epiphysis (SCFE). Intraoperative monitoring of the femoral head perfusion has been recommended as a method of predicting osteonecrosis; however, the accuracy of this assessment has not been well documented.

Higher Pavlik Harness Treatment Failure Is Seen in Graf Type IV Ortolani-positive Hips in Males

Eduardo N. Novais MD, Lauryn A. Kestel BS, Patrick M. Carry BA, Mariana L. Meyers MD

Patients with developmental dysplasia of the hip (DDH) whose hips are dislocated but reducible (Ortolani positive) are more likely to experience Pavlik harness treatment failure than are patients with dysplastic and reduced but dislocatable (Barlow positive) hips. However, data regarding factors associated with failure are limited and conflicting.

Among Musculoskeletal Surgeons, Job Dissatisfaction Is Associated With Burnout

Olivier D. R. Wulfften Palthe MD, Valentin Neuhaus MD, Stein J. Janssen MD, Thierry G. Guitton MD, PhD, David Ring MD, PhD

Burnout is common in professions such as medicine in which employees have frequent and often stressful interpersonal interactions where empathy and emotional control are important. Burnout can lead to decreased effectiveness at work, negative health outcomes, and less job satisfaction. A relationship between burnout and job satisfaction is established for several types of physicians but is less studied among surgeons who treat musculoskeletal conditions.

How Does Wear Rate Compare in Well-functioning Total Hip and Knee Replacements? A Postmortem Polyethylene Liner Study

Robin Pourzal PhD, Christopher B. Knowlton BS, Deborah J. Hall BS, Michel P. Laurent PhD, Robert M. Urban, Markus A. Wimmer PhD

The longevity of total hip (THR) and knee replacements (TKR) that used historical bearing materials of gamma-in-air sterilized UHMWPE was affected more by osteolysis in THRs than in TKRs, although osteolysis remains a concern in TKRs. Therefore, the study of polyethylene wear is still of interest for the knee, particularly because few studies have investigated volumetric material loss in tibial knee inserts. For this study, a unique collection of autopsy-retrieved TKR and THR components that were well-functioning at the time of retrieval was used to compare volumetric wear differences between hip and knee polyethylene components made from identical material.

Reply to the Letter to the Editor: Does Degenerative Lumbar Spine Disease Influence Femoroacetabular Flexion in Patients Undergoing Total Hip Arthroplasty?

Christina I. Esposito PhD, Theodore T. Miller MD, Han Jo Kim MD, Brian T. Barlow MD, Timothy M. Wright PhD, Douglas E. Padgett MD, Seth A. Jerabek MD, David J. Mayman MD
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