Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Published in
Clinical Orthopaedics and Related Research®
Volume 475 | Issue 9 | Sep, 2017
Articles

Editorial: How Does CORR ® Evaluate Survey Studies?

Matthew B. Dobbs MD, Mark C. Gebhardt MD, Terence J. Gioe MD, Paul A. Manner MD, Raphaël Porcher PhD, Clare M. Rimnac PhD, Montri D. Wongworawat MD, Seth S. Leopold MD

Do Surgeon Expectations Predict Clinically Important Improvements in WOMAC Scores After THA and TKA?

Hassan M. K. Ghomrawi PhD, MPH, Carol A. Mancuso MD, Allison Dunning MS, Alejandro Gonzalez Della Valle MD, Michael Alexiades MD, Charles Cornell MD, Thomas Sculco MD, Matthias Bostrom MD, David Mayman MD, Robert G. Marx MD, Geoffrey Westrich MD, Michael O’Dell MD, Alvin I. Mushlin MD

Failure of THA or TKA to meet a patient’s expectations may result in patient disappointment and litigation. However, there is little evidence to suggest that surgeons can consistently anticipate which patients will benefit from those interventions.

Do Orthopaedic Oncologists Agree on the Diagnosis and Treatment of Cartilage Tumors of the Appendicular Skeleton?

Tomas Zamora MD, Julio Urrutia MD, Daniel Schweitzer MD, Pedro Pablo Amenabar MD, Eduardo Botello MD

Distinguishing a benign enchondroma from a low-grade chondrosarcoma is a common diagnostic challenge for orthopaedic oncologists. Low interrater agreement has been observed for the diagnosis of cartilaginous neoplasms among radiologists and pathologists, but, to our knowledge, no study has evaluated inter- and intraobserver agreement among orthopaedic oncologists grading these lesions using initial clinical and imaging information. Determining such agreement is important since it reflects the certainty in the diagnosis by orthopaedic oncologists. Agreement also is important as it will guide future treatment and prognosis, considering that there is no gold standard for diagnosis of these lesions.

Periprosthetic Joint Infection Is the Main Cause of Failure for Modern Knee Arthroplasty: An Analysis of 11,134 Knees

Chuan Kong Koh MBChB, Irene Zeng PhD, Saiprassad Ravi MBChB, Mark Zhu MBChB, Kelly G. Vince MD, Simon W. Young FRACS

Although large series from national joint registries may accurately reflect indications for revision TKAs, they may lack the granularity to detect the true incidence and relative importance of such indications, especially periprosthetic joint infections (PJI).

Venous Thromboembolism Prophylaxis After TKA: Aspirin, Warfarin, Enoxaparin, or Factor Xa Inhibitors?

Abiram Bala MD, James I. Huddleston MD, Stuart B. Goodman MD, PhD, William J. Maloney MD, Derek F. Amanatullah MD, PhD

There is considerable debate regarding the ideal agent for venous thromboembolism (VTE) prophylaxis after TKA. Numerous studies and meta-analyses have yet to provide a clear answer and often omit one or more of the commonly used agents such as aspirin, warfarin, enoxaparin, and factor Xa inhibitors.

What is the Responsiveness and Respondent Burden of the New Knee Society Score?

Rajesh N. Maniar MS Orth, MCh Orth, Parul R. Maniar MS, FRCO, Debashish Chanda MS, Ortho, Dnyaneshwar Gajbhare MBBS, MD, Toral Chouhan MBA

Although the new Knee Society score (NKSS) has been validated by a task force, a longitudinal study of the same cohort of patients to evaluate the score’s responsiveness and respondent burden has not been reported, to our knowledge.

Free Vascularized Fibular Grafting Improves Vascularity Compared With Core Decompression in Femoral Head Osteonecrosis: A Randomized Clinical Trial

Lu Cao MD, Changan Guo MD, Jifei Chen MD, Zenggan Chen MD, Zuoqin Yan MD

Management of osteonecrosis of the femoral head remains challenging. Core decompression and free vascularized fibular grafting are commonly used surgical procedures for treatment of osteonecrosis of the femoral head. Few studies, however, have compared these two procedures in a randomized controlled study, in terms of improved vascularity of the femoral head, progression of disease, or hip scores.

Similar Clinical Outcomes with Preoperative and Postoperative Start of Thromboprophylaxis in THA: A Register-based Study

Pål O. Borgen MD, Are H. Pripp PhD, Eva Dybvik PhD, Lilian Leistad PhD, Ola E. Dahl MD, PhD, Olav Reikerås MD, PhD

Elective THA is associated with a high risk of thromboembolic events. Although these events may be less common now than they were in the past, they can be serious, and most patients undergoing the procedure therefore still receive thromboprophylaxis. However, controversy remains regarding whether to begin thromboprophylaxis before THA or after to best balance the risks of clotting and bleeding.

Reliability and Validity of the Musculoskeletal Tumor Society Scoring System for the Upper Extremity in Japanese Patients

Kosuke Uehara MD, Koichi Ogura MD, Toru Akiyama MD, Yusuke Shinoda MD, Shintaro Iwata MD, Eisuke Kobayashi MD, Yoshikazu Tanzawa MD, Tsukasa Yonemoto MD, Hirotaka Kawano MD, Akira Kawai MD

The Musculoskeletal Tumor Society (MSTS) scoring system developed in 1993 is a widely used disease-specific evaluation tool for assessment of physical function in patients with musculoskeletal tumors; however, only a few studies have confirmed its reliability and validity.

Can A Multivariate Model for Survival Estimation in Skeletal Metastases (PATHFx) Be Externally Validated Using Japanese Patients?

Koichi Ogura MD, PhD, Tabu Gokita MD, PhD, Yusuke Shinoda MD, PhD, Hirotaka Kawano MD, PhD, Tatsuya Takagi MD, PhD, Keisuke Ae MD, PhD, Akira Kawai MD, PhD, Rikard Wedin MD, PhD, Jonathan A. Forsberg MD, PhD

Objective survival estimates are important when treating or studying outcomes in patients with skeletal metastases. One decision-support tool, PATHFx (www.pathfx.org) is designed to predict each patient’s postsurgical survival trajectory at 1, 3, 6, and 12 months in patients undergoing stabilization for skeletal metastases. PATHFx has been externally validated in various western centers, but it is unknown whether it may be useful in Asian patient populations.

Pathologically Benign Lymph Nodes Can Mimic Malignancy on Imaging in Patients With Angiomatoid Fibrous Histiocytoma

Gary A. Ulaner MD, PhD, John H. Healey MD, Edward A. Athanasian MD

Angiomatoid fibrous histiocytoma (AFH) is a rare soft tissue neoplasm, and its rarity makes studying it difficult. We found that several of our patients with AFH presented with radiologically suspicious local lymph nodes that were sampled because of their imaging characteristics, but the nodes proved to be benign on pathologic evaluation. Although the frequency of this finding is unknown, it seems important for orthopaedic oncologists who care for patients with AFH to know whether suspicious-appearing associated nodes in these patients warrant aggressive management.

Can a Three-Component Prosthesis be Used for Conversion of Painful Ankle Arthrodesis to Total Ankle Replacement?

Markus Preis MD, Travis Bailey MD, Lucas S. Marchand MD, Alexej Barg MD

In patients with painful ankle arthrodesis, the surgical treatment is challenging, and may include takedown of ankle arthrodesis and conversion to a total ankle replacement (TAR). This procedure is technically demanding given the altered anatomy after arthrodesis. Few studies have evaluated TAR in the setting of prior arthrodesis.

Teaching the Basics: Development and Validation of a Distal Radius Reduction and Casting Model

Mark A. Seeley MD, Peter D. Fabricant MD, MPH, J. Todd R. Lawrence MD, PhD

Approximately one-third of reduced pediatric distal radius fractures redisplace, resulting in further treatment. Two major modifiable risk factors for loss of reduction are reduction adequacy and cast quality. Closed reduction and immobilization of distal radius fractures is an Accreditation Council for Graduate Medical Education residency milestone. Teaching and assessing competency could be improved with a life-like simulation training tool.

What Injury Mechanism and Patterns of Ligament Status Are Associated With Isolated Coronoid, Isolated Radial Head, and Combined Fractures?

In Hyeok Rhyou MD, Ji-Ho Lee MD, Kyung Chul Kim MD, Kee Baek Ahn MD, Seong Cheol Moon MD, Hyeong Jin Kim MD, Jung Hyun Lee MD

Isolated coronoid, isolated radial head, and combined coronoid and radial head fractures are common elbow fractures, and specific ligamentous injury of each fracture configuration has been reported. However, the osseous injury mechanism related to ligament status remains unclear.

Combined Administration of ASCs and BMP-12 Promotes an M2 Macrophage Phenotype and Enhances Tendon Healing

Richard H. Gelberman MD, Stephen W. Linderman MPhil, Rohith Jayaram MS, Anna D. Dikina PhD, Shelly Sakiyama-Elbert PhD, Eben Alsberg PhD, Stavros Thomopoulos PhD, Hua Shen PhD

Outcomes after intrasynovial tendon repair are highly variable. An intense inflammatory cascade followed by a delayed healing response can cause adhesion formation and repair-site failure that severely impair the function of repaired digits. No effective remedies exist to fully address these issues. Cell- and growth factor-based therapies have been shown to modulate inflammation and improve cell proliferation and matrix synthesis and therefore are promising treatment approaches for intrasynovial tendon repair.

Reply to the Letter to the Editor: The Chitranjan Ranawat Award: Running Subcuticular Closure Enables the Most Robust Perfusion After TKA: A Randomized Clinical Trial

Cody C. Wyles MD, Steven R. Jacobson MD, Matthew T. Houdek MD, Dirk R. Larson MS, Michael J. Taunton MD, Franklin H. Sim MD, Rafael J. Sierra MD, Robert T. Trousdale MD

Letter to Editor: Editorial: Appropriate Use? Guidelines on Arthroscopic Surgery for Degenerative Meniscus Tears Need Updating

James Rickert MD, Tom Boniface MD, Dwight W. Burney MD, Tom Grogan MD, Paul E. Levin MD, Mark Piasio MD, MBA, Rob Rutherford MD, Alexandra E. Page MD
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