Most Read Papers - Orthopedics

Systematic reviews are conducted through a consistent and reproducible method to search, appraise, and summarize information. Within the evidence-based pyramid, systematic reviews can be at the apex when incorporating high-quality studies, presenting the strongest form of evidence given their synthesis of results from multiple primary studies to level IV evidence, depending on the studies they incorporate. When combined and supplemented with a meta-analysis using statistical methods to pool the results of three or more studies, systematic reviews are powerful tools to help answer research questions...

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BACKGROUND: Whether the use of PRP as an adjuvant of rotator cuff repairs leads to improved tendon healing and better functional outcomes remains unclear in clinical evidence. PURPOSE: The main purpose of this study was to assess whether the use of leukocyte-poor platelet-rich plasma (LP-PRP) as an adjuvant to arthroscopic rotator cuff repair (ARCR) decreases the rate of retears compared with a control group. The secondary objective was to analyze whether LP-PRP improves patient-reported outcomes...

BACKGROUND: Cutibacterium acnes ( C acnes ) is a commensal skin bacterium, primarily found in sebaceous glands and hair follicles, with a high prevalence in the shoulder region. It is the most common pathogenic organism in prosthetic joint infections after shoulder arthroplasty. Because of its low virulence, its diagnosis remains difficult. PURPOSE: To evaluate the relative effects of topical preparations in reducing C acnes in shoulder surgery. STUDY DESIGN: Meta-analysis; Level of evidence, 1...

Knee osteoarthritis (OA) affects 30% of individuals over 60 and 40% over 70 years old. The incidence of radiological knee OA is 373 per 10,000 person-years, but symptomatic knee OA registers as a considerably lower rate of 50 per 10,000 person-years. For symptomatic cases that are not candidates for surgical intervention, various treatment options include exercise, weight loss, pharmacological management, bracing, physical therapy, oral supplementation, and intra-articular injection with corticosteroids, hyaluronic acid, or orthobiologics such as platelet-rich plasma (PRP)...

PURPOSE: The aim of this study was to evaluate the clinical and radiological outcomes in the treatment of acute acromioclavicular joint (ACJ) separations using an all-endoscopic double cerclage endobutton technique compared to an arthroscopic-assisted single bundle endobutton technique. The secondary aim was to analyze the complication, failure and revision rate of both procedures. MATERIAL AND METHODS: All patients with acute ACJ separations Rockwood IIIB and V who were operated on using an all-endoscopic double-cerclage technique (2019-2022) or an arthroscopic-assisted single bundle technique (2017-2019) were included...

BACKGROUND: There is ongoing debate about the best way to manage ramp lesions at the time of anterior cruciate ligament (ACL) reconstruction (ACLR). Type 3 lesions are not visible by the transnotch approach without superior debridement, making the management debate even more problematic. PURPOSE/HYPOTHESIS: The purpose of this study was to evaluate the rate of secondary surgical interventions according to the management method of a type 3 ramp lesion concomitant with primary ACLR...

OBJECTIVE: Platelet-rich plasma (PRP) use in treating orthopedic conditions has increased, yet evidence of its clinical efficacy is inconsistent and limited by heterogeneity in osteoarthritis (OA) severity, PRP preparations and protocols, and clinical outcome measurement. This review aims to characterize the variations in postinjection protocols in studies assessing the clinical efficacy of PRP for knee OA. LITERATURE SURVEY: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...

INTRODUCTION: This study aimed to: 1) compare treatment outcomes between debridement, antibiotics, and implant retention (DAIR) and partial or complete revision arthroplasty (RA) for early postoperative and acute hematogenous total hip arthroplasty (THA) periprosthetic joint injection (PJI) and 2) identify factors associated with treatment outcome. METHODS: The study consisted of a retrospective cohort of patients who underwent surgery for PJI between 2004 and 2021...

PURPOSE: To compare the clinical outcomes of periportal capsulotomy versus interportal capsulotomy with closure using a standard clinical algorithm at a minimum of 2 years after hip arthroscopy. METHODS: A retrospective cohort study of patients treated from July 2015 to October 2017 was conducted to determine the effects of 2 capsular management approaches on clinical outcomes. When patient pathology limited adequate exposure via periportal capsulotomy, an interportal capsulotomy was performed...

Massive rotator cuff tears (MRCTs) are a challenge to treat with options from arthroscopic rotator cuff repair to reverse shoulder arthroplasty. Arthroscopic repair may still be an option even in the setting of advanced Goutallier changes and Hamada grades and regardless of healing. As the lifetime risk of revision for a 55 year old patient having an RSA was approximately 1 in 3, arthroscopic surgical management of MRCTs should not be discounted. An individualized approach that should consider the patient's radiographs (severity of arthritis), function (i...

Cells undergo a major epigenome reconfiguration when reprogrammed to human induced pluripotent stem cells (hiPS cells). However, the epigenomes of hiPS cells and human embryonic stem (hES) cells differ significantly, which affects hiPS cell function1-8 . These differences include epigenetic memory and aberrations that emerge during reprogramming, for which the mechanisms remain unknown. Here we characterized the persistence and emergence of these epigenetic differences by performing genome-wide DNA methylation profiling throughout primed and naive reprogramming of human somatic cells to hiPS cells...

Chronic lateral knee pain after uneventful total knee arthroplasty can be challenging to manage. We present 3 cases where the pain transiently resolved with injections of local anesthetic. Diagnostic arthroscopy revealed cement protrusion at the lateral femoral bone-prosthesis interface. Passive full knee extension during the curing phase is routine to ensure cement pressurization and optimal bonding. This may enable cement extrusion at the lateral femoral interface and result in persistent pain. Therefore, prevention measures should include thorough visualization of the implant after cementing...

OBJECTIVE: To determine the efficacy of extracorporeal shockwave therapy (ESWT) and investigate outcomes following the use of ESWT for athletes and physically active individuals. DESIGN: Systematic review. DATA SOURCES: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and searched four databases: PubMed (NLM), Embase (Elsevier), CINAHL Complete (EBSCO) and Web of Science (Clarivate). ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Included studies were randomised controlled trials, cohort and case-control studies, cases series and reports that evaluated outcomes following ESWT for athletes, physically active individuals and occupational groups requiring regular physical activity such as military cadets...

BACKGROUND: Hip arthroscopy is rapidly advancing, with positive published outcomes at short- and midterm follow-up; however, available long-term data remain limited. PURPOSE: To evaluate outcomes of primary hip arthroscopy at a minimum 10-year follow-up at 2 academic centers by describing patient-reported outcomes and determining reoperation and total hip arthroplasty (THA) rates. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Patients with primary hip arthroscopy performed between January 1988 and April 2013 at 2 academic centers were evaluated for postoperative patient-reported outcomes-including the visual analog scale, Tegner Activity Scale score, Hip Outcome Score Activities of Daily Living and Sport Specific subscales, modified Harris Hip Score, Nonarthritic Hip Score, 12-item International Hip Outcome Tool, surgery satisfaction, and reoperations...

AIMS: Surgical approaches that claim to be minimally invasive, such as the direct anterior approach (DAA), are reported to have a clinical advantage, but are technically challenging and may create more injury to the soft-tissues during joint exposure. Our aim was to quantify the effect of soft-tissue releases on the joint torque and femoral mobility during joint exposure for hip resurfacing performed via the DAA. METHODS: Nine fresh-frozen hip joints from five pelvis to mid-tibia cadaveric specimens were approached using the DAA...

OBJECTIVES: To assess the correlation between the amount of proximal screw lateralization and clinical symptoms in patients treated with a cephalomedullary nail after a pertrochanteric fracture. DESIGN: Retrospective study. SETTING: Level 1 trauma center. PATIENT SELECTION CRITERIA: Patients operated for a pertrochanteric fracture (OTA/AO A1, A2, A3) between 2019 and 2022 and treated with a cephalomedullary nail were included...

INTRODUCTION: Spino-pelvic characteristics, including sacral slope (SS), are commonly evaluated in different positions pre-THA (total hip arthroplasty). This study aimed to: 1) investigate the change in spino-pelvic parameters at 7 days (early) and 1 year post-THA; and 2) identify patient characteristics associated with a change in SS of more than 7° post-THA. METHODS: We prospectively studied 250 patients who underwent unilateral THA [132 women, age 66 years (range, 32 to 88)] and underwent biplanar images preoperatively and at 7 days and 1 year post-THA...

Patellar tendinopathy is a frequent overuse injury in sports that can cause significant pain and disability. It requires evidence-based guidelines on effective prevention and management. However, optimal treatments remain uncertain. We aimed to analyze available meta-analyses to summarize treatment recommendations, compare therapeutic modalities, examine included trials, and offer methodological suggestions to improve future systematic reviews. Meta-analyses were systematically searched for in PubMed (PROSPERO: CRD42023457963)...

BACKGROUND: Little is known about the effect of modern hip arthroscopy on the natural history of femoroacetabular impingement syndrome (FAIS) with respect to joint preservation. PURPOSE: To (1) characterize the natural history of FAIS and (2) understand the effect of modern hip arthroscopy by radiographically comparing the hips of patients who underwent only unilateral primary hip arthroscopy with a minimum follow-up of 10 years. STUDY DESIGN: Cohort study; Level of evidence, 3...