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Does Medicaid Insurance Confer Adequate Access to Adult Orthopaedic Care in the Era of the Patient Protection and Affordable Care Act?

Background A current appraisal of access to orthopaedic care for the adult patient receiving Medicaid is important, since Medicaid expansion was written into law by the Patient Protection and Affordable Care Act (PPACA). Questions/Purposes (1) Do orthopaedic practices provide varying access to orthopaedic care for simulated patients with Medicaid insurance versus private...

Properties and Corrosion Performance of Self-reinforced Composite PEEK for Proposed Use as a Modular Taper Gasket

Background Fretting corrosion in medical alloys is a persistent problem, and the need for biomaterials that can effectively suppress mechanically assisted crevice corrosion in modular taper junctions or otherwise insulate metal-on-metal interfaces in mechanically demanding environments is as yet unmet. Questions/purposes The purpose of this study is to characterize a novel...

Anterolateral Ligament of the Knee Shows Variable Anatomy in Pediatric Specimens

Background Anterior cruciate ligament (ACL) reconstruction failure rates are highest in youth athletes. The role of the anterolateral ligament in rotational knee stability is of increasing interest, and several centers are exploring combined ACL and anterolateral ligament reconstruction for these young patients. Literature on the anterolateral ligament of the knee is sparse in...

Will My Tibial Fracture Heal? Predicting Nonunion at the Time of Definitive Fixation Based on Commonly Available Variables

Background Accurate prediction of tibial nonunions has eluded researchers. Reliably predicting tibial nonunions at the time of fixation could change management strategies and stimulate further research. Questions/purposes We asked (1) whether data from medical records, fracture characteristics, and radiographs obtained at the time of fixation would identify features predictive of...

Gamma Radiation Sterilization Reduces the High-cycle Fatigue Life of Allograft Bone

Background Sterilization by gamma radiation impairs the mechanical properties of bone allografts. Previous work related to radiation-induced embrittlement of bone tissue has been limited mostly to monotonic testing which does not necessarily predict the high-cycle fatigue life of allografts in vivo. Questions/Purposes We designed a custom rotating-bending fatigue device to answer...

What Factors Are Associated With Failure of Compressive Osseointegration Fixation?

conventional intramedullary stems and to evaluate the potential benefits of preventing stress shielding and preserving bone stock in revision situations. Acknowledgments We thank Sabina Blizzard BS, and Shannon

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

BS, Sheila Sanders BSN, and Patricia Piasecki MS (all from the Department of Orthopedics, Rush University Medical Center) for retrieving patient information and help with data analysis. 1. Ashraf T

High Risk of Failure With Bimodular Femoral Components in THA

Background The bimodular femoral neck implant (modularity in the neck section and prosthetic head) offers several implant advantages to the surgeon performing THAs, however, there have been reports of failure of bimodular femoral implants involving neck fractures or adverse tissue reaction to metal debris. We aimed to assess the results of the bimodular implants used in the THAs...

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

. Acknowledgments We thank Children’s Hospital Colorado Hip Program Staff that helped create and establish the dedicated hip clinic: Amy Edstrom RN, Mikaela Kurkowski BS, and Robin Sawarynski PA-C (all from the

Is Local Infiltration Analgesia Superior to Peripheral Nerve Blockade for Pain Management After THA: A Network Meta-analysis

Background Local infiltration analgesia and peripheral nerve blocks are common methods for pain management in patients after THA but direct head-to-head, randomized controlled trials (RCTs) have not been performed. A network meta-analysis allows indirect comparison of individual treatments relative to a common comparator; in this case placebo (or no intervention), epidural...

Can Vascular Injury be Appropriately Assessed With Physical Examination After Knee Dislocation?

inconclusive, angiography may be warranted. Acknowledgments We thank Stephen Bowen BS (University of Virginia, School of Medicine, Charlottesville, VA, USA) for help with data collection. 1. Bui KL , Ilaslan H

Most American Academy of Orthopaedic Surgeons’ Online Patient Education Material Exceeds Average Patient Reading Level

Background Advancing health literacy has the potential to improve patient outcomes. The American Academy of Orthopaedic Surgeons’ (AAOS) online patient education materials serve as a tool to improve health literacy for orthopaedic patients; however, it is unknown whether the materials currently meet the National Institutes of Health/American Medical Association’s recommended...

Large-magnitude Pelvic and Retroperitoneal Tissue Damage Predicts Organ Failure

Background Pelvic and retroperitoneal trauma is a major cause of morbidity and mortality in multiply injured patients. The Injury Severity Score (ISS) has been criticized for underrepresenting and inaccurately defining mechanical injury. The influence of pelvic injury volume on organ dysfunction and multiple organ failure (MOF) has not been described. Through the use of CT, this...

Does Anteromedial Portal Drilling Improve Footprint Placement in Anterior Cruciate Ligament Reconstruction?

Background Considerable debate remains over which anterior cruciate ligament (ACL) reconstruction technique can best restore knee stability. Traditionally, femoral tunnel drilling has been done through a previously drilled tibial tunnel; however, potential nonanatomic tunnel placement can produce a vertical graft, which although it would restore sagittal stability, it would not...

When Can I Drive After Orthopaedic Surgery? A Systematic Review

Background Patients often ask their doctors when they can safely return to driving after orthopaedic injuries and procedures, but the data regarding this topic are diverse and sometimes conflicting. Some studies provide observer-reported outcome measures, such as brake response time or simulators, to estimate when patients can safely resume driving after surgery, and patient...

What Are the 30-day Readmission Rates Across Orthopaedic Subspecialties?

postoperative length of stay and readmission after elective laminectomy for lumbar spinal stenosis . Spine (Phila Pa 1976 ). 2014 ; 39 : 833 - 840 . 4. Brooke BS , Stone DH , Cronenwett JL , Nolan B , DeMartino

What Is the Utility of Biomarkers for Assessing the Pathophysiology of Hip Osteoarthritis? A Systematic Review

Background Innovations in biologics offer great promise in the treatment of patients with orthopaedic conditions and in advancing our ability to monitor underlying disease pathophysiology. Our understanding of the pathophysiology of hip osteoarthritis (OA) has improved significantly in the last decade. Femoroacetabular impingement (FAI) and hip dysplasia are increasingly...

Hindfoot Arthrodesis with the Blade Plate: Increased Risk of Complications and Nonunion in a Complex Patient Population

Background Previous hindfoot surgeries present a unique challenge to hindfoot arthrodesis, as the patients may have multiple incisions around the hindfoot. In high-risk patients with compromised soft tissues, a posterior approach can provide an alternative for a fresh soft tissue plane for the surgery. The use of a blade plate construct is widely accepted; however, there are...