Physicians Need to Move Beyond Checklists to Address Disparities in Arthroplasty Care
One of the many challenges that orthopaedic surgeons face today is evaluating a patient as a whole by looking beyond a checklist that determines eligibility for surgery. When orthopaedic surgeons decline to perform joint replacements on patients with comorbidities, are underrepresented populations being disproportionately impacted? The data show the answer is yes.
The Van Gorder Approach for Total Elbow Arthroplasty
Surgical management of the triceps during exposure for total elbow arthroplasty (TEA) is critical to a successful outcome. Previously described techniques include elevating the triceps insertion from one side or leaving the triceps insertion attached and dislocating the joint. Another approach to the elbow, first described in 1933 by Willis Campbell, MD, and subsequently modified by George Van Gorder, MD, involves turning down the triceps tendon without disrupting the triceps insertion. This approach offers complete visualization of the joint and provides excellent exposure for TEA. Only the original report of the technique and a small series of patients using this technique for TEA exist in the literature. The goal of this study was to evaluate outcomes of the Van Gorder approach in a large series of patients undergoing TEA.
COVID-Positive Ankle Fracture Patients are at Increased Odds of Perioperative Surgical Complications Following Open Reduction Internal Fixation Surgery
Ankle fractures have continued to occur through the COVID pandemic and, regardless of patient COVID status, often need operative intervention for optimizing long-term outcomes. For healthcare optimization, patient counseling, and care planning, understanding if COVID-positive patients undergoing ankle fracture surgery are at increased risk for perioperative adverse outcomes is of interest.
Patients With Ehlers-Danlos Syndromes Experience Higher Rates of Prosthetic Dislocation After Total Hip Arthroplasty and Worse Implant Survival at 5 Years
Ehlers-Danlos syndromes (EDS) are genetic connective tissue disorders affecting multiple organ systems that frequently result in connective tissue hyperlaxity and early osteoarthritis. Compared with patients without EDS, patients with EDS were found to have a higher rate of perioperative dislocation and markedly lower implant survival at 5 years. These findings are consistent with the increased connective tissue laxity associated with EDS.
Finite Element Analysis of Cannulated Screws as Prophylactic Intervention of Hip Fractures
The frequency of hip fractures, a major cause of morbidity and mortality for geriatric patients, is expected to increase exponentially in the next few decades. The purpose of this study was to assess the ability of stainless-steel cannulated screws to reduce the risk of a femoral neck fracture, if placed prophylactically prior to a fall.
Cerebral Palsy Should Not Be a Barrier to Total Hip Replacement Surgery
Individuals with neurological conditions can face obstacles when seeking medical treatment. Patients with cerebral palsy (CP) may experience painful symptoms of hip osteoarthritis as adults and may potentially be overlooked for consideration as surgical candidates for total hip arthroplasty. A recent study by Yale researchers found that those with and without CP had comparable 5-year outcomes after total hip replacement surgery. The authors hope the results will lend a voice and support for patients with CP who may be searching for relief of hip pain.
The Role of Physiatry in the Continuum of Care
Physiatry offers a holistic and comprehensive care plan that works in partnership with other specialties in orthopaedics, and beyond, to restore function and maximize independence for patients. As a field, physiatry is unique because it focuses on the whole patient by addressing an individual's physical, emotional, neurological, medical, vocational, and social needs. Rummana Aslam, MBBS helps patients get back to the life they had before experiencing a severe illness, surgery, or trauma.
3D Imaging Helps Orthopaedic Surgeons Prepare for Success
Orthopaedic surgeons, like many physicians who perform surgery, often rely on imaging to understand a case prior to entering the operating room. Images such as X-rays however only create a two-dimensional snapshot that often leaves much to interpretation and do not accurately or vividly depict the surface areas of bone. Thanks to virtual reality manipulation technology that 3D imaging offers, surgeons are able to plan a surgery using guides and jigs, which are later used during surgery to provide the surgeon with a precise cutting path or accurate drill angles.
Impacts of COVID-19 on Orthopaedic Surgery Residency/Spine Trainee Application Trends
The COVID-19 pandemic has had widespread impact across medical educational sectors, including cancellations and delays of board exams, interruptions in clinical rotations and electives, altered processes for away rotations, and conversion to virtual interviews. These changes, combined with applicant and program uncertainty, may affect the 2021 residency application cycle for competitive fields such as orthopaedic surgery. In consideration of spine trainees and the spine fellow application pipeline, the current study aims to evaluate for deviations in trends found in applications to an orthopaedic surgery residency program from the 2021 cycle compared to six years prior.
Clinical Characteristics and Perioperative Complication Profiles of COVID-19–Positive Patients Undergoing Hip Fracture Surgery
The cited study aimed to understand whether COVID-19 positivity was associated with an increased risk of adverse events after geriatric hip fracture surgery. After matching and controlling for confounding variables, the team of Yale researchers determined that COVID-19–positive hip fracture patients had increased odds of multiple postoperative adverse events. The authors concluded that clinicians caring for patients with geriatric hip fractures should be mindful of increased perioperative adverse events associated with COVID-19 positivity in caring for these patients during the ongoing global pandemic.
Stem Cell Therapy Reducing Need for Nearly 10% of Hip Replacements
Collapsed femoral heads caused by osteonecrosis—otherwise known as avascular necrosis— unfortunately represent the root cause for approximately 10% of all hip replacements nationwide. Daniel Wiznia, MD, is utilizing a stem cell treatment at Yale School of Medicine and integrating new techniques along with 3D imaging technology as part of a joint-preservation procedure.
How Andrea Halim, MD, Juggles Responsibilities as a Parent and an Orthopaedic Surgeon
Andrea Halim, MD shares how she juggles the responsibilities as a parent and an orthopaedic surgeon. For many surgeons, it can be just as exhausting as it is rewarding. As a mother of two young children, Dr. Halim believes becoming a parent as made her a better doctor.
Healthcare is a Team Effort for Connecticut Sun
The elite players of the WNBA Connecticut Sun know that winning is a team effort. So, too, do the medical professionals from Yale New Haven Health and Lawrence + Memorial Hospital who provide an array of healthcare services to keep the players in winning form under the leadership of team physician, Michael Medvecky, MD.
Maintaining Perspective: Lee Rubin, MD, Reflects on the Pandemic
Lee E. Rubin, MD, is an associate professor and division chief of Adult Reconstruction with the Department of Orthopaedics & Rehabilitation as well as chief of the Total Joint Replacement Program at Yale New Haven Hospital. He offers an inside look, not only to what physicians and surgeons have experienced during the pandemic, but what he has done personally to keep focused and prioritize mental health.
UPDATED- 4-1: Yale Orthopaedics & Rehabilitation to Open Urgent Care Clinic During COVID-19 Pandemic
An urgent care clinic is being opened at the Yale Physicians Building to help Yale New Haven Hospital's Emergency Department with patients who need musculoskeletal care during the COVID-19 pandemic.