Ensuring Bone Health for Adolescents Identifying as Transgender
With a grant from Women's Health Research at Yale, Dr. Stuart Weinzimer, in collaboration with Drs. Thomas Carpenter and Christy Olezeski, is using sophisticated methods to obtain a picture of the dynamic process of bone development in adolescents undergoing gender-affirming hormone therapy.
Patient Demographic and Socioeconomic Factors Associated with Physical Therapy Utilization after Uncomplicated Meniscectomy
Meniscal tears are common orthopaedic injuries that may be caused by trauma or degenerative changes in the knee joint. The extent to which physical therapy (PT) is used after meniscectomy is unknown. The objective of this study was to estimate the extent to which PT is implemented after meniscectomy and to identify factors associated with its utilization.
Predictors of Physical Abuse in Elder Patients with Fracture
Elder abuse is a public health issue requiring attention. Unlike abuse in the pediatric population, predictors of elder abuse in patients with fracture have not been well defined. Elderly patients with physical abuse and fracture were abstracted using the 2007 to 2017 National Emergency Department Sample database. Univariate comparisons, multivariate regression, and adjusted odds ratios were used to determine independent predictors of elder abuse compared with nonabuse fracture controls.
How Do I Know If I Need a Cortisone Shot?
If you’re an athlete prone to overuse injuries or if you have a chronic condition like arthritis, chances are you’ve had a cortisone injection—or at least discussed the treatment with your medical provider. Cortisone injections are most commonly delivered to joints, including those in the hip, knee, shoulder, spine, or wrist, to tamp down inflammation and pain—with the goal of getting people back to their everyday activities.Source: Yale Medicine
Assessment of complications associated with casting of acute distal radius fractures in adults
Controversy exists regarding the closed treatment of distal radius fractures. Circumferential casting of acute distal radius fractures has been shown to be safe in children, however, little research has demonstrated its safety in adults. The purpose of this study was to assess the risk of complications associated with casting acute distal radius fractures in adult patients.
Accuracy of guide wire placement for femoral neck stabilization using 3D printed drill guides
The goal of stabilization of the femoral neck is to limit morbidity and mortality from fracture. Of three potential methods of fixation, (three percutaneous screws, the Synthes Femoral Neck System, and a dynamic hip screw), each requires guide wire positioning of the implant(s) in the femoral neck and head. Consistent and accurate positioning of these systems is paramount to reduce surgical times, stabilize fractures effectively, and reduce complications. To help expedite surgery and achieve ideal implant positioning in the geriatric population, we have developed and validated a surgical planning methodology using 3D modelling and printing technology.
Orthopaedics & Rehabilitation Welcomes Most Gender Diverse Resident Class in Program History
Orthopaedics is widely known to be the least gender and ethnically diverse surgical specialty. Despite national statistics, work has been well underway at Yale to create equitable opportunities for those striving to pursue surgical training in one of the most competitive specialties in medicine. As a result, Yale Orthopaedics & Rehabilitation will be welcoming the most gender diverse resident class in its program’s history.
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.