When Metastatic Cancer Weakens Bone, the AORIF Procedure Can Help
AORIF is a minimally invasive procedure that uses tiny incisions and high-tech imaging to guide treatment directly to the area the cancer has invaded. The procedure provides hope for patients with cancer that has metastasized to weight-bearing bone, making it difficult to pursue lifesaving treatments. Thanks to this minimally invasive procedure, patients recover quickly, regain mobility, and keep up with other lifesaving cancer treatments.Source: Yale Medicine
Yale Southwick Society Expands Orthopaedic Interest Group to Create Opportunities in Honor of Inaugural Chair’s Legacy
The Southwick Society was founded in the Fall of 2022 to support the continuing advancement of musculoskeletal education for medical students and is taught by the department’s faculty and residents. Students who join will receive mentorship opportunities, clinical education, and tactile exercises to prepare them for a future career in orthopaedic surgery.
Over One-Third of Patients with Multi-Ligament Knee Injuries and An Intact Anterior Cruciate Ligament Demonstrate Medial Meniscal Ramp Lesions on Magnetic Resonance Imaging
The objective of this study was to determine the incidence of ramp lesions and posteromedial tibial plateau (PMTP) bone bruising on magnetic resonance imaging (MRI) in patients with multiligament knee injuries (MLKIs) and an intact anterior cruciate ligament (ACL). Over one-third of MLKI patients with an intact ACL were diagnosed with medial meniscus ramp lesions (MMRLs) on MRI in this series. PMTP bone bruising was observed in 66.7% of patients with MMRLs, suggesting that increased vigilance for identifying MMRLs at the time of ligament reconstruction should be practiced in patients with this bone bruising pattern.
Yale Veterans Coordinate Delivery of Orthopaedic Medical Supplies to Ukraine
Sometimes purpose, service, and responsibility converge to create new opportunities for meaningful action. For Adrian Bonenberger and his wife, Iryna Solomko, this included making another trip to Ukraine. Bonenberger is the editor of Yale Medicine Magazine and Solomko is a Ukrainian journalist who works for Voice of America. Their latest travel to Kyiv took place in October, shortly after the city had been struck by cruise missile and kamikaze drone attacks, and would serve myriad purposes.
An open-access plug-in program for 3D modelling distinct material properties of cortical and trabecular bone
The authors demonstrate the development and use of a pre-processing plug-in program with a 3D modelling image processing software suite (Synopsys Simpleware, ScanIP) to assist with identifying, isolating, and defining cortical and trabecular bone material properties from patient specific computed tomography scans. The workflow starts by calibrating grayscale values of each constituent element with a phantom – a standardized object with defined densities. Using an established power law equation, we convert the apparent density value per voxel to a Young’s Modulus. The resulting “calibrated” scan can be used for modeling and in-silico experimentation with Finite Element Analysis.
Evaluating surface coatings to reduce bone cement adhesion to point of care 3D printed molds in the intraoperative setting
Polymethyl methacrylate, or “bone cement,” can be used intraoperatively to replace damaged or diseased bone and to deliver local antibiotics. 3D printed molds allow surgeons to form personalized and custom shapes with bone cement. One factor hindering the clinical utility of anatomically accurate 3D printed molds is that cured bone cement can be difficult to remove due to the strong adhesion between the mold and the bone cement. One way to reduce the adhesion between the 3D printed mold and the cured bone cement is with the use of a surface coating, such as a lubricant. This study sought to determine the optimal surface coating to prevent bone cement adhesion to 3D printed molds that could be utilized within a sterile operating room environment.
Adult Reconstruction Division Welcomes Ansab Khwaja, MD as 2022-23 Total Joint Replacement Surgery Fellow
Ansab Khwaja, MD, was born in Karachi, Pakistan, and moved to Seattle with his family when he was 10 years old. While receiving a degree in philosophy from the University of Washington, he worked with the school’s athletic trainers, giving him his first glimpse into orthopaedics. He earned early distinction as the ‘Outstanding First Year Sports Medicine Intern.’ He then remained at the University of Washington for medical school where he was a leader in the Orthopaedic Interest Group and his extensive volunteerism earned him a community service award.
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.
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.
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.
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.