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  • 1
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    Online Resource
    Short-Term Complications and Outcomes of the Cadence Total Ankle Arthroplasty
    SAGE Publications ; 2022
    In:  Foot & Ankle International Vol. 43, No. 3 ( 2022-03), p. 371-377
    Details
    In: Foot & Ankle International, SAGE Publications, Vol. 43, No. 3 ( 2022-03), p. 371-377
    Abstract: Total ankle arthroplasty (TAA) is an increasingly popular option for the operative treatment of ankle arthritis. The Cadence TAA entered clinical use in 2016 and was designed to address common failure modes of prior systems. We report early complications and radiographic and clinical outcomes of this total ankle system at a minimum of 2 years of follow-up. Methods: We performed a retrospective review of a consecutive cohort of patients undergoing primary Cadence TAA by a single surgeon from 2016 to 2017. Complications and reoperations were documented using the American Orthopaedic Foot & Ankle Society (AOFAS) TAA reoperation coding system. Patients completed the Foot and Ankle Ability Measure (FAAM) Activities of Daily Living (ADL) and Sport subscales, SF-12 Mental (MCS) and Physical (PCS) Component Summaries, and visual analog scale (VAS) pain rating (0-100). Radiographic evaluation was performed to assess postoperative range of motion (ROM) of the sole of the foot relative to the long axis of the tibia, alignment, and implant complications. Results: Fifty-eight patients with a mean age of 63.3 years and mean body mass index of 31.9 kg/m 2 were included. Twelve of 58 patients (20.7%) underwent an additional procedure(s) within 2 years, including 3 (5.2%) who required removal of one or both components, 2 for infection and 1 for osteolysis. Forty-three patients were followed for a minimum of 2 years with radiographic imaging; 1 patient’s (2.3%) radiographs had signs of peri-implant osteolysis, with no cases demonstrating loosening or subsidence. FAAM-ADL, FAAM-Sport, SF-12 PCS, and VAS pain scores all improved at a mean of 27.4 months postoperatively, with mean score changes (± SD) of 16.3 (± 22.0), 25.3 (± 24.5), 6.0 (± 11.1), and −32.3 (± 39.8), respectively. Radiographic analysis revealed that average coronal alignment improved from 6.9 degrees from neutral preoperatively to 2.3 degrees postoperatively. The average ROM of the foot relative to the tibia was 36.5 degrees total arc of motion based on lateral radiographs. Conclusion: Early experience with this 2-component total ankle replacement was associated with a high component retention rate, improved coronal plane alignment, good postoperative ROM, radiographically stable implants, and improved patient function. Level of Evidence: Level IV, case series.
    Type of Medium: Online Resource
    ISSN: 1071-1007 , 1944-7876
    URL: Article
    DOI: 10.1177/10711007211043853
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
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  • 2
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    2.4mm Non-Cannulated Screws are Non-Inferior to 4.0mm Cannulated Screws for Medial Malleolar Fixation in Unstable Ankle Fractures
    SAGE Publications ; 2020
    In:  Foot & Ankle Orthopaedics Vol. 5, No. 4 ( 2020-10-01), p. 2473011420S0021-
    Details
    In: Foot & Ankle Orthopaedics, SAGE Publications, Vol. 5, No. 4 ( 2020-10-01), p. 2473011420S0021-
    Abstract: Ankle; Trauma Introduction/Purpose: Ankles fractures are the third most common adult fractures, representing significant cost to society. This makes the effectiveness of ankle open reduction internal fixation (ORIF) an important area for study. The majority of existing literature on medial malleolus fracture fixation involves biomechanical testing in synthetic bone or cadaveric models. We sought to compare the clinical efficacy of medial malleolar fixation with 2.4mm non-cannulated screws to 4.0mm cannulated screws by evaluating rates of loss of reduction and hardware failure. Methods: We performed a propensity-score-matched retrospective cohort study on patients who underwent ORIF of an unstable ankle fracture with fixation of the medial malleolus with either 2.4mm non-cannulated (N=51 ankles in 51 patients) or 4.0mm cannulated (N=60 ankles in 60 patients) screws. Vertically oriented medial malleolus fractures or those in which additional fixation was used were excluded. We identified post-operative complications and compared follow-up radiographs with immediate post-operative radiographs for signs of hardware failure or loss of reduction. Mean age was 50.2 years (SD 13.9). There was no significant difference between groups in age, BMI, Charleston Comorbidity Index (CCI), smoking or diabetes status. The 2.4mm patients were more likely to require syndesmosis fixation (56.9% 2.4mm, 30.0% 4.0mm, p=0.007) but not posterior malleolus fixation (25.5% 2.4mm, 28.3% 4.0mm, p=0.831). Most medial malleoli were fixed with 2 screws (1 screw 9.8%, 2 screws 90.2% 2.4mm, 1 screw 7.0%, 2 screws 93.0% 4.0mm, p=0.60). Results: There was no significant difference in total complications (7.8% 2.4mm, 15.0% 4.0mm, p=0.375), operative complications (5.9% 2.4mm, 5.0% 4.0mm, p=1.00), loss of medial reduction (3.9% 2.4mm, 6.7% 4.0mm, p=0.69), or medial hardware breakage (2.0% 2.4mm, 0% 4.0mm, p=0.45). The two patients in the 2.4mm screw group with loss of medial malleolus fixation were noncompliant with non-weight bearing restrictions and failed by screw backing out, while the 4 patients in the 4.0mm group failed by medial fracture fragment displacement around stable screws. The 4.0mm group had more nonoperative complications (0% 2.4mm, 10.0% 4.0mm, p=0.031); one of these was delayed union of the medial malleolus, while the remainder were delayed lateral wound healing or sural or superficial peroneal distribution paresthesias, which appeared unrelated to medial fixation type. Conclusion: When used for medial malleolus fixation in unstable ankle fractures, 2.4mm non-cannulated screws do not have higher rates of loss of reduction or hardware failure compared to 4.0mm cannulated screws. Given their decreased cost and equivalent ease of insertion, surgeons should consider their use when fixing unstable ankle fractures.
    Type of Medium: Online Resource
    ISSN: 2473-0114 , 2473-0114
    URL: Article
    DOI: 10.1177/2473011420S00214
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
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  • 3
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    A Retrospective Analysis of Results and Outcomes after Cadence Total Ankle Arthroplasty Implanted through the End of 2017
    SAGE Publications ; 2020
    In:  Foot & Ankle Orthopaedics Vol. 5, No. 4 ( 2020-10-01), p. 2473011420S0021-
    Details
    In: Foot & Ankle Orthopaedics, SAGE Publications, Vol. 5, No. 4 ( 2020-10-01), p. 2473011420S0021-
    Abstract: Ankle; Ankle Arthritis Introduction/Purpose: Total ankle arthroplasty (TAA) is an increasingly popular operative treatment of ankle arthritis, due to its ability to decrease adjacent joint degeneration and preserve gait mechanics compared to ankle arthrodesis. However, ankle arthroplasty components have a shorter mean longevity then their hip, knee, or shoulder counterparts. The Cadence TAA entered clinical use in 2016 and was designed to address common failure modes of prior systems. We report here on radiographic and clinical outcomes and early complications of the Cadence TAA system at a minimum of 2 years follow-up. Methods: Patients who underwent primary Cadence TAA from 2016 through 2017 by one fellowship-trained foot and ankle surgeon were eligible. Exclusion criteria included prior ipsilateral ankle arthrodesis or arthroplasty and lack of followup. Chart review was performed for eligible patients to identify complications and reoperations. Patients were contacted to obtain Foot and Ankle Ability Measure (FAAM) Activities of Daily Living (ADL) and Sport subscores, SF-12 Mental (MCS) and Physical Health (PCS) subscores, and Visual Analog Scale (VAS) pain levels (rated 0-100). Scores were analyzed with 2-sided repeated measures T- tests, with P 〈 0.05 as significant. A second, blinded, fellowship-trained foot and ankle surgeon evaluated followup 5-view radiographs of each ankle to measure range of motion (ROM), alignment, peri-implant osteolysis, and component loosening or subsidence. Subsidence or loosening were defined, respectively, as 〉 2mm or 〉 2⁰ change in position for the tibial component and 〉 5mm or 〉 5⁰ change for the talar component. Results: Sixty patients were included with mean age 64 and mean BMI 32.0. Thirty patients (50%) had concurrent other procedure(s). FAAM-ADL, FAAM-Sports, SF-12 PCS, and VAS pain scores all improved significantly at mean 2.24 years post-op (Table 1). Ten patients (6.7%) had operative complications requiring 15 surgeries (mean 265 days to first reoperation). Three patients (5%) required removal of one or both components, for 2-year implant survival of 95.0%. Two revisions were for infection and one for osteolysis. This produced a mechanical failure rate of 1/60 (1.7%). Radiographic analysis revealed average coronal alignment improved from 7.4⁰ from neutral preoperatively to 2.2⁰ postoperatively. Average ROM was 36.5⁰ total arc of motion. One of 38 (2.6%) had signs of peri-implant osteolysis, with no cases demonstrating loosening or subsidence. Conclusion: Two-year follow-up of the Cadence TAA system demonstrates mechanically stable implants resulting in improved patient function and preserved ankle range of motion. Outcomes compare favorably to those of other TAA systems at 2-year follow-up. Further radiographic and clinical follow-up are needed to evaluate implant longevity and long-term patient functional outcomes. [Table: see text]
    Type of Medium: Online Resource
    ISSN: 2473-0114 , 2473-0114
    URL: Article
    DOI: 10.1177/2473011420S00215
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
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  • 4
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    Coronal Shear Fractures of the Distal Humerus: A Review of Diagnosis, Treatment, and Outcomes
    SAGE Publications ; 2021
    In:  HAND Vol. 16, No. 5 ( 2021-09), p. 577-585
    Details
    In: HAND, SAGE Publications, Vol. 16, No. 5 ( 2021-09), p. 577-585
    Abstract: Fractures of the capitellum and trochlea are uncommon fractures of the elbow and can be challenging to treat due to their size, location, and articular nature. Because of their intra-articular nature and predilection toward displacement, these fractures are typically treated operatively. Furthermore, capitellum fractures have high rates of associated injuries, including radial head fractures or lateral collateral ligament injury in ~30% to 60% of patients. In addition to open reduction internal fixation, operative options include fragment excision, arthroscopic assisted reduction and fixation, and elbow arthroplasty. In this article, we undertake a comprehensive literature review of capitellum fractures of the distal humerus, in an attempt to summarize the existing body of evidence and propose areas of future study.
    Type of Medium: Online Resource
    ISSN: 1558-9447 , 1558-9455
    URL: Article
    DOI: 10.1177/1558944719878817
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2316440-2
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  • 5
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    Cutaneous Basal Cell Carcinoma with Bone Metastases: An Orthopaedic Case Report
    Hindawi Limited ; 2019
    In:  Case Reports in Orthopedics Vol. 2019 ( 2019-06-23), p. 1-5
    Details
    In: Case Reports in Orthopedics, Hindawi Limited, Vol. 2019 ( 2019-06-23), p. 1-5
    Abstract: Basal cell carcinoma (BCC) is the most common skin cancer, and its incidence is increasing. Though metastatic BCC (mBCC) is uncommon, the literature demonstrates a 0.0028%-0.55% rate of metastasis. We report on a patient treated at our institution who was found to have mBCC with osseous metastases. To our knowledge, this is the first report of mBCC in the orthopaedic literature. Orthopaedic oncologists should consider mBCC in patients diagnosed with carcinoma of unknown origin, with a known history of BCC, or individuals with light skin pigmentation and age 50 or greater. This can help clinicians make the correct diagnosis and provide the appropriate treatment.
    Type of Medium: Online Resource
    ISSN: 2090-6749 , 2090-6757
    URL: Article
    DOI: 10.1155/2019/1628980
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2019
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  • 6
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    Immediate Weight-Bearing and Range of Motion After Internal Fixation of Selected Malleolar Fractures: A Retrospective Controlled Study
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Journal of Orthopaedic Trauma Vol. 35, No. 6 ( 2021-06), p. 308-314
    Details
    In: Journal of Orthopaedic Trauma, Ovid Technologies (Wolters Kluwer Health), Vol. 35, No. 6 ( 2021-06), p. 308-314
    Abstract: We studied the safety of immediate weight-bearing as tolerated (IWBAT) and immediate range of motion (IROM) after open reduction internal fixation (ORIF) of selected malleolar ankle fractures (defined as involving bony or ligamentous disruption of 2 or more of the malleoli or syndesmosis without articular comminution) and attempted to identify risk factors for complications. Design: Retrospective case–control study. Setting: Level 1 Urban Trauma Center and multiple community hospitals, orthopedic specialty hospitals, and outpatient surgicenters within one metropolitan area. Patients/Participants: Of 268 patients at our level 1 trauma center who underwent primary ORIF of a selected malleolar fracture from 2013 to 2018, we identified 133 (49.6%) who were selected for IWBAT and IROM. We used propensity score matching to identify 172 controls who were non–weight-bearing (NWB) and no range of motion for 6 weeks postoperatively. The groups did not differ significantly in age, body mass index, Charleston Comorbidity Index, smoking status, diabetes status, malleoli involved, percentages undergoing medial malleolus (60.9% IWBAT vs. 51.7% NWB), posterior malleolus (24.1% IWBAT, 26.7% NWB), or syndesmosis fixation (41.4% IWBAT, 42.4% NWB, P = 0.85). Intervention: IWBAT and IROM after ankle ORIF versus NWB for 6 weeks. Main Outcome Measurements: Postoperative complications, including delayed wound healing, superficial or deep infection, and loss of reduction. Results: There was no significant difference in total complications ( P = 0.41), nonoperative complications ( P = 0.53), or operative complications, including a loss of reduction ( P = 0.89). We did not identify any factors associated with an increased complication risk, including posterior malleolus or syndesmosis fixation, diabetes, age, or preinjury-assisted ambulation. Conclusions: We failed to demonstrate a difference in complications in general and loss of reduction in particular when allowing immediate weight-bearing/ROM in selected cases of operatively treated malleolar fractures, suggesting this may be safe. Future prospective randomized studies are necessary to determine if immediate weight-bearing/ROM is safe and whether it offers any benefits to patients with operatively treated malleolar fractures. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
    Type of Medium: Online Resource
    ISSN: 0890-5339
    URL: Article
    DOI: 10.1097/BOT.0000000000002003
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
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  • 7
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    Maternally recruited Aurora C kinase is more stable than Aurora B to support mouse oocyte maturation and early development
    Proceedings of the National Academy of Sciences ; 2012
    In:  Proceedings of the National Academy of Sciences Vol. 109, No. 33 ( 2012-08-14)
    Details
    In: Proceedings of the National Academy of Sciences, Proceedings of the National Academy of Sciences, Vol. 109, No. 33 ( 2012-08-14)
    Abstract: This study answers the question of why oocytes contain two AURKs that appear to have redundant functions. We propose that AURKC is an example of one of the many isoforms of cell-cycle regulators, such as the germ-cell–specific tyrosine kinase WEE1B, which is recruited for translation during oocyte meiotic maturation to support meiosis, fertilization, and early embryonic cell division. Further, we propose that these recruited mRNAs represent a strategy to switch from a program of oocyte growth without cell division, during the prolonged cell-cycle arrest, to meiotic and mitotic divisions without growth, specifically in the early embryonic cleavage stages. To determine whether AURKC contributes to oocyte maturation, we generated Aurkc −/− mice. Females have fewer pups per litter; further, a significant fraction of their oocytes are arrested in meiosis I and show a higher incidence of abnormally aligned chromosomes. Moreover, fewer embryos from Aurkc −/− female × Aurkc +/+ male crosses develop to the blastocyst stage when cultured in vitro due to failure of cytokinesis. This result is consistent with a loss of AURKB activity over time in the Aurkc −/− mice. Using fluorescently tagged reporter proteins, we found that AURKB is degraded more rapidly than AURKC. Moreover, endogenous AURKC levels increase during maturation due to recruitment of Aurkc mRNA for translation. Taken together, these observations demonstrate that AURKC compensates for loss of AURKB resulting from differences in both message recruitment and protein stability. Many reasons can be envisioned as to why different cell types express different isoforms of a protein. During meiosis, haploid gametes develop from diploid precursor cells by two successive cell divisions: the first, of chromosome homologs, and the second, of chromatids, without an intervening cell cycle. It is therefore tempting to speculate that AURKC exists because its mitotic counterparts (AURKA and -B), which regulate a single round of sister chromatid segregation per cell cycle, cannot regulate this unique cell cycle. Despite this obvious difference, several observations suggest that AURKC may not have a unique function. These observations include high sequence identity, AURKC’s ability to compensate for the loss of AURKB when ectopically expressed in somatic cells, and its ability to support embryonic cell divisions in mouse embryos lacking AURKB before reaching the blastocyst stage ( 3 – 5 ). Aurora kinases (AURKs) are major regulators of cell division. Mammals contain three AURK isoforms as follows: ubiquitously expressed AURKA and AURKB and germ-cell–specific AURKC ( 1 , 2 ). We address here the question of why oocytes contain AURKC although it functions similarly to AURKB ( 3 – 5 ). We demonstrate that female mice lacking AURKC are subfertile due to aberrant oocyte and embryo phenotypes during their development, which lead to a failure of cell division. This defect is accompanied by gradual loss of AURK activity, therefore resulting in more severe phenotypes observed in embryos than observed in oocytes. Further, AURKC is more stable than AURKB in oocytes, and Aurkc mRNA is more efficiently recruited for translation than Aurkb mRNA is ( Fig. P1 ). Our findings address why different cell types express different protein isoforms with redundant functions.
    Type of Medium: Online Resource
    ISSN: 0027-8424 , 1091-6490
    URL: Article
    DOI: 10.1073/pnas.1120517109
    RVK:
    TA 1000
    RVK:
    WA 15000
    Language: English
    Publisher: Proceedings of the National Academy of Sciences
    Publication Date: 2012
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  • 8
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    Effects of Upper Extremity Elevation on Intra-Cast Pressure and Digital Perfusion in a Fiberglass Short-Arm Cast Model
    SLACK, Inc. ; 2021
    In:  Orthopedics Vol. 44, No. 4 ( 2021-07)
    Details
    In: Orthopedics, SLACK, Inc., Vol. 44, No. 4 ( 2021-07)
    Abstract: The goal of this study was to determine the relationship of digital artery pressure to arm position and forearm skin surface pressure using a short-arm cast experimental setup, to ascertain the safest position for the injured casted upper extremity. A total of 27 volunteers were placed in bilateral short-arm fiber-glass casts with an empty 50-mL bladder bag under the cast and attached to a pressure transducer. Digital systolic pressure (P dig ), and skin surface pressure under the cast (P skin ) were assessed in 4 positions. Measurements were taken with and without 50 mL air in the bladder bag. A total of 54 forearms were evaluated. Both arm position and P skin had a significant effect on P dig ( P 〈 .001 for both), with increasing elevation leading to a decrease in P dig ( r =−0.50). The effect size of position on P dig was large, whereas that of Pskin was small (partial eta-squared=0.371 and 0.028, respectively). Linear regression analysis of P skin and P dig with air in the neutral position yielded a moderate negative relationship with body mass index ( r =−0.64, P 〈 .001 for P skin ; r =0.49, P 〈 .001 for P dig ) and wrist circumference ( r =−0.66, P 〈 .001 for P skin ; r =0.52, P 〈 .001 for P dig ), without significant association with forearm length. For volunteers with short-arm fiberglass casts, increasing arm elevation had a large effect size on digital arterial pressure, whereas 50 mL simulated swelling had only a small effect size. Decreasing body mass index and forearm circumference correlated with increased skin surface pressure and decreased digital arterial pressure. These findings show that aggressive elevation of the injured limb may not be as desirable as previously believed. [ Orthopedics . 2021;44(4):e487–e492.]
    Type of Medium: Online Resource
    ISSN: 0147-7447 , 1938-2367
    URL: Article
    DOI: 10.3928/01477447-20210618-05
    Language: English
    Publisher: SLACK, Inc.
    Publication Date: 2021
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  • 9
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    Peroneal Tendon Sheath Ultrasound Guided Corticosteroid Injection: Clinical Outcomes and Complications
    SAGE Publications ; 2019
    In:  Foot & Ankle Orthopaedics Vol. 4, No. 4 ( 2019-10-01), p. 2473011419S0017-
    Details
    In: Foot & Ankle Orthopaedics, SAGE Publications, Vol. 4, No. 4 ( 2019-10-01), p. 2473011419S0017-
    Abstract: Ankle Introduction/Purpose: Painful peroneal tendon pathologies fall into three primary categories: tendinopathy, tendon subluxation/dislocation, and tendon tears/ruptures. For symptomatic peroneal tendinopathy and tears, treatment traditionally begins with NSAIDs, rest/activity modification, physical therapy, and immobilization and with surgery typically reserved for cases of failed non-operative treatment. Ultrasound-guided peroneal tendon sheath (US PTS) corticosteroid injection is an additional nonoperative modality used by many orthopedists, however limited data has been published on its safety and efficacy. The purpose of this study was to assess clinical outcomes following US PTS corticosteroid injection for chronic tendinopathy or tears. We hypothesized that following injection, patients would have improved pain without increased incidence of spontaneous tendon rupture. Methods: We identified a retrospective cohort of patients who had undergone US PTS corticosteroid injection for pain due to peroneal tendinopathy, tears, or subluxation. Underlying diagnosis was based on clinical exam, MRI results, and/or intraoperative findings, when available. Medical record data was supplemented by email or telephone follow-up. Collected information included patient age, sex, BMI, smoking status, worker’s compensation status, prior surgeries about the foot and ankle, duration of symptoms prior to injection, perceived improvement in pain following injection and its duration, number of injections, progression to surgery, and any perceived adverse outcomes of injection. Results: We identified 96 patients (109 injections). Thirty-seven (38.5%) had previous foot and ankle surgery, with 17 (17.7%) having surgery specifically on the peroneal tendons. 24/96 (25%) progressed to have surgery on their peroneal tendons following injection. Following injection, 38/87 (43.7%) of patients experienced 0 -1 weeks of pain relief, 11/87 (12.6%) 2-6 weeks, 6/87 (6.9%) 7-12 weeks, and 32/87 (36.8%) 〉 12 weeks of pain relief. Pre-injection duration of symptoms correlated positively with post- injection duration of pain relief (p=0.036). There was no significant difference between progression to surgery or duration of pain relief based on peroneal pathology, prior surgery, smoking status, worker’s compensation status, sex, or BMI. There were 2 reported complications (1.8%): one case of self-limited sural nerve irritation and one of peroneus longus tear progression. Conclusion: In this series of 109 US PTS corticosteroid injections, the complication rate was 1.8%. Pre-injection symptom duration correlated positively with post-injection pain relief duration. Our study demonstrates US PTS corticosteroid injection is safe in patients with pain originating from peroneal tendon tears or tendinopathy, including those who have undergone prior surgery, and should be considered in a comprehensive protocol of nonoperative management. Further research is needed to elucidate the effect of multiple injections and of injection timing, as well as whether these injections can decrease the rate of patients progressing to surgery.
    Type of Medium: Online Resource
    ISSN: 2473-0114 , 2473-0114
    URL: Article
    DOI: 10.1177/2473011419S00175
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
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  • 10
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    Scaphotrapezoid Assessment during Thumb Carpometacarpal Arthroplasty: A Cadaveric Study
    Georg Thieme Verlag KG ; 2021
    In:  Journal of Wrist Surgery Vol. 10, No. 06 ( 2021-12), p. 528-532
    Details
    In: Journal of Wrist Surgery, Georg Thieme Verlag KG, Vol. 10, No. 06 ( 2021-12), p. 528-532
    Abstract: Background Due to limited sensitivity of radiographs for scaphotrapeziotrapezoid (STT) arthritis and the high rate of concurrence between thumb carpometacarpal (CMC) and STT arthritis, intraoperative visualization of the STT joint is recommended during CMC arthroplasty. Purpose We quantified the percentage of trapezoid facet of the scaphotrapezoid (ST) joint that could be visualized during this approach, and compared it to the degree of preoperative radiographic STT arthritis. Methods We performed dorsal surgical approach to the thumb CMC joint after obtaining fluoroscopic anteroposterior, lateral, and oblique wrist radiographs of 11 cadaver wrists. After trapeziectomy, the ST joint was inspected and the visualized portion of the trapezoid articulation marked with an electrocautery. The trapezoid was removed, photographed, and the marked articular surface area and total surface area were independently measured by two authors using an image analysis software. The radiographs were analyzed for the presence of STT arthritis. Results The mean visualized trapezoid surface area during standard approach for CMC arthroplasty was 60.3% (standard deviation: 24.6%). The visualized percentage ranged widely from 16.7 to 96.5%. There was no significant correlation between degree of radiographic arthritis and visualized percentage of the joint (p = 0.77). Conclusions: On average, 60% of the trapezoid joint surface was visualized during routine approach to the thumb CMC joint, but with very large variability. Direct visualization of the joint did not correlate with the degree of radiographic STT arthritis. Clinical Relevance A combination of clinical examination, pre- and intraoperative radiographs, and intraoperative visualization should be utilized to assess for STT osteoarthritis and determine the need for surgical treatment. Level of Evidence This is a Cadaveric Research Article.
    Type of Medium: Online Resource
    ISSN: 2163-3916 , 2163-3924
    URL: Article
    DOI: 10.1055/s-0041-1729992
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2021
    detail.hit.zdb_id: 2678060-4
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