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Proc Inst Mech Eng H 2020 Jul 9:954411920935759. Epub 2020 Jul 9.

Department of Mechanical and Industrial Engineering, Ryerson University, Toronto, ON, Canada.

This study provides the first biomechanical comparison of the fixation constructs that can be created to treat transverse acetabular fractures when using the "gold-standard" posterior versus the anterior approach with and without a total hip arthroplasty in the elderly. Synthetic hemipelvises partially simulating osteoporosis (n = 24) were osteotomized to create a transverse acetabular fracture and then repaired using plates/screws, lag screws, and total hip arthroplasty acetabular components in one of four ways: posterior approach (n = 6), posterior approach plus a total hip arthroplasty acetabular component (n = 6), anterior approach (n = 6), and anterior approach plus a total hip arthroplasty acetabular component (n = 6). All specimens were biomechanically tested. Read More

J Orthop 2020 Jul-Aug;20:326-331. Epub 2020 Jun 6.

Department of Orthopaedic Surgery at Diakovere Annastift, Hannover Medical School, Hannover, Germany.

Aim: Short-stem total hip arthroplasty is designed to preserve proximal bone stock in case of eventual revision, potentially benefiting younger and more active patients. This prospective, single-center study assessed the safety and performance of the partially neck-sparing Nanos™ short-stem uncemented prosthesis at 24 months using clinical outcome scores and radiographic results.

Methods: Between April 2011 and February 2015, 52 subjects (mean age, 54. Read More

Clin J Sport Med 2020 Jul;30(4):378-382

Kramer Orthopedics, Newport Beach, CA.

Background: Literature regarding surfing injuries is scarce and most studies report a high number of minor injuries. Recent literature suggests that musculoskeletal injuries are more common than previously reported. In the mid 2000s, competitive surfing has seen an increase in aerial maneuvers, as they have become more highly rewarded by the judging panel, which may be contributing to a change in injury patterns. Read More

J Orthop Trauma 2020 Jun 29. Epub 2020 Jun 29.

Objectives: To compare outcomes after surgical treatment of Pipkin I and II femoral head fractures treated with either a surgical dislocation (SD) or a direct anterior approach (The Modified Heuter Approach) STUDY DESIGN:: Retrospective, multi - centre SETTING:: Three Level I trauma care centres PATIENTS:: 49 patients operated for Pipkin types I or II femoral head fractures. 27 - using SD and 22 - using modified Heuter approach.

Interventions: Initial closed reduction of the joint followed by open reduction and internal fixation of the fracture/ fragment excision. Read More

J Orthop Trauma 2020 Aug;34 Suppl 2:S23-S24

Department of Orthopaedics, University of Rochester, Strong Memorial Hospital, Rochester, NY.

Femoral neck fractures are a common injury pattern, especially within the elderly. Replacement with either hemiarthroplasty or total hip arthroplasty allows for immediate weight-bearing. This video demonstrates the direct anterior approach to total hip arthroplasty for management of displaced femoral neck fractures. Read More

J Orthop Trauma 2020 Aug;34 Suppl 2:S19-S20

Department of Orthopaedic Surgery, Boston Medical Center, Boston University Medical School, Boston, MA.

This case demonstrates a recognized association between an acetabular injury pattern and underlying morphology of the hip. In the patient discussed, hyperflexion of the hip results in the engagement of the present CAM lesion, and the resulting subluxation leads to a fracture of the posterior wall and instability of the hip. This combination of pathologies was addressed with a surgical dislocation approach to address both the CAM lesion and fix the posterior wall. Read More

J Orthop Surg (Hong Kong) 2020 Jan-Apr;28(2):2309499020937862

Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

This report describes clinical and radiographic characteristics of two pediatric patients with a presumptive diagnosis of subchondral fracture of the femoral head made based on their clinical course and imaging findings. An 8-year-old boy and an 8-year-old girl had subchondral fracture in the femoral head without osteonecrosis, which was verified by contrast-enhanced magnetic resonance imaging. Although complete disappearance of the fracture line was confirmed in the boy, the girl had a residual femoral head deformity after conservative treatment. Read More

J Orthop Surg (Hong Kong) 2020 Jan-Apr;28(2):2309499020936848

Department of Orthopaedics, Hanil General Hospital, 308 Uicheon-ro, Dobong-Gu, Seoul, Korea.

Many studies have shown that surgical management still leads to the best outcomes in elderly patients with hip fractures, with some studies showing non-inferiority of nonsurgical management as compared to surgery in fragility fractures. Evidence-based guidelines on whether to operate on these patients are lacking. A systematic literature search was conducted regarding outcomes of nonoperatively treated hip fractures in elderly patients with various comorbidities. Read More

J Bone Miner Res 2020 Jul 8. Epub 2020 Jul 8.

Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.

We have found that early-life exposures are associated with areal bone mineral density (aBMD) at ages 8 and 16 years. This study aimed to assess whether these associations persist into young adulthood when peak bone mass (PBM) is achieved and extend this analysis to microarchitecture. Participants were followed from perinatal period to 25 years old (n = 201). Read More

Geriatr Orthop Surg Rehabil 2020 24;11:2151459320936444. Epub 2020 Jun 24.

Department of Orthopedic Surgery, School of Medicine, Jichi Medical University, Shimotsuke, Japan.

Introduction: The TFN-ADVANCED Proximal Femoral Nailing System (TFNA) 235 mm (DePuySynthes) and Proximal Femoral Nail Antirotation (PFNA)-II 240 mm (DePuySynthes) were developed to obtain better stability for patients with trochanteric hip fractures without increasing surgical time and amount of blood loss. However, there are currently no studies concerning clinical and radiological outcomes of patients treated using these proximal femoral nails (PFNs) that have been performed in the Japanese population. The aim of this study was to retrospectively evaluate the clinical outcomes associated with 235 to 240 mm PFNs for Japanese patients >70 years old with trochanteric hip fractures who could walk independently before the injury. Read More

Geriatr Orthop Surg Rehabil 2020 26;11:2151459320935094. Epub 2020 Jun 26.

Department of Anesthesiology, Perioperative Pain and Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Introduction: Based upon the Third National Health and Nutrition Examination Survey data, iron deficiency anemia is the cause of at least 20% of cases of anemia in adults over the age of 65. This is especially relevant in patients undergoing major orthopedic surgery as substantial perioperative blood loss is possible, leading to a high rate of allogeneic blood transfusion in total hip replacements, total knee replacements, and hip fracture repairs.

Significance: The results of this systematic review may be of interest to clinicians and hospital administrators evaluating the clinical efficacy and cost effectiveness of intravenous (IV) iron administration prior to major orthopedic surgery. Read More

Ann Med Surg (Lond) 2020 Aug 18;56:116-120. Epub 2020 Jun 18.

Department of Surgery, Section of Orthopedics, The Aga Khan University Hospital, Pakistan.

Introduction: Induction of new residents and surgical trainees in most institutes occurs once a year. Fresh residents with no experience, may pose a threat to the surgical procedure outcome and there can be a potential increase in patients' morbidity and mortality as a result of this turnover. Literature is inconclusive about this effect. Read More

Bone Joint Res 2020 Jun 30;9(6):314-321. Epub 2020 Jun 30.

Institute for Biomechanics, BG Unfallklinik Murnau, Murnau am Staffelsee, Germany.

Aims: Evaluate if treating an unstable femoral neck fracture with a locking plate and spring-loaded telescoping screw system would improve construct stability compared to gold standard treatment methods.

Methods: A 31B2 Pauwels' type III osteotomy with additional posterior wedge was cut into 30 fresh-frozen femur cadavers implanted with either: three cannulated screws in an inverted triangle configuration (CS), a sliding hip screw and anti-rotation screw (SHS), or a locking plate system with spring-loaded telescoping screws (LP). Dynamic cyclic compressive testing representative of walking with increasing weight-bearing was applied until failure was observed. Read More

Bone Joint J 2020 Jul 7:1-10. Epub 2020 Jul 7.

Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK.

Aims: The primary aim was to assess the independent influence of coronavirus disease (COVID-19) on 30-day mortality for patients with a hip fracture. The secondary aims were to determine whether: 1) there were clinical predictors of COVID-19 status; and 2) whether social lockdown influenced the incidence and epidemiology of hip fractures.

Methods: A national multicentre retrospective study was conducted of all patients presenting to six trauma centres or units with a hip fracture over a 46-day period (23 days pre- and 23 days post-lockdown). Read More

Bone Joint J 2020 Jul 7:1-10. Epub 2020 Jul 7.

University College London Hospitals, The Princess Grace Hospital, and The NIHR Biomedical Research Centre at UCLH, London, UK.

Aims: During the COVID-19 pandemic, many patients continue to require urgent surgery for hip fractures. However, the impact of COVID-19 on perioperative outcomes in these high-risk patients remains unknown. The objectives of this study were to establish the effects of COVID-19 on perioperative morbidity and mortality, and determine any risk factors for increased mortality in patients with COVID-19 undergoing hip fracture surgery. Read More

J Am Geriatr Soc 2020 Jul 7. Epub 2020 Jul 7.

Boston Claude D. Pepper Older Americans Independence Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Objectives: Analyses performed by the Sarcopenia Definitions and Outcomes Consortium (SDOC) identified cut-points in several metrics of grip strength for consideration in a definition of sarcopenia. We describe the associations between the SDOC-identified metrics of low grip strength (absolute or standardized to body size/composition); low dual-energy x-ray absorptiometry (DXA) lean mass as previously defined in the literature (appendicular lean mass [ALM]/ht ); and slowness (walking speed <.8 m/s) with subsequent adverse outcomes (falls, hip fractures, mobility limitation, and mortality). Read More

Proc Inst Mech Eng H 2020 Jul 7:954411920941383. Epub 2020 Jul 7.

MatOrtho Limited, Leatherhead, UK.

A novel thin-walled direct-to-bone fixation ceramic cup was tested under critical impact loads simulating lateral fall and car crash scenarios. Three sizes of BIOLOX delta ceramic cups (total hip replacement cup with bearing diameter of 32 mm and two hip resurfacing cups with bearing diameters of 40 and 64mm) were implanted into reamed Sawbones blocks representing acetabulae. Three cups of each size were fully supported by the block and three were implanted with 15° of the cup's outer diameter unsupported by the block. Read More

Radiology 2020 Jul 7:192167. Epub 2020 Jul 7.

From the Russell H. Morgan Department of Radiology and Radiological Science, (A.H., J.E., P.T.J., S.D.) Department of Orthopaedic Surgery (A.S.L.), and High Value Practice Academic Alliance (A.H., A.S.R., P.T.J., S.D.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3140D, Baltimore, MD 21287; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass (R.K., S.E.S.); Department of Emergency Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Mass (A.S.R.); and Library of Evidence, Harvard Medical School, Boston, Mass (R.K., A.S.R.).

Background The overall rate of hip fractures not identified on radiographs but that require surgery (ie, surgical hip fractures) remains unclear in elderly patients who are suspected to have such fractures based on clinical findings. Moreover, the importance of advanced imaging in these patients has not been comprehensively assessed. Purpose To estimate the frequency of radiographically occult hip fracture in elderly patients, to define the higher-risk subpopulation, and to determine the diagnostic performance of CT and bone scanning in the detection of occult fractures by using MRI as the reference standard. Read More

J Am Geriatr Soc 2020 Jul 6. Epub 2020 Jul 6.

Department of Medicine, Division of Geriatrics; School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA.

Background: Many health systems are establishing geriatrics-orthopedics (Geri-Ortho) comanagement programs; however, there is paucity of published information on existing programs' variations in clinical operations, structure, and reported implementation challenges and perceived successes.

Objective: Our objective was to obtain detailed information about the variety of existing Geri-Ortho comanagement programs in the United States.

Design/particpants: We conducted a cross-sectional survey of 44 existing Geri-Ortho comanagement programs, with 23 (52%) of programs responding. Read More

Osteoporos Int 2020 Jul 6. Epub 2020 Jul 6.

Department of Cornea, External Disease & Refractive Surgery, HanGil Eye Hospital, Catholic Kwandong University College of Medicine, 35 Bupyeong-daero, Bupyeong-gu, Incheon, 21388, Republic of Korea.

The risks for hip fracture and vertebral fracture, but not the risk for distal radius fracture, were significantly higher in the blindness group than in the control group with a maximum 12-year follow-up.

Purpose: To evaluate the influence of visual impairment on the risk for osteoporotic fractures at common sites: hip, thoracic/lumbar vertebra, and distal radius.

Methods: This longitudinal follow-up study used a database of a national sample cohort from 2002 to 2013 provided by the Korean National Health Insurance Service. Read More

Sci Rep 2020 Jul 6;10(1):11115. Epub 2020 Jul 6.

Department of Computational Medicine, University of California, Los Angeles, CA, 90095, USA.

Alendronate and raloxifene are among the most popular anti-osteoporosis medications. However, there is a lack of head-to-head comparative effectiveness studies comparing the two treatments. We conducted a retrospective large-scale multicenter study encompassing over 300 million patients across nine databases encoded in the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM). Read More

J Clin Med 2020 Jul 2;9(7). Epub 2020 Jul 2.

Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar, Technische Universität München, 81675 München, Germany.

Background: Fractures of the proximal femur constitute daily work in orthopedic trauma surgery. With the continuous increase of obesity in the general population, surgeons face several known technical challenges. The aim of this study was to investigate the association of high body mass index (BMI) in patients with proximal femur fractures with intra- and postoperative adverse events, as well as with functional outcomes after successful surgery. Read More

Medicine (Baltimore) 2020 Jul;99(27):e20970

Background: There has been a paucity of cohort trials directly comparing multiple cannulated screws (MCS) and sliding hip screws (SHS) in femoral neck fractures at any level. Thus, a well-conducted clinical trial with an adequate sample size is urgently needed. We undertake a retrospective study to compare outcomes in patients who undertake MCS or SHS fixation for femoral neck fractures. Read More

Medicine (Baltimore) 2020 Jul;99(27):e20926

Department of Neurological Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei.

Studies show that vertebral fractures could predict the risk of hip fractures. We aimed to evaluate the potential benefits of whether the timing of vertebroplasty (VP) for vertebral fracture associated with the risk of hip fracture for hip replacement.We identified 142,782 patients from the Taiwan National Health Insurance Database with thoracolumbar vertebral fracture (International Classification of Diseases, Ninth Revision, Clinical Modification:805. Read More

J Knee Surg 2020 Jul 6. Epub 2020 Jul 6.

Orthopaedic Research Department, Holy Cross Orthopaedic Research Institute, Ft. Lauderdale, Florida.

Despite the high incidence of sarcopenia in the orthopaedic community, studies evaluating the influence of sarcopenia following primary total knee arthroplasty (TKA) are limited. Therefore, the purpose of this study is to determine if sarcopenic patients undergoing primary TKA have higher rates of (1) in-hospital lengths of stay (LOS); (2) medical complications; (3) implant-related complications; (4) fall risk; (5) lower extremity fracture risk; and (6) costs of care. Sarcopenia patients were matched to controls in a 1:5 ratio according to age, sex, and medical comorbidities. Read More

Eur J Radiol 2020 Jun 24;130:109154. Epub 2020 Jun 24.

Department of Health Sciences (DISSAL), University of Genoa, Genova, Italy; Department of Radiology, IRCCS San Martino Hospital, Genova, Italy.

Purpose: The aim of our study is to evaluate the spectrum of MRI findings in transplanted Multiple Myeloma (MM) patients with hip/pelvic pain and to correlate these findings with standard prognostic clinical outcomes.

Methods: A retrospective interpretation of the MRI findings of 54 MM patients with hip/pelvic pain were done according to MY-RADS guidelines. MRI findings included: type of bone marrow involvement and incidental findings (osteonecrosis and fractures). Read More

J Arthroplasty 2020 Jun 9. Epub 2020 Jun 9.

Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY; Department of Orthopaedic Surgery, NewYork-Presbyterian Hospital, Weill Cornell Medical Center, New York, NY.

Background: With the shift in hip fracture epidemiology toward older individuals as well as the shift in demographics toward nonagenarians, it is important to understand the outcomes of treatment for these patients.

Methods: Geriatric patients (≥65 years old) who underwent surgery for hip fracture were identified in the 2005-2017 National Surgical Quality Improvement Program database and stratified into 2 age groups: <90 and ≥90 years old (nonagenarians). Preoperative and procedural characteristics were compared. Read More

J Arthroplasty 2020 Jun 9. Epub 2020 Jun 9.

Department of Trauma and Orthopedic Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Frankfurt am Main, Germany.

Background: In difficult-to-treat cases, it is necessary to add debridement steps in prosthesis-free interval of 2-stage exchange. We aimed to analyze the functional and clinical outcome of patients treated with a multistage exchange of total hip arthroplasty without the use of spacers, rather only cementless implants.

Methods: Between 2009 and 2018, 84 patients (mean age: 67. Read More

Nurs Health Sci 2020 Jul 5. Epub 2020 Jul 5.

School of Nursing and Midwifery, Centre for Quality and Patients Safety Research Faculty of Health, Deakin University, Geelong, Victoria, Australia.

This retrospective cohort study aimed to determine the incidence, and preoperative, intraoperative and postoperative risk factors for postoperative delirium in older patients undergoing surgical fixation of a hip fracture. Electronic medical records were examined of 260 patients who underwent a surgical fixation of a hip fracture between June 2017 and October 2018 at a university-affiliated tertiary care hospital in Victoria, Australia. Demographic, clinical and perioperative data were examined for potential risk factors for postoperative delirium. Read More

Endocrine 2020 Jul 4. Epub 2020 Jul 4.

Department of Endocrinology, Odense University Hospital, Odense, Denmark.

Purpose: Fracture risk in hypothyroid patients is debated, and since the effects of hypothyroidism on bone microarchitecture and strength are unclarified, we investigated these characteristics by high-resolution peripheral quantitative computed tomography (HR-pQCT).

Methods: Two approaches were used: a cross-sectional control study, comparing 32 hypothyroid women (mean age; 47 ± 12 years) suffering from Hashimoto's thyroiditis with 32 sex-, age-, and menopause-matched healthy controls; a prospective study, where 27 of the women were reexamined 1 year after restoration of euthyroidism. HR-pQCT of the distal radius and tibia, and dual-energy X-ray absorptiometry (DXA) of the spine and hip were performed. Read More

Int Orthop 2020 Jul 4. Epub 2020 Jul 4.

Department of Orthopaedic Surgery, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.

Background: Pre-operative evaluation of pelvic motion using the sacral slope (SS) has been proposed for risk assessment of dislocation after total hip arthroplasty (THA). The purposes of this study were to elucidate the statistical characteristics of pre-operative and post-operative pelvic mobility and investigate the relationship between pre-operative spinopelvic factors and post-operative pelvic mobility.

Methods: Eighty-six patients with osteoarthritis were assessed. Read More

Z Gerontol Geriatr 2020 Jul 4. Epub 2020 Jul 4.

Department of Clinical Gerontology and Geriatric Rehabilitation, Robert-Bosch-Hospital, Stuttgart, Stuttgart, Germany.

Objective: Physical exercise is associated with many health benefits. Especially for older adults it is challenging to achieve an appropriate adherence to exercise programs. The outcome expectations for exercise scale 2 (OEE-2) is a 13-item self-report questionnaire to assess negative and positive exercise outcome expectations in older adults. Read More

Eur J Radiol 2020 Jun 21;130:109139. Epub 2020 Jun 21.

University of Pittsburgh. University of Pittsburgh Medical Center (UPMC)Department of Radiology, 200 Lothrop St., UPMC Montefiore, Room NE 538, Pittsburgh, PA 15213, United States. Electronic address:

Purpose: Recent papers have shown the utility of deep learning in detecting hip fractures with pelvic radiographs, but there is a paucity of research utilizing deep learning to detect pelvic and acetabular fractures. Creating deep learning models also requires appropriately labeling x-ray positions and hardware presence. Our purpose is to train and test deep learning models to detect pelvic radiograph position, hardware presence, and pelvic and acetabular fractures in addition to hip fractures. Read More

Bone 2020 Jul 2:115519. Epub 2020 Jul 2.

Nara Medical University School of Medicine, 840 Shijocho, Kashihara, Nara 634-8521, Japan.

Purpose: The association between serum concentrations of uric acid (UA), a potent endogenous antioxidant, and fracture risk has not yet been examined for morphometric vertebral fracture (VF). This study aimed to determine whether serum UA concentrations are associated with risks of clinical osteoporotic fracture (OPF) and morphometric VF after adjusting for confounding factors including UA-lowering medications (ULMs).

Materials And Methods: A total of 2012 Japanese men aged ≥65 years completed the baseline study, which included serum UA measurement and X-ray absorptiometry-based VF assessment. Read More

Bone 2020 Jul 2:115516. Epub 2020 Jul 2.

Aarhus University Hospital, Endocrinology and Internal Medicine, Palle Juul Jensen Boulevard 115, DK8200 Aarhus N, Denmark. Electronic address:

Efficient therapies are available for the treatment of osteoporosis. Bisphosphonates and denosumab are the most commonly used antiresorptive therapies. Despite differences in the increase in bone mineral density seen with these drugs, the reductions in fracture risk are similar; 50-70%, 20%, and 40% for vertebral, non-vertebral and hip fractures, respectively. Read More

Injury 2020 Jun 25. Epub 2020 Jun 25.

Department of Orthopaedics, Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark.

Introduction: Sustaining a hip fracture is a life changing event for many elderlies. While doctors and researchers tend to be preoccupied with mortality and complication rates, patients are more concerned by other aspects e.g. Read More

BMC Musculoskelet Disord 2020 Jul 4;21(1):435. Epub 2020 Jul 4.

Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.

Background: To aid design of exercise trials for people with pelvic and lower limb fragility fractures a systematic review was conducted to identify what types of exercise interventions and mobility outcomes have been assessed, investigate intervention reporting quality, and evaluate risk of bias in published trials.

Methods: Systematic searches of electronic databases (CENTRAL, MEDLINE, EMBASE, PEDro) 1996-2019 were conducted to identify randomised controlled trials of exercise for pelvic or lower limb fragility fractures. Two reviewers independently screened titles and abstracts. Read More

Injury 2020 Jun 17. Epub 2020 Jun 17.

Karolinska Institutet, Department of Clinical Science Intervention and Technology, Sweden; Department of Orthopaedics, Karolinska University Hospital, Huddinge, Sweden.

Background And Purpose: A femoral neck fracture (FNF) may have long term effects on the patient's health related quality of life (HRQoL) and mortality, especially in patients younger than 70 years. These long-term effects are unknown since most studies have a short follow-up. The aim of this study was to investigate self-assessed hip function, HRQoL and factors associated with 10-years mortality after a FNF. Read More

J Surg Res 2020 Jun 30;255:456-462. Epub 2020 Jun 30.

Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.

Background: The 5-factor modified frailty index (mFI-5) and the 11-factor modified frailty index (mFI-11) are equally effective in predicting adverse outcomes in the American College of Surgeons National Surgical Quality Improvement Program database. The similarly structured American College of Surgeons Trauma Quality Improvement Program (TQIP) database has not been studied with these two frailty indices. We hypothesized that the mFI-5 and mFI-11 could similarly predict adverse outcomes with TQIP data. Read More

J Bone Joint Surg Am 2020 Jul;102(13):e69

Orthopaedic Department, Parc Taulí Hospital Universitari, Universitat Autònoma de Barcelona, Sabadell, Spain.

Background: The outbreak of coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), in December 2019 in Wuhan, People's Republic of China, has developed into an unprecedented pandemic with enormous pressure on health-care providers around the world. A higher mortality rate has been described in older infected individuals. Patients with hip fracture are a particularly vulnerable population during this pandemic because older age is associated with a higher mortality rate. Read More

J Orthop Trauma 2020 Jun 26. Epub 2020 Jun 26.

Department of Orthopaedic Surgery, University of Alabama at Birmingham, 1313 13 St S, Birmingham, AL, 35205.

Objectives: To compare 90-day and 1-year outcomes, including mortality, of femoral neck fracture patients undergoing total hip arthroplasty (THA) by direct anterior approach (DAA) versus posterior approach (PA).

Design: Retrospective cohort SETTING:: Level I Trauma Center PATIENTS:: One hundred forty-three consecutive intracapsular femoral neck fractures treated with THA from 2010-2018. The minimum follow-up was 12 months and the average follow-up was 14. Read More

J Orthop Trauma 2020 Jun 26. Epub 2020 Jun 26.

Hennepin County Medical Center, Minneapolis, MN, USA.

Objective: To evaluate the clinical and patient-reported outcomes of patients with femoral head fractures treated at a single level I trauma center with a minimum 10-year follow-up.

Design: Retrospective review SETTING:: Academic Level-1 Trauma Center PATIENTS/PARTICIPANTS:: One hundred and one consecutive femoral head fractures were identified for this study. The final study group consisted of 28 patients with a minimum of 10-years of clinical follow-up. Read More

J Chin Med Assoc 2020 Jul;83(7):686-689

Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.

Background: Traumatic hip dislocation with or without acetabular fractures can lead to various outcomes of the hip. Long-term follow-up studies on traumatic hip dislocation are few. We conducted a retrospective study of the treatment and long-term outcomes in patients with hip dislocation to determine prognostic factors. Read More

J Orthop Surg (Hong Kong) 2020 Jan-Apr;28(2):2309499020935996

South Western Sydney Clinical School, UNSW Australia, Ingham Institute of Applied Medical Research, NSW, Australia.

Background: Before-and-after studies are a valuable study design in situations where randomization is not feasible. These studies measure an outcome both before and after an intervention and compare the outcome rates in both time periods to determine the effectiveness of the intervention. Before-and-after studies do not involve a contemporaneous control group and must, therefore, take into account any underlying secular trends to separate the effect of the intervention from any pre-existing trend. Read More

Int Orthop 2020 Jul 2. Epub 2020 Jul 2.

University of Nis, Medical faculty , Nis, Serbia.

Purpose: Acetabular fractures are accompanied by complications such as post-traumatic osteoarthritis (OA) of the hip and avascular necrosis (AVN) of the femoral head. The aim of the study was to evaluate improvement of life quality and functional recovery after total hip arthroplasty (THA) in patients with post-traumatic OA and AVN.

Methods: We retrospectively reviewed 23 patients with post-traumatic OA of the hip and AVN of the femoral head who undergone THA, out of 63 patients who were previously surgically treated for acetabular fractures. Read More

Chirurg 2020 Jul 2. Epub 2020 Jul 2.

Centrum für Muskuloskeletale Chirurgie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.

In most cases periprosthetic fractures of the acetabulum are complex injuries and are extremely challenging for the treating medical team. Over the years the frequency of this overall rare entity has increased due to demographic changes. In recent years several treatment algorithms were published and provided the possibility of developing standardized treatment concepts. Read More

Ann Transl Med 2020 Jun;8(11):681

Trauma Emergency Center, Third Hospital of Hebei Medical University, Shijiazhuang, China.

Background: The aim of our study was to compare the clinical effect of short dynamic hip screw (DHS) combined with fibula bone graft and short DHS combined with cannulated screws (CS) on the treatment of femoral neck fracture in young adults.

Methods: Thirty-five Pauwels type III femoral neck fracture patients between January 2014 and May 2019 were divided into two groups: group A (patients treated with DHS combined with fibula bone graft) and group B (patient treated with DHS combined with CS). The operative time, intraoperative blood loss, fracture healing time and complication of two groups were recorded. Read More

Endocrinol Metab (Seoul) 2020 Jun 24;35(2):359-366. Epub 2020 Jun 24.

Department of Preventive Medicine, Ajou University School of Medicine, Suwon, Korea.

Background: The value of the Fracture Risk Assessment Tool (FRAX) and the trabecular bone score (TBS) for assessing osteoporotic fracture risk has not been fully elucidated in Koreans. We conducted this study to clarify the predictive value of FRAX adjusted by TBS for osteoporotic fractures in Korean women.

Methods: After screening 7,192 eligible subjects from the Ansung cohort, 1,165 women aged 45 to 76 years with available bone mineral density (BMD) and TBS data were enrolled in this study. Read More

Osteoporos Int 2020 Jul 1. Epub 2020 Jul 1.

Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK.

The risk of a recurrent fragility fracture is particularly high immediately following the fracture. This study provides adjustments to FRAX-based fracture probabilities accounting for the site of a recent fracture.

Introduction: The recency of prior fractures affects subsequent fracture risk. Read More