bluuebunny/crossref_metadata_2025_split huggingface dataset:
Paget-Schroetter Syndrome: A Case Report of effort induced upper extremity venous thrombosis
Authors: Bishai Shariff K. , Knesek David , Rodriguez Francisco , Ball Guy 
Published: August 2023

Effort induced thrombosis of the axillary-subclavian vein, also referred as Paget-Schroetter syndrome, is a relatively uncommon type of deep vein thrombosis of the upper extremity. Although rare, understanding its clinical presentation and etiology is essential for timely diagnosis and formatting correct treatment protocols. Most upper extremity deep vein thrombosis are secondary to either underlying pathology including cancer, chronic indwelling catheters, and hypercoaguable states making their clinical diagnosis relatively straight forward. On the contrary, effort induced deep vein thrombosis most commonly occur in young otherwise healthy people. Early detection and treatment of this type of thrombosis are essential in preventing late-term complications including post-thrombotic syndrome, and pulmonary embolus. There is no current consensus in treatment of effort induced upper extremity thrombosis with literature supporting conservative versus surgical treatment depending on patient presentation and physician preference.
Looking Forward: A Systematic Review Assessing Risk Factors Predicting Orthopaedic Trauma “Loss to Follow-up”
Authors: Kirchner Gregory , Kerbel Yehuda , Kim Andrew , Stein Matthew , Ryan William , Mehta Samir 
Published: August 2023

Introduction Loss to follow-up is common after orthopaedic trauma and may disproportionately affect vulnerable populations. Therefore, the purpose of this study was to understand patient characteristics increasing risk of lack of follow-up after orthopaedic trauma. Methods The Medline and Cochrane Library databases were queried with combinations of MeSH terms and keywords related to patient compliance in orthopaedic surgery were used. Inclusion criteria were: 1) published in the English language; 2) described patients who underwent surgical treatment for a traumatic orthopedic injury; 3) recorded patient compliance for at least the first scheduled outpatient follow-up appointment; 4) reported characteristics associated with patients who failed to comply with outpatient follow-up or reported patient-cited reasons for failure to comply with outpatient follow-up. Data extracted included rate of follow-up, demographic characteristics (e.g., race/ethnicity and measures of socioeconomic status), patient-reported reasons for non-compliance, and patient-reported outcome measures. Results Nine studies representing 7,188 patients met the inclusion criteria. A total of 1,728 (24.0%) of patients were considered lost to follow-up over a range of 2 weeks to 2 years after surgery. Males, younger patients, current tobacco users, and uninsured or patients with government insurance plans were commonly lost to follow-up. Of 166 patients questioned for reasons for failure to follow-up, 31 (18.7%) cited distance or inconvenience as the primary reason. Meanwhile, 19 (11.4%) stated that they did not attend because they felt well. Conclusion Our review confirms that there is a high rate of follow-up non-compliance after orthopaedic trauma. Furthermore, this study found that the orthopaedic trauma patient lost to follow-up is likely to be male, young, a current tobacco user, and uninsured or on a government health insurance plan.
Preparedness for Matching into an Orthopaedic Surgery Residency: Student Perspectives as a Model for Institutional Progression
Authors: Pizzo Dane , Filtes Peter , Chandra Akhil , Nasra Matthew , Aryee Jomar , Adolfsen Stephen , McPartland Thomas , Katt Brian 
Published: August 2023

Objective With the increasingly competitive nature of matching into an orthopaedic surgery residency, there is an opportunity for medical schools and orthopaedic faculty to enhance their students’ candidacy. In this study, we aim to evaluate medical students’ satisfaction with our institution’s provision of resources, identify areas of strengths and weaknesses within our department, and use these findings to implement action plans for institutional advancement. Design This is a prospective, cross-sectional survey study of alumni from our institution, an allopathic medical school affiliated with a tertiary-care university teaching-hospital, who successfully matched into an orthopaedic surgery residency program between 2006 and 2021. Setting Robert Wood Johnson Medical School (RWJMS) Department of Orthopaedic Surgery, New Brunswick, NJ Participants The survey was distributed to 83 matched alumni from our institution, 45 (54.2%) responded to the survey. Results Forty-four (97.8%) survey respondents successfully matched into a PGY-1 orthopaedic surgery residency position on their first attempt. Nearly 70.0% of survey respondents matched into their top 3 ranked residency program while ~90.0% matched into their top 5 ranked residency program. Survey respondents reported that board exam scores (33.3%), performance on away rotations (28.9%), and letters of recommendation (15.6%) were their greatest strengths, while research experience (53.3%), lack of inclusion in AOA (17.8%), and board exam scores (15.6%) were their greatest weaknesses. On survey responses evaluated using a 1-5 Likert scale, survey respondents reported that their sub-internship at our home institution adequately prepared them to excel on away rotations (4.38 ± 0.912). Conversely, survey respondents from our institution rated faculty and resident’s receptiveness to students seeking research opportunities the lowest (3.38 ± 1.007). Conclusions An internal assessment of orthopaedic departments at medical institutions, utilizing student perspectives, can be a useful tool for identifying the strengths and weaknesses of a program’s ability to prepare students to successfully match into an orthopaedic residency. After identification, programs must be able to hone strengths and mitigate weaknesses by setting objectives for improvement and implementing action plans to ensure deficiencies are adequately addressed.
The “Other Side” of Conflict: examining the challenges of female orthopaedic surgeons in the workplace.
Authors: Rodarte Patricia , Kammire Maria S. , Cannada Lisa K. , Poon Selina , Israel Heidi 
Published: August 2023

Introduction Gender bias has not been studied extensively within orthopaedic surgery, where only 8% of practicing orthopaedic surgeons in the US identify as female. As more women enter the field, it is critical to examine female orthopaedic surgeons’ experiences in navigating conflict and its impact on their career and wellbeing. Methods An anonymous 54-question survey was distributed through the Ruth Jackson Orthopaedic Society membership roster (n=1.1K) and Women in Orthopaedics (n=1.6K), an online group exclusive to female orthopaedic surgeons in practice/training. Questions inquired about several workplace conflict scenarios. Results There were 373 female respondents. 55% were between 35 and 45 years old, 79% were White/Caucasian, 10% Asian/Asian American, 4% Black/African American, and 4% Hispanic/Latinx. Results showed that 73% had been described as “bossy, too assertive, pushy, demanding, or difficult”, 80% had to do more administrative work in clinic than their male counterparts, and 51% had been reported for behaviors that a male counterpart had not. Respondents who were reported noted depression (n=40), anxiety (n=69), burnout (n=85), and sleep disturbances (n=48) as emotional effects of the event. Additionally, 29 respondents reported being forced out or leaving their previous job due to workplace conflict. When asked if they would choose the same career again, 21% said no. Discussion Female orthopaedic surgeons encounter unique workplace challenges that diminish career satisfaction and contribute to burnout. Understanding and acknowledging this relationship between gender bias and orthopaedic surgery is essential to create a more positive working environment for female orthopaedic surgeons and encourage incoming trainees.
Stemless Humeral Implants in Anatomic Total Shoulder Arthroplasty: The Future is Now
Authors: Murthi Anand M. , Gupta Puneet , Wright Melissa A. 
Published: August 2023

ABSTRACT Anatomic total shoulder arthroplasty (TSA) is frequently used in patients with glenohumeral osteoarthritis and other shoulder degenerative joint disease for pain relief and improving shoulder function. Much research is underway to find ways of improving TSA. One area of interest is the design and characteristics of the humeral components, with a particular emphasis on the length of the humeral stem. Currently, there is significant interest and discussion around stemless humeral implants. Stemless humeral implants have many advantages, including greater preservation of bone stock, reduced blood loss and operative times, and reduced stress shielding compared to stemmed humeral components in TSA. As many surgeons are now using these implants, much studies have been conducted evaluating the functional outcomes, biomechanical properties, and complications of these stemless humeral implants, often in comparison to other stemmed humeral implants. Here, we aim to provide a concise review of the advantages, limitations, and future directions for stemless humeral implants.
Customized Individually-Made and Conventional Total Knee Implants are associated with Similar Improvements in Patient-Reported Outcomes
Authors: Herndon Carl L. , Frederick Jeremy S. , Farah Omar K. , Santos Walkania , Shah Roshan P. , Cooper H. John 
Published: August 2023

Background Customized individually-made (CIM) implants aim to reproduce knee kinematics by restoring patient-specific anatomy. There is sparse data comparing outcomes of CIM implants with conventional implants. The purpose of this study was to compare short-term outcomes of total knee arthroplasty (TKA) performed with CIM versus off-the-shelf (OTS) implants. Methods We retrospectively compared clinical outcomes of 123 CIM TKAs with 282 concurrent, matched OTS TKAs performed at a single academic medical center by two high-volume arthroplasty surgeons. All CIM TKA were included. Perioperative outcomes evaluated included hospital length-of-stay (LOS), discharge disposition, and patient-reported outcome measures (PROMs) at baseline, 3 months, and 1 year. Student’s t-tests were used for continuous variables, and chi-squared tests were used for categorical variables. Results Baseline demographics were statistically similar between groups. CIM Baseline WOMAC Pain and Physical Function scores were statistically, but not clinically, better. There were no differences in LOS (CIM 2.19d vs. OTS 2.35d; p=0.30) or proportion discharged home (78.7% vs. 83.5%, p=0.26). There were no differences in WOMAC subscores or the KSS Functional Score at 3-month and 1-year follow-up. The CIM cohort had a statistically significant, but not clinically significant, higher KSS-Function score at 1-year (79.4 vs. 72.6, p=0.02), but the change from preoperative baseline was not significant between groups. Conclusions Compared to traditional TKA implants, CIM implants offered similar improvements and patient-reported outcome scores through the first postoperative year. Longer-term outcomes as well as cost-effectiveness of CIM implants should be studied.
Career Choice Disclosure and Clerkship Grades Among Orthopaedic Residency Applicants
Authors: Mulcahey Mary K. , Henstenburg Jeffrey M. , Hinkle Andrew J. , Stamm Michaela A. , Morley Meghan , Luginbuhl Joshua 
Published: August 2023

Objective Medical student clerkship evaluations are susceptible to preceptor bias. Students interested in orthopaedics may choose not to disclose their career path during clerkships to avoid bias. The purpose of this study was to identify factors that may lead to grading bias, including career choice disclosure, among medical students interested in a career in orthopaedic surgery. Design A cross-sectional survey was performed by distributing an anonymous electronic survey. Respondents were asked if they disclosed an interest in orthopaedic surgery during core clerkships and whether or not they believed it impacted their grade. The relationship between demographic variables including age, gender, race, ethnicity, and geographical location were also collected and compared. Setting Multiple institutions in different geographic locations in the US. Participants Medical students in orthopaedic interest groups or those who completed an orthopaedic surgery rotation. Results Of 149 responses, 90 (60.1%) of students chose to disclose an interest in orthopaedics during all clerkships. Over 50% of students were able to achieve honors in core clerkships except for OB/Gyn (41/112, 36.6% honors) and emergency medicine (17/59, 28.8% honors). On average, 7.9% of students believed disclosure had a negative impact on their grade, but in internal medicine and OB/Gyn, those that disclosed were able to achieve honors more often than those that did not. Males (38/50, 76%) were given honors more often than females (11/24, 45.8%) in their surgery clerkship and those that identified as “other” race (1/6, 16.7%) achieved fewer honors in surgery and pediatrics compared to White, Black, Asian, Indian, and Hispanic students (48/68, 70.6%). Conclusion Some students believe disclosing an interest in orthopaedics may negatively impact their grade, but the opposite may be true. Other potential areas of bias include gender and race. More research is needed to improve the clerkship evaluation process given an increasingly competitive application process.
Optimizing Outcomes in Shoulder Arthroplasty: Mitigating Surgical Complications in High-Risk Patients – Case Report
Authors: Szukics Patrick , Ford Elizabeth , Fliegel Brian , Baker William , McMillan Sean 
Published: August 2023

Background The risk of a periprosthetic joint infection after arthroplasty can be devastating to a patient, with the possibility of loss of limb or even death. There are multiple tools at the surgeon’s disposal to help minimize the risk of a complication occurring, and we present a novel intra-operative sterilization technique that has the potential to further minimize these unwanted outcomes. Case Presentation A 60-year-old right hand dominant male who had previously undergone two attempted rotator cuff spearing surgeries on his right shoulder now presents with continued right shoulder pain and evidence of rotator cuff arthropathy on imaging. He wished to proceed with a reverse total shoulder arthroplasty (rTSA). Due to his multiple surgeries on this shoulder as well as his medical comorbidities, we were concerned with his elevated risk for intra-operative complications, blood loss and hematoma formation, as well as risk for a periprosthetic joint infection. We present our technique for minimizing the risk of these undesirable outcomes, one of which is a novel intra-operative sterilization technique with sterile betadine being used in the surgical wound. Conclusions Our technique to optimize the patient preoperatively, minimize periprosthetic joint infection, and maintain adequate hemostasis throughout the surgery can be utilized to help surgeons minimize the risk of sustaining these unwanted outcomes.
Radiographic Outcomes using a Diaphyseal Engaging Femoral Stem for Revision Total Hip Arthroplasty
Authors: Coden Gloria , Zink Thomas , Fang Christopher , Garvey Kirsten , Schafer Eric , Mattingly David , Gordon Matthew , Smith Eric 
Published: August 2023

Introduction Diaphyseal engaging femoral stems are often required for revision total hip arthroplasty (THA) due to complex anatomy. However, no studies have been performed to identify the best implant or intraoperative radiographic parameters of stability. We sought to evaluate the rate of complications and radiographic parameters of an uncemented diaphyseal engaging femoral stem in revision THA. Methods We retrospectively reviewed 54 patients who underwent revision THA using an uncemented diaphyseal engaging modular femoral stem between 2012 and 2019 with mean follow-up of 1.4 years. Mean age was 66.3 years (range 23-90), and 47.2% of patients were female. 36 (73.5%) hips were classified as a Paprosky 3a and 13 (26.5%) patients were classified as a Paprosky 3b. We calculated the radiographic subsidence, canal fill ratio, and complete cortical contact percentage, defined as the sum of anterior, posterior, medial, and lateral cortical contact. Chi-square related-samples t-test, and Pearson’s correlation coefficient were used to compare values. Significance was set at <0.05. Results Postoperative periprosthetic infection occurred in 4 patients (7.41%) and was the most common complication. There were no revisions for aseptic loosening or failure of the diaphyseal engaging femoral stem. Canal fill ratio (mean=85.85%, p<0.001) and complete cortical contact (mean=71.74%, p<0.001) were less than the expected, while subsidence was higher than the expected (mean=2.07mm, p<0.001). Complete cortical contact was not associated with canal fill ratio (p=0.07) or subsidence (p=0.50). Discussion This uncemented diaphyseal engaging femoral stem had a low complication rate (11.11%) when used for revision THA. While canal fill ratio and complete cortical contact was less than the expected mean of 100%, it was not correlated with subsidence. It is important for surgeons to know that this uncemented diaphyseal engaging femoral stem can be well fitting despite low canal fill ratio and cortical contact.
Cognitive Deficits Following Concussion: A Systematic Review
Authors: Collins Lacee K , Ofa Sione A. , Miskimin Cadence , Mulcahey Mary 
Published: August 2023

Context In the U.S., approximately 1.6 to 3.8 million concussions occur yearly as a result of sports. Athletes are especially at risk of sustaining cognitive deficits as a result of a concussion. These can manifest as impairments of attention, verbal and visual memory, visual perception, and executive function. Objective The purpose of this study was to examine cognitive deficits following sport-related concussions in the acute, intermediate, and long-term time period after initial head trauma. Data Sources A systematic review of the literature was performed according to PRISMA guidelines using the PubMed, Psychinfo, and Web of Science databases. Study Selection Search terms included sports-related concussion, traumatic brain injury (TBI), and cognitive impairments. Studies were excluded if they measured non-cognitive deficits or had subjective results. Participant characteristics such as average age, gender, and athletic status were also included from all articles. Study Design Systematic Review. Level of Evidence Level 4. Data Extraction Studies were included if they met the following criteria: explicit time points following injury, focus on cognitive deficits, and injuries were not self-diagnosed. Results Twenty-six studies, with a total of 4,534 patients, were included. Ten of twenty-six (38.4%) studies were separated into control groups versus concussed groups, while nine of twenty-six (34.6%) compared baseline scores to post-injury scores. In the included studies, cognitive deficits were seen across all of the domains in all three time periods following an initial concussion. Conclusion A sports related concussion could result in cognitive deficits in the domains of visual memory, verbal memory, processing speed, executive function, and reaction time. Additionally, athletes typically experience cognitive deficits for only days to weeks following a sports related concussion, but symptoms can continue for months or years following the injury, depending on severity. These conclusions should be taken into consideration when determining inidivudalized return-to-play protocol for each athlete.
Voices of Experience: Advice to Medical Students, Residents, Fellows, and Young Surgeons
Authors: Abboud, MD Joseph , Barber, MD Matt , Barsoum, MD Wael , Cannada, MD Lisa , Levine, MD William , Plancher, MD Kevin , Kirschenbaum, MD Ira H. 
Published: August 2023

This Open Editorial is the edited transcript of an online seminar run by The Journal of Orthopaedic Experience & Innovation. If features Dr. William Levine, Dr. Joseph Abboud, Dr. Wael Barsoum, Dr. Matt Barber, Dr. Lisa Cannada, and Dr. Kevin Plancher. The session is moderated by Dr. Ira Kirschenbaum, the Editor-in-Chief of The Journal of Orthopaedic Experience & Innovation.
Élaboration et validation d’une échelle de mesure de la professionnalisation des étudiants et des étudiantes universitaires en sciences de la santé
Authors: Bélisle Marilou , Heilporn Géraldine , Lavoie Patrick , Lakhal Sawsen , Lechasseur Kathleen , Fernandez Nicolas , Caty Marie-Eve , Chichekian Tania 
Published: August 2023

Cet article présente les résultats d’une étude ayant pour objectif l’élaboration et la validation d’une échelle de mesure de la professionnalisation des étudiants et étudiantes universitaires en sciences de la santé. Des éléments de preuve de contenu, de processus de réponse et de structure interne de cette échelle ont été apportés au fil de l’étude, entre autres grâce à une collecte de données auprès de 561 étudiants et étudiantes de premier et deuxième cycles provenant de quatre universités québécoises. Les analyses factorielles exploratoires appuient une structure interne à quatre facteurs, avec une très bonne cohérence interne. Un quatrième facteur (valorisation de la profession) s’ajoute aux trois facteurs (compétences, identité et culture professionnelles) énoncés dans le cadre conceptuel initial. Les analyses factorielles confirmatoires confirment cette structure ainsi que la relation entre ces quatre facteurs de premier ordre et un unique facteur de professionnalisation de second ordre. Cette échelle constitue un instrument robuste permettant d’étudier la professionnalisation des étudiants et étudiantes aux différentes étapes de leur formation en sciences de la santé.
Développement et validation d’une mesure de bien-être social au doctorat : l’échelle du sentiment de communauté scientifique
Authors: Vincent Cynthia , Plante Isabelle , Tremblay-Wragg Émilie 
Published: August 2023

Plusieurs études qualitatives suggèrent que le sentiment de faire partie de la communauté scientifique est essentiel à la réussite du parcours doctoral. Bien que quelques outils aient été développés pour capter certaines composantes du sentiment de communauté scientifique, il n’existe aucun instrument pour mesurer ce construit dans sa globalité. La présente étude visait donc à développer l’Échelle du sentiment de communauté scientifique (ÉSCS) et à en examiner les qualités psychométriques auprès d’un échantillon de 318 doctorants au Canada. Cinq indicateurs de la validité de construit (exploratoire, confirmatoire, discriminante, prédictive et concourante) et trois indicateurs de fidélité (cohérence interne, test-retest et stabilité temporelle) de l’ÉCSC ont été examinés. En somme, cette échelle comporte 18 items répartis en trois facteurs (perception d’appartenir, d’influencer et de bénéficier de soutien) présentant tous de bons indices de cohérence interne. Les qualités psychométriques de l’ÉSCS justifient son usage dans des études ultérieures.