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1. Effect of Aspirin Versus Low-Molecular-Weight Heparin Thromboprophylaxis on Medication Satisfaction and Out-of-Pocket Costs: A Secondary Analysis of a Randomized Clinical Trial

Author

O’Hara, Nathan N., Frey, Katherine P., Stein, Deborah M., Levy, Joseph F., Slobogean, Gerard P., Castillo, Renan, Firoozabadi, Reza, Karunakar, Madhav A., Gary, Joshua L., Obremskey, William T., Seymour, Rachel B., Cuschieri, Joseph, Mullins, C. Daniel, O’Toole, Robert V., Carlini, Anthony R., Fowler, Brianna E., Taylor, Tara J., Wegener, Stephen T., Weston-Farber, Elias, Herndon, Steven Craig, Marvel, Debra, Jurkovich, Gregory J., Lee, Christopher, Malhotra, Ajai K., Riedel, Matthew D., DeCoster, Thomas A., Vercellotti, Gregory M., Wells, Jeffrey L., Westrick, Edward R., Bosse, Michael J., Christmas, A. Britton, Cunningham, Kyle William, Hsu, Joseph R., Huynh, Toan, Jacobs, David George, Kempton, Laurence B., Sims, Stephen H., Churchill, Christine, Carroll, Eben A., Babcock, Sharon, Miller, Preston R., Pilson, Holly T., Goodman, James Brett, Holden, Martha B., Weaver, Michael J., Esposito, John G., Goldhaber, Samuel Z., Heng, Marilyn, McGovern, Madeline M., Velmahos, George C., von Keudell, Arvind, Rivera, Jessica C., Gitajn, Ida Leah, Schneider, Prism S., Buckley, Richard E., Gallant, Jodi, McKay, Paula, Kleweno, Conor P., Agel, Julie, Natoli, Roman M., Gaski, Greg E., Heincelman, Carrie L., Jang, Yohan, Lopas, Luke A., McKinley, Todd O., Richard, Raveesh Daniel, Sorkin, Anthony T., Virkus, Walter, Hill, Lauren C., Hymes, Robert A., Holzman, Michael, Panjshiri, Farhanaz, Schulman, Jeff E., Ramsey, Lolita, Cuff, Jaslynn A.N., Haut, Elliott R., Warner, Stephen J., Cotton, Bryan A., Guevara, Keyla D., Claridge, Jeffrey A., Vallier, Heather A., Breslin, Mary A., Connelly, Daniel, Ghulam, Qasim M., Haac, Bryce E., LeBrun, Christopher T., Manson, Theodore T., Nascone, Jason, Pensy, Raymond A., Pollak, Andrew N., Udogwu, Ugochukwu N., Burke, Cynthia Elaine, Degani, Yasmin, DeLeon, Genaro A., Hannan, Zachary D., Healey, Kathleen M., Howe, Andrea L., Marinos, Dimitrius P., McKegg, Phillip C., McKibben, Natasha S., Zingas, Nicolas H., Evans, Andrew R., Askam, Brad M., Boulton, Christina, Weinlein, John C., Bergin, Patrick F., Bergin, Patrick F., Kutcher, Matthew E., Morellato, John, Nehete, Priyanka V., Yener, Ugur, Whiting, Paul S., Domes, Christopher, Kuhn, Gabrielle R., Gajari, Vamshi, Moreno-Diaz, Andres Fidel, Rodriguez-Baron, Elsa B., Rodriguez-Buitrago, Andres, Stinner, Daniel J., Trochez, Karen M., DePalo, Peter, Kennedy, Leah C., Lienhard, Karin, Martin, Ryan, Yee, Stephanie C., Leonard, Jordan, Arif, Hikmatullah, Brown, Krista, Deeter, Lakye Lenee, Sardesai, Neil, Bangura, Abdulai T., Demyanovich, Haley K., Eglseder, W. Andrew, Gupta, Jayesh, Isaac, Marckenley, Mulliken, Alexandra, Crisco, MJ., Lueckel, Stephanie N., Brown, Gregory A., Breazeale, Stephen, Fisher, Stephen N., Wild, Jason R., Beebe, Michael J., Khanna, Rajinder M., Brauer, Deborah, and Boyce, Robert H.

Published
2024
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2. Risk-stratified thromboprophylaxis effects of aspirin versus low-molecular-weight heparin in orthopedic trauma patients: A secondary analysis of the PREVENT CLOT trial

Author

OʼHara, Nathan N., OʼToole, Robert V., Frey, Katherine P., Castillo, Renan C., Cuschieri, Joseph, Haut, Elliott R., Slobogean, Gerard P., Firoozabadi, Reza, Christmas, A. Britton, Obremskey, William T., Carlini, Anthony R., Gaski, Greg E., Kutcher, Matthew E., Marvel, Debra, Stein, Deborah M., Levy, Joseph F., Wegener, Stephen T., Fowler, Brianna E., Taylor, Tara J., Weston-Farber, Elias, Herndon, Steven Craig, Jr., DeCoster, Thomas A., Jurkovich, Gregory J., Lee, Christopher, Malhotra, Ajai K., Riedel, Matthew D., Wells, Jeffrey L., Altman, Daniel T., Westrick, Edward R., Bosse, Michael J., Karunakar, Madhav A., Cunningham, Kyle W., Huynh, Toan, Jacobs, David G., Kempton, Laurence B., Phelps, Kevin D., Seymour, Rachel B., Sims, Stephen H., Churchill, Christine, Carroll, Eben A., Babcock, Sharon, Miller, Preston R., Pilson, Holly T., Goodman, James Brett, Weaver, Michael J., Esposito, John G., Goldhaber, Samuel Zachary, Heng, Marilyn, McGovern, Madeline M., Velmahos, George C., von Keudell, Arvind G., Rivera, Jessica C., Gitajn, Ida Leah, Schneider, Prism S., Buckley, Richard E., Johal, Herman S., Gallant, Jodi L., McKay, Paula, Kleweno, Conor P., Agel, Julie, Arif, Hikmatullah, McKinley, Todd O., Natoli, Roman M., Heincelman, Carrie L., Jang, Yohan, Lopas, Luke A., Mullis, Brian H., Richard, Raveesh D., Virkus, Walter, Hill, Lauren C., Hymes, Robert A., Holzman, Michael, Malekzadeh, A. Stephen, Panjshiri, Farhanaz, Schulman, Jeff E., Ramsey, Lolita, Ahn, James, Cuff, Jaslynn A. N., Gary, Joshua L., Warner, Stephen J., Cotton, Bryan A., Vallier, Heather A., Claridge, Jeffrey A., Breslin, Mary A., Cowley, R Adams, Connelly, Daniel, Eglseder, W. Andrew, Haac, Bryce E., Healey, Kathleen Marie, LeBrun, Christopher T., Manson, Theodore, McKibben, Natasha S., Mulliken, Alexandra, Nascone, Jason, Pensy, Raymond A., Pollak, Andrew N., Sciadini, Marcus F., Udogwu, Ugochukwu N., Zingas, Nicolas, Burke, Cynthia Elaine, DeLeon, Genaro A., Hannan, Zachary D., Howe, Andrea L., Marinos, Dimitrius P., McKegg, Phillip C., Evans, Andrew R., Askam, Brad M., Joseph, Bellal, Lowe, Jason, Weinlein, John C., Bergin, Patrick F., Bhanat, Eldrin L., Khanna, Rajinder, Morellato, John, Nehete, Priyanka V., Domes, Christopher, Whiting, Paul S., Goodspeed, David C., Kuhn, Gabrielle R., Guillamondegui, Oscar D., Moreno-Diaz, Andres Fidel, Stinner, Daniel J., Pritchett, Charles, Jr., and Trochez, Karen M.

Published
2024
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10. The Effect of Price on Surgeons’ Choice of Implants: A Randomized Controlled Survey

Author

Adams, Julie, Vochteloo, A.J.H., Powell, Andrew John, Marcus, Alexander, Andreas, Platz, Miller, Anna N., Berner, A.B. Arne, Altintas, Burak, Sears, Benjamin W., Calfee, Ryan P., Ekholm, Carl, Fernandes, C.H., Porcellini, Giuseppe, Jones, Clifford, Moreno-Serrano, Constanza L., Manke, Chad, Crist, Brett D., Haverkamp, Daniel, Hanel, Doug, Merchant, Milind, Rikli, Daniel A., Shafi, Mohamed, Patiño, Juan M., Duncan, Scott F., Ballas, Efsthathios G., Harvey, Edward, Walbeehm, E.T., Schumer, Evan D., Evans, Peter J., Suarez, Fabio, Lopez-Gonzalez, Francisco, Seibert, Franz Josef, DeSilva, Gregory, Bayne, Grant J., Guitton, T.G., Nancollas, Michael, Lane, Lewis B., Westly, Stephen K., Villamizar, Harold Alonso, Pountos, Ippokratis, Hofmeister, Eric, Biert, Jan, Goslings, J. Carel, Bishop, Julius, Gillespie, James A., Grandi Ribeiro Filho, Jose Eduardo, Huang, Jerry I., Nappi, James F., Rubio, Jorge, Scolaro, John A., Yao, Jeffrey, Chivers, Karel, Jeray, Kyle, Lee, Kendrick, Rumball, Kevin M., Mica, Ladislav, Adolfsson, Lars E., Borris, Lars C., Benson, Leon, Austin, Luke S., Richard, Marc J., Kastelec, Matej, Costanzo, Ralph M., Kessler, Michael W., Palmer, M. Jason, Pirpiris, Marinis, Grafe, Michael W., Akabudike, Ngozi M., Shortt, Nicholas L., Kanakaris, Nikolaos K., Wilson, Neil, Levy, Ofer, Althausen, Peter, Lygdas, P., Sancheti, Parag, Parnes, Nata, Krause, Peter, Jebson, Peter, Guenter, Lob, Peters, R.W., Ramli, Radzeli Mohd, Shatford, Russell, Rowinski, Sergio, Gilbert, Richard S., Kamal, Robin N., Zura, Robert D., Rodner, Craig, Pesantez, Rodrigo, Ruch, David, Kennedy, Stephen A., Hurwit, Shep, Kaplan, Saul, Kronlage, Steve, Meylaerts, S.A., Omara, Timothy, Swiontkowski, Marc, DeCoster, Thomas, Wasterlain, Amy S., Melamed, Eitan, Bello, Ricardo, Karia, Raj, and Capo, John T.

Published
2017
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31. Correspondence

Author

Carr, James B., Marsh, J. Lawrence, Nepola, James V., Bonar, Susan, DeCoster, Thomas A., and Hurwitz, Shepard R.

Published
1996

33. Scapula fractures: interobserver reliability of classification and treatment

Author

Neuhaus, Valentin, Bot, Arjan G. J., Guitton, Thierry G., Ring, David C., Abdel-Ghany, Mahmoud I., Abrams, Jeffrey, Abzug, Joshua M., Adolfsson, Lars E., Balfour, George W., Bamberger, H. Brent, Barquet, Antonio, Baskies, Michael, Batson, W. Arnold, Baxamusa, Taizoon, Bayne, Grant J., Begue, Thierry, Behrman, Michael, Beingessner, Daphne, Biert, Jan, Bishop, Julius, Alves, Mateus Borges Oliveira, Boyer, Martin, Brilej, Drago, Brink, Peter R. G., Brunton, Lance M., Buckley, Richard, Cagnone, Juan Carlos, Calfee, Ryan P., Campinhos, Luiz Augusto B., Cassidy, Charles, Catalano, Louis, Chivers, Karel, Choudhari, Pradeep, Cimerman, Matej, Conflitti, Joseph M., Costanzo, Ralph M., Crist, Brett D., Cross, Brian J., Dantuluri, Phani, Darowish, Michael, De Bedout, Ramon, Decoster, Thomas, Dennison, David G., Denoble, Peter H., Desilva, Gregory, Dienstknecht, Thomas, Duncan, Scott F., Duralde, Xavier A., Durchholz, Holger, Egol, Kenneth, Ekholm, Carl, Elias, Nelson, Erickson, John M., Esparza, J. Daniel Espinosa, Fernandes, C. H., Fischer, Thomas J., Fischmeister, Martin, Jaime, Forigua E., Getz, Charles L., Gilbert, Richard S., Giordano, Vincenzo, Glaser, David L., Gosens, Taco, Grafe, Michael W., Filho, Jose Eduardo Grandi Ribeiro, Gray, Robert R. L., Gulotta, Lawrence V., Gummerson, Nigel William, Hammerberg, Eric Mark, Harvey, Edward, Haverlag, R., Henry, Patrick D. G., Hobby, Jonathan L., Hofmeister, Eric P., Hughes, Thomas, Itamura, John, Jebson, Peter, Jenkinson, Richard, Jeray, Kyle, Jones, Christopher M., Jones, Jedediah, Jubel, Axel, Kaar, Scott G., Kabir, K., Kaplan, F. Thomas D., Kennedy, Stephen A., Kessler, Michael W., Kimball, Hervey L., Kloen, Peter, Klostermann, Cyrus, Kohut, Georges, Kraan, G. A., Kristan, Anze, Loebenberg, Mark I., Malone, Kevin J., Marsh, L., Martineau, Paul A., Mcauliffe, John, Mcgraw, Iain, Mehta, Samir, Merchant, Milind, Metzger, Charles, Meylaerts, S. A., Miller, Anna N., Wolf, Jennifer Moriatis, Murachovsky, Joel, Murthi, Anand, Nancollas, Michael, Nolan, Betsy M., Omara, Timothy, Omid, Reza, Ortiz, Jose A., Overbeck, Joachim P., Page, Richard S., Castillo, Alberto Pérez, Pesantez, Rodrigo, Polatsch, Daniel, Porcellini, G., Prayson, Michael, Quell, M., Ragsdell, Matthew M., Reid, James G., Reuver, J. M., Richard, Marc J., Richardson, Martin, Rizzo, Marco, Rowinski, Sergio, Rubio, Jorge, Guerrero, Carlos G. Sánchez, Satora, Wojciech, Schandelmaier, Peter, Scheer, Johan H., Schmidt, Andrew, Schubkegel, Todd A., Schulte, Leah M., Schumer, Evan D., Sears, Benjamin W., Shafritz, Adam B., Shortt, Nicholas L., Siff, Todd, Silva, Dario Mejia, Smith, Raymond Malcolm, Spruijt, Sander, Stein, Jason A., Pemovska, Emilija Stojkovska, Streubel, Philipp N., Swigart, Carrie, Swiontkowski, Marc, Thomas, George, Tolo, Eric T., Turina, Matthias, Tyllianakis, Minos, Van Den Bekerom, Michel P. J., Van Der Heide, Huub, Van De Sande, M. A. J., Van Eerten, P. V., Verbeek, DIederik O. F., Hoffmann, David Victoria, Vochteloo, A. J. H., Wagenmakers, Robert, Wall, Christopher J., Wallensten, Richard, Wascher, Daniel C., Weiss, Lawrence, Wiater, J. Michael, Wills, Brian P. D., Wint, Jeffrey, Wright, Thomas, Young, Jason P., Zalavras, Charalampos, Zura, Robert D., Zyto, Karol, Orthopedic Surgery and Sports Medicine, Other departments, Other Research, and Graduate School

Subjects
Male, medicine.medical_specialty, Interobserver reliability, Radiography, Fleiss' kappa, Fractures, Bone, New International Classification for Scapular Fractures, OTA/AO fracture classification, reliability, scapula, Female, Humans, Imaging, Three-Dimensional, Observer Variation, Reproducibility of Results, Scapula, Tomography, X-Ray Computed, Surgery, Orthopedics and Sports Medicine, Reliability study, medicine, Ao classification, Reliability (statistics), Orthodontics, business.industry, General Medicine, Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10], business, Kappa
Abstract

Item does not contain fulltext OBJECTIVES: There is substantial variation in the classification and management of scapula fractures. The first purpose of this study was to analyze the interobserver reliability of the OTA/AO classification and the New International Classification for Scapula Fractures. The second purpose was to assess the proportion of agreement among orthopaedic surgeons on operative or nonoperative treatment. DESIGN: Web-based reliability study. SETTING: Independent orthopaedic surgeons from several countries were invited to classify scapular fractures in an online survey. PARTICIPANTS: One hundred three orthopaedic surgeons evaluated 35 movies of three-dimensional computerized tomography reconstruction of selected scapular fractures, representing a full spectrum of fracture patterns. MAIN OUTCOME MEASUREMENTS: Fleiss kappa (kappa) was used to assess the reliability of agreement between the surgeons. RESULTS: The overall agreement on the OTA/AO classification was moderate for the types (A, B, and C, kappa = 0.54) with a 71% proportion of rater agreement (PA) and for the 9 groups (A1 to C3, kappa = 0.47) with a 57% PA. For the New International Classification, the agreement about the intraarticular extension of the fracture (Fossa (F), kappa = 0.79) was substantial and the agreement about a fractured body (Body (B), kappa = 0.57) or process was moderate (Process (P), kappa = 0.53); however, PAs were more than 81%. The agreement on the treatment recommendation was moderate (kappa = 0.57) with a 73% PA. CONCLUSIONS: The New International Classification was more reliable. Body and process fractures generated more disagreement than intraarticular fractures and need further clear definitions. 01 maart 2014

Published
2014

34. Reliability of the classification of proximal femur fractures: Does clinical experience matter?

Author

Crijns, Tom J., primary, Janssen, Stein J., additional, Davis, Jacob T., additional, Ring, David, additional, Sanchez, Hugo B., additional, Althausen, Peter, additional, Amini, Michael H., additional, Appleton, Paul, additional, Babis, George C., additional, Babst, Reto H., additional, Ballas, Efstathios G., additional, Barquet, Antonio, additional, Begue, Thierry, additional, Bishop, Julius, additional, Borris, Lars C., additional, Buckley, Richard, additional, Chesser, Tim, additional, Choudhari, Pradeep, additional, Cornell, Charles, additional, Crist, Brett D., additional, DeCoster, Thomas A., additional, Elias, Nelson, additional, Frihagen, Frede, additional, Garnavos, Christos, additional, Giordano, Vincenzo, additional, Haverlag, R., additional, Havlicek, Tomo, additional, Hurwit, Shep, additional, Ibrahim, Edward F., additional, Iyer, Vishwanath M., additional, Jenkinson, Richard, additional, Jeray, Kyle, additional, Kabir, Koroush, additional, Kanakaris, Nikolaos K., additional, Klostermann, Cyrus, additional, Kreder, Hans J., additional, Kreis, B.E., additional, Kristan, Anze, additional, Lygdas, P., additional, McGraw, Iain, additional, Mica, Ladislav, additional, Mirck, B., additional, Moreta-Suarez, Jesus, additional, Morgan, Steven J., additional, Nikolaou, Vassilios S., additional, Omara, Timothy, additional, Pesantez, Rodrigo, additional, Pirpiris, Marinis, additional, Poelhekke, L.M.S.J., additional, Pountos, Ippokratis, additional, Prayson, Michael, additional, Quell, M., additional, Rodríguez-Roiz, Juan M., additional, Satora, Wojciech, additional, Schandelmaier, Peter, additional, Schepers, T., additional, Short, Nicholas L., additional, Smith, Raymond M., additional, Spoor, A.B., additional, Stojkovska Pemovska, Emilija, additional, Swiontkowski, Marc, additional, Taitsman, Lisa, additional, Tosounidis, Theodoros, additional, Tyllianakis, Minos, additional, Van bergen, C.J.A., additional, Van de Sande, M.A.J., additional, Van Helden, S.H., additional, Verbeek, Diederik O., additional, Wascher, Daniel C., additional, and Weil, Yoram, additional

Published
2018
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35. The Effect of Price on Surgeons’ Choice of Implants: A Randomized Controlled Survey

Author

Wasterlain, Amy S., primary, Melamed, Eitan, additional, Bello, Ricardo, additional, Karia, Raj, additional, Capo, John T., additional, Adams, Julie, additional, Vochteloo, A.J.H., additional, Powell, Andrew John, additional, Marcus, Alexander, additional, Andreas, Platz, additional, Miller, Anna N., additional, Berner, A.B. Arne, additional, Altintas, Burak, additional, Sears, Benjamin W., additional, Calfee, Ryan P., additional, Ekholm, Carl, additional, Fernandes, C.H., additional, Porcellini, Giuseppe, additional, Jones, Clifford, additional, Moreno-Serrano, Constanza L., additional, Manke, Chad, additional, Crist, Brett D., additional, Haverkamp, Daniel, additional, Hanel, Doug, additional, Merchant, Milind, additional, Rikli, Daniel A., additional, Shafi, Mohamed, additional, Patiño, Juan M., additional, Duncan, Scott F., additional, Ballas, Efsthathios G., additional, Harvey, Edward, additional, Walbeehm, E.T., additional, Schumer, Evan D., additional, Evans, Peter J., additional, Suarez, Fabio, additional, Lopez-Gonzalez, Francisco, additional, Seibert, Franz Josef, additional, DeSilva, Gregory, additional, Bayne, Grant J., additional, Guitton, T.G., additional, Nancollas, Michael, additional, Lane, Lewis B., additional, Westly, Stephen K., additional, Villamizar, Harold Alonso, additional, Pountos, Ippokratis, additional, Hofmeister, Eric, additional, Biert, Jan, additional, Goslings, J. Carel, additional, Bishop, Julius, additional, Gillespie, James A., additional, Grandi Ribeiro Filho, Jose Eduardo, additional, Huang, Jerry I., additional, Nappi, James F., additional, Rubio, Jorge, additional, Scolaro, John A., additional, Yao, Jeffrey, additional, Chivers, Karel, additional, Jeray, Kyle, additional, Lee, Kendrick, additional, Rumball, Kevin M., additional, Mica, Ladislav, additional, Adolfsson, Lars E., additional, Borris, Lars C., additional, Benson, Leon, additional, Austin, Luke S., additional, Richard, Marc J., additional, Kastelec, Matej, additional, Costanzo, Ralph M., additional, Kessler, Michael W., additional, Palmer, M. Jason, additional, Pirpiris, Marinis, additional, Grafe, Michael W., additional, Akabudike, Ngozi M., additional, Shortt, Nicholas L., additional, Kanakaris, Nikolaos K., additional, Wilson, Neil, additional, Levy, Ofer, additional, Althausen, Peter, additional, Lygdas, P., additional, Sancheti, Parag, additional, Parnes, Nata, additional, Krause, Peter, additional, Jebson, Peter, additional, Guenter, Lob, additional, Peters, R.W., additional, Ramli, Radzeli Mohd, additional, Shatford, Russell, additional, Rowinski, Sergio, additional, Gilbert, Richard S., additional, Kamal, Robin N., additional, Zura, Robert D., additional, Rodner, Craig, additional, Pesantez, Rodrigo, additional, Ruch, David, additional, Kennedy, Stephen A., additional, Hurwit, Shep, additional, Kaplan, Saul, additional, Kronlage, Steve, additional, Meylaerts, S.A., additional, Omara, Timothy, additional, Swiontkowski, Marc, additional, and DeCoster, Thomas, additional

Published
2017
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38. Risk Factors for Surgical Site Infections Following Anterior Cruciate Ligament Reconstruction

Author

Murphy, Michael V., primary, Du, Dongyi (Tony), additional, Hua, Wei, additional, Cortez, Karoll J., additional, Butler, Melissa G., additional, Davis, Robert L., additional, DeCoster, Thomas A., additional, Johnson, Laura, additional, Li, Lingling, additional, Nakasato, Cynthia, additional, Nordin, James D., additional, Ramesh, Mayur, additional, Schum, Michael, additional, Von Worley, Ann, additional, Zinderman, Craig, additional, Platt, Richard, additional, and Klompas, Michael, additional

Published
2016
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44. Closed Locked Intramedullary Nailing of Femoral Shaft Fractures in the Elderly

Author

DeCoster, Thomas A and Miller, Richard A

Subjects
Aged, 80 and over, Male, Treatment Outcome, integumentary system, Age Factors, Humans, Clinical and Basic Science, Female, Middle Aged, Femoral Fractures, Aged, Fracture Fixation, Intramedullary, Retrospective Studies
Abstract

A review was performed of all patients over the age of 60 years who were treated with a locked intramedullary nail for a femoral shaft fracture. There were 15 patients with 16 femoral shaft fractures. Four patients died perioperatively. Of the surviving 11 patients with 12 fractures, union occurred in 100 percent. Knee range of motion was greater than 100 degrees in 11 of the 12 knees. Nine of the 11 patients returned to their preoperative level of ambulation. Intramedullary nailing of femoral shaft fractures in patients over the age of 60 years is an effective method of treatment. The mortality rate in elderly patients who sustain this injury is comparable to that seen after a femoral neck fracture in this age.

Published
2003

45. PARTIAL VERSUS COMPLETE TRAPEZIECTOMY FOR TREATMENT OF CARPOMETACARPAL JOINT ARTHRITIS: A CADAVERIC BIOMECHANICAL COMPARISON

Author

Rogers, Rebecca, DeCoster, Thomas, Moneim, Moheb, Eldredge, Jonathan, Andrews, Ron, Mercer, Deana, Rogers, Rebecca, DeCoster, Thomas, Moneim, Moheb, Eldredge, Jonathan, Andrews, Ron, and Mercer, Deana

Subjects
Arthroplasty; thumb; carpometacarpal joints; trapezium; bone osteoarthritis
Abstract

Purpose: We aimed to evaluate the stability of the thumb carpometacarpal joint following either complete removal of the trapezium(TR) or partial removal of the trapezium and of the base of the first metacarpal (PTR). We utilized local capsular tissue for interposition graft in both cases. Methods: Right and left fresh frozen cadaveric hands from the same donor were randomized so that TR or PTR repair was performed randomly on the right or left hand of each pair. In the TR group we removed the entire trapezium. In the PTR group we removed 2mm of distal trapezium and 2mm of thumb metacarpal base. For both repairs, we interposed a capsular tissue graft. The cadaveric hands were stabilized in a jig designed to apply load across six thumb tendons. We measured gap closure distances prior to and following surgery and examined the joints by radiograph. Distances were measured using the Hough Transform model for measurement of abstract shapes. In order to detect a difference in gap distances between groups of 2mm with an alpha error of 0.05 and a beta error of 0.20, 18 hands were required. Results: The designated surgery was successfully performed on all hands. At baseline, mean gap differences did not vary between groups under load, while after surgery the TR group had greater mean gap closure when compared to the PTR group (4.44mm±1.70 vs 2.42mm±1.92, P<.001). No bone on bone contact was noted in any of the operated joints. Discussion: We found that PTR of the thumb basal joint leads to less gap closure of the joint when placed under simulated physiological load when compared to the complete removal of the trapezium. Clinical Relevance: Decreased gap closure under load may lead to preservation of thumb length and stability. Key words: Arthroplasty; thumb; carpometacarpal joints; trapezium; bone osteoarthritis

Published
2013

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