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Objective Due to controversy and the lack of information in the literature, we conducted this study to assess the impact of online teaching on students’ academic performance during the coronavirus (COVID-19) pandemic and evaluate whether the theoretical part of a surgical specialty, such as an orthopedic surgery, can be learned efficiently using online modalities. Design This is an observational study that compared the learning outcomes of medical students, in college of medicine at King Saud University, who took fully online orthopedic surgery courses into the learning outcomes of those who took similar courses in-person prior to the COVID-19 pandemic Participants Grades of 530 fourth-year medical students were collected. Of the total participants, 321 (60.6%) were males and 209 (39.4%) were females. A total of 270 (50.9%) students attended in-person classes while 260 (49.1%) students attended online classes during the pandemic Results For the online classes, the grades ranged between 20.5 and 40 with a median 32.6. Students who attended online classes had significantly higher grades than those who received in-person classes (32.4 ± 4.8 versus 30.2 ± 4.3, p

Rupture of the anterior cruciate ligament (ACL) is a common orthopedic injury. Various graft options are available for the reconstruction of ruptured ACL. Using the hamstring muscle as an autograft was first described in 1934, and it remains a commonly harvested graft for ACL reconstruction. Hamstring autografts can be harvested using the traditional anteromedial approach or the newer posteromedial technique. An isolated semitendinosus tendon can be used or combined with the gracilis tendon. There are numerous methods for graft fixation, such as intra-tunnel or extra-tunnel fixation. This comprehensive review discusses the different hamstring muscle harvesting techniques and graft preparation options and fixation methods. It provides a comprehensive overview for choosing the optimal surgical technique when treating patients.

Limited evidence is available on mid-term follow-up for patients with body mass index (BMI) ≥ 40 receiving a unicompartmental knee arthroplasty (UKA). The primary objective of this study was to investigate survival of the UKA in patients with BMI ≥ 40. Secondary objectives were to assess functional and patient reported outcome measures (PROMs). Survival analysis with endpoint revision of any component for any reason was conducted using Kaplan–Meier technique on 121 knees (103 patients) that underwent UKA with Oxford Phase 3 implant (Oxford Knee, Biomet, Swindon, United Kingdom) between September 2001 and March 2014 by seven surgeons. Survivorship differences were compared using Log Rank (Mantel-Cox) tests, and Cox Proportional Hazard Model was used to assess predictors of failure. Preoperative PROMs were compared at 2 and 5 years postoperatively using paired t-tests. Mean age of patients was 58 years (43–75), mean BMI 43 kg/m2 (40–51), and mean follow-up 7 years (2 months to 15 years). Survival rate for the whole cohort was 92% at 2 years and 86% at 5 years. Females had a significantly higher revision rate than males (p = 0.043). A total of 19 knees required revision (16 to TKA, 2 polyethylene liner exchanges, and 1 femoral component and liner revision). With respect to PROMs, there was a significant improvement at 2 and 5 years (p

The treatment strategies for rotator cuff tears have grown more sophisticated in recent years. Over the past decade, arthroscopic superior capsular reconstruction (SCR) has become popular for treating irreparable rotator cuff tears. Despite the popularity, the literature on the clinical outcomes of SCR is limited. Several surgical procedures using variable graft materials and different techniques have been proposed promising early clinical results with improvements in shoulder pain, range of motion, and overall function. In this paper, we present a case of bilateral massive irreparable rotator cuff tears, with a full description of our surgical technique and the successful outcome of our management.

Tibial plateau fractures are quite common among lower limb fractures. Several fracture classifications exist including Schatzker classification, in which tibial plateau fractures are divided into six types where each increasing numerical category indicates increasing severity of the injury and worsening prognosis. Arthroscopic-assisted techniques using a lateral or medial metaphyseal window have shown results comparable to open internal fixation methods with multiple advantages. We present a case of a medically and surgically free 40-year-old lady who presented to our emergency department complaining of left knee pain following a fall from the stairs. Clinically there was significant swelling and tenderness over the lateral aspect of the left proximal tibia, radiographs showed a Schatzker type III tibial plateau fracture, confirmed by computed tomography (CT). A combined intraoperative arthroscopic- and fluoroscopic-guided reduction of the articular depression through a lateral cortical window was achieved and the fracture was fixed using a minimally invasive fixation technique. The postoperative course was uneventful. The patient had recovered full range of motion and the wounds were barely visible. One-year X-ray showed healed fracture without any evidence of displacement or subsidence.

Introduction Chondrosarcoma is the second most common primary malignancy of bone that can occur in multiple locations in the skeleton. It has been rarely reported in the proximal radius. While surgical resection is the primary treatment modality for individuals with localized disease, reconstruction can be challenging in the elbow joint due to its complex anatomy. 3D printing technology can be used in such complex cases to restore the normal anatomy after resection. Case presentation We present a case of mesenchymal chondrosarcoma in a 33-year-old male occurring in the proximal radius, restricting his elbow motion. That was resected and reconstructed using 3D modeling. Restoring a functional range of motion without instability. Discussion Many surgical options for chondrosarcoma presented over the years including en bloc resection, resection with or without reconstruction, or amputation. Usage of 3D modeling in the orthopedic surgery field is relatively new and it can be used in pre-operative planning and shortens surgical time. 3D printing in our case helped in obtaining a full range of motion (flexion, extension, pronation, and supination) for the patient. Conclusion It's important to reconstruct elbow joint support structure and function after resection of such a large malignant tumor in young patients. We used 3D printed implant to maintain a functional limb and it was an excellent alternative treatment., Highlights • Chondrosarcoma occurring in the proximal radius is very rare. Up to our knowledge, this is the second case report. • We report a case of proximal radius chondrosarcoma managed by reconstruction with Three-Dimension printed implant. • 3D printing in the field of orthopedic surgery is relatively new and has upscaled medical management. • A description of a surgical technique to reconstruct proximal radius and maintaining full range of motion of the elbow.

Pain control following total knee arthroplasty (TKA) is crucial to hasten rehabilitation and decrease morbidity. We evaluated whether there is a difference between epidural infusion and continuous femoral nerve block with respect to postoperative pain control and rehabilitation course. Fifty patients completed the study. There was no statistically significant difference in the pain scores (P=0.33), morphine consumption (P=0.09) mean blood pressure or heart rate (P=0.957, and P=0.716) between groups. The postoperative daily mobilization (P=0.80), knee joint range of motion (P=0.83), and straight leg test (P=0.99) were also similar between both groups. Patients were highly satisfied with their pain management in both groups without statistically significant difference (P=0.98).

To determine the frequency of wound infection and neurological injuries in patients with idiopathic scoliosis who underwent posterior spinal fusion without use of drains.Case series.Department of Orthopaedics, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from February 2007 to June 2010.Patients who underwent similar technique of posterior spinal fusion instrumentation for the correction of scoliosis without use of drain were included. Wound Demographics, wound healing, complications and duration of hospital stay were considered and described as frequency and mean values.The average age at the time of surgery was 12.80 ± 1.30 years, duration of surgery was 3.80 ± 0.86 hours, hospital stay was 3.84 ± 0.78 days and patients were followed-up over the last 30 months. There was no incidence of any neurological complication and deep infection. However, only 2 (4.16%) cases with superficial skin infection were treated with dressing and antibiotics with full recovery.The wound healing is adequate without using drain for patients with idiopathic scoliosis who underwent posterior spinal fusion and instrumentation when good wash, watertight closure technique and appropriate antibiotics coverage is provided.