Risk Factors for Corticosteroid-associated Osteonecrosis in Children: A National Database Study.

Background: Corticosteroid-associated osteonecrosis presents a risk for severe pain and joint collapse. While the relationship between corticosteroid treatment and osteonecrosis in pediatric patients is well-documented, less is known about which patients are at greatest risk across medical conditions. The purpose of this study was to identify high-risk pediatric populations for developing osteonecrosis following corticosteroid treatment across autoimmune, inflammatory, and oncologic conditions.

Erratum: Health Equity Research in Orthopaedic Surgery: A Systematic Review and Needs Assessment.

[This corrects the article DOI: 10.2106/JBJS.OA.

Disparities Research in Sports Medicine Lacks Qualitative Studies, Community Engagement, and Original Interventions.

Background: Across the health care landscape, patients experience disparities based on insurance, sex, gender, race, and other determinants. Such findings have been reported in orthopaedic sports medicine; nonetheless, the overall quality of the literature, including its limitations and impact, is unknown. Understanding this will allow researchers to address areas of need and ultimately reduce disparities.

Health Equity Research in Orthopaedic Surgery: A Systematic Review and Needs Assessment.

Background: The aim of health equity research was to initially identify inequities and ultimately eliminate them. Little is known about the content, quality, and impact of health equity research in the orthopaedic literature. Therefore, the purpose of this study was to characterize the state of health equity research in orthopaedic surgery, with attention to temporal and specialty trends, research methodology, and intervention development.

Disparities Research in Pediatric Orthopaedic Surgery: Is the Needle Moving?

Background: Disparities in health care are well documented and may have major medical and socioeconomic implications in populations that are already marginalized. While research identifying disparities is important, community partnerships and interventions to address inequities are critical to establish long-term infrastructure and lasting impact. The purpose of this study is to investigate trends and characteristics of disparities research in pediatric orthopaedics, with attention to study design, intervention implementation, and federal funding.

Medial and lateral posterior tibial slope in the skeletally immature: Variability across pediatric ages without a consistent trend.

Introduction: Increased knee posterior tibial slope (PTS) angle elevates anterior cruciate ligament (ACL) strain and ACL injury risk. Adult biomechanical research indicates that decreasing the PTS may reduce ACL injuries. Younger patients have much higher risk of ACL injury than adults, with limited anatomic research on tibial slope.

Retrospective Analysis and Characterization of Avascular Necrosis By Bone Location in Pediatric Leukemia/Lymphoma Patients.

Background: Avascular necrosis (AVN) is a serious complication of high-dose steroid therapy for pediatric patients with leukemia/lymphoma. AVN affects multiple bones and joints, leading to significant pain in different bone regions, early-onset osteoarthritis, and early joint replacement. Early detection and intervention for AVN may prevent pain and progressive joint collapse.

Impact of Pediatric Knee Anatomy on ACL Reconstruction: Lessons Learned From Cadaveric Dissections-A Review.

Anterior Cruciate Ligament (ACL) injuries in pediatric patients are rising and present unique challenges for orthopedic surgeons due to skeletal immaturity and risk for physeal damage during ACL reconstruction. This review aims to share insights from pediatric cadaveric anatomic studies and related research to inform surgical management of ACL injuries in skeletally immature patients. We highlight age-dependent variations in the distances between the ACL and medial collateral ligament and their respective physes, developmental variability in the anterolateral structures of the pediatric knee, and variability in the proximity of the neurovascular bundle's proximity to the iliotibial band graft pathway during ACL reconstruction.

Complication Rates Following Tibial Tubercle Osteotomy With and Without Distalization in Young Patients With Patellar Instability: A Multicenter Study.

Background: Tibial tubercle osteotomy (TTO) is a surgical procedure for the management of patellofemoral instability (PFI). Tubercle distalization requires a complete osteotomy detachment and has been shown to have an increased rate of certain complications in predominantly adult cohorts. With this study we identify and compare the complication rate of 2 TTO techniques-anteromedializing alone (AM) and anteromedializing with concomitant distalization (AMD) among young patients.

A Cadaveric Study of the Sagittal Patellar Insertion of the Medial Patellofemoral Ligament in Children: Implications for Reconstruction.

Background: Patellofemoral instability is a common problem, and medial patellofemoral ligament (MPFL) reconstruction is a standard treatment approach for recurrent instability. The accurate restoration of anatomy in MPFL reconstruction is essential. While coronal-plane anatomy of the MPFL patellar insertion has been previously reported, sagittal-plane anatomy has not been widely studied.

Suture anchor fixation of the pediatric posteromedial and posterolateral meniscotibial ligament complex matches or exceeds native tissue strength: A cadaveric study.

Objectives: This study aimed to compare the biomechanical strength and stiffness of the native posteromedial and posterolateral meniscotibial ligament complex (MTLC) to suture anchor repair of the MTLC.

Methods: Biomechanical testing was performed on 24 fresh-frozen pediatric human knees. Four conditions were tested: native posteromedial MTLC (n ​= ​14), native posterolateral MTLC (n ​= ​14), posteromedial MTLC repair (n ​= ​5), and posterolateral MTLC repair (n ​= ​5).

Advancing sustainability in healthcare: A scoping review of global recycling practices in operating rooms.

The healthcare sector, particularly operating rooms (ORs), generates significant waste, contributing to global environmental pollution. This scoping review aimed to assess global recycling practices in ORs across various surgical specialties, identifying key barriers and strategies for improvement. A comprehensive literature search using PubMed and Embase and PRISMA reporting guidelines yielded 35 studies for inclusion.

Intercostal Nerve Cryoablation Reduces Opioid Use and Length of Stay Without Increasing Adverse Events: A Retrospective Cohort Study of 5442 Patients Undergoing Surgical Correction of Pectus Excavatum.

Objective: To examine differences in opioid use, length of stay, and adverse events after minimally invasive correction of pectus excavatum (MIRPE) with and without intercostal nerve cryoablation.

Background: Small studies show that intraoperative intercostal nerve cryoablation provides effective analgesia with no large-scale evaluations of this technique.

Methods: The pediatric health information system database was used to perform a retrospective cohort study comparing patients undergoing MIRPE at children's hospitals before and after the initiation of cryoablation.

Postoperative Antibiotics for Complicated Appendicitis in Children: Piperacillin/Tazobactam Versus Ceftriaxone with Metronidazole.

Introduction: Recent studies are discordant regarding postoperative use of piperacillin/tazobactam (PT) versus ceftriaxone/metronidazole (CM) for pediatric complicated appendicitis. Some argue that the broader spectrum PT decreases intraabdominal abscess formation; however, antibiotic stewardship, and once-a-day dosing favor CM. We aim to compare outcomes of postoperative antibiotic utilization using a large administrative database.

Effectiveness of one minute per level intercostal nerve cryoablation for postoperative analgesia after surgical correction of pectus excavatum.

Purpose: Intraoperative intercostal nerve cryoablation has emerged as a promising modality for postoperative analgesia following Surgical Correction of Pectus Excavatum (SCOPE). Most centers use two-minute cryoablation per level, although data from histologic and adult studies suggest the effectiveness of one-minute freezes. We aimed to describe our center's experience with one minute per level cryoablation.

Effect of consumer-grade wearable device data on clinician decision making during post-discharge telephone calls after pediatric surgery.

Background: During post-discharge telephone calls after pediatric surgery, clinicians must rely on parents/caregivers' assessment of symptoms, which can be inaccurate and often lead to unnecessary emergency department (ED) visits. Physiology (heart rate and physical activity) data from consumer-grade wearables, e.g.

Cancer Awareness and Barriers to Medical Treatment Among Syrian Refugees and Lebanese Citizens in Lebanon.

The Syrian conflict has forced over a million refugees into Lebanon, which now faces the challenge of providing healthcare for this large, vulnerable population. Syrian refugees and Lebanese citizens suffer from an immense burden of cancer and encounter many barriers to obtaining healthcare. An increase in cancer awareness could prompt earlier diagnosis and treatment.