Haglund’s deformity is a common cause of foot pain, with high success rates of surgical intervention. Because early weightbearing rehabilitation correlates with better surgical results, the integrity of anchors employed in these surgeries needs to be evaluated for proper fixation strength, leading to improved postoperative outcomes. The ultrasonically interdigitated anchor is a biodegradable suture anchor that is melted into bony trabeculae using ultrasound, leaving a small biological footprint and less interference on computed tomography and magnetic resonance imaging scans, without loss of fixation strength. We performed a review of 44 patients aged 26 to 84 years treated with either ultrasonically interdigitated anchors or fully threaded titanium anchors during Haglund’s deformity excision. Overall, 7 of 14 patients who received an ultrasonically interdigitated anchor reported raw PROMIS (Patient-Reported Outcomes Measurement Information System) scores averaging 14.3, with an average return to ambulation time of 4.2 weeks. Fifteen of 30 patients receiving a fully threaded titanium anchor reported raw PROMIS scores averaging 9.7, with an average return to ambulation time of 3.5 weeks. We found little difference between the outcomes between the 2 anchors and no massive failures or infections in either group, implying that ultrasonically interdigitated anchors are a viable option for Achilles tendon reattachment during Haglund’s deformity repair surgery. Levels of Evidence: Level III: Case control study
:Orthopaedic hardware explantation is a multifaceted topic with complex legal, ethical, and scientific aspects that require thorough exploration. Issues of device ownership, explant-induced disease propagation, and potential device resale pose legal risks to providers and health-care institutions. Ethically, implant removal highlights the potential that performing procedures at the request of the patient will incentivize patient compliance and strengthen the patient-surgeon relationship. However, the return of explanted hardware to patients could hinder scientific study and innovation, ultimately limiting advancement in risk reduction and patient outcomes. Continued research into these topics remains paramount to ensure that clinicians and institutions deliver optimal patient care while abiding with legal and ethical imperatives. This article addresses the legal, ethical, and scientific issues that are pertinent to returning an explanted orthopaedic implant to the patient and the potential ramifications of such practice.
The main purpose of this study was to explore the mental health and subjective well‐being of staff working with adolescents with severe and profound multiple learning difficulties. The participants were 19 teachers and 25 teaching assistants working in an inner London, local authority, specialist day provision. A demographic questionnaire, the Hospital Anxiety and Depression Scale, the Connor‐Davidson Resilience Scale, the Positive Affect Scale, and the Satisfaction with Life Scale were used as data collection tools. The inferential statistical tools used were t‐tests and correlational analyses. The study brought to light a high number of borderline and abnormal anxiety scores among all staff. The study also found a significant difference in the resilience scores of teachers and teaching assistants, with teaching assistants scoring higher on the resilience scale. The results, alongside findings from previous research, call for better mental health support for teachers and staff working in the field of special educational needs and disabilities. The study highlights the emotional toll on educators, and the need for mitigation strategies that promote good mental health outcomes for both teachers and students.
Background:Performing cadaveric dual-energy x-ray absorptiometry (DEXA) scanning is a routine part of orthopaedic biomechanical research, but it is not without cost. Matched pairs are often used in biomechanical studies to further equalize comparison groups. Despite the widespread use of matched-pair analysis, the practical utility of obtaining routine DEXA scans remains unknown. The authors' objective was to determine the value of DEXA scans in biomechanical cadaveric trauma studies.
Methods:The authors identified 10 sequential journal articles from the Journal of Orthopaedic Trauma from February 2013 to February 2019 that were biomechanical studies with two comparison groups using matched pairs, which were DEXA-scanned prior to experimentation. For each study, the authors determined the number of pairs used, number of pairs discarded, any significant differences in bone density between groups compared, and how density results were reported for individual specimens or pairs.
Results:None of the 113 matched pairs reported in these studies were discarded because of DEXA scan results. There were inconsistencies between studies on reported units of measurement and how the specimens were compared. No significant differences in density between the compared groups were reported in the 10 studies. No studies disclosed the bone density for any individual specimen or score difference for any individual pair.
Conclusions:As currently used in the literature, routine DEXA scans of cadaveric matched-pair specimens do not typically lead to any modification of experimental design or reporting of results.
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