University Of California Los Angeles

Patients who underwent outpatient total knee arthroplasty showed a slightly higher risk for perioperative surgical complications that was statistically significant in results of a retrospective study presented at the American Academy of Orthopaedic Surgeons Annual Meeting and published in TheJournal of Bone & Joint Surgery.

The appropriate indications for arthroscopic ankle fusion remain a topic of active debate. Several studies have demonstrated rates of nonunion and other complications with the arthroscopic technique that are low and comparable to traditional open approaches for ankle fusion. Despite this, open approaches continue to be widely used. This Orthopedics Today Round Table provides diverse opinions regarding the potential advantages and limits of arthroscopic fusion with regard to the amount of correction possible for patients with associated deformities.

SAN FRANCISCO — Although it comprises a relatively small area of the brain, the hypothalamus has an extremely important function and there’s growing evidence that suggests it plays a pivotal role in various forms of headache, including migraines and cluster headaches, according to Andrew C. Charles, MD, director of headache research and treatment program and professor of neurology at the David Geffen School of Medicine at UCLA.

The patient is a 35-year-old right-hand dominant woman with 2 years of chronic right shoulder pain. She previously sustained a cerebral hemorrhage related to postpartum hypertension, which resulted in right-sided hemiparesis 2 years prior to presentation. At baseline, she had right upper extremity paresis that was worse than her right lower extremity paresis. She was able to walk short distances around the house, but her shoulder pain impaired her ability to take care of her three children. Her complaints were centered around shoulder pain that occurred while trying to use her arm. She currently uses her right hand as a helping hand to post objects that she then lifts with her left hand, but she cannot grasp or lift independently with the right upper extremity.

CHICAGO — The addition of ribociclib to fulvestrant significantly improved PFS in women with hormone receptor-positive, HER-2-negative advanced breast cancer, irrespective of prior endocrine therapy for advanced disease, according to results of the phase 3 MONALEESA-3 trial presented at the ASCO Annual Meeting.

The use of atherectomy to treat PAD and CAD is rising because of encouraging short-term results and a favorable reimbursement climate. But the question remains whether, particularly in conjunction with other technologies, atherectomy provides durable long-term results. A number of trials underway may ultimately decide that question.

The American Association for Cancer Research will present several scientific awards during its annual meeting, scheduled for April 14-18 in Chicago.

Inferior vena cava filters have emerged as a popular tool to reduce risk for pulmonary emoblism. Nevertheless, their use can be a polarizing issue among physicians.

A 70-year-old right-hand-dominant man presented to the orthopedic clinic with 3 months of worsening left shoulder pain after having undergone total shoulder arthroplasty for primary glenohumeral arthritis 1.5 years earlier at an outside hospital. The patient denied any history of trauma but noted new areas of redness and skin discoloration over his left shoulder. He denied any systemic signs of illness including fevers, chills or night sweats, but did note increasing difficulty with range of motion secondary to pain. The patient attempted 3 months to 6 months of organized physical therapy, but experienced worsening disability and pain with his activities of daily living. The patient was a non-smoker with no significant medical history. On exam, the patient’s left shoulder showed a well-healed deltopectoral incision with small areas of blotchy erythema surrounding the incision. Range of motion (ROM) was 90° forward elevation (FE), 45° external rotation (ER) and internal rotation (IR) to S1. The motor exam demonstrated weakness in FE and IR, but neurologic examination was normal.

Chronic total occlusion is commonly observed in patients who undergo coronary angiography. Successful recanalization of CTO can improve patient symptoms, as assessed by the Seattle Angina Questionnaire. However, the treatment of CTO represents a challenging lesion subset for PCI.