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  1. Article ; Online: Patellar Instability Current Concepts and Controversies.

    Kanakamedala, Ajay C / Lezak, Bradley A / Alaia, Michael J / Jazrawi, Laith M

    Bulletin of the Hospital for Joint Disease (2013)

    2024  Volume 82, Issue 1, Page(s) 43–52

    Abstract: Recurrent patellar instability can significantly impact patients' quality of life and function. A large amount of research on patellar instability has been conducted in the past two decades, and a number of traditionally held principles of treatment have ...

    Abstract Recurrent patellar instability can significantly impact patients' quality of life and function. A large amount of research on patellar instability has been conducted in the past two decades, and a number of traditionally held principles of treatment have been challenged. This review addresses three current concepts and controversies in the treatment of patellar instability, specifically what factors lead to an increased tibial tubercle-trochlear groove distance and how to address them, when to add a tibial tubercle osteotomy to a medial patellofemoral ligament (MPFL) reconstruction, and which medial patellar stabilizers should be reconstructed. Based on current evidence, there are a few recommendations that can be made at this time. While trochleoplasty does have concerns with regard to reproducibility and complication risk, surgeons should consider this technique especially in cases with Dejour D trochlear dysplasia given high failure rates with other techniques. When evaluating whether to concomitantly perform a tibial tubercle osteotomy (TTO) with a MPFL, a TTO does appear to improve outcomes in the presence of maltracking or a positive J sign even with a tibial tuberosity-trochlear grove distance (TT-TG) of 18 to 20 mm, whereas patients without maltracking with a TT-TG of up to 25 mm may do well with an isolated MPFL reconstruction. Lastly, while MPFL reconstruction continues to have the most robust data supporting favorable outcomes, a number of biomechanical studies and short-term clinical studies have suggested promising results with medial quadriceps tendon femoral ligament and hybrid techniques.
    MeSH term(s) Humans ; Joint Instability/etiology ; Joint Instability/surgery ; Patellofemoral Joint/diagnostic imaging ; Patellofemoral Joint/surgery ; Quality of Life ; Reproducibility of Results ; Femur
    Language English
    Publishing date 2024-01-01
    Publishing country United States
    Document type Review ; Journal Article
    ZDB-ID 390411-8
    ISSN 2328-5273 ; 1936-9727 ; 1936-9719 ; 0018-5647 ; 0883-9344 ; 2328-4633
    ISSN (online) 2328-5273 ; 1936-9727
    ISSN 1936-9719 ; 0018-5647 ; 0883-9344 ; 2328-4633
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  2. Article ; Online: No difference in operative time, outcomes, cosmesis, or return to activity and/or sport after minimally invasive versus open repair of primary Achilles ruptures: a retrospective review.

    Savage-Elliott, Ian / Li, Zachary I / Moore, Michael R / Lezak, Bradley / Jazrawi, Taylor / Golant, Alexander / Meislin, Robert J

    European journal of orthopaedic surgery & traumatology : orthopedie traumatologie

    2024  

    Abstract: Purpose: To compare clinical outcomes and the rate of return to sport among patients that have undergone minimally invasive repair versus open approach of an acute Achilles tendon rupture.: Methods: Patients who underwent surgical repair of acute ... ...

    Abstract Purpose: To compare clinical outcomes and the rate of return to sport among patients that have undergone minimally invasive repair versus open approach of an acute Achilles tendon rupture.
    Methods: Patients who underwent surgical repair of acute Achilles tendon rupture at a single urban academic institution from 2017 to 2020 with minimum 2-year follow-up were reviewed retrospectively. Preinjury sport participation and preinjury work activity information, the Achilles tendon Total Rupture Score (ATRS), the Tegner Activity Scale, Patient-Reported Outcomes Measurement Information System for mobility and pain interference were collected.
    Results: In total, 144 patients were initially included in the study. Of these, 63 patients were followed with a mean follow-up of 45.3 ± 29.2 months. The mean operative time did not significantly differ between groups (p = 0.938). Patients who underwent minimally invasive repair returned to sport at a rate of 88.9% at a mean of 10.6 ± 5.8 months, compared to return rate of open procedures of 83.7% at 9.5 ± 5.5 months. There were no significant differences in ATRS (p = 0.246), Tegner (p = 0.137) or VAS pain (p = 0.317) scores between groups. There was no difference in cosmetic satisfaction between PARS and open repair groups (88.4 vs. 76.0; p = 0.244).
    Conclusion: Patients who underwent minimally invasive repair of acute Achilles tendon ruptures demonstrate no significant differences with respect to cosmesis, operative time, patient-reported outcomes and the rate and level of return to activities when compared to an open approach.
    Level of evidence: III.
    Language English
    Publishing date 2024-03-04
    Publishing country France
    Document type Journal Article
    ZDB-ID 1231084-0
    ISSN 1432-1068 ; 1633-8065 ; 0948-4817 ; 0940-3264
    ISSN (online) 1432-1068
    ISSN 1633-8065 ; 0948-4817 ; 0940-3264
    DOI 10.1007/s00590-024-03859-0
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  3. Article: Global orthopaedic trauma surgeons highlight telenomics during the COVID-19 era: A case for advancing telemedicine in orthopaedics.

    Cole, Peter A / Lezak, Bradley A / Schroder, Lisa K

    Journal of clinical orthopaedics and trauma

    2021  Volume 17, Page(s) 182–185

    Abstract: The Coronavirus (COVID-19) pandemic sparked rapid widespread adoption of telemedicine throughout specialties, including orthopaedics. A succession of factors, starting with payers, followed by provider adoption, and reciprocated by patient approval, ... ...

    Abstract The Coronavirus (COVID-19) pandemic sparked rapid widespread adoption of telemedicine throughout specialties, including orthopaedics. A succession of factors, starting with payers, followed by provider adoption, and reciprocated by patient approval, created newly accepted telehealth practices that have moved from trial to norm in a short time span. Orthopaedic surgeons believe telehealth will endure as a permanent change to their practice beyond the COVID-19 era, however, many permanent changes must take place by payers, providers, and patients to sustain telehealth into the future. The goal of this paper is to highlight the indelibility of telemedicine adoption in orthopaedic practices globally, characterize the chain of events that led to its large-scale adoption, and catalyze discussion around actionable next steps to sustain its benefits.
    Language English
    Publishing date 2021-03-26
    Publishing country India
    Document type Journal Article ; Review
    ZDB-ID 2596956-0
    ISSN 2213-3445 ; 0976-5662
    ISSN (online) 2213-3445
    ISSN 0976-5662
    DOI 10.1016/j.jcot.2021.03.015
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  4. Article ; Online: Global experience of orthopaedic trauma surgeons facing COVID-19: a survey highlighting the global orthopaedic response.

    Lezak, Bradley A / Cole, Peter A / Schroder, Lisa K

    International orthopaedics

    2020  Volume 44, Issue 8, Page(s) 1519–1529

    Abstract: Background: The COVID-19 (SARS-CoV-2) pandemic has significantly affected all aspects of healthcare, including orthopaedics. Due to the unique challenges presented by COVID-19 as well as the distinct timeframes that it will surge in different ... ...

    Abstract Background: The COVID-19 (SARS-CoV-2) pandemic has significantly affected all aspects of healthcare, including orthopaedics. Due to the unique challenges presented by COVID-19 as well as the distinct timeframes that it will surge in different geographies, much can be learned from the experiences of orthopaedic professionals in many global settings. The goal of this project is to characterize the preparations, strategies, lessons, and personal experiences of orthopaedic trauma surgeons and departments across the world in combating COVID-19. In doing so, we will shed light on current practices and challenges, which may help us manage the current pandemic in addition to preparing for future global pandemics that may arise.
    Methods: A 20-item questionnaire was sent out to 150 orthopaedic trauma surgeons representing 42 countries who were identified based on professional relationships and/or prior involvement in international meetings either led or participated by the senior author.
    Results: The questionnaire was completed by 63 orthopaedic trauma surgeons representing 28 countries and 14 US states. The results of this study show that orthopaedic trauma departments across the world have been greatly impacted by COVID-19 with 91% of participating hospitals currently having a reduced case load compared with pre-COVID-19 and only 17% of respondents currently performing elective orthopaedic surgery. Furthermore, 30% of orthopaedic departments have deployed orthopaedic personnel to non-orthopaedic floors in order to help mitigate the increased patient load and 86% of respondents noted at least some shortage of PPE. Lastly 73% of participating orthopedic departments including those in LMICs, have incorporated telemedicine into their practice with a majority stating that it would most likely become a permanent change to their practice post-COVID-19.
    Conclusion: To our knowledge, this is the largest data set characterizing global COVID-19 situations and responses of orthopaedic trauma practices around the world. There is much to be learned from each of the participants' responses in order to persevere during the current pandemic, as well as to prepare for future pandemics as it relates specifically to orthopaedic trauma practices.
    MeSH term(s) Betacoronavirus ; COVID-19 ; Coronavirus Infections ; Elective Surgical Procedures ; Hospitals ; Humans ; Orthopedic Procedures ; Orthopedic Surgeons ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2 ; Surveys and Questionnaires
    Keywords covid19
    Language English
    Publishing date 2020-06-13
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 80384-4
    ISSN 1432-5195 ; 0341-2695
    ISSN (online) 1432-5195
    ISSN 0341-2695
    DOI 10.1007/s00264-020-04644-4
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  5. Article ; Online: Global experience of orthopaedic trauma surgeons facing COVID-19

    Lezak, Bradley A. / Cole, Peter A. / Schroder, Lisa K.

    International Orthopaedics

    a survey highlighting the global orthopaedic response

    2020  Volume 44, Issue 8, Page(s) 1519–1529

    Keywords Orthopedics and Sports Medicine ; covid19
    Language English
    Publisher Springer Science and Business Media LLC
    Publishing country us
    Document type Article ; Online
    ZDB-ID 80384-4
    ISSN 1432-5195 ; 0341-2695
    ISSN (online) 1432-5195
    ISSN 0341-2695
    DOI 10.1007/s00264-020-04644-4
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: The Development of a Surgical Mission in the Peruvian Amazon: A 15-Year Expedition.

    Lezak, Bradley A / Cole, Peter A / Schroder, Lisa K

    The Journal of bone and joint surgery. American volume

    2019  Volume 102, Issue 4, Page(s) e13

    Abstract: Musculoskeletal disorders and injuries represent a substantial proportion of the global burden of disease. This burden is particularly prevalent in low and middle-income countries that already have insufficient health-care resources. The purpose of this ... ...

    Abstract Musculoskeletal disorders and injuries represent a substantial proportion of the global burden of disease. This burden is particularly prevalent in low and middle-income countries that already have insufficient health-care resources. The purpose of this paper is to highlight the vision, the history, the implementation, and the challenges in establishing an orthopaedic surgical mission in a developing nation to help address the epidemic of musculoskeletal trauma.Scalpel At The Cross (SATC) is a nonprofit Christian orthopaedic surgical mission organization that sends teams of 10 to 20 members to Pucallpa, Peru, a rural town in the Amazon, to evaluate patients with musculoskeletal conditions, many that require surgery. The organization employs 4 full-time staff members and has included over 400 medical volunteers in 32 surgical campaigns since 2005. SATC has provided approximately 8.1 million U.S. dollars in total medical care, while investing approximately 2.2 million U.S. dollars in implementation and overhead.Given the projected increase in trauma in low and middle-income countries, the SATC model may be increasingly relevant as a possible blueprint for other medical professionals to take on similar endeavors. This paper also highlights the importance of continued research into the effectiveness of various organizational models to advance surgical services in these countries.
    MeSH term(s) Expeditions ; Humans ; Medical Missions/organization & administration ; Musculoskeletal Diseases/surgery ; Musculoskeletal System/injuries ; Musculoskeletal System/surgery ; Orthopedic Procedures ; Orthopedics ; Peru ; Religious Missions/organization & administration ; Rural Health Services ; Time Factors
    Language English
    Publishing date 2019-12-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 220625-0
    ISSN 1535-1386 ; 0021-9355
    ISSN (online) 1535-1386
    ISSN 0021-9355
    DOI 10.2106/JBJS.19.00813
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  7. Article: Global experience of orthopaedic trauma surgeons facing COVID-19: a survey highlighting the global orthopaedic response

    Lezak, Bradley A / Cole, Peter A / Schroder, Lisa K

    Int Orthop

    Abstract: BACKGROUND: The COVID-19 (SARS-CoV-2) pandemic has significantly affected all aspects of healthcare, including orthopaedics. Due to the unique challenges presented by COVID-19 as well as the distinct timeframes that it will surge in different geographies, ...

    Abstract BACKGROUND: The COVID-19 (SARS-CoV-2) pandemic has significantly affected all aspects of healthcare, including orthopaedics. Due to the unique challenges presented by COVID-19 as well as the distinct timeframes that it will surge in different geographies, much can be learned from the experiences of orthopaedic professionals in many global settings. The goal of this project is to characterize the preparations, strategies, lessons, and personal experiences of orthopaedic trauma surgeons and departments across the world in combating COVID-19. In doing so, we will shed light on current practices and challenges, which may help us manage the current pandemic in addition to preparing for future global pandemics that may arise. METHODS: A 20-item questionnaire was sent out to 150 orthopaedic trauma surgeons representing 42 countries who were identified based on professional relationships and/or prior involvement in international meetings either led or participated by the senior author. RESULTS: The questionnaire was completed by 63 orthopaedic trauma surgeons representing 28 countries and 14 US states. The results of this study show that orthopaedic trauma departments across the world have been greatly impacted by COVID-19 with 91% of participating hospitals currently having a reduced case load compared with pre-COVID-19 and only 17% of respondents currently performing elective orthopaedic surgery. Furthermore, 30% of orthopaedic departments have deployed orthopaedic personnel to non-orthopaedic floors in order to help mitigate the increased patient load and 86% of respondents noted at least some shortage of PPE. Lastly 73% of participating orthopedic departments including those in LMICs, have incorporated telemedicine into their practice with a majority stating that it would most likely become a permanent change to their practice post-COVID-19. CONCLUSION: To our knowledge, this is the largest data set characterizing global COVID-19 situations and responses of orthopaedic trauma practices around the world. There is much to be learned from each of the participants' responses in order to persevere during the current pandemic, as well as to prepare for future pandemics as it relates specifically to orthopaedic trauma practices.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #597515
    Database COVID19

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  8. Article: Surgeon Level of Expertise in Adult Reconstruction: A Brief Communication Regarding the Need for Reporting the Level of Expertise.

    Yakkanti, Ramakanth R / Massel, Dustin H / Lezak, Bradley A / Haziza, Sagie / Milner, Jacob E / Chen, David / Hernandez, Victor H

    Arthroplasty today

    2021  Volume 8, Page(s) 1–4

    Abstract: The purpose of the current brief communication is to establish a discussion regarding level of expertise (LOE) documentation in future arthroplasty clinical studies and to document the trend in adoption of LOE among arthroplasty publications to date. A ... ...

    Abstract The purpose of the current brief communication is to establish a discussion regarding level of expertise (LOE) documentation in future arthroplasty clinical studies and to document the trend in adoption of LOE among arthroplasty publications to date. A review of
    Language English
    Publishing date 2021-02-17
    Publishing country United States
    Document type Journal Article
    ISSN 2352-3441
    ISSN 2352-3441
    DOI 10.1016/j.artd.2020.12.011
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  9. Article ; Online: Surgeon level of expertise reported in

    Massel, Dustin H / Lezak, Bradley A / Summers, Spencer H / Yakkanti, Ramakanth R / Hui-Chou, Helen G / Chen, David L

    The Journal of hand surgery, European volume

    2020  Volume 45, Issue 9, Page(s) 904–908

    Abstract: The purpose of the study was to evaluate the trend in documentation of surgeon level of expertise among ... ...

    Abstract The purpose of the study was to evaluate the trend in documentation of surgeon level of expertise among the
    MeSH term(s) Hand/surgery ; Humans ; Reproducibility of Results ; Specialties, Surgical ; Surgeons ; United States
    Language English
    Publishing date 2020-06-19
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2272801-6
    ISSN 2043-6289 ; 1753-1934
    ISSN (online) 2043-6289
    ISSN 1753-1934
    DOI 10.1177/1753193420932517
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  10. Article: Intra-operative referencing technique is non-inferior to use of fluoroscopy for acetabular component positioning in anterior hip arthroplasty.

    Summers, Spencer / Ocksrider, Justin / Lezak, Bradley / Zachwieja, Erik C / Schneiderbauer, Michaela Maria

    Journal of clinical orthopaedics and trauma

    2020  Volume 15, Page(s) 71–75

    Abstract: Background: Intra-operative fluoroscopy has been shown to improve the accuracy of acetabular component positioning when compared to no fluoroscopy in direct anterior approach (DAA) total hip arthroplasty (THA). Due to logistical reasons, our senior ... ...

    Abstract Background: Intra-operative fluoroscopy has been shown to improve the accuracy of acetabular component positioning when compared to no fluoroscopy in direct anterior approach (DAA) total hip arthroplasty (THA). Due to logistical reasons, our senior author has been performing DAA THA at one institution without the use of fluoroscopy and has created an intraoperative referencing technique to aid in acetabular component positioning. The purpose of this study is to evaluate the accuracy of acetabular component positioning using fluoroscopy when compared to an intra-operative referencing technique without fluoroscopy.
    Methods: A total of 214 consecutive primary DAA THA were performed by one surgeon at two institutions and were retrospectively reviewed over a 3-year period. Intra-operative fluoroscopy was used with all patients at Institution A (N = 154). At institution B (N = 60), no fluoroscopy was used, and an intra-operative referencing technique was employed to assist in placement of the acetabular component.
    Results: In the fluoroscopy group, 91% of components met our abduction target, 90% met our anteversion target, and 82.5% simultaneously met both targets. In the non-fluoroscopy group, 98% of components met our abduction target, 92% met our anteversion target, and 90% simultaneously met both targets. There was no difference between groups for placement of the component within both targets simultaneously (p = .171).
    Conclusion: Use of our intra-operative referencing technique is non-inferior in placing acetabular components within a pre-defined safe zone when compared to use of intraoperative fluoroscopy. The intra-operative reference technique can be a helpful adjunct for ensuring accurate acetabular component positioning while simultaneously reducing cost and limiting radiation exposure.
    Language English
    Publishing date 2020-10-20
    Publishing country India
    Document type Journal Article
    ZDB-ID 2596956-0
    ISSN 2213-3445 ; 0976-5662
    ISSN (online) 2213-3445
    ISSN 0976-5662
    DOI 10.1016/j.jcot.2020.10.032
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