Peds Ortho

Lit. Update with Muharrem Yazici

FIRST TRANS-ATLANTIC EPISODE featuring special guest and SRS immediate past-president Dr. Muharrem Yazici from Ankara, Turkey.  Featured discussion focuses on graduation strategies for Early-Onset scoliosis patients treated with distraction-based growing rods. We also dive into other recent studies in the lightning round discussing long-term follow-up of discoid meniscus surgery, THA in patients with open tri-radiates, the use of antibiotics in supracondylar humerus fractures, and what steps individuals can take to promote diversity in orthopedic surgery.  Your hosts are Craig Louer from Vanderbilt University, Josh Holt from The University of Iowa, and Carter Clement from Children’s Hospital of New Orleans. Music by A.A. Alto.

Links:
pedsorthopodcast@gmail.com
Twitter: @CraigLouer
Twitter: @CarterClementMD

High-Yield OITE Webinar Link: https://zoom.us/webinar/register/4916341745008/WN_NnSH1O0TTpSvhFLiCBUxhQ
 
Featured article:
Clinical Outcomes of 3-column Osteotomy at Growing Rod Graduation
Cayli, Cem MD*; Dursun, Gokay MD*; Cetik, R. Mert MD*; Ramazanov, Rafik MD†; Demirkiran, H. Gokhan MD*; Ayvaz, Mehmet MD*; Yazici, Muharrem MD*
Hacettepe University Hospital, Ankara, Turkey.

Lightning Round:

Rate of Scoliosis Correction After Anterior Spinal Growth Tethering for Idiopathic Scoliosis
Takahashi, Yohei, MD; Saito, Wataru, MD, PhD; Yaszay, Burt, MD; Bartley, Carrie E., MA; Bastrom, Tracey P., MA; Newton, Peter O., MD;  The Journal of Bone and Joint Surgery - Scientific Articles: 08 July 2021 - Volume 103 - Issue 18 - p. 1718-1723

Minimally Invasive Fusionless Surgery for Scoliosis in Spinal Muscular Atrophy: Long-term Follow-up Results in a Series of 59 Patients
Mathilde Gaume, Etienne Saudeau, Marta Gomez-Garcia de la Banda, Viviane Azzi-Salameh, Blaise Mbieleu, Delphine Verollet, Audrey Benezit, Jean Bergounioux, Aben Essid, Isabelle Doehring, Ivana Dabaj, Isabelle Desguerre, Christine Barnerias, Vicken Topouchian, Christophe Glorion, Susana Quijano-Roy, Lotfi Miladi

Long-term Minimum 15-Year Follow-up After Lateral Discoid Meniscus Rim Preservation Surgery in Children and Adolescents
Lins, Laura A.B. MD, MPH, ATC*; Feroe, Aliya G. MPH†,‡; Yang, Brian MD§; Williams, Kathryn A. MS†; Kocher, Sophia D.∥; Sankarankutty, Saritha MBBS†; Micheli, Lyle J. MD†,‡; Kocher, Mininder S. MD, MPH†,‡
Boston CHildrens Hospital
Assessment of the Viability and Union Feature of Diaphysis Reconstruction Using Pasteurized Tumor Bone and Intramedullary Free Fibular After Tumor Resection
Ji, Tao MD*; Li, Yuan MD†; Xing, Zhili MD‡; Tang, Xiaodong MD*; Yang, Rongli MD*; Guo, Wei MD, PhD*
The Open Triradiate Cartilage: How Young Is Too Young for Total Hip Arthroplasty?
Rainer, William DO; Shirley, Matthew B. MD; Trousdale, Robert T. MD; Shaughnessy, William J. MD

Efficacy of Antibiotics in Supracondylar Fractures
Bhatt, Etasha MD*; Ridley, Taylor J. MD†; Kruckeberg, Bradley MD‡; Quanbeck, Zachary MD*; Quanbeck, Deborah S. MD*,§,∥; Schiffern, Alison MD*,§,∥

Brooks, J., & Caird, M. (2021). It’s Not a Stereotype if It’s True . . . Right? Creating Welcoming Environments in Pediatric Orthopaedics. JPOSNA, 3(3). Retrieved from https://www.jposna.org/ojs/index.php/jposna/article/view/318

Brooks, J., Cho, R., Franklin, C., Hammouri, Q., Payares-Lizano, M., Poon, S., Sabatini, C., & POSNA JEDI Committee. (2021). Just the Beginning – A Brief Look at the Past, Present, and Future of POSNA Diversity. JPOSNA, 3(3). Retrieved from https://www.jposna.org/ojs/index.php/jposna/article/view/313

Lit. Update with Rachel Goldstein

Special live session from the 2021 AAOS Meeting in San Diego. Featuring special guest Rachel Goldstein from CHLA who joins us to discuss DDH. Discussion focuses on ultrasound assessment of children with dysplasia and the ominous finding of an inverted labrum. We also dive into other recent studies in the lightning round discussing the femoral head-shaft angle in children with Cerebral Palsy, NOF of the distal tibia, the effects of lumbar fusion on cervical sagittal alignment in patients with Lenke 5 AIS, and the ease of acquiring skills to diagnose DDH via ultrasound enhanced physical examination. Your hosts are Josh Holt from The University of Iowa, Carter Clement from Children’s Hospital of New Orleans, and Julia Sanders from Children’s Hospital Colorado. Music by A.A. Alto.

 

Featured article:

An Inverted Acetabular Labrum is Predictive of Pavlik Harness Treatment Failure in Children with Developmental Hip Dysplasia. Adrian Lin, Ali Siddiqui, Lillian Lai, Rachel Goldstein. JPO. Sept 2021.

 

Lightning Round:

1. The Femoral Head-Shaft Angle is Not a Predictor of Hip Displacement in Children Under 5 Years with Cerebral Palsy: A Population-based Study of Children at GMFCS Levels III-V. Terje Terjesen, Joachim Horn. JPO. 2021

 

2. Nonossifying Fibroma of the Distal Tibia: Predictors of Fracture and Management Algorithm. Soroush Baghdadi, Jie Nguyen, Alexandre Arkader. JPO. 2021

 

3. Does Selective Posterior Correction and Fusion Surgery Influence Cervical Sagittal Alignment in Patient with Lenke Type 5 Adolescent Idiopathic Scoliosis?- A 5-year Follow-up Retrospective Cohort Study. Toshiki Okubo, Mitsuru Yagi, Satoshi Suzuki et al. Spine. 2021

 

4. What is the Intraobserver Reliability of an Ultrasound-enhanced Physical Examination of the Hip in Infants? A Prospective Study on the Ease of Acquiring Skills to Diagnose Hip Dysplasia. Neha Jejurikar, Leon Moscona-Mishy, Monica Rubio, Romina Cavallaro, Pablo Castaneda. COOR. 2021

Lit. Update with Jennifer Beck

Jennifer Beck from UCLA and the Orthopaedic Institute for Children joins us to discuss bone health in children including how to incentivize patients to take their vitamin D and relative energy deficiency in sport (RED-S). We also discuss some of Dr. Beck's preferences for ACL reconstruction and highlight new literature on screening for cervical instability in Down Syndrome, implant selection for Triplanes, whether ankle fractures with syndesmosis injuries do worse, and more! Your hosts are Carter Clement from Children's Hospital of New Orleans and Josh Holt from University of Iowa. Music by A.A. Alto.

 

Featured article:

 

What is New in Pediatric Bone Health? Jennifer J Beck, Susan T Mahan, Philip Nowicki, Verena M Schreiber, Barbara Minkowitz. JPO. Sept 2021.

 

Lightning Round: 

 

1. Repeat Pediatric Trisomy 21 Radiographic Exam: Does Atlantoaxial Instability Develop Over Time? Jennifer M Bauer, Virkamal K Dhaliwal, Samuel R Browd, Walter F Krengel 3^rd. JPO. Sept 2021.

 

2. Comparison of K-wire versus screw fixation after open reduction of transitional (Tillaux and triplane) distal tibia fractures. Neeraj Mishra, Shiyao Wang, Zackary Kerk Hsiang Chua, Kai Yet Lam, Arjandas Mahadev. JPO B. Sept 2021.

 

3. Local Bone Grafting Is Sufficient for Instrumented Adolescent Idiopathic Scoliosis Surgery: A Preliminary Study. Alper Yataganbaba, Abhay Gahukamble, Georgia Antoniou, Brian J C Freeman, Peter J Cundy. JPO. Sept 2021.

 

4. Functional outcomes of unstable ankle fractures with and without syndesmotic fixation in the adolescent population. Conner J. Paez, Benjamin M. Lurie, Vidyadhar V. Upasani, Andrew T. Pennock. JCO. Online June 2021.

 

5. Radiographic Coronal Imbalance and Shoulder Asymmetry Continue to Improve Between 2 and 5 Years Following Surgery of Adolescent Idiopathic Scoliosis. Hughes, Jessica; Bastrom, Tracey P.; Bartley, Carrie E.; Newton, Peter O. MD; Parent, Stefan; Cahill, Patrick J.; Lonner, Baron MD; Shah, Suken A.; Samdani, Amer; Harms Study Group; Yaszay, Burt MD. JPO. Aug 2021.

 

6. Comparison of Surgical Outcomes for Distal Rectus Femoris Transfer and Resection Surgeries in Children With Cerebral Palsy With Stiff Knee Gait. Jose J Salazar-Torres, Chris Church, Thomas Shields, Nancy Lennon, M Wade Shrader, Julieanne P Sees, Freeman Miller. JPO. Sept 2021.

 

Lit. Update with Jeff Nepple

Jeff Nepple from Wash U in St Louis joins us to discuss cartilage wear patterns in FAI and SCFE and implications for treatment from the most recent JPO. We also highlight new literature regarding resorbable implants in pediatrics, Pavlik harness success in hip dysplasia patients with irreducible dislocations, and much more. Your hosts are Carter Clement from Children's Hospital of New Orleans, Craig Louer from Vanderbilt, Josh Holt from Iowa and Julia Sanders from Children's Hospital Colorado. Music by A.A. Alto.

 

Featured article:

 

Lieberman EG, Pascual-Garrido C, Abu-Amer W, Nepple JJ, Shoenecker PL, Clohisy JC. Patients With Symptomatic Sequelae of Slipped Capital Femoral Epiphysis Have Advanced Cartilage Wear at the Time of Surgical Intervention. J Pediatr Orthop. 2021 Jul 1;41(6):e398-e403.

 

Lightning Round: 

 

1. Baldini M, Coppa V, Falcioni D, Senigagliesi E, Marinelli M, Gigante AP. Use of resorbable magnesium screws in children: systematic review of the literature and short-term follow-up from our series. J Child Orthop. 2021 Jun 1;15(3):194-203. 

 

2. Patel HA, Chaudhry S, Lee MC, Solomito M. Streamlining Postoperative Care After Pediatric Supracondylar Humerus Fractures: Is Follow-up After Pin Removal Routinely Needed? J Pediatr Orthop. 2021 Jul 1;41(6):e464-e469.

 

3. Nicolaou N, Luo Q, Giles SN, Maruthainar K, Kitchen MP, Thomas S, Fernandes JA, Roposch A. Mechanical Analysis of Explanted Telescopic Rods in the Management of Osteogenesis Imperfecta: A Multicenter Study. J Pediatr Orthop. 2021 Jul 1;41(6):e448-e456. 

 

4. Imerci A, Rogers KJ, Bhattacharjee A, Bowen JR, Thacker MM. Risk Factors for Failure of Pavlik Harness Treatment in Infants With Dislocated Hips That Are Evaluated by Dynamic Sonography. J Pediatr Orthop. 2021 Jul 1;41(6):e386-e391. 

 

5. Fletcher AN, Liles JL, Pereira GF, Danilkowicz RM, Amendola A, Riboh JC. The Intrarater and Inter-rater Reliability of Radiographic Evaluation of the Posterior Tibial Slope in Pediatric Patients. J Pediatr Orthop. 2021 Jul 1;41(6):e404-e410.

Lit. Update with Todd Milbrandt

Todd Milbrandt of Mayo discusses his recent research on vertebral body tethering and bending films from Spine Deformity. We also highlight papers from the newest editions of JBJS, JPO, JPO-B, and JPOSNA. Your hosts are Carter Clement from Children’s Hospital of New Orleans, Craig Louer from Vanderbilt, Josh Holt from Iowa, and Julia Sanders from Children's Hospital Colorado. Music by A. A. Alto.

 

Primary articles:

1. Defining the learning curve in CT-guided navigated thoracoscopic vertebral body tethering. Smitha Mathew, A Noelle Larson, D Dean Potter, Todd A Milbrandt. Spine Deformity May 2021.

2. Comparison of slot-scanning standing, supine, and fulcrum radiographs for assessment of curve flexibility in adolescent idiopathic scoliosis: a pilot study. Lauren M Swany, A Noelle Larson, A Fettah Buyuk, Todd A Milbrandt. Spine Deformity May 2021.

 

Lightning Round:

1. Prolonged non-weightbearing treatment decreases femoral head deformity compared to symptomatic treatment in the initial stage of Legg-Calvé-Perthes disease. Jeffrey B Peck, Dustin A Greenhill, William Z Morris, Dang-Huy Do, Molly F McGuire, Harry K W Kim.  Journal of Pediatric Orthopedics. Part B 2021 May 20.

 

2. Human Position Brace Versus Pavlik Harness for Infants Under 6 Months of Age With Developmental Dislocation of the Hip: A Comparison of Therapeutic Efficacy. Pan Gou, Yuan Zhang, Jun Wu, Jun Li, Xiang Li, Ming Li, Xing Liu. Journal of Pediatric Orthopedics 2021 May 13.

 

3. Novel device for nonsurgical correction of rigid forefoot adduction in children. Daniel Freedman, Pavel Kotlarsky, Mark Eidelman. Journal of Pediatric Orthopedics. Part B 2021 May 14.

 

4. Improved Bowel Function With Oral Methylnaltrexone Following Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis. Adrian J Lin, Andrew J Costandi, Eugene Kim, David L Skaggs, Lindsay M Andras, Neha Patel, Carl Lo, Kenneth D Illingworth.  Journal of Pediatric Orthopedics 2021 May 18.

 

5. Surgical Treatment of Solitary Periarticular Osteochondromas About the Knee in Pediatric and Adolescent Patients: Complications and Functional Outcomes. Mark Wu, Evan T Zheng, Megan E Anderson, Patricia E Miller, Samantha A Spencer, Benton E Heyworth. Journal of Bone and Joint Surgery. American Volume 2021 May 24.

 

6. Hogue, G. (2021). Early Onset Scoliosis Series Announcement. JPOSNA, 3(2). Retrieved from https://www.jposna.org/ojs/index.php/jposna/article/view/286

 

7. Murphy, R., & Mooney, J. (2021). The First Generation of Early Onset Scoliosis Care. JPOSNA, 3(2). Retrieved from https://www.jposna.org/ojs/index.php/jposna/article/view/281

 

8. Welborn, M., Sanders, J., & D’Astous, J. (2021). The Evolution of EDF Casting. JPOSNA, 3(2). Retrieved from https://www.jposna.org/ojs/index.php/jposna/article/view/282

 

Best of POSNA 2021 - Spine Subspecialty Day

Sumeet Garg of Children’s Hospital Colorado and Craig Eberson of University Orthopedics at Brown University moderate the POSNA 2021 Virtual Spine Subspecialty Day episode, discussing key abstracts from this years meeting in Dallas. Featured authors include Vishal Sarwahi of Cohen Children’s Medical Center and Burt Yaszay of Rady Children’s Hospital. Your host is Josh Holt from the Stead Family Children’s Hospital at The University of Iowa. Music by A. A. Alto.

 

Abstracts discussed:

 

Ambulatory Neuromuscular Scoliosis Patients have Similar Rates of Infection, Perioperative Complications, and Revision to Adolescent Idiopathic Scoliosis Patients. Vishal Sarwahi MBBS; Sayyida Hasan; Yungtai Lo; Terry D. Amaral MD; Jesse Galina; Aaron Atlas. Cohen Children's Medical Center, New Hyde Park, NY

 

Breaking the Dogma: Does UIV have to be T2 in CP Patients Undergoing Spinal Fusion for their Neuromuscular Scoliosis? Jakub Sikora-Klak; Paul D. Sponseller MD; Tracey P. Bastrom MA; Suken A. Shah MD; Patrick John Cahill MD; Mark F. Abel MD; Amer F. Samdani MD; Peter O. Newton MD; Burt Yaszay MD. Rady Children's Hospital, San Diego, CA

 

For further information, see annual meeting program: https://posna.org/POSNA/media/Documents/Events/Final-Program_1.pdf

 

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POSNA 2021 Young Member Forum - Growing Up Ortho

The Arabella Leet Memorial Young Member Forum of the 2021 POSNA Annual Meeting is hosted by Dan Miller of Gillette and Siobhan Murphy-Zane of Children's Hospital Colorado. This session features three POSNA allstars who grew up as the children of pediatric orthopedists: Benjamin Roye of Columbia, Jonathan Schoenecker of Vanderbilt, and Craig Birch of Boston Children's. Produced by Carter Clement and Craig Louer. Music by A.A. Aalto.

POSNA 2021 Young Member Forum - What Our Spouses Really Think

The Arabella Leet Memorial Young Member Forum of the 2021 POSNA Annual Meeting is hosted by Siobhan Murphy-Zane of Children's Hospital Colorado and Dan Miller of Gillette. This session features pediatric orthopedists and their spouses, discussing pearls and pitfalls of building a family together. Guests include Siobhan's husband, Richard Zane, Jennifer Weiss of Kaiser Permanente in Los Angeles, Jennifer Laine of Gillette and her husband Louis Kohl, Jay Albright of Children's Hospital Colorado and his wife Stacy Albright, and Amy Mcintosh of TSRH and her husband Rich Mcintosh. Produced by Carter Clement and Craig Louer. Music by A.A. Aalto.

Special Edition - Live at POSNA2021 with Collin May, Coleen Sabatini, Jon Schoenecker, & Salil Upasani

Special Edition recorded as a live panel at the POSNA2021 Annual Meeting with content from the first day of scientific presentations covering Trauma and Infection. Featured authors include Drs. Collin May of Boston Children's Hospital, Coleen Sabatini of UCSF, Jon Schoenecker of Vanderbilt, and Salil Upasani of Rady Children's Hospital.

Your hosts are Carter Clement from Children’s Hospital of New Orleans, Nick Fletcher from Children's Healthcare of Atlanta/Emory, Josh Holt from University of Iowa, & Craig Louer from Vanderbilt University.  Music by A. A. Alto.

 

Abstracts discussed with the Case Pictures:

Abstract #14:

Intraoperative Internal Rotation Stress Test in Displaced Pediatric Supracondylar Humerus Fractures Improves Outcomes.  Andrew Bateman Rees; Jacob Schultz; Lucas C. Wollenman; Stephanie N. Moore-Lotridge PhD; Jeffrey E. Martus MD; Gregory A. Mencio MD; Jonathan G. Schoenecker MD

Abstract #16:

Operative Versus Non-operative Treatment of Z-Type Comminuted Clavicle Fractures in Adolescents: A Substratified Cohort Analysis.  Coleen S. Sabatini MD; Eric W. Edmonds MD; Elizabeth Liotta; Katelyn Hergott; Donald S. Bae MD; Michael T. Busch MD; Henry Bone Ellis MD; Mininder S. Kocher MD; G Ying Li MD; Jeffrey Jerome Nepple MD; Nirav Kiritkumar Pandya MD; Andrew Pennock MD; Crystal Perkins MD; David D. Spence MD; David Williams PhD; Samuel Clifton Willimon MD; Philip Wilson MD; Benton E. Heyworth MD

Abstract #8

Practice Variation in the Surgical Management of Children with Non-Abscess Forming Acute Osteomyelitis: Policy or Clinical Judgement.  Vidyadhar S V Upasani MD; Jessica Davis Burns MD; Tracey P. Bastrom MA; Keith D. Baldwin MD; Jonathan G. Schoenecker MD; Benjamin J. Shore MD.

Abstract #19

Management of Syndesmotic Injuries in Children and Adolescents: Results of a Cross-Sectional Survey.  Caroline Williams; Benjamin J. Shore MD; Nicholas Sullivan; Blair Stewig; Dennis Kramer MD; Yi-Meng Yen MD; Collin May MD.

 

For further information, see annual meeting program and abstracts:

https://posna.org/POSNA/media/Documents/Events/2021%20Annual%20Meeting/2021-Abstract-Book.pdf

 

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Best of POSNA 2021 - Hip Subspecialty Day

Rachel Goldstein of CHLA moderates the POSNA 2021 Virtual Hip Subspecialty Day episode, discussing key abstracts from the upcoming meeting. Featured authors include Ernie Sink of HSS, Jeffrey Nepple of St. Louis Children's, and David Chong of Oklahoma University. Your host is Carter Clement from Children’s Hospital of New Orleans. Music by A. A. Alto.

 

Abstracts discussed:

 

Patients That Undergo Concomitant Hip Arthroscopy and Periacetabular Osteotomy Obtain Minimal Clinically Important Difference More Than Patients That Undergo Isolated Periacetabular Osteotomy: An analysis of 231 hips. Anthony Essilfie; Stacy Robustelli BS; Ernest Sink MD The Hospital for Special Surgery, New York, NY

 

Intermediate Term Results of Combined Surgical Dislocation and Periacetabular Osteotomy for Complex Perthes Deformities: Can We Save the Hip? Serena Freiman; Jeffrey Jerome Nepple MD; Gail Pashos; Perry L. Schoenecker MD; John Clohisy MD Washington University School of Medicine, St. Louis Missouri

 

Reliability and Validity of Assessment of Legg-Calve-Perthes Disease Hypoperfusion with Perfusion MRI. David Y. Chong MD; Tim Schrader MD; Jennifer C. Laine MD; Scott Yang MD; Shawn R. Gilbert MD; Harry KW Kim MD; International Perthes Study Group

 

For further information, see annual meeting program: https://posna.org/POSNA/media/Documents/Events/Final-Program_1.pdf

 

Please subscribe and send all feedback to pedsorthopodcast@gmail.com