Erratum to 'Total Hip Arthroplasty for Ankylosis Requiring Rotational Rectus Femoris Flap and Skin Graft for Wound Closure' [Arthroplasty Today 6 (2020) 141-145].

[This corrects the article DOI: 10.1016/j.artd.2020.03.001.].

Does Implant Removal Across the Sacroiliac Joint Improve Pain and Outcomes?

OBJECTIVES: To determine if removal of previously inserted iliosacral screws improved posterior pelvic pain and Short Musculoskeletal Form Assessment (SMFA) scores. DESIGN: Retrospective database review. SETTING: Level-1 trauma center. PATIENTS/INTERVENTION: Twenty-five patients who underwent iliosacral screw removal. MAIN OUTCOME MEASURE: SMFA score. RESULTS: Eighty-eight percent of patients stated that they were satisfied with the procedure and would undergo screw removal again. SMFA functional and bothersome scores decreased (improved) after the screw removal procedure, both at 3 months and at the final follow-up. Two-eight percent of the patients required narcotics before surgery compared with 8% after screw removal. No surgical complications occurred during screw removal. CONCLUSION: A select group of patients who have symptomatic screws across the sacroiliac joint may benefit from elective screw removal. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Total Hip Arthroplasty for Ankylosis Requiring Rotational Rectus Femoris Flap and Skin Graft for Wound Closure.

We present a case report of a 51-year-old Ghanaian immigrant who underwent total hip arthroplasty in the setting of spontaneous ankylosis of unknown etiology. The increase in offset of the patient's limb through reconstruction, in combination with severe soft-tissue atrophy of the lower extremity, resulted in a soft-tissue defect that could not be closed primarily. This ultimately required a rectus femoris rotational flap and skin grafting for coverage. We describe the surgical technique used for conversion of an ankylosed hip to total hip arthroplasty, as well as the technique for management of a large proximal thigh soft-tissue defect with rectus femoris muscle flap coverage.

Congenital anterior shoulder dislocation in a newborn treated with closed reduction.

Case: This rare case presents an isolated congenital shoulder dislocation in a twin delivery, without traumatic delivery. Delivered by emergent cesarean section at 33 weeks gestation, the infant presented with a lateral shoulder crease with x-rays showing anterior and inferior dislocation. Treatment included prompt reduction and stabilization, with follow-up ultrasound demonstrating a physeal injury. Conclusions: This case report presents the only published congenital shoulder dislocation in an infant after an atraumatic twin cesarean delivery. Prompt reduction, stabilization, and ultrasound imaging to assess for physeal injury is our recommended management for this scenario.

Safety and feasibility of outpatient ACDF in an ambulatory setting: A retrospective chart review.

BACKGROUND: Outpatient spinal surgery is becoming increasingly common and in some areas is now the preferred course for certain procedures. Many different procedures, including ACDF, have been examined in the outpatient setting in the past few years but to our knowledge none have included the ambulatory setting. METHODS: All ACDF procedures performed during the time frame of the study were included. Charts were pulled and evaluated using the outcome measures. One and two-level ACDF were divided into respective cervical levels and individually analyzed. RESULTS: Single level ACDF comprised 62% (n = 74) of the total surgeries. Single level ACDF patients averaged a total hospital stay time of 4.7 hours, with a maximum total stay time of 8.2 hours and a minimum stay time of 0.8 hours. Two-level ACDF made up 38% (n = 45) of the total surgeries. The average total stay time for two level ACDF was 5.4 hours, with a maximum time of 9.6 hours and a minimum of 3.4 hours. All patients were comparable in age and gender. There were no major operating complications and neither re-admissions nor deaths after discharge. There were two transfers from ambulatory surgical centers to inpatient status for observation only. CONCLUSIONS: Outpatient one and two-level ACDF with plate fixation can safely be done on an outpatient ambulatory basis. The data suggest that all subaxial cervical levels can be treated. Patient fusion and satisfaction data were not obtained and thus cannot be commented upon. CLINICAL RELEVANCE: Ambulatory ACDF should be considered as a feasible option for reducing hospital stay as well as the associated healthcare costs.