Peds Ortho POSNA

This episode covers highlights from EPOSNA 2024, the combined meeting of POSNA and EPOS. Guests include: Dr. Jonathan Schoenecker (POSNA) and Dr. Melinda Witbreuk (EPOS) – co-moderators of Session 1 (Trauma), Dr. Peter Newton (POSNA) and Dr. Carol Hasler (EPOS) – co-moderators of Session 2 (Best of Spine), Prof. Deborah Eastwood (EPOS) and Dr. Steven Frick (POSNA) – co-moderators of Session 3B (Foot & Ankle), Dr. Yrjänä Nietosvaara (EPOS) and Dr. Julie Samora (POSNA) – co-moderators of Session 4B (Hand & Upper Extremity), Dr. Unni Narayanan (POSNA) and Dr. Ana Presedo (EPOS) – co-moderators of Session 4C (Neuromuscular). Your hosts are Tyler McDonald from University of South Alabama, Jessica McQuerry from University of Florida, Melissa Allen from Duke, and Breann Tisano from Boston Children’s. Music by A. A. Aalto.

Dr. Jonathan Schoenecker from Vanderbilt joins the show to discuss his recent research on using CRP to manage musculoskeletal infections. This episode also covers recent research on the value of axial imaging in infections, numerous hip preservation treatments and considerations, and more. This episode is sponsored by OrthoFix. Your hosts are Craig Louer from Vanderbilt, Carter Clement from Children’s Hospital of New Orleans, Josh Holt from University of Iowa, and Julia Sanders from Children’s Hospital Colorado. Music by A. A. Aalto.
 
"Main Event" Citations
1. CRP Predicts the Need to Escalate Care After Initial Debridement for Musculoskeletal Infection. Moore-Lotridge et al. JPO. 2024 Mar. PMID: 37997444
2. Clinical Utility of Repeat Magnetic Resonance Imaging Studies Among Children With Acute Hematogenous Osteomyelitis. Thorne et al. JPO. 2024 Mar. PMID: 38477331
"Lightning Round" Citations
1. A Role for Thyroid Testing in Slipped Capital Femoral Epiphysis? 32% Rate of Abnormal Values in Tested Patients. Nielsen et al. JPO. 2024 Feb. PMID: 38415747
2. Intraoperative Epiphyseal Perfusion Monitoring Does Not Reliably Predict Osteonecrosis Following Treatment of Unstable SCFE. Ellsworth et al. JPO. 2024 Feb. PMID: 38411144
3. Traditional Versus Water-resistant Short Leg Casting: A Randomized Controlled Pilot Study. Carveth et al. JPO. 2024 Feb. PMID: 38329338
4. Microwave Ablation of the Pig Growth Plate: Proof of Concept for Minimally Invasive Epiphysiodesis. Noonan et al. CORR. 2024 Mar. PMID: 38471002

This month we are joined by Dr. Raymond Liu from Case Western Reserve and Rainbow Babies in Cleveland to discuss his work on skeletal maturity grading systems, patient reported outcomes in limb deformity, and 3D anatomical studies. Hear about Mongolia pushing the limits in rigid nailing of pediatric femur fractures and stick around for highlights from the lightning round including ultrasound for fracture diagnosis, guided growth for patellar instability and 3D analysis after spinal fusion.
 
Your hosts are Julia Sanders from Children’s Hospital Colorado, Carter Clement from Children’s Hospital of New Orleans, Craig Louer from Vanderbilt, and Josh Holt from University of Iowa. Music by A. A. Aalto.
 
For more information on the JPO Journal Club organized by Dr Liu, please contact Caroline Eaton from Advancing Pediatric Orthopaedics at ceaton@faportho.org.
 
To download the "What's the Skeletal Maturity" app for free, visit your device app store (Android currently undergoing upgrades, but available soon!)
 
Citations for papers discussed:
 
Moon TJ, Canitia E, Amakoutou K, et al. Prospective Multicenter Preliminary Validation of Limb Deformity-modified Scoliosis Instruments in Pediatric Patients With Limb Deformity. J Pediatr Orthop. 2024;44(3):e260-e266.
 
Furdock RJ, Sun KJ, Ren B, et al. The Reliability of the Modified Fels Knee Skeletal Maturity System. J Pediatr Orthop. 2024;44(2):e192-e196.
 
Nedder VJ, Chen KJ, May CC, Abzug JM, Liu RW. Developmental Anatomy of the Radial Bow in Pediatric Patients using 3D Imaging. J Pediatr Orthop. Published online February 23, 2024.
 
Catanzano, A. , Upasani, V. , Bryan, T. , Yaszay, B. & Newton, P. (2024). Breaking the Rules in Three Dimensions: What to Expect After a Thoracic-only Fusion With Structural Thoracic and Thoracolumbar Curves. Journal of Pediatric Orthopaedics, 44 (3), e242-e248. 
 
Combs, K. & Kocher, M. (2024). US for Initial Diagnosis of a Suspected Distal Radial Fracture in Children Was Noninferior to Radiography for Arm Function at 28 Days. The Journal of Bone and Joint Surgery, 106 (4), 354. doi: 10.2106/JBJS.23.01337.
 
Tomasevich, Kelly M.a; Kantor, Adam H.a; Metz, Allan K.a; Hanson, Indiana T.b; Froerer, Devin L.c; Rosenthal, Reece M.a; Aoki, Stephen K.a. Mid-term outcomes of temporary medial distal femoral hemiepiphysiodesis with and without medial patellofemoral ligament repair for recurrent patellar instability in skeletally immature patients with genu valgum. Journal of Pediatric Orthopaedics B 33(2):p 119-129, March 2024.

Dr. Mark Seeley from Geisinger Health System joins the show for a stimulating discussion on a wide range of topics including his practice as an employed surgeon in a healthcare system with its own health plan and some of the unique opportunities this provides. We discuss the role of surgeons in stewardship of healthcare spending. Dr. Seeley elaborates on his work in education and his recent study evaluating a novel femur osteotomy simulation tool. Articles selected for the lightning round include MRI predictors of residual hip dysplasia 10-years after hip reduction, risks of refracture after operatively treated both bone forearm fractures, and complications of operative treatment for lateral condyle humeral fractures with associated elbow dislocation. Your hosts are Josh Holt from University of Iowa and Julia Sanders from Children's Hospital Colorado. Music by A. A. Aalto.

Dr. Dan Perry, a children’s orthopaedist and NIHR research professor from Liverpool, joins the show to discuss his recent research, including numerous ongoing multicenter trials spanning the UK and beyond: SCIENCE, CRAAFT, FORCE, BASIS, ODD SOCKS, to name a few. The lightning round touches on compartment syndrome in ECMO, why pedipods get low online reviews, and more. Your hosts are Carter Clement from Children’s Hospital of New Orleans and Craig Louer from Vanderbilt. Music by A. A. Aalto.
 
References:
 
Joseph et al. Radiological assessment of hip disease in children with cerebral palsy: development of a core measurement set. Bone & Joint Open. Nov 2023. PMID 37909150.
 
Bridges et al. Acute Compartment Syndrome in Pediatric Patients on Extracorporeal Membrane Oxygenation Support. JPO. Dec 2023 Epub. PMID 38084004.
 
Torres-Izquierdo et al. Is There a Role for Isolated Closed Reduction in the Emergency Department Without Fixation for Displaced Proximal Humerus Fractures in Adolescents? JPO. Dec 2023 Epub. PMID 38151963.
 
Martino et al. The Optimal Age for Surgical Management of DDH Differs by Treatment Method. JPO. Nov 2023 Epub. PMID 37970702.
 
Hitchman et al. An Analysis of Negative One-star Patient Reviews and Complaints for Pediatric Orthopaedic Surgeons throughout the United States: A Retrospective Study. JPO. Nov 2023 Epub. PMID 37970712.

Drs. Tyler McDonald from the University of South Alabama and Phil Nowicki from Grand Rapids host this year’s coverage of the IPOS meeting. Guests include Dr. Todd Milbrant from Mayo who discusses IPOS planning and Ponseti casting pitfalls, Dr. Kishore Mulpuri from the University of British Columbia who discusses orphan hip conditions, Dr. Tony Riccio from TSRH who discusses foot deformities including pearls for the arthrogrypotic foot, Dr. Christine Ho from TSRH who discusses operative vs. nonoperative management of various dislocations and other sports-related injuries, Dr. Reid Nichols from Nemours who discusses teaching and bunions, Valerie Parrish, PA-C and Tracy Warhoover, RN who discuss the education of APP’s at IPOS, and Dr. Derek Kelly from Campbell Clinic who presents the 2023 IPOS award winners. This episode is produced by Tyler McDonald and Phil Nowicki along with Carter Clement from Children’s Hospital of New Orleans. Music by A.A. Aalto.