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Background: With the rise of social media and other web-based platforms, there has been a shift in how medical research findings are disseminated. Questions/Purposes : We sought to investigate how often orthopedic surgeons use different knowledge-seeking methods and how confident they were in their ability to stay up-to-date. Methods : We distributed a 23-question survey to 120 orthopedic surgeons employed at a single tertiary-care metropolitan orthopedic hospital. The survey collected the surgeons' use of reference managers, RSS feeds, and preferred methods of staying up-to-date. Respondents were asked to report the number of hours they spent staying up-to-date per week and their success with keeping up with orthopedic specialty literature. Results : A total of 85 physicians responded (median age, 52 years); 83% of respondents who spent 3 or more hours a week in keeping up-to-date with the literature said they felt successful in doing so, while 40% of participants who spent less than 1 hour a week said they felt successful. Fifty-five percent of surgeons under the median age used social media, while only 29% of surgeons over the median age used social media. Conclusions : This survey suggests that spending only 1 to 2 hours per week was enough to make the orthopedic surgeons we surveyed feel confident that they were keeping up with the literature in their specialty. These findings also suggest that it may be more important for surgeons to choose a convenient method of literature review that will enable them to maximize time spent reading, rather than attempting to use any one source., Competing Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Peter D. Fabricant, MD, MPH, reports relationships with WishBone, Osso VR, and Pediatric Orthopaedic Society of North America (POSNA). The other authors report no potential conflicts of interest., (© The Author(s) 2022.)

Epidemiological studies are essential in medicine and public health as they help identify risk factors and causes of diseases. Additionally, they are key to planning, implementing, and evaluating health interventions aimed at preventing and controlling the spread of diseases. Among these studies, analytical observational studies, such as cross-sectional, case–control, and cohort studies, are the most used. The validity of their results largely depends on the robustness of the design, execution, and statistical analysis. Objective: The objective of this study is to examine the most common errors in the selection of methodological design and statistical tests in analytical observational studies and to provide recommendations to correct them. Methodology: A comprehensive review of the available literature on methodology in epidemiological observational studies was conducted, focusing on cross-sectional, case–control, and cohort studies. Common errors in the selection of designs and statistical tests were identified and analyzed. Results and Conclusions: Errors in the selection of methodological design and statistical tests are common in epidemiological observational studies. Based on the identified errors, a series of recommendations is provided to improve the selection of methodological design and statistical tests, thereby increasing the reliability of the results in cross-sectional, case–control, and cohort studies. [ABSTRACT FROM AUTHOR]

Purpose: Tibiofemoral rotation through the knee joint, specifically relative external tibial rotation, has been identified as a potential contributing factor to patellar instability. The purpose of this study is to investigate the relationship between severity of instability with degree of tibiofemoral rotation in three clinical cohorts: fixed or obligatory dislocators (in which the patella either is constantly laterally dislocated or laterally dislocates with every instance of knee flexion, respectively), standard traumatic instability patients, and normal controls. Methods: A retrospective study was performed with three cohorts from April 2009 to February 2019: fixed or obligatory dislocators, standard traumatic instability patients, and controls with normal magnetic resonance imaging (MRI) of the knee. All fixed or obligatory dislocation patients from the study time frame were analyzed; controls and standard traumatic instability patients were randomly selected. Inclusion criteria were age under 18 years and qualifying diagnosis; exclusion criteria were outside institution MRI and previous MPFL reconstruction or tibial tubercle osteotomy. Tibiofemoral rotation was measured blindly on initial axial MRI using the posterior femoral and tibial condylar lines. Tibial tubercle to trochlear groove distance (TT–TG) was measured. Intraclass correlation coefficient (ICC) was calculated among four measurers. Results: A total of 100 patients were included, 20 fixed or obligatory dislocators, 40 standard traumatic instability patients, and 40 controls. Median age was 13.2 years (range 10–17 years), with 55 females. Age was significantly higher in the standard traumatic instability group than both the control (p < 0.001) and fixed or obligatory dislocator groups (p = 0.003). ICC for TT–TG and tibiofemoral rotation were 0.92 and 0.96, respectively. Fixed or obligatory dislocator patients averaged 8.5° external tibiofemoral rotation, standard traumatic instability patients 1.6° external tibiofemoral rotation, and controls 3.8° internal tibiofemoral rotation. Both tibiofemoral rotation and TT–TG were highest in the fixed or obligatory dislocator cohort, followed by the standard traumatic instability cohort, and lowest in the controls (p < 0.0001 for tibiofemoral rotation and TT–TG). Multivariate analysis showed no correlation between age and tibiofemoral rotation. Conclusions: Measurement of tibiofemoral rotation was reproducible with excellent interrater reliability. The degree of tibiofemoral rotation is correlated with severity of patellar instability, with the greatest external tibiofemoral rotation in fixed or obligatory dislocator patients, followed by standard traumatic instability patients, and slight internal tibiofemoral rotation in controls. High external tibiofemoral rotation may be an important pathoanatomic factor in fixed or obligatory dislocators, and with further understanding may become a prognostic factor or surgical target. Level of evidence: III. [ABSTRACT FROM AUTHOR]

Purpose: To assess the different surgical techniques and their outcomes following tibial tubercle transfer (TTT) in patients with patellar maltracking. Methods: A systematic search of the literature was performed in PubMed, EMBASE and Cochrane Library. Studies reporting patient-reported outcome measures (PROMs) or clinical outcome following: TTT in patients with patellar maltracking were included. Collected PROMs were Lysholm, Kujala, IKDC score, and VAS pain. Clinical outcome included reported clinical success, patient satisfaction, complications and removal of hardware (ROH). Overall pre-, post-operative and change scores were estimated using random-effects meta-analysis models. Results were reported as overall mean and per transfer direction. Results: A total of 26 studies and 761 patients (818 knees, mean age 35 years, mean follow-up 5.0 years) were included. In 73% of the studies, surgery was performed after failed conservative treatment. Transfer direction was anteromedial in 76% of all procedures. Overall Lysholm score improved from 61 to 91, Kujala from 52 to 85, IKDC from 53 to 81, and VAS from 6.2 to 2.5, respectively. Clinical success was reported in 79% of patients, and 80% of patients reported to have satisfactory results. Rates of complications and ROH were 13% and 29%, respectively. Conclusions: TTT for management of patellar maltracking can lead to good results with clinically meaningful improvement, an overall clinical success of 79% and overall patient satisfaction of 80% when appreciating the underlying anatomic condition and using appropriate technique. The level of evidence was low, and large-scale prospective, comparative cohort studies with uniform outcome scales are needed to confirm these findings. Level of evidence: IV. [ABSTRACT FROM AUTHOR]

»: An osteochondral fracture (OCF) of the patella or the femur is a frequent sequela after an episode of acute patellofemoral instability., »: Patients commonly present with anterior knee pain after direct trauma to the patella or a noncontact twisting injury., »: Radiographs and magnetic resonance imaging (MRI) are the most common imaging modalities that are used to diagnose OCFs., »: Arthroscopy may be indicated in cases of displaced OCFs, and the decision regarding osteochondral fragment fixation or loose body removal depends on fragment size, location, and extent of injury., »: Most of the current literature suggests worse outcomes for patients with OCFs who undergo nonoperative treatment, no significant differences in outcomes for patients sustaining an acute patellar dislocation with or without an OCF, and inconclusive results concerning outcomes for patients treated with loose body removal compared with fixation., »: Current outcome data are limited by studies with low levels of evidence; therefore, well-designed randomized controlled trials are needed., Competing Interests: Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSREV/A825)., (Copyright © 2022 by The Journal of Bone and Joint Surgery, Incorporated.)

The original Magellan partner institutions and the Smithsonian Astrophysical Observatory, Texas A&M University, and The University of Texas at Austin have undertaken to construct an extremely large telescope in Chile. The Giant Magellan Telescope is built around seven 8.4m borosilicate honeycomb mirror segments, six of which are off-axis. The collecting area is equivalent to that of a filled aperture 21.5m in diameter, the angular resolution is equivalent to a filled 24.4m telescope. The telescope mount is highly compact and delivers light to the focal plane in two reflections. Instruments are mounted at either a low-background straight Gregorian focus, or to one of several folded Gregorian foci behind the center primary mirror segment. A set of candidate first generation instruments has been defined and conceptual design studies are underway. The first off-axis primary mirror segment has been cast and will soon be polished as part of a proto-typing program. The current schedule calls for first light in mid 2015. This contribution describes the telescope and the considerations that led to its design. [ABSTRACT FROM PUBLISHER]