Bradford O. Parsons

Bio: Bradford O. Parsons is an academic researcher from Icahn School of Medicine at Mount Sinai. The author has contributed to research in topics: Arthroplasty & Rotator cuff. The author has an hindex of 17, co-authored 68 publications receiving 947 citations. Previous affiliations of Bradford O. Parsons include University of York & Mount Sinai Hospital.

Arthroscopically assisted coronoid fracture fixation: a preliminary report.

Abstract: We investigated the feasibility of arthroscopically assisted reduction and fixation of small coronoid fractures and the anterior capsule for treatment of patients with Regan and Morrey Types I and II (O’Driscoll Types I and II) coronoid fractures with instability of the ulnohumeral joint. Four consecutive patients with this fracture type underwent arthroscopically assisted treatment and were evaluated at a minimum of 1 year (mean, 76 weeks; range, 58–92 weeks). All patients achieved a functional range of motion with an average flexion/extension arc of 2.5° to 140° and full pronation and supination. No patient had recurrent elbow instability. One patient had removal of a prominent suture over the subcutaneous border of the ulna. Arthroscopically assisted management of coronoid fractures can provide excellent observation, enabling anatomic repair without extensive soft tissue dissection. Preservation of the soft tissue attachments of small coronoid fragments and repair of the capsule are possible with this technique.

Fracture and Dislocation Classification Compendium-2018

Abstract: From the *Department of Orthopaedic Surgery, McGovern Medical School, University of Texas Health Sciences Center at Houston, ** Department of Orthopaedic Surgery, Zuckerberg San Francisco General Hospitial, University of California, San Francisco; *** Department of Orthopaedic Surgery, Harborview Medical Center, Seattle, **** University of Iowa Department of Orthopaedics and Rehabilitation, Iowa City, ***** Department of Orthopaedic Surgery; University of Louisville School of Medicine Disclosure: The authors report no conflicts of interest. Material presented in this Compendium is based on the Comprehensive Classification of Fractures of Long Bones by M.E. Müller, J. Nazarian, P. Koch and J. Schatzker, Springer-Verlag, Berlin, 1990. The Orthopaedic Trauma Association is indebted to Professor Maurice Müller for allowing use of the system. Correspondence: James F. Kellam, Department of Orthopaedic Surgery, McGovern Medical School, University of Texas Health Sciences Center at Houston, 6431 Fannin Street, MSB 6.146, Houston Texas, 77030 (e-mail: James.F.Kellam@uth.tmc.edu) Copyright © 2017 by AO Foundation, Davos, Switzerland; Orthopaedic Trauma Association, IL, US To encourage the use of this classification and this fracture classification compendium, the figures may be reproduced and the classification may be used for research, educational and or medical purposes without the need to request permission from the OTA, AO Foundation or the publisher. It cannot be used commercially or for-profit without permission. Foreword

Detection, evaluation, and management of preoperative anaemia in the elective orthopaedic surgical patient: NATA guidelines

Abstract: Previously undiagnosed anaemia is common in elective orthopaedic surgical patients and is associated with increased likelihood of blood transfusion and increased perioperative morbidity and mortality. A standardized approach for the detection, evaluation, and management of anaemia in this setting has been identified as an unmet medical need. A multidisciplinary panel of physicians was convened by the Network for Advancement of Transfusion Alternatives (NATA) with the aim of developing practice guidelines for the detection, evaluation, and management of preoperative anaemia in elective orthopaedic surgery. A systematic literature review and critical evaluation of the evidence was performed, and recommendations were formulated according to the method proposed by the Grades of Recommendation Assessment, Development and Evaluation (GRADE) Working Group. We recommend that elective orthopaedic surgical patients have a haemoglobin (Hb) level determination 28 days before the scheduled surgical procedure if possible (Grade 1C). We suggest that the patient's target Hb before elective surgery be within the normal range, according to the World Health Organization criteria (Grade 2C). We recommend further laboratory testing to evaluate anaemia for nutritional deficiencies, chronic renal insufficiency, and/or chronic inflammatory disease (Grade 1C). We recommend that nutritional deficiencies be treated (Grade 1C). We suggest that erythropoiesis-stimulating agents be used for anaemic patients in whom nutritional deficiencies have been ruled out, corrected, or both (Grade 2A). Anaemia should be viewed as a serious and treatable medical condition, rather than simply an abnormal laboratory value. Implementation of anaemia management in the elective orthopaedic surgery setting will improve patient outcomes.

Complications of shoulder arthroplasty

Abstract: Early and mid-range followup studies of shoulder arthroplasty have been encouraging, showing good and excellent results in > 90% of shoulders. Despite this success, complications in shoulder replacement surgery are inevitable, with an incidence of approximately 14%. Numerous complications have been identified and include the following factors in order of decreasing frequency: instability, rotator cuff tear, ectopic ossification, glenoid component loosening, intraoperative fracture, nerve injury, infection, and humeral component loosening. Successful treatment of these difficulties requires careful identification and subsequent analysis of all factors contributing to the complication, knowing that the etiology is often multifactorial. Failed shoulder arthroplasty can be successfully managed with revision surgery, but the technically challenging surgery and the overall results are inferior compared with other diagnostic categories.

Tendon and ligament regeneration and repair: clinical relevance and developmental paradigm.

Abstract: Tendon and ligament (T/L) are dense connective tissues connecting bone to muscle and bone to bone, respectively. Similar to other musculoskeletal tissues, T/L arise from the somitic mesoderm, but they are derived from a recently discovered somitic compartment, the syndetome. The adjacent sclerotome and myotome provide inductive signals to the interposing syndetome, thereby upregulating the expression of the transcription factor Scleraxis, which in turn leads to further tenogenic and ligamentogenic differentiation. These advances in the understanding of T/L development have been sought to provide a knowledge base for improving the healing of T/L injuries, a common clinical challenge due to the intrinsically poor natural healing response. Specifically, the three most common tendon injuries involve tearing of the rotator cuff of the shoulder, the flexor tendon of the hand, and the Achilles tendon. At present, injuries to these tissues are treated by surgical repair and/or conservative approaches, including biophysical modalities such as physical rehabilitation and cryotherapy. Unfortunately, the healing tissue forms fibrovascular scar and possesses inferior mechanical and biochemical properties as compared to native T/L. Therefore, tissue engineers have sought to improve upon the natural healing response by augmenting the injured tissue with cells, scaffolds, bioactive agents, and mechanical stimulation. These strategies show promise, both in vitro and in vivo, for improving T/L healing. However, several challenges remain in restoring full T/L function following injury, including uncertainties over the optimal combination of these biological agents as well how to best deliver tissue engineered elements to the injury site. A greater understanding of the molecular mechanisms involved in T/L development and natural healing, coupled with the capability of producing complex biomaterials to deliver multiple growth factors with high spatiotemporal resolution and specificity, will allow tissue engineers to more closely recapitulate T/L morphogenesis, thereby offering future patients the prospect of T/L regeneration, as opposed to simple tissue repair.