Level IV: Systematic review.

Background. Utilization of physician rating websites continues to expand. There is limited information on how these websites function and influence patient perception and physicians’ practices. No study to our knowledge has investigated online ratings and comments of orthopaedic foot and ankle surgeons. We identified factors impacting online ratings and comments for this subset of surgeons. Methods. 210 orthopaedic foot and ankle surgeons were selected from the American Orthopaedic Foot and Ankle Society (AOFAS) website. Demographic information, ratings, and comments were reviewed on the 3 most visited public domain physician ratings websites: HealthGrades.com , Vitals.com, and Ratemds.com. Content differences between positive and negative comments were evaluated. Results. The mean review rating of 4.03 ± 0.57 out of 5 stars. 84% of the total number of ratings were either 1 star (17%) or 5 stars (67%). Most positive comments related to outcome, physician personality, and communication, whereas most negative comments related to outcome, bedside manner, and waiting time. χ2 Analyses revealed statistically significant proportions of positive comments pertaining to surgeon-dependent factors (eg, physician personality, knowledge, skills) and negative comments concerning surgeon-independent factors (eg, waiting time, logistics). Conclusion. This study examined online ratings and written comments of orthopaedic foot and ankle surgeons. Surgeons had a generally favorable rating and were likely to have positive comments. Patients were likely to write positive comments about surgeon personality and communication, and negative comments pertaining to bedside manner and waiting time. Knowledge and management of online content may allow surgeons to improve patient satisfaction and online ratings. Level of Evidence: Level IV

Level V, expert opinion.

No abstract

Arthrofibrosis is a common, but often overlooked, condition that imparts significant morbidity following injuries and surgery to the foot and ankle. The most common etiologies are related to soft tissue trauma with subsequent fibrotic and contractile scar tissue formation within the ligaments and capsule of the ankle. This leads to pain, alterations in gait, and ankle dysfunction. Initial treatment often includes extensive physical therapy, however, if severe enough surgical options exist. Although the literature regarding ankle arthrofibrosis is scarce, this review article provides a greater understanding of the pathogenesis of arthrofibrosis and describes the current and future therapeutic options to treat fibrotic joints. Level of Evidence: Level V, expert opinion.

One of the most sensitive, time-consuming, and variable steps of chromatin immunoprecipitation (ChIP) is chromatin sonication. Traditionally, this process can take hours to properly sonicate enough chromatin for multiple ChIP assays. Further, the length of sheared DNA is often inconsistent. In order to faithfully measure chemical and structural changes at the chromatin level, sonication needs to be reliable. Thus, chromatin fragmentation by sonication represents a significant bottleneck to downstream quantitative analysis. To improve the consistency and efficiency of chromatin sonication, we developed and tested a cavitation enhancing reagent based on sonically active nanodroplets. Here, we show that nanodroplets increase sonication efficiency by 16-fold and provide more consistent levels of chromatin fragmentation. Using the previously characterized chromatin in vivo assay (CiA) platform, we generated two distinct chromatin states in order to test nanodroplet-assisted sonication sensitivity in measuring post-translational chromatin marks. By comparing euchromatin to chemically induced heterochromatin at the same CiA:Oct4 locus, we quantitatively measure the capability of our new sonication technique to resolve differences in chromatin structure. We confirm that nanodroplet-assisted sonication results are indistinguishable from those of samples processed with traditional sonication in downstream applications. While the processing time for each sample was reduced from 38.4 to 2.3 min, DNA fragment distribution sizes were significantly more consistent with a coefficient of variation 2.7 times lower for samples sonicated in the presence of nanodroplets. In conclusion, sonication utilizing the nanodroplet cavitation enhancement reagent drastically reduces the amount of processing time and provides consistently fragmented chromatin of high quality for downstream applications.

No abstract

Amphiphilic phospholipid-iodinated polymer conjugates were designed and synthesized as new macromolecular probes to enable a highly radiopaque and biocompatible imaging technology. Bioconjugation of PEG 2000-phospholipids and iodinated polyesters by click...