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Journal of the American Academy of Orthopaedic Surgeons

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https://www.readbyqxmd.com/read/30325881/quality-measures-in-foot-and-ankle-care
#1
Grace Xiong, Chase G Bennett, Loretta Chou, Robin N Kamal
BACKGROUND: Quality measures may be operationalized in payment models or quality reporting programs to assess foot and ankle surgeons, but if existing measures allow accurate representation of a foot and ankle surgeon's practice is unclear. METHODS: National quality measures databases, clinical guidelines, and MEDLINE/PubMed were systematically reviewed for quality measures relevant to foot and ankle care. Measures meeting internal criteria were categorized by clinical diagnosis, National Quality Strategy priority, and Donabedian domain...
October 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/30325880/statistical-fragility-and-the-role-of-p-values-in-the-sports-medicine-literature
#2
Robert L Parisien, David P Trofa, Jesse Dashe, Patrick K Cronin, Emily J Curry, Freddie H Fu, Xinning Li
INTRODUCTION: Comparative trials evaluating categorical outcomes have important implications on surgical decision making. The purpose of this study was to examine the statistical stability of sports medicine research. METHODS: Comparative clinical sports medicine research studies involving anterior cruciate ligament, meniscus, and knee instability were reviewed in two journals between 2006 and 2016. The statistical stability for each study outcome was determined by the number of event reversals required to change the P value to either greater or less than 0...
October 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/30325879/reducing-lateral-femoral-cutaneous-nerve-palsy-in-obese-patients-in-the-beach-chair-position-effect-of-a-standardized-positioning-and-padding-protocol
#3
Benjamin J Levy, Brandon M Tauberg, Ari J Holtzman, Konrad I Gruson
INTRODUCTION: To report on the effectiveness of a standardized patient positioning and padding protocol in reducing lateral femoral cutaneous nerve (LFCN) palsy in obese patients who have undergone shoulder surgery in the beach chair position. METHODS: We retrospectively reviewed the medical records of 400 consecutive patients with a body mass index (BMI) of ≥30 kg/m who underwent either open or arthroscopic shoulder surgery in the beach chair position by a single surgeon...
October 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/30325878/evaluation-and-treatment-of-patients-with-acetabular-osteolysis-after-total-hip-arthroplasty
#4
Neil P Sheth, Joshua C Rozell, Wayne G Paprosky
As the demand for total hip arthroplasty (THA) continues to increase, the burden of revision THA is also expected to increase. Although the quality of polyethylene has improved markedly, osteolysis continues to be a risk for older designs and younger, active patients. Although progressive but typically asymptomatic in early stages, osteolysis can result in component failure and complicate revision surgery. Serial radiographs are paramount for monitoring progression. Although select cases may be treated with observation, surgery should be considered based on age, activity level, and projected life span...
October 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/30320736/response-to-letter-to-the-editor-costs-and-radiographic-outcomes-of-rotational-ankle-fractures-treated-by-orthopaedic-surgeons-with-or-without-trauma-fellowship-training
#5
Walter W Virkus, Robert J Wetzel, Todd O McKinley, Anthony T Sorkin, Jeffery S Cheeseman, Lauren C Hill, Laurence B Kempton
No abstract text is available yet for this article.
October 12, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/30320735/letter-to-the-editor-costs-and-radiographic-outcomes-of-rotational-ankle-fractures-treated-by-orthopaedic-surgeons-with-or-without-trauma-fellowship-training
#6
John Y Kwon, J Kent Ellington, Christopher P Miller
No abstract text is available yet for this article.
October 12, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/30320734/clinical-approach-in-youth-sports-medicine-patients-and-guardians-desired-characteristics-in-sports-medicine-surgeons
#7
Jennifer J Beck, Martha M Murray, Melissa A Christino
INTRODUCTION: Adolescent athletes' and their guardians' preferences for sports medicine surgeon characteristics are unknown. METHODS: Unique, anonymous surveys regarding preferences in characteristics of sports medicine surgeons were given to both patients (aged 10 to 18 years) and their guardians before being seen by a sports medicine surgeon. RESULTS: Patients and their guardians reported shared decision making as the most important surgeon characteristic, followed by understanding patients' sports and goals...
October 12, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/30320733/the-role-of-athletic-event-coverage-in-orthopaedic-residency-training-a-national-survey-of-residency-program-directors
#8
Daniel J Miller, David P Trofa, Robert L Parisien, Peter C Noback, T Sean Lynch, Charles A Popkin, Charles M Jobin, William N Levine, Christopher S Ahmad
INTRODUCTION: No Accreditation Council for Graduate Medical Education guidelines exist regarding athletic event coverage by orthopaedic residents. This study assesses the availability and characteristics of event coverage opportunities in residency programs. METHODS: An anonymous web-based survey assessing resident athletic event coverage opportunities was distributed to members (n = 158) of the American Orthopaedic Association's Council of Orthopaedic Residency Directors...
October 12, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/30320732/translating-orthopaedic-technologies-into-clinical-practice-challenges-and-solutions
#9
Suzanne A Maher, Richard Kyle, Bernard F Morrey, Michael J Yaszemski
Despite the wealth of innovation in the orthopaedic sciences, few technologies translate to clinical use. By way of a 2-day symposium titled "AAOS/ORS Translating Orthopaedic Technologies into Clinical Practice: Pathways from Novel Idea to Improvements in Standard of Care Research Symposium," key components of successful commercialization strategies were identified as a passionate entrepreneur working on a concept aimed at improving patient outcomes and decreasing the cost and burden of disease; a de-risking strategy that has due recognition of the regulatory approval process and associated costs while maximizing the use of institutional, state, and federal resources; and a well thought-out and prepared legal plan and high quality, protected intellectual property...
October 12, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/30320731/prevalence-and-risk-factors-of-limited-musculoskeletal-health-literacy-in-the-outpatient-setting-a-logistic-regression-model
#10
Peter C Noback, Mani Seetharaman, Direk Tantigate, Robert J Strauch, Melvin P Rosenwasser, J Turner Vosseller
INTRODUCTION: The purpose of this study was to determine the risk factors of limited musculoskeletal health literacy (MHL) in a general population of orthopaedic patients. METHODS: Patients presenting to either a foot or ankle surgeon or hand or wrist surgeon were given the Literacy in Musculoskeletal Problems (LiMP) questionnaire, a nine-item survey for assessing "limited" MHL (LiMP score < 6). After confirming group homogeneity, the two populations were analyzed together to determine factors significantly correlated with and predictive of limited MHL...
October 12, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/30320730/meniscal-and-chondral-pathology-associated-with-anterior-cruciate-ligament-injuries
#11
Andrew N Pike, Jeanne C Patzkowski, Craig R Bottoni
Anterior cruciate ligament (ACL) ruptures are commonly associated with meniscal and articular cartilage injuries, and the presence of these defects influences both short- and long-term outcomes. Multiple variables are predictive of this pathology including time from injury, age, and sex. Revision ACL reconstructions demonstrate higher rates of chondral injury than primary reconstructions. Menisci are important secondary stabilizers of the knee in the setting of ACL deficiency, and specific tear types are more consistently associated with ACL injury...
October 12, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/30320729/alzheimer-dementia-in-the-orthopaedic-patient
#12
Arun Aneja, David A Zuelzer, Eric S Moghadamian, Stephen L Kates
Alzheimer disease is a neurologic disorder characterized by the progressive cognitive decline. As the population continues to age, orthopaedic surgeons need to become familiar with surgical and nonsurgical treatment considerations in this complex population. Despite the advances in geriatric and dementia care, surgical and postoperative management of both elective and emergent surgery remain complex and controversial in this patient population. Appropriate perioperative and postoperative management can optimize outcomes, and the management can significantly affect the quality of life of patient and caregiver and limit disease burden...
October 12, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/30320728/common-tumors-and-tumor-like-lesions-of-the-shoulder
#13
Donald H Lee, Jeffrey M Hills, Martin I Jordanov, Kenneth A Jaffe
Shoulder lesions range from tumor-like lesions such as simple bone cysts to aggressive high-grade sarcomas. The clinical presentation is often nonspecific with shoulder pain as the primary complaint, which may lead to a delayed or missed diagnosis. Delayed diagnosis or a poorly planned biopsy of a malignant shoulder lesion can have a detrimental effect on the patient's prognosis and treatment options. Because the initial patient assessment is crucial for successful treatment, knowledge of the key features of common shoulder tumors and tumor-like conditions can help determine the diagnosis and treatment plan...
October 12, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/30308529/sideline-management-of-nonmusculoskeletal-injuries-by-the-orthopaedic-team-physician
#14
Austin W Chen, Cortney S Archbold, Mark Hutchinson, Benjamin G Domb
Although recognized as the most well-trained providers to address musculoskeletal injuries, many orthopaedic surgeons do not routinely treat patients with nonmusculoskeletal issues in their clinical practice. Nonetheless, when serving as a team physician, an orthopaedic surgeon may need to initiate management of or manage many nonmusculoskeletal issues. Knowing how to accurately diagnose and initiate management of sports-related medical and surgical conditions is an important facet of being an orthopaedic team physician...
October 10, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/30303844/quality-measures-in-total-hip-and-total-knee-arthroplasty
#15
Derek F Amanatullah, Thomas McQuillan, Robin N Kamal
INTRODUCTION: Total joint arthroplasty represents the largest expense for a single condition among Medicare beneficiaries. Payment models exist, such as bundled payments, where physicians and hospitals are reimbursed based on providing cost-efficient, high-quality care. There is a need to explicitly define "quality" relevant to hip and knee arthroplasty. Based on prior quality measure research, we hypothesized that less than 20% of developed quality measures are outcome measures...
October 9, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/30300218/management-of-developmental-dysplasia-of-the-hip-in-infants-up-to-six-months-of-age-intended-for-use-by-orthopaedic-specialists
#16
Julie Samora, Robert H Quinn, Jayson Murray, Ryan Pezold, Quinn Hall
The American Academy of Orthopaedic Surgeons has developed the Appropriate Use Criteria (AUC) for the Management of Developmental Dysplasia of the Hip in Infants up to Six Months of Age: Intended for Use by Orthopaedic Specialists. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The Management of Developmental Dysplasia of the Hip in Infants up to Six Months of Age: Intended for Use by Orthopaedic Specialists AUC clinical patient scenarios were derived from indications typical of patients presenting with developmental dysplasia of the hip in clinical practice...
October 8, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/30300217/management-of-developmental-dysplasia-of-the-hip-in-infants-up-to-six-months-of-age-intended-for-use-by-general-pediatricians-and-referring-physicians
#17
Samora Julie, Robert H Quinn, Jayson Murray, Ryan Pezold, Quinn Hall
The American Academy of Orthopaedic Surgeons has developed the Appropriate Use Criteria (AUC) for the Management of Developmental Dysplasia of the Hip in Infants up to Six Months of Age: Intended for Use by General Pediatricians and Referring Physicians. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain best outcomes while considering the subtleties and distinctions necessary in making clinical decisions...
October 8, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/30300216/optimizing-clinical-use-of-biologics-in-orthopaedic-surgery-consensus-recommendations-from-the-2018-aaos-nih-u-13-conference
#18
Constance R Chu, Scott Rodeo, Nidhi Bhutani, Laurie R Goodrich, Johnny Huard, James Irrgang, Robert F LaPrade, Christian Lattermann, Ying Lu, Bert Mandelbaum, Jeremy Mao, Louis McIntyre, Allan Mishra, George F Muschler, Nicolas S Piuzzi, Hollis Potter, Kurt Spindler, John M Tokish, Rocky Tuan, Kenneth Zaslav, William Maloney
Concern that misinformation from direct-to-consumer marketing of largely unproven "biologic" treatments such as platelet-rich plasma and cell-based therapies may erode the public trust and the responsible investment needed to bring legitimate biological therapies to patients have resulted in calls to action from professional organizations and governing bodies. In response to substantial patient demand for biologic treatment of orthopaedic conditions, the American Academy of Orthopaedic Surgeons convened a collaborative symposium and established a consensus framework for improving and accelerating the clinical evaluation, use, and optimization of biologic therapies for musculoskeletal diseases...
October 8, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/30300215/two-surgeon-approach-for-complex-spine-surgery-rationale-outcome-expectations-and-the-case-for-payment-reform
#19
Jennifer M Bauer, Vijay Yanamadala, Suken A Shah, Rajiv K Sethi
There is an increased trend in complex spine deformity cases toward a two attending surgeon approach, but the practice has not become widely accepted by payers. Multiple studies have shown that spine surgery complications increase with the duration of case, estimated blood loss, and use of transfusions, as well as in certain high-risk populations or those requiring three-column osteotomies. Dual-surgeon cases have been shown to decrease estimated blood loss, transfusion rate, surgical times, and therefore complication rates...
October 8, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/30299341/effect-of-obesity-on-perioperative-complications-hospital-costs-and-length-of-stay-in-patients-with-open-ankle-fractures
#20
Joseph A Gil, Wesley Durand, Joseph P Johnson, Avi D Goodman, Alan H Daniels
INTRODUCTION: The objective of this study was to examine the effect of obesity on perioperative complications and the cost of surgical management of open ankle fractures. METHODS: This study examined data from the National Inpatient Sample. The primary outcome variables assessed were occurrence of any complication, complication subtype, length of stay, and total hospital costs. RESULTS: Patients with obesity accounted for 10.1% (n = 8.972) of the total cohort...
October 5, 2018: Journal of the American Academy of Orthopaedic Surgeons
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