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Orthopedic Surgery

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https://www.readbyqxmd.com/read/28088603/hospital-readmissions-after-surgery-how-important-are-hospital-and-specialty-factors
#1
Robert H Hollis, Laura A Graham, Joshua S Richman, Melanie S Morris, Hillary J Mull, Tyler S Wahl, Edith Burns, Laurel A Copeland, Gordon L Telford, Amy K Rosen, Kamal F Itani, Jeffrey Whittle, Todd H Wagner, Mary T Hawn
BACKGROUND: Hospital readmission rates after surgery may represent an overall hospital effect or a combination of specialty and patient effects. We hypothesized that hospital readmission rates for procedures within specialties were more strongly correlated than rates across specialties within the same hospital. STUDY DESIGN: For general, orthopedic, and vascular specialties at Veterans Affairs hospitals during 2008-2014, 30-day risk-adjusted readmission rates were estimated for six high-volume procedures and each specialty...
January 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28087215/surgical-outcome-of-posterior-ankle-impingement-syndrome-with-concomitant-ankle-disorders-treated-simultaneously-in-patient-engaged-in-athletic-activity
#2
Wataru Miyamoto, Shinya Miki, Hirotaka Kawano, Masato Takao
BACKGROUND: It is unclear whether simultaneous surgery for posterior ankle impingement syndrome (PAIS) and concomitant ankle disorders, such as anterior ankle impingement syndrome (AAIS), lateral ankle instability (LAI), and osteochondral lesion of the talus (OLT), allows for early return to athletic activity. METHODS: Ninety-seven patients who engaged in athletic activity (mean age 27 [range 18-43] years) and were treated by a hindfoot endoscopic approach for PAIS alone or simultaneously for PAIS and concomitant ankle disorders were included in this study...
January 10, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28079742/the-hybrid-method-for-the-treatment-of-congenital-talipes-equinovarus-preliminary-results-on-92-consecutive-feet
#3
Federico Canavese, Mounira Mansour, Guillemette Moreau-Pernet, Yannael Gorce, Alain Dimeglio
Over the past 4 years, our pediatric orthopedic unit has developed a new hybrid protocol combining the advantages of Ponseti's method and the French functional physiotherapy method. Sixty-one patients (92 feet) completed treatment. Clubfoot was unilateral in 30 (49.2%) patients and bilateral in 31 (50.8%) patients. The mean Dimeglio score at the start of treatment was 13.5/20 (range: 6/20-19/20). All patients had clinical and radiographic follow-up for at least 2 years (range: 2-4 years). If orthopedic treatment was ineffective and feet showed no improvement, further surgery was performed...
January 10, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28079735/incidence-of-local-anesthetic-systemic-toxicity-in-orthopedic-patients-receiving-peripheral-nerve-blocks
#4
Eva E Mörwald, Nicole Zubizarreta, Crispiana Cozowicz, Jashvant Poeran, Stavros G Memtsoudis
BACKGROUND AND OBJECTIVES: Peripheral nerve blocks are increasingly used. However, despite low complication rates, concerns regarding local anesthetic systemic toxicity remain. Although recent studies suggest that this severe complication has decreased considerably, there is a paucity of data about it on a national level. We sought to elucidate the incidence of local anesthetic systemic toxicity on a national level and therefore provide guidance toward the need for preparedness in daily anesthetic practice...
January 9, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28076930/hormone-receptor-expression-in-human-fascial-tissue
#5
C Fede, G Albertin, L Petrelli, M M Sfriso, C Biz, R De Caro, C Stecco
Many epidemiologic, clinical, and experimental findings point to sex differences in myofascial pain in view of the fact that adult women tend to have more myofascial problems with respect to men. It is possible that one of the stimuli to sensitization of fascial nociceptors could come from hormonal factors such as estrogen and relaxin, that are involved in extracellular matrix and collagen remodeling and thus contribute to functions of myofascial tissue. Immunohistochemical and molecular investigations (real-time PCR analysis) of relaxin receptor 1 (RXFP1) and estrogen receptor-alpha (ERα) localization were carried out on sample of human fascia collected from 8 volunteers patients during orthopedic surgery (all females, between 42 and 70 yrs, divided into pre- and post-menopausal groups), and in fibroblasts isolated from deep fascia, to examine both protein and RNA expression levels...
November 2, 2016: European Journal of Histochemistry: EJH
https://www.readbyqxmd.com/read/28075435/cardiac-biomarkers-predict-1-year-mortality-in-elderly-patients-undergoing-hip-fracture-surgery
#6
Spyridon Katsanos, Andreas F Mavrogenis, Nikolaos Kafkas, Celestino Sardu, Vasileios Kamperidis, Panagiota Katsanou, Dimitrios Farmakis, John Parissis
This prospective study included 152 elderly patients (mean age, 80 years; range, 72-88 years) with a hip fracture treated surgically. Comorbidities were evaluated, and B-type natriuretic peptide was measured at baseline and at postoperative days 4 and 5 in addition to troponin I. Major cardiac events were recorded, and 1-year mortality was assessed. Comorbidity models with the important multivariate predictors of 1-year mortality were analyzed. Overall, 9 patients (6%) experienced major cardiac events postoperatively during their hospitalization...
January 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/28074463/importance-of-fixation-of-posterior-malleolus-fracture-in-trimalleolar-fractures-a-retrospective-study
#7
Sinan Karaca, Meriç Enercan, Güzelali Özdemir, Sinan Kahraman, Mutlu Çobanoğlu, Metin Küçükkaya
BACKGROUND: The aim of this retrospective study was to evaluate treatment effect and importance of posterior malleolus (PM) fixation in surgically treated trimalleolar fractures. METHODS: A total of 57 cases of ankle joint fracture involving PM and treated with open reduction and internal fixation technique between 2004 and 2011 were evaluated. PM fixation was performed with cannulated screws in 46 cases, and in 11 cases, PM plate was used. All patients were assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score, American Academy of Orthopedic Surgeons (AAOS) foot and ankle questionnaire, and Visual Analog Score (VAS) pain scale...
November 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28069094/a-practical-tool-for-surveillance-of-surgical-site-infections-a-5-year-experience-in-orthopedic-surgeries
#8
Shmuel Benenson, Allon E Moses, Matan J Cohen, Meir Brezis, Naomi Minster, Carmela Schwartz, Leonid Kandel, Meir Liebergall, Yoav Mattan
Continuous surveillance of surgical-site infection (SSI) is labor intensive. We developed a semiautomatic surveillance system partly assisted by surgeons. Most patients who developed postdischarge SSI were readmitted, which allowed us to limit postdischarge surveillance to this group. This procedure significantly reduced workload while maintaining high sensitivity and specificity for SSI diagnosis. Infect Control Hosp Epidemiol 2017;1-4.
January 10, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28066735/arthroscopic-approach-and-anatomy-of-the-hip
#9
Alessandro Aprato, Matteo Giachino, Alessandro Masse
BACKGROUND: Hip arthroscopy has gained popularity among the orthopedic community and a precise assessment of indications, techniques and results is constantly brought on. METHODS: In this chapter the principal standard entry portals for central and peripheral compartment are discussed. The description starts from the superficial landmarks for portals placement and continues with the deep layers. For each entry point an illustration of the main structures encountered is provided and the principal structures at risk for different portals are accurately examined...
July 2016: Muscles, Ligaments and Tendons Journal
https://www.readbyqxmd.com/read/28065868/clinical-impact-of-positive-propionibacterium-acnes-cultures-in-orthopedic-surgery
#10
Valery Lavergne, Michel Malo, Cinzia Gaudelli, Michelle Laprade, Stéphane Leduc, Pierre Laflamme, Dominique M Rouleau
BACKGROUND: The clinical significance of a positive culture to Propionibacterium acnes in orthopedic specimens remains unclear, whether about its role as a contaminant or a pathogen, or its impact as a coinfectant. Therefore we performed a retrospective study to provide a more accurate description of the clinical impact of P.acnes in an orthopedic population aiming to determine: 1) if there is a clinical difference between P.acnes infection and contamination? 2) if there is a clinical difference between P...
January 5, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28064351/orthopedic-trauma-surgery-and-hospital-cost-analysis-in-refugees-the-effect-of-the-syrian-civil-war
#11
Altuğ Duramaz, Mustafa Gökhan Bilgili, Berhan Bayram, Nezih Ziroğlu, Alkan Bayrak, Mustafa Cevdet Avkan
PURPOSE: The aim of this study was to evaluate the musculoskeletal injury types, injury mechanisms, surgical techniques and treatment costs of Syrian refugees. METHODS: Totally 158 patients (67 female, 91 male) treated in our clinic in 34 months period between January 2012 and October 2014 were included in the study. The mean age of the patients was 39.3 years (range: 18-82 years). The patients were evaluated for age, gender, mechanism of injury, location and type of fracture, presence of accompanying injuries, injury severity score, surgical technique, complications, mortality/morbidity and treatment cost...
January 7, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28064303/popliteal-artery-pseudoaneurysm-successfully-treated-with-amplatzer-vascular-plug
#12
K W Liew, B D K Leong
Popliteal artery pseudoaneurysm is uncommon. They usually result from penetrating or blunt trauma, arterial reconstructive surgery, invasive diagnostic or surgical orthopedic procedures. They can cause arterial thrombosis and limb ischeamia. We report a 53 year old Chinese gentleman with popliteal artery pseudoaneurysm who presented with right lower limb numbness and paralysis in toes extension. He gave a history of acupuncture treatment around the popliteal fossa of the affected limb. Clinical examination revealed a pulsatile mass in the popliteal fossa...
October 2016: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28063517/the-increasing-problem-of-subclinical-and-overt-hypervitaminosis-d-in-india-an-institutional-experience-and-review
#13
Lokesh Kumar Sharma, Deep Dutta, Neera Sharma, Adesh Kisanji Gadpayle
OBJECTIVE: The aim of this study was to determine the changes in serum vitamin D distribution at an institute in India over the past 6 y and compare it with global trends. METHODS: We conducted an audit of 25-hydroxyvitamin D (25-OHD), calcium, and plasma intact parathyroid hormone (iPTH) reporting from January 2011 to February 2016. References for review were identified through searches of PubMed, Medline, and Embase for articles published until February 2016 using keywords "hypervitaminosis D" (MeSH Terms) OR "vitamin D toxicity" (All Fields) OR "vitamin-D intoxication" (All Fields)...
February 2017: Nutrition
https://www.readbyqxmd.com/read/28061863/prognostic-indicators-for-perioperative-survival-after-diaphragmatic-herniorrhaphy-in-cats-and-dogs-96-cases-2001-2013
#14
Claire Legallet, Kelley Thieman Mankin, Laura E Selmic
BACKGROUND: To determine associations between perioperative mortality after surgery for traumatic diaphragmatic hernia, medical records of 17 cats and 79 dogs that underwent diaphragmatic herniorrhaphy were reviewed. RESULTS: The combined perioperative survival rate was 81.3% (88.2% in cats and 79.8% in dogs). Data from acute and chronic cases was assessed separately. Of the acute cases (12 cats and 48 dogs), 10 cats (83.3%) and 38 dogs (79.2%) survived to discharge...
January 7, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/28060333/mesenchymal-stromal-cell-culture-and-delivery-in-autologous-conditions-a-smart-approach-for-orthopedic-applications
#15
Luisa Trombi, Serena Danti, Sara Savelli, Stefania Moscato, Delfo D'Alessandro, Claudio Ricci, Stefano Giannotti, Mario Petrini
Human Mesenchymal Stromal Cells (hMSCs) are cultured in vitro with different media. Limits on their use in clinical settings, however, mainly depend on potential biohazard and inflammation risks exerted by xenogeneic nutrients for their culture. Human derivatives or recombinant materials are the first choice candidates to reduce these reactions. Therefore, culture supplements and materials of autologous origin represent the best nutrients and the safest products. Here, we describe a new protocol for the isolation and culture of bone marrow hMSCs in autologous conditions - namely, patient-derived serum as a supplement for the culture medium and fibrin as a scaffold for hMSC administration...
December 8, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28057478/developments-in-ambulatory-surgery-in-orthopedics-in-france-in-2016
#16
REVIEW
C Hulet, G Rochcongar, C Court
Under the new categorization introduced by the Health Authorities, ambulatory surgery (AS) in France now accounts for 50% of procedures, taking all surgical specialties together. The replacement of full hospital admission by AS is now well established and recognized. Health-care centers have learned, in coordination with the medico-surgical and paramedical teams, how to set up AS units and the corresponding clinical pathways. There is no single model handed down from above. The authorities have encouraged these developments, partly by regulations but also by means of financial incentives...
November 15, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28057095/-comparison-of-curative-effect-and-prognosis-analysis-of-patients-with-spinal-metastases-treated-by-percutaneous-vertebroplasty-combined-with-postoperative-radiotherapy-and-radiotherapy-alone
#17
X Y Cao, Y S Liu, M X Lei, S B Liu, S G Zhou, Y C Cao, W G Jiang
Objective: To evaluate the efficacy of percutaneous vertebroplasty(PVP) combined with postoperative radiotherapy and radiotherapy alone in the treatment of spinal metastatic tumors and to evaluate the prognostic factors for survival. Methods: From December 2011 to December 2015, according to the choice of treatment, patients in group A(60 cases) were treated with PVP combined with postoperative radiotherapy and those in group B(50 cases) underwent radiotherapy alone, age, sex, primary tumor type , and other basic characteristics were analyzed in both groups in department of orthopedics and radiotherapy department, 307 Hospital of the People's Liberation Army...
December 20, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28057033/reducing-the-risk-of-impaired-bone-apposition-to-titanium-screws-with-the-use-of-fibroblast-growth-factor-2-apatite-composite-layer-coating
#18
Kengo Fujii, Atsuo Ito, Hirotaka Mutsuzaki, Shinji Murai, Yu Sogo, Yuki Hara, Masashi Yamazaki
BACKGROUND: Loosening of screws is a common problem in orthopedic and maxillofacial surgery. Modifying the implant surface to improve the mechanical strength of screws has been tried and reported. We developed screws coated with fibroblast growth factor-2 (FGF-2)-apatite composite layers. We then showed, in a percutaneous external fixation model, that this composite layer had the ability to hold and release FGF-2 slowly, thereby reducing the risk of pin tract infection of the percutaneous external fixation...
January 5, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28057012/clinical-results-of-arthroscopic-surgery-in-patients-over-50%C3%A2-years-of-age-what-viability-does-it-have-as-a-joint-preservative-surgery
#19
Mitsutoshi Moriya, Kensuke Fukushima, Katsufumi Uchiyama, Naonobu Takahira, Takeaki Yamamoto, Yojiro Minegishi, Masashi Takaso
BACKGROUND: To identify whether hip arthroscopy is a suitable option for treating hip pain in elderly patients and investigate the clinical outcomes of hip arthroscopic surgery for labrum tear and/or osteoarthritis in patients over 50 years of age. METHODS: Between August 2009 and May 2014, a series of 23 patients (6 men and 17 women) with a mean age of 59 years underwent arthroscopy. We retrospectively examined the clinical records, radiographs, and outcome questionnaires from all patients...
January 6, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28056157/evaluation-of-orthopedic-trauma-surgery-follow-up-and-impact-of-a-routine-callback-program
#20
Aaron J Casp, Jodi Wells, Russell Holzgrefe, David Weiss, David Kahler, Seth R Yarboro
A high rate of patients lost to follow-up is a common problem in orthopedic trauma surgery. This adversely affects the ability to produce accurate clinical outcomes research. The purpose of this project was to (1) evaluate the rate of loss to follow-up at an academic level I trauma center; (2) identify the patient-reported reasons for loss to follow-up; and (3) evaluate the efficacy of a routine patient callback program. All patients who underwent surgery in the orthopedic trauma division of the University of Virginia Medical Center from April 1, 2014, to September 30, 2014, and did not complete their postoperative clinic follow-up were analyzed...
January 5, 2017: Orthopedics
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