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Orthopaedic review

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https://www.readbyqxmd.com/read/28651296/early-discharge-hospital-at-home
#1
REVIEW
Daniela C Gonçalves-Bradley, Steve Iliffe, Helen A Doll, Joanna Broad, John Gladman, Peter Langhorne, Suzanne H Richards, Sasha Shepperd
BACKGROUND: Early discharge hospital at home is a service that provides active treatment by healthcare professionals in the patient's home for a condition that otherwise would require acute hospital inpatient care. This is an update of a Cochrane review. OBJECTIVES: To determine the effectiveness and cost of managing patients with early discharge hospital at home compared with inpatient hospital care. SEARCH METHODS: We searched the following databases to 9 January 2017: the Cochrane Effective Practice and Organisation of Care Group (EPOC) register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, and EconLit...
June 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28650679/establishing-maximal-medical-improvement-after-arthroscopic-rotator-cuff-repair
#2
William A Zuke, Timothy S Leroux, Bonnie P Gregory, Austin Black, Brian Forsythe, Anthony A Romeo, Nikhil N Verma
BACKGROUND: As health care transitions from a pay-for-service to a pay-for-performance infrastructure, the value of orthopaedic care must be defined accurately. Significant efforts have been made in defining quality and cost in arthroplasty; however, there remains a lag in ambulatory orthopaedic care. PURPOSE: Two-year follow-up has been a general requirement for reporting outcomes after rotator cuff repair. However, this time requirement has not been established scientifically and is of increasing importance in the era of value-based health care...
June 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28648410/the-great-unknown-a-systematic-literature-review-about-risk-associated-with-intraoperative-imaging-during-orthopaedic-surgeries
#3
REVIEW
Amir Matityahu, Ryan K Duffy, Sabine Goldhahn, Alexander Joeris, Peter H Richter, Florian Gebhard
INTRODUCTION: Modern techniques in orthopaedic surgery using minimally invasive procedures, and increased use of fluoroscopic imaging present a potential increased risk to surgeons due to ionizing radiation exposure. This article is a systematic review of recent literature on radiation exposure of orthopaedic surgeons. MATERIALS AND METHODS: Pubmed and Cochrane searches were performed on intraoperative radiation exposure covering English and German articles published between 1...
April 21, 2017: Injury
https://www.readbyqxmd.com/read/28648408/nhsla-litigation-in-hip-fractures-lessons-learnt-from-nhsla-data
#4
Joseph Ring, Christopher Talbot, Charlotte Cross, Kunal Hinduja
Hip fractures are a major cause of trauma related death, usually occurring in vulnerable elderly patients. There are an estimated 70,000 hip fractures in the UK per year with numbers set to rise. The estimated annual cost to the healthcare economy is in the region of £2 billion. A 17-year review examining litigation related to hip fractures was undertaken. Under a freedom of information request, data was obtained relating to all orthopaedic claims made to the NHS Litigation Authority (NHSLA) between 1995 and 2012...
June 19, 2017: Injury
https://www.readbyqxmd.com/read/28644117/reverse-total-shoulder-arthroplasty-for-complex-three-and-four-part-proximal-humerus-fractures-in-elderly-patients-a-review
#5
George F Lebus V, Hassan R Mir, Brandon D Bushnell
Complex proximal humerus fractures in elderly patients represent a difficult problem for orthopaedic surgeons. Classically, treatment methods have included nonoperative management, open reduction and internal fixation, and hemiarthroplasty. Outcomes of nonoperative management for these complex fractures have been poor, and results of traditional operative techniques are variable at best. Over the past several years, reverse total shoulder arthroplasty (RTSA) has been increasingly employed in these injuries with encouraging results...
2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/28643102/post-operative-rotator-cuff-integrity-based-on-sugaya-s-classification-can-reflect-abduction-muscle-strength-of-the-shoulder
#6
Masahito Yoshida, Phillipe Collin, Thierry Josseaume, Alexandre Lädermann, Hideyuki Goto, Katumasa Sugimoto, Takanobu Otsuka
PURPOSE: Magnetic resonance (MR) imaging is common in structural and qualitative assessment of the rotator cuff post-operatively. Rotator cuff integrity has been thought to be associated with clinical outcome. The purpose of this study was to evaluate the inter-observer reliability of cuff integrity (Sugaya's classification) and assess the correlation between Sugaya's classification and the clinical outcome. It was hypothesized that Sugaya's classification would show good reliability and good correlation with the clinical outcome...
June 22, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28639869/economic-burden-of-inpatient-admission-of-ankle-fractures
#7
Justin D Stull, Suneel B Bhat, Justin M Kane, Steven M Raikin
BACKGROUND: Ankle fractures are among the most prevalent traumatic orthopaedic injuries. A large proportion of patients sustaining operative ankle fractures are admitted directly from the emergency department prior to operative management. In the authors' experience, however, many closed ankle injuries may be safely and effectively managed on an outpatient basis. The aim of this study was to characterize the economic impact of routine inpatient admission of ankle fractures. METHODS: A retrospective review of all outpatient ankle fracture surgery performed by a single foot and ankle fellowship-trained surgeon at a tertiary level academic center in 2012 was conducted to identify any patients requiring postoperative inpatient admission...
June 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28639846/antibiotic-prophylaxis-is-not-indicated-prior-to-dental-procedures-for-prevention-of-periprosthetic-joint-infections
#8
Willem M H Rademacher, Geert H I M Walenkamp, Dirk Jan F Moojen, Johannes G E Hendriks, Theo A Goedendorp, Frederik R Rozema
Background and purpose - To minimize the risk of hematogenous periprosthetic joint infection (HPJI), international and Dutch guidelines recommended antibiotic prophylaxis prior to dental procedures. Unclear definitions and contradictory recommendations in these guidelines have led to unnecessary antibiotic prescriptions. To formulate new guidelines, a joint committee of the Dutch Orthopaedic and Dental Societies conducted a systematic literature review to answer the following question: can antibiotic prophylaxis be recommended for patients (with joint prostheses) undergoing dental procedures in order to prevent dental HPJI? Methods - The Medline, Embase, and Cochrane databases were searched for randomized controlled trials (RCTs), reviews, and observational studies up to July 2015...
June 22, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28633784/complications-of-talar-neck-fractures-by-hawkins-classification-a%C3%A2-systematic-review
#9
REVIEW
Richard K Jordan, Kunaal R Bafna, Jiayong Liu, Nabil A Ebraheim
The goal of the present study was to perform a systematic review of the published data on talar neck fractures for a better understanding of the postoperative clinical outcomes using open reduction and internal fixation stratified by Hawkins type. A PubMed search was performed using the keywords "talar," "neck," and "fracture." This search identified 209 potential studies, which were reviewed to yield 16 studies that met the criteria. The surgical outcomes of talar neck fractures stratified by the Hawkins classification analyzed in the present study were as follows: American Orthopaedic Foot and Ankle Society scale score was 77...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28633149/tibial-eminence-involvement-with-tibial-plateau-fracture-predicts-slower-recovery-and-worse-postoperative-range-of-knee-motion
#10
Sanjit R Konda, Adam Driesman, Arthur Manoli, Roy I Davidovitch, Kenneth A Egol
OBJECTIVES: To examine 1-year functional and clinical outcomes in patients with tibial plateau fractures with tibial eminence involvement. DESIGN: Retrospective analysis of prospectively collected data. SETTING: Academic Medical Center. PATIENTS/PARTICIPANTS: All patients who presented with a tibial plateau fracture (Orthopaedic Trauma Association (OTA) 41-B and 41-C). INTERVENTION: Patients were divided into fractures with a tibial eminence component (+TE) and those without (-TE) cohorts...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28632656/intramedullary-nail-fixation-of-atypical-femur-fractures-with-bone-marrow-aspirate-concentrate-leads-to-faster-union-a-case-control-study
#11
Andrew J Lovy, Jun S Kim, John Di Capua, Sulaiman Somani, Stephanie Shim, Aakash Keswani, Rohit Hasija, Yangguan Wu, David Joseph, Richard Ghillani
OBJECTIVES: To evaluate bone marrow aspirate concentrate (BMAC) use in the treatment of AFF. DESIGN: Retrospective case control. SETTING: Level 1 trauma center. PATIENTS: Complete AFF, defined according to American Society of Bone and Mineral Research (ASBMR) criteria, from September 2009 to April 2015 with minimum 1-year follow-up. INTERVENTION: Operative treatment with antegrade intramedullary nails...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28632590/comparison-of-anterior-and-posterior-surgery-for-degenerative-cervical-myelopathy-an-mri-based-propensity-score-matched-analysis-using-data-from-the-prospective-multicenter-aospine-csm-north-america-and-international-studies
#12
So Kato, Aria Nouri, Dongjin Wu, Satoshi Nori, Lindsay Tetreault, Michael G Fehlings
BACKGROUND: Surgeons often choose between 2 different approaches (anterior and posterior) for surgical treatment of degenerative cervical myelopathy on the basis of imaging features of spinal cord compression, the number of levels affected, and the spinal alignment. However, there is a lack of consensus on which approach is preferable. The objective of the present study was to use magnetic resonance imaging (MRI)-based propensity-score-matched analysis to compare postoperative outcomes between the anterior and posterior surgical approaches for degenerative cervical myelopathy...
June 21, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28632455/joint-preservation-techniques-in-orthopaedic-surgery
#13
Philip J York, Frank B Wydra, Matthew E Belton, Armando F Vidal
CONTEXT: With increasing life expectancy, there is growing demand for preservation of native articular cartilage to delay joint arthroplasties, especially in younger, active patients. Damage to the hyaline cartilage of a joint has a limited intrinsic capacity to heal. This can lead to accelerated degeneration of the joint and early-onset osteoarthritis. Treatment in the past was limited, however, and surgical treatment options continue to evolve that may allow restoration of the natural biology of the articular cartilage...
June 1, 2017: Sports Health
https://www.readbyqxmd.com/read/28631285/quality-assurance-of-falls-reduction-in-an-orthopaedic-ward-using-a-novel-bedside-trolley-table-set-up-strategy
#14
Shuang Quan Chan, Marianne Wadsley, Sue Ferriere
OBJECTIVE: To assess whether a novel bedside trolley table set-up decreased inpatient falls (IF) postintervention. METHODS: From December 2012 to December 2014, geriatric patients admitted to our orthopaedic ward with extreme falls risk had a bedside trolley placed between them and a floor sensor mat to give responders more time to prevent IF. Pre- and postintervention falls data was reviewed for falls reduction using falls per month as comparison standard. IF were classified as high or low/medium risk using St Thomas's Risk Assessment Tool In Falling Elderly inpatients (STRATIFY) scoring...
June 20, 2017: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/28630851/vacuum-assisted-closure-in-patients-with-post-operative-infections-after-instrumented-spine-surgery-a-series-of-12-cases
#15
Maya Kale, Pravin Padalkar, Varshil Mehta
INTRODUCTION: Post-operative wound infections after spinal surgery is a very serious problem, leading to a risk of significant morbidity which may even lead to prolonged hospitalization. Various treatment protocols have been recommended for debridement, antibiotic, and soft-tissue management, but with mixed results. However, the risk of morbidity is still high with these treatment options. Vacuum-assisted closure (VAC) system has been gaining popularity recently in the management of subacute, acute, and chronic wounds...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28630718/ability-to-return-to-work-without-restrictions-in-workers-compensation-patients-undergoing-hip-arthroscopy
#16
Simon Lee, Gregory L Cvetanovich, Randy Mascarenhas, Thomas H Wuerz, Richard C Mather, Charles A Bush-Joseph, Shane J Nho
The purpose of this study was to investigate the ability of worker's compensation (WC) patients to return to work without restrictions after hip arthroscopy. Twenty-nine WC patients along with age and gender matched controls who underwent hip arthroscopy were retrospectively reviewed after achieving maximum medical improvement (MMI) status at minimum 1 year postoperatively. Patient demographic factors were evaluated, along with the Hip Outcome Score Activities of Daily Living and Sports-Specific subscales, and the modified Harris Hip Score (mHHS)...
January 2017: Journal of Hip Preservation Surgery
https://www.readbyqxmd.com/read/28630219/a-rare-case-of-sigmoid-colon-perforation-with-subsequent-psoas-abscess-collection-with-extensive-involvement-of-the-sartorius-muscle
#17
Ali Wadood, Abdulrahman Odeh, Khizer Rana, Shafquat Zaman
A middle-aged man was admitted with worsening hip pain, fevers and reduced mobility. These symptoms were preceded by a mechanical fall but despite regular analgesia, symptoms did not resolve. His prior medical history included ischaemic heart disease, hypertension and hypercholesterolaemia. A trauma and orthopaedic review revealed a painful left hip with reduced range of motion. In addition, some mild tenderness in the left iliac fossa was noted. Blood tests revealed markedly raised inflammatory markers. Plain radiographs and ultrasound were normal...
June 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28629991/physical-activity-and-sedentary-behaviour-subsequent-to-serious-orthopaedic-injury-a-systematic-review
#18
REVIEW
Christina L Ekegren, Ben Beck, Rachel E D Climie, Neville Owen, David W Dunstan, Belinda J Gabbe
OBJECTIVE: To systematically review and synthesise the evidence on physical activity and sedentary behaviour following serious orthopaedic injury. DATA SOURCES: Eight electronic databases and reference lists of relevant articles were searched from inception to March 2016. STUDY SELECTION: Studies on physical activity and sedentary behaviour measured objectively or via self-report among patients with serious orthopaedic injury (acute bone or soft-tissue injury requiring emergency hospital admission and/or non-elective surgery) were included...
June 16, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28628487/do-toddler-s-fractures-of-the-tibia-require-evaluation-and-management-by-an-orthopaedic-surgeon-routinely
#19
John S Adamich, Mark W Camp
OBJECTIVE: The majority of uncomplicated toddler fractures of the tibia (toddler's fractures) do not need an orthopaedic surgeon's intervention or follow-up. However, inexperienced emergency room physicians, general practitioners and orthopaedic trainees and surgeons understandably defer to a cautious approach of referral and subsequent frequent clinical and radiographic follow-up. An evidence-based pathway can help prevent this overtreatment, reduce unnecessary radiation exposure and decrease the financial burden on families and the healthcare system...
June 16, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28627415/examination-to-assess-the-clinical-exam-and-documentation-of-spine-pathology-among-orthopaedic-residents
#20
Jack M Haglin, John L Zeller, Kenneth A Egol, Donna P Phillips
BACKGROUND: The Accreditation Council of Graduate Medical Education (ACGME) guidelines require residency programs to teach and evaluate residents in six overarching "core competencies" and document progress through educational milestones. In order to assess the progress of orthopaedic interns' skills in performing a history, physical exam, and documentation of the encounter for a standardized patient with spinal stenosis, a Structured Objective Clinical Examination (OSCE) was conducted for 13 orthopaedic intern residents, following a one month boot camp that included communications skills and curriculum in history and physical examination...
June 13, 2017: Spine Journal: Official Journal of the North American Spine Society
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