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Orthopaedic review

Richard J Napier, Brendan J Gallagher, Darrin S Wilson
Background: The 1994 Northern Ireland ceasefire heralded a new beginning for the region after 30-years of violence. In the 20-years following the cessation of hostilities, paramilitary punishment attacks continue to occur in breach of the ceasefire. The aim of this study was to review trends in these attacks over the 20-years and their impact on orthopaedic services. Methods: We conducted a retrospective review of patients admitted under orthopaedic services following paramilitary assault across Northern Ireland over the last 20-years...
May 2017: Ulster Medical Journal
Matthew A Dorweiler, Michael A Boin, Andrew W Froehle, Matthew W Lawless, Jedediah H May
The use of tranexamic acid (TXA) in total knee arthroplasty (TKA) has become common practice. Recent literature has demonstrated a reduction in postoperative knee swelling and drain output while using TXA. Our purpose is to analyze the range of motion (ROM) following TKA in patients who received TXA compared with a control group. We hypothesize that patients treated with TXA will have improved early postoperative ROM when compared with controls. A retrospective chart review was performed for patients who underwent TKA from 2010 to 2012 performed by a single orthopaedic surgeon...
March 13, 2018: Journal of Knee Surgery
Lester W M Chan, Antony W Gardner, Merng Koon Wong, Kenon Chua, Ernest B K Kwek
INTRODUCTION: Non-prosthetic peri-implant fractures (NPPIFs) are an under-reported entity. Management is challenging because of alterations in anatomy, the presence of orthopaedic implants and phenomena such as stress shielding, disuse osteopenia and fracture remodeling. The aims of this paper were to review patterns of injury, management and outcomes and to propose a classification system to aid further research. MATERIALS AND METHODS: This study is a multi-centered retrospective case series...
March 12, 2018: Archives of Orthopaedic and Trauma Surgery
Graham McGeoch, Kieran Holland, Melissa Kerdemelidis, Nikki Elliot, Brett Shand, Catherine Fink, Anne Dixon, Carolyn Gullery
INTRODUCTION Unmet needs are a key indicator of the success of a health system. Clinicians and funders in Christchurch, Canterbury, New Zealand were concerned that unmet health need was hidden. AIM The aim of this survey was to estimate the proportion of patients attending general practice who were unable to access clinically indicated referred services. METHODS The survey used a novel method to estimate unserviced health needs. General practitioners (GPs, n = 54) asked their patients (n = 2135) during a consultation about any health needs requiring a referred service...
December 2017: Journal of Primary Health Care
Karim Sabeh, Milad Alam, Samuel Rosas, Shahrose Hussain, Michaela Schneiderbauer
INTRODUCTION: The growing trends of total knee arthroplasty (TKA) foreshadow an inevitable increase in the financial burden on healthcare expenditure estimated to almost nine billion dollars annually. This study aims to demonstrate the potential savings when using all-polyethylene (AP) compared to metal-backed (MB) tibial components and describes the cost variability amongst three major commercially available implants. MATERIALS AND METHODS: The cost of AP versus MB implants was analyzed using a large nationwide database, Emergency Care Research Institute (ECRI)...
March 12, 2018: Surgical Technology International
Nicholas A Bedard, Andrew J Pugely, Michael McHugh, Nathan Lux, Jesse E Otero, Kevin J Bozic, Yubo Gao, John J Callaghan
BACKGROUND: Use of large clinical and administrative databases for orthopaedic research has increased exponentially. Each database represents unique patient populations and varies in their methodology of data acquisition, which makes it possible that similar research questions posed to different databases might result in answers that differ in important ways. QUESTIONS/PURPOSES: (1) What are the differences in reported demographics, comorbidities, and complications for patients undergoing primary TKA among four databases commonly used in orthopaedic research? (2) How does the difference in reported complication rates vary depending on whether only inpatient data or 30-day postoperative data are analyzed? METHODS: Patients who underwent primary TKA during 2010 to 2012 were identified within the National Surgical Quality Improvement Programs (NSQIP), the Nationwide Inpatient Sample (NIS), the Medicare Standard Analytic Files (MED), and the Humana Administrative Claims database (HAC)...
January 2018: Clinical Orthopaedics and related Research
Christian Jung, Lena Tepohl, Reina Tholen, Knut Beitzel, Stefan Buchmann, Thomas Gottfried, Casper Grim, Bettina Mauch, Gert Krischak, Hans Ortmann, Christian Schoch, Frieder Mauch
Background: Tears and lesions of the rotator cuff are a frequent cause of shoulder pain and disability. Surgical repair of the rotator cuff is a valuable procedure to improve shoulder function and decrease pain. However, there is no consensus concerning the rehabilitation protocol following surgery. Objectives: To review and evaluate current rehabilitation contents and protocols after rotator cuff repair by reviewing the existing scientific literature and providing an overview of the clinical practice of selected German Society of Shoulder and Elbow Surgery e...
2018: Obere Extremität
Kolja Gelse, Peter Angele, Peter Behrens, Peter Brucker, Jakob Fay, Daniel Günther, Peter Kreuz, Jörg Lützner, Henning Madry, Peter E Müller, Philipp Niemeyer, Geert Pagenstert, Thomas Tischer, Markus Walther, Wolfgang Zinser, Gunter Spahn
BACKGROUND: In clinical practice, there is still no definite treatment algorithm for focal, partial thickness cartilage lesions (grade II - III). It is well-established that debridement (shaving/lavage) of large degenerative cartilage lesions is not recommended, but there is no such recommendation in the case of focal, partial thickness cartilage defects. MATERIALS AND METHODS: The scientific rationale of cartilage shaving and joint lavage was investigated and a systematic analysis was performed of the literature on the clinical effect of cartilage debridement...
March 9, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
Mohit Bajaj, Giorgio Stefanutti, Haemish Crawford, Vipul Upadhyay
AIM: Pelvic fractures constitute between 0.3% and 4% of all paediatric injuries, with a mortality rate up to 25%. This study aims to review the experience with pelvic fractures at Starship Children's Hospital and demonstrate its role as a marker of severe trauma. METHODS: A retrospective review of children with pelvic fractures managed at our institution in the 20-year period between July 1995 and May 2015 was performed. The search identified 179 consecutive children admitted with a pelvic fracture...
March 9, 2018: New Zealand Medical Journal
Harry M Lightsey, David E Kantrowitz, Hasani W Swindell, David P Trofa, Christopher S Ahmad, T Sean Lynch
Background: The optimal postoperative rehabilitation protocol following repair of complete proximal hamstring tendon ruptures is the subject of ongoing investigation, with a need for more standardized regimens and evidence-based modalities. Purpose: To assess the variability across proximal hamstring tendon repair rehabilitation protocols published online by United States (US) orthopaedic teaching programs. Study Design: Cross-sectional study...
February 2018: Orthopaedic Journal of Sports Medicine
A B M Boni Rietveld, F M T Hagemans
Posterior ankle impingement syndrome (PAIS) is a painful, usually limited plantar flexion of the ankle joint due to soft tissue impingement or a bony impediment often coinciding with tendinopathy of the flexor hallucis longus (FHL) behind the medial malleolus. In persistent complaints, the bony impediment is removed, the tunnel of the FHL tendon is released, or a combination of both procedures has traditionally been performed by open surgery. In 2000, an endoscopic surgical technique for PAIS and FHL tendinopathy was introduced...
March 15, 2018: Journal of Dance Medicine & Science
Andrew Chia Chen Chou, Ho Yin Kevin Wong, Sumanth Kumar, Arjandas Mahadev
BACKGROUND: Distal humerus physeal separations are rare pediatric elbow fractures that are often misdiagnosed and difficult to treat. Adequate reduction is often technically challenging and up to 71% of children develop postoperative cubitus varus. We propose using the medial and lateral humeral lines as an adjunct to elbow arthrography in order to guide intraoperative fixation of distal humerus physeal separations to reduce the incidence of postoperative cubitus varus. METHODS: From 2009 to 2014, all pediatric patients under the age of 3 diagnosed with a distal humerus physeal separation and treated surgically at our institution were included for analysis...
March 5, 2018: Journal of Pediatric Orthopedics
Christopher W Jones, Seth A Jerabek
BACKGROUND: Computer-assisted surgical (CAS) navigation has been developed with the aim of improving the accuracy and precision of total knee arthroplasty (TKA) component positioning and therefore overall limb alignment. The historical goal of knee arthroplasty has been to restore the mechanical alignment of the lower limb by aligning the femoral and tibial components perpendicular to the mechanical axis of the femur and tibia. Despite over 4 decades of TKA component development and nearly 2 decades of interest in CAS, the fundamental question remains; does the alignment goal and/or the method of achieving that goal affect the outcome of the TKA in terms of patient-reported outcome measures and/or overall survivorship? The quest for reliable and reproducible achievement of the intraoperative alignment goal has been the primary motivator for the introduction, development, and refinement of CAS navigation...
January 31, 2018: Journal of Arthroplasty
Haley M Merrill, Daniel M Dean, Jay L Mottla, Steven K Neufeld, Daniel J Cuttica, Matthew M Buchanan
Background Orthopaedic surgeons frequently prescribe pain medications during the postoperative period. The efficacy of these medications at alleviating pain after foot/ankle surgery and the quantity of medication required (and conversely, leftover) are unknown. METHODS: Patients undergoing foot/ankle surgery during a 3-month period who met inclusion criteria were surveyed at their first postoperative visit. Information collected included gender, number of prescribed pills remaining, satisfaction with pain control, and willingness to surrender leftover opioids to a Drug Enforcement Administration (DEA) disposal center...
March 1, 2018: Foot & Ankle International
Danielle Thomas, David Thordarson
BACKGROUND: Hallux rigidus is a common osteoarthritic disease of the first metatarsophalangeal joint (MTPJ). Few salvage treatment options exist that preserve motion for patients who have failed an initial procedure and who are not amenable to fusion, typically patients who are active or who would like to wear high heels. Allograft tendon interpositional arthroplasty is an unconventional salvage treatment option that may preserve motion and prevent bone loss. METHODS: A retrospective chart review is reported of 19 patients who failed previous procedures and refused fusion who underwent allograft tendon interpositional arthroplasty of the hallux MTPJ by a single surgeon between 2012 and 2015...
March 1, 2018: Foot & Ankle International
Brecht Serraes, Martin van Leen, Jos Schols, Ann Van Hecke, Sofie Verhaeghe, Dimitri Beeckman
The aims of this study were to identify, assess, and summarise available evidence about the effectiveness of static air mattress overlays to prevent pressure ulcers. The primary outcome was the incidence of pressure ulcers. Secondary outcomes included costs and patient comfort. This study was a systematic review. Six electronic databases were consulted: Cochrane Library, EMBASE, PubMed (Medline), CINAHL (EBSCOhost interface), Science direct, and Web of Science. In addition, a hand search through reviews, conference proceedings, and the reference lists of the included studies was performed to identify additional studies...
March 5, 2018: International Wound Journal
Woojin Cho, Alan Varkey Job, Jing Chen, Jung Hwan Baek
Three-dimensional (3D) printing is a transformative technology with a potentially wide range of applications in the field of orthopaedic spine surgery. This article aims to review the current applications, limitations, and future developments of 3D printing technology in orthopaedic spine surgery. Current preoperative applications of 3D printing include construction of complex 3D anatomic models for improved visual understanding, preoperative surgical planning, and surgical simulations for resident education...
February 2018: Asian Spine Journal
Takato Aihara, Tomoaki Toyone, Yasuaki Murata, Kazuhide Inage, Makoto Urushibara, Juntaro Ouchi
Study Design: Retrospective review of prospectively collected outcome data. Purpose: To compare 5-year outcomes following decompression with fusion (FU) and microendoscopic decompression (MED) in patients with degenerative lumbar spondylolisthesis (DLS) and to define surgical indication limitations regarding the use of MED for this condition. Overview of Literature: There have been no comparative studies on mid- or long-term outcomes following FU and MED for patients with DLS...
February 2018: Asian Spine Journal
Ajay C Lall, Benjamin G Domb
The use of biologic augments such as platelet-rich plasma and platelet-rich fibrin for tendon pathology has skyrocketed within the past 5-7 years amongst orthopaedic patients. Many retrospective series exist with small sample sizes and variable clinical applications. Patient psyche, price of product, and outcomes may be more intimately related than once thought. In this commentary, we briefly review the placebo and psychometric effect of medicine.
March 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Shujie Tang, Zhuomao Mo, Renwen Zhang
OBJECTIVE: To evaluate evidence for the effectiveness of acupuncture in the treatment of lumbar disc herniation (LDH). METHODS: Electronic databases were searched to identify randomised controlled trials (RCTs) of acupuncture for LDH. A meta-analysis was conducted using RevMan 5.3 and the evidence level was assessed using GRADE methodology. RESULTS: Thirty RCTs involving 3503 participants were included in the study. Meta-analysis showed that acupuncture had a higher total effective rate than lumbar traction (RR=1...
March 1, 2018: Acupuncture in Medicine: Journal of the British Medical Acupuncture Society
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