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Orthopaedic review articles

M Aurich, D Albrecht, P Angele, C Becher, S Fickert, J Fritz, P E Müller, P Niemeyer, M Pietschmann, G Spahn, M Walther
Background: Osteochondral lesions (OCL) of the ankle are a common cause of ankle pain. Although the precise pathophysiology has not been fully elucidated, it can be assumed that a variety of factors are responsible, mainly including traumatic events such as ankle sprains. Advances in arthroscopy and imaging techniques, in particular magnetic resonance imaging (MRI), have improved the possibilities for the diagnosis of OCLs of the ankle. Moreover, these technologies aim at developing new classification systems and modern treatment strategies...
October 21, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Ganggang Zhang, Alice Brion, Anne-Sophie Willemin, Marie-Hélène Piet, Vanessa Moby, Arnaud Bianchi, Didier Mainard, Laurent Galois, Pierre Gillet, Marthe Rousseau
During the past two decades, with a huge and rapidly increasing clinical need for bone regeneration and repair, bone substitutes are more and more seen as a potential solution. Major innovation efforts are being made to develop such substitutes, some having advanced even to clinical practice. It is now time to turn to natural biomaterials. Nacre, or mother-of-pearl, is an organic matrix-calcium carbonate coupled shell structure produced by molluscs. In vivo and in vitro studies have revealed that nacre is osteoinductive, osteoconductive, biocompatible and biodegradable...
October 17, 2016: Journal of Biomedical Materials Research. Part A
M T Nousiainen, S A McQueen, J Hall, W Kraemer, P Ferguson, J L Marsh, R R Reznick, M R Reed, R Sonnadara
As residency training programmes around the globe move towards competency-based medical education (CBME), there is a need to review current teaching and assessment practices as they relate to education in orthopaedic trauma. Assessment is the cornerstone of CBME, as it not only helps to determine when a trainee is fit to practice independently, but it also provides feedback on performance and guides the development of competence. Although a standardised core knowledge base for trauma care has been developed by the leading national accreditation bodies and international agencies that teach and perform research in orthopaedic trauma, educators have not yet established optimal methods for assessing trainees' performance in managing orthopaedic trauma patients...
October 2016: Bone & Joint Journal
J M Bos, P M L A van den Bemt, W Kievit, J L W Pot, J E Nagtegaal, A Wieringa, M M L van der Westerlaken, G J van der Wilt, P A G M de Smet, C Kramers
AIM: The P-REVIEW study was a prospective, multicenter, open intervention study, designed to determine whether a multifaceted intervention of educating the prescriber combined with medication review and pharmaceutical visits to the ward by the hospital pharmacist could lead to a reduction of drug-related complications among surgical patients. METHODS: 6780 admissions of 5940 patients who were admitted to surgical, urological and orthopaedic wards during the usual care period and 6484 admissions of 5711 patients during the intervention period were included...
September 27, 2016: British Journal of Clinical Pharmacology
David Pomarino, Juliana Ramírez-Llamas, Stephan Martin, Andrea Pomarino
: The idiopathic toe walking (ITW) gait pattern is characterized in children for walking since the beginning on their first steps on the forefoot; however, these children are able to support their whole foot on the ground. ITW can only be diagnosed in the absence of any orthopaedic or neurological condition known to cause tiptoe walking. The aim of this article is to review other references and provide an outline of the different treatment options, including the 3-step-pyramid insole treatment concept for children with ITW...
September 19, 2016: Foot & Ankle Specialist
Afshin A Anoushiravani, Jason Patton, Zain Sayeed, Mouhanad M El-Othmani, Khaled J Saleh
Recent trends in clinical research have moved attention toward reporting clinical outcomes and resource consumption associated with various care processes. This change is the result of technological advancement and a national effort to critically assess health care delivery. As orthopedic surgeons traverse an unchartered health care environment, a more complete understanding of how clinical research is conducted using large data sets is necessary. The purpose of this article is to review various advantages and disadvantages of large data sets available for orthopaedic use, examine their ideal use, and report how they are being implemented nationwide...
October 2016: Orthopedic Clinics of North America
Fleur E E De Vries, Elon D Wallert, Joseph S Solomkin, Benedetta Allegranzi, Matthias Egger, E Patchen Dellinger, Marja A Boermeester
OBJECTIVE: Systematically review and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) studies on prophylactic negative pressure wound therapy (pNPWT) to prevent surgical site infections (SSIs). INTRODUCTION: pNPWT has been suggested as a new method to prevent wound complications, specifically SSIs, by its application on closed incisional wounds. METHODS: This review was conducted as part of the development of the Global Guidelines for prevention of SSIs commissioned by World Health Organization in Geneva...
September 2016: Medicine (Baltimore)
Lisa Phillips, Sasha Carsen, Anisha Vasireddi, Kishore Mulpuri
BACKGROUND: Patient-reported outcomes are increasingly used as primary measures of success and impact of health care services. There is no current consensus on the efficacy of functional health status (FHS) or health-related quality of life (HRQoL) evaluation in pediatric orthopaedic surgery. The purpose of this study was to quantify and characterize the use of such patient-reported outcomes in the pediatric orthopaedic literature over the last several years. METHODS: A cross-sectional review of 6 orthopaedic journals-Journal of Bone and Joint Surgery, Bone and Joint Journal, Spine, Journal of Pediatric Orthopaedics A, Journal of Pediatric Orthopaedics B, and Journal of Children's Orthopaedics, was conducted by 2 independent reviewers...
September 3, 2016: Journal of Pediatric Orthopedics
L D Buirs, L W A H Van Beers, V A B Scholtes, T Pastoors, S Sprague, R W Poolman
OBJECTIVE: The objective of this systematic review of the literature was to identify the predictors of functional outcome after total hip arthroplasty (THA). METHOD: A systematic literature search in Web of Science, CINAHL, EMBASE and PubMed was conducted on 23 June 2015. The articles were selected based on their quality, relevance and measurement of the predictive factor. The level of evidence of all studies was determined using the GRADE rating scheme. RESULTS: The initial search resulted in 1092 citations...
2016: BMJ Open
L Jeyaseelan, S Chandrashekar, A Mulligan, H A Bosman, A J S Watson
AIMS: The mainstay of surgical correction of hallux valgus is first metatarsal osteotomy, either proximally or distally. We present a technique of combining a distal chevron osteotomy with a proximal opening wedge osteotomy, for the correction of moderate to severe hallux valgus. PATIENTS AND METHODS: We reviewed 45 patients (49 feet) who had undergone double osteotomy. Outcome was assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) and the Short Form (SF) -36 Health Survey scores...
September 2016: Bone & Joint Journal
Cory T Walsh, Louis C Grandizio, Joel C Klena, John M Parenti, Gerard J Cush
BACKGROUND: The foot and ankle (FA) content domain is a component of the orthopaedic in-training examination (OITE). Levels of evidence (LoE) have been infrequently studied on the OITE. The purpose of this study is to determine if LoE for primary journal articles referenced for FA questions increased over a 15-year period. We also aim to determine if reference characteristics and question taxonomy have changed during this period. METHODS: All 132 questions and 261 references in the FA content domain from 1995 to 1997 and from 2010 to 2012 were included...
August 25, 2016: Journal of Surgical Education
Jeffrey H Weinreb, Ryu Yoshida, Mark P Cote, Michael B O'Sullivan, Augustus D Mazzocca
PURPOSE: The purpose of this study was to evaluate how database use has changed over time in Arthroscopy: The Journal of Arthroscopic and Related Surgery and to inform readers about available databases used in orthopaedic literature. METHODS: An extensive literature search was conducted to identify databases used in Arthroscopy and other orthopaedic literature. All articles published in Arthroscopy between January 1, 2006, and December 31, 2015, were reviewed. A database was defined as a national, widely available set of individual patient encounters, applicable to multiple patient populations, used in orthopaedic research in a peer-reviewed journal, not restricted by encounter setting or visit duration, and with information available in English...
August 24, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Joshua C Rozell, Mark Hasenauer, Derek J Donegan, Mark Neuman
The treatment of hip fractures in the elderly represents a major public health priority and a source of ongoing debate among orthopaedic surgeons and anesthesiologists. Most of these injuries are treated with surgery in an expedient fashion. From the surgical perspective, there are certain special considerations in this population including osteoporosis, pre-existing arthritis, age, activity level, and overall health that contribute to the type of surgical fixation performed. Open reduction and internal fixation versus arthroplasty remain the two major categories of treatment...
2016: F1000Research
Richard J VanTienderen, John C Dunn, Nicholas Kusnezov, Justin D Orr
PURPOSE: The purpose of this study is to present a systematic review of the literature regarding the use of fresh bulk osteochondral allograft transfer for treatment of large osteochondral lesions of the talus (OCLT) in an effort to characterize the functional outcomes, complications, and reoperation rates. METHODS: A search of the PubMed, CINAHL, Embase, and Cochrane Databases was performed between January 1, 1990, and March 1, 2016, and included all articles related to outcomes after fresh talar allograft transplantation for OCLT...
August 18, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Youssra Marjoua, Ryan Xiao, Cameron Waites, Brian W Yang, Mitchel B Harris, Andrew J Schoenfeld
BACKGROUND CONTEXT: Over the course of the last decade, interest in the use of large data repositories for clinical research in orthopedic and spine surgery has grown substantially. Detractors maintain that the clinical relevance of research conducted using large registries is limited, and that the academic influence of such studies is minimal. Such contentions have not been empirically evaluated. PURPOSE: This study sought to perform a systematic review of spinal research conducted using the National Surgical Quality Improvement Program (NSQIP)...
August 9, 2016: Spine Journal: Official Journal of the North American Spine Society
Alejandro Marquez-Lara, Ian D Hutchinson, Fiesky Nuñez, Thomas L Smith, Anna N Miller
BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) are often avoided by orthopaedic surgeons because of their possible influence on bone-healing. This belief stems from multiple studies, in particular animal studies, that show delayed bone-healing or nonunions associated with NSAID exposure. The purpose of this review was to critically analyze the quality of published literature that evaluates the impact of NSAIDs on clinical bone-healing. METHODS: A MEDLINE and Embase search was conducted to identify all articles relating to bone and fracture-healing and the utilization of NSAIDs...
March 15, 2016: JBJS Rev
D J Bryson, D L J Morris, F S Shivji, K R Rollins, S Snape, B J Ollivere
Prophylactic antibiotics can decrease the risk of wound infection and have been routinely employed in orthopaedic surgery for decades. Despite their widespread use, questions still surround the selection of antibiotics for prophylaxis, timing and duration of administration. The health economic costs associated with wound infections are significant, and the judicious but appropriate use of antibiotics can reduce this risk. This review examines the evidence behind commonly debated topics in antibiotic prophylaxis and highlights the uses and advantages of some commonly used antibiotics...
August 2016: Bone & Joint Journal
S F DeFroda, J A Gil, C T Born
PURPOSE: Fractures of the lower extremity, particularly of the femur and acetabulum, may be difficult to immobilize with splinting alone. These injuries may be best stabilized with the application of various types of skeletal traction. Often, traction is applied percutaneously in an emergent setting, making the knowledge of both superficial and deep anatomy crucial to successful placement. METHODS: Review was performed via PubMed search as well as referencing the Orthopaedic literature...
July 23, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Lindsay E Hickerson, Diederik O Verbeek, Craig E Klinger, David L Helfet
This video reviews the indications, surgical approach, and case examples of the anterolateral approach to a distal tibial plafond fracture. If this approach is used in a staged fashion, when the soft envelope is ready, it affords excellent visualization for fracture fixation through thick skin flaps. An associated article reviews a cohort of 44 mainly type C3 pilon injuries treated by 2 orthopaedic traumatologist using the anterolateral approach after staged external fixation. An anatomic or good fracture reduction was obtained in 41 fractures with 13...
August 2016: Journal of Orthopaedic Trauma
H Humphreys, K Becker, P M Dohmen, N Petrosillo, M Spencer, M van Rijen, A Wechsler-Fördös, M Pujol, A Dubouix, J Garau
Surgical site infections (SSIs) are among the most common healthcare-associated infections, and contribute significantly to patient morbidity and healthcare costs. Staphylococcus aureus is the most common microbial cause. The epidemiology of S. aureus is changing with the dissemination of newer clones and the emergence of mupirocin resistance. The prevention and control of SSIs is multi-modal, and this article reviews the evidence on the value of screening for nasal carriage of S. aureus and subsequent decolonization of positive patients pre-operatively...
June 18, 2016: Journal of Hospital Infection
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