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Patient safety orthopedic

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https://www.readbyqxmd.com/read/27904518/testing-the-feasibility-and-safety-of-the-nintendo-wii-gaming-console-in-orthopedic-rehabilitation-a-pilot-randomized-controlled-study
#1
Andreas Ficklscherer, Jonas Stapf, Kay Michael Meissner, Thomas Niethammer, Matthias Lahner, Markus Wagenhäuser, Peter E Müller, Matthias F Pietschmann
INTRODUCTION: The Nintendo Wii game console is already used as an additional training device for e.g. neurological wards. Still there are limited data available regarding orthopedic rehabilitation. The authors' objective was to examine whether the Nintendo Wii is an appropriate and safe tool in rehabilitation after orthopedic knee surgery. MATERIAL AND METHODS: A prospective, randomized, controlled study comparing standard physiotherapy vs. standard physiotherapy plus game console training (Wii group) in patients having anterior cruciate ligament (ACL) repair or knee arthroplasty was conducted...
December 1, 2016: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/27902945/artificial-cervical-disc-replacement-with-the-prestige-lp-prosthesis-for-the-treatment-of-non-contiguous-2-level-cervical-degenerative-disc-disease-a-minimum-24-month-follow-up
#2
Tingkui Wu, Beiyu Wang, Chen Ding, Yang Meng, Jigang Lou, Yi Yang, Hao Liu
OBJECTIVE: We describe the features of non-contiguous 2-level cervical degenerative disc disease (NCDDD), investigate the safety and feasibility of artificial cervical disc replacement (ACDR) for the treatment of NCDDD, and expect that our study will provide spine surgeons with an alternative procedure for NCDDD. METHODS: Twenty-five patients with NCDDD received ACDR with a Prestige-LP prosthesis. Clinical outcomes were evaluated using the 36-Short Form (SF-36, Mental Component Summary [MCS] and Physical Component Summary [PCS]), Visual Analog Scale (VAS), Japanese Orthopedic Association (JOA), and Neck Disability Index (NDI) scores...
November 17, 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/27900707/fluoroscopy-guided-biodegradable-spacer-implantation-using-local-anesthesia-safety-and-efficacy-study-in-patients-with-massive-rotator-cuff-tears
#3
E Gervasi, E Maman, A Dekel, E Cautero
BACKGROUND: The management of massive rotator cuff tears (MRCTs) is challenging and associated with a high failure rates. Studies have shown that advanced age, lower American Society of Anesthesiologists physical status score and concomitant comorbidities are associated with higher risks of death and postoperative complications. This study was designed to assess the safety and efficacy of fluoroscopy-guided biodegradable spacer implantation under local anesthesia, in patients with MRCT and comorbidities completely or partially contraindicating surgeries under general anesthesia...
December 2016: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/27899440/the-elimination-of-transfer-distances-is-an-important-part-of-hospital-design
#4
Sauli Karvonen, Isto Nordback, Jussi Elo, Jouni Havulinna, Heikki-Jussi Laine
OBJECTIVE: The objective of the present study was to describe how a specific patient flow analysis with from-to charts can be used in hospital design and layout planning. BACKGROUND: As part of a large renewal project at a university hospital, a detailed patient flow analysis was applied to planning the musculoskeletal surgery unit (orthopedics and traumatology, hand surgery, and plastic surgery). METHOD: First, the main activities of the unit were determined...
November 29, 2016: HERD
https://www.readbyqxmd.com/read/27894329/efficacy-of-early-controlled-motion-of-the-ankle-compared-with-no-motion-after-non-operative-treatment-of-an-acute-achilles-tendon-rupture-study-protocol-for-a-randomized-controlled-trial
#5
Kristoffer Weisskirchner Barfod, Maria Swennergren Hansen, Per Holmich, Anders Troelsen, Morten Tange Kristensen
BACKGROUND: Early controlled ankle motion is widely used in the non-operative treatment of acute Achilles tendon rupture, though its safety and efficacy have never been investigated in a randomized setup. The objectives of this study are to investigate if early controlled motion of the ankle affects functional and patient-reported outcomes. METHODS/DESIGN: The study is performed as a blinded, randomized, controlled trial with patients allocated in a 1:1 ratio to one of two parallel groups...
November 29, 2016: Trials
https://www.readbyqxmd.com/read/27890310/same-day-total-hip-arthroplasty-performed-at-an-ambulatory-surgical-center-90-day-complication-rate-on-549-patients
#6
Gregg R Klein, Jason M Posner, Harlan B Levine, Mark A Hartzband
BACKGROUND: There is an increasing interest in outpatient total hip arthroplasty (THA), as there are perceived benefits to the patient, insurer, and overall healthcare system. However, the safety of outpatient total joint arthroplasty has not been studied. METHODS: Five hundred forty-nine patients who underwent mini-posterior THA at a freestanding independent ambulatory surgical center (ASC) were reviewed. All patients were discharged to home on the day of surgery...
October 20, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27889092/current-quality-measurement-tools-are-insufficient-to-assess-complications-in-orthopedic-surgery
#7
Arjun S Sebastian, Stephanie F Polites, Amy E Glasgow, Elizabeth B Habermann, Robert R Cima, Sanjeev Kakar
PURPOSE: The American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) is a clinically-derived, validated tool to track outcomes in surgery. The Agency for Healthcare Research and Quality Patient Safety Indicators (AHRQ-PSI) are a set of computer algorithms run on administrative data to identify adverse events. The purpose of this study is to compare complications following orthopedic surgery identified by ACS-NSQIP and AHRQ-PSI. METHODS: Patients between 2010 and 2012 who underwent orthopedic procedures (arthroplasty, spine, trauma, foot and ankle, hand, and upper extremity) at our tertiary-care, academic institution were identified (n = 3,374)...
November 23, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27885960/high-dose-tranexamic-acid-reduces-intraoperative-and-postoperative-blood-loss-in-posterior-lumbar-interbody-fusion
#8
Junichi Kushioka, Tomoya Yamashita, Shinya Okuda, Takafumi Maeno, Tomiya Matsumoto, Ryoji Yamasaki, Motoki Iwasaki
OBJECTIVE Tranexamic acid (TXA), a synthetic antifibrinolytic drug, has been reported to reduce blood loss in orthopedic surgery, but there have been few reports of its use in spine surgery. Previous studies included limitations in terms of different TXA dose regimens, different levels and numbers of fused segments, and different surgical techniques. Therefore, the authors decided to strictly limit TXA dose regimens, surgical techniques, and fused segments in this study. There have been no reports of using TXA for prevention of intraoperative and postoperative blood loss in posterior lumbar interbody fusion (PLIF)...
November 25, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27871603/prophylactic-phenylephrine-infusion-for-the-prevention-of-hypotension-after-spinal-anesthesia-in-the-elderly-a-randomized-controlled-clinical-trial
#9
Fabrice Ferré, Philippe Marty, Laura Bruneteau, Virgine Merlet, Benoît Bataille, Anne Ferrier, Claude Gris, Matt Kurrek, Olivier Fourcade, Vincent Minville, Agnes Sommet
STUDY OBJECTIVE: Hypotension frequently occurs during spinal anesthesia (SA), especially in the elderly. Phenylephrine is effective to prevent SA-induced hypotension during cesarean delivery. The objective of this study was to evaluate the efficacy and safety of prophylactic infusion of phenylephrine after SA for orthopedic surgery in the elderly. DESIGN: This prospective, randomized, double-blind, and placebo-controlled study included 54 patients older than 60 years undergoing elective lower limb surgery under SA (injection of 10 mg of isobaric bupivacaine with 5 μg of sufentanyl)...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27868167/the-role-of-ugandan-district-hospital-orthopedic-units-in-the-care-of-vulnerable-road-users-a-cross-sectional-study
#10
Dan K Kisitu, Lauren E Eyler, Isaac Kajja, Gonzaga Waiswa, Titus Beyeza, David R Ragland, Isabelle Feldhaus, Catherine Juillard, Rochelle A Dicker
BACKGROUND: Musculoskeletal injuries are a common cause of morbidity after road traffic injury (RTI) in motorizing countries. District hospitals provide front-line orthopedic care in Uganda and other sub-Saharan African nations. Improving care at the district hospital level is an important component of the World Health Organization's strategy for surgical and trauma systems strengthening, but the data necessary to inform RTI safety and care initiatives has previously been insufficient at the district hospital level...
December 2016: Injury Epidemiology
https://www.readbyqxmd.com/read/27829731/dynamic-thermal-acoustic-response-for-human-bone-materials-at-different-energy-levels-a-diagnosis-approach
#11
Ashok Kumar Thella, James Rizkalla, Neeraj Rathi, Monika Kakani, Ahdy Helmy, Paul Salama, Maher E Rizkalla
BACKGROUND: The non-invasive diagnostic approaches have gained high attention in recent years, utilizing high technology sensor systems, including infrared, microwave devices, acoustic transducers, etc. The patient safety, high resolution images, and reliability are among the driving forces toward high technology approaches. The thermal and acoustic responses of the materials may reflect the important research parameters such as penetration depth, power consumption, and temperature change used for the practical models of the system...
March 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/27818444/utilization-and-outcomes-of-inpatient-surgery-at-safety-net-hospitals
#12
Lindsey A Herrel, Sandra L Wong, Zaojun Ye, David C Miller
Funding changes enacted with health care reform may compromise care and outcomes for vulnerable populations undergoing surgery in safety-net hospitals (SNHs). We performed a retrospective cohort study of surgical patients from 2007 through 2011. We examined the distribution of surgical procedures for SNHs (quartile of hospitals with the highest proportion of Medicaid plus self-pay discharges) vs. non-SNHs (lowest quartile). We fit multivariable models to compare in-hospital mortality, prolonged length of stay (LOS), and hospital costs at SNHs vs...
2016: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/27817153/use-of-fentanyl-iontophoretic-transdermal-system-its-ionsys-%C3%A2-in-the-management-of-patients-with-acute-postoperative-pain-a-case-series
#13
Steven Poplawski, Matthew Johnson, Philip Philips, Leopold H J Eberhart, Tilo Koch, Loretta M Itri
Fentanyl iontophoretic transdermal system (ITS) [IONSYS(®), The Medicines Company, Parsippany, NJ, USA] is a needle-free, patient-controlled, postoperative opioid pain management treatment. It is indicated for the short-term management of acute postoperative pain in adults requiring opioid analgesia in the hospital. The safety and effectiveness of fentanyl ITS for acute postoperative pain management has been demonstrated in a range of surgery and patient types studied in seven phase 3 trials (three placebo-controlled trials and four active-comparator trials)...
December 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27811597/predictors-of-at-home-arterial-oxygen-desaturation-events-in-ambulatory-surgical-patients
#14
Chuck Biddle, Charles Elam, Laura Lahaye, Gordon Kerr, Laura Chubb, Brad Verhulst
OBJECTIVES: Little is known about the early recovery phase occurring at-home after anesthesia and surgery in ambulatory surgical patients. We studied quantitative oximetry and quality-of-life metrics in the first 48 hours after same-day orthopedic surgery examining the association between the recovery metrics and specific patient and procedural factors. METHODS: We used the STOP-Bang score to quantify patient risk for obstructive sleep apnea in 50 adult patients at 2 centers using continuous portable oximetry and patient journaling...
November 2, 2016: Journal of Patient Safety
https://www.readbyqxmd.com/read/27811198/the-efficacy-and-safety-of-edoxaban-for-vte-prophylaxis-post-orthopedic-surgery-a-systematic-review
#15
Lamia AlHajri, Sima Jabbari, Hind AlEmad, Khawla AlMahri, Maryam AlMahri, Noora AlKitbi
BACKGROUND: Venous thromboembolism (VTE) is a common complication that manifests during and/or after hospitalization, as well as postsurgeries including orthopedic surgeries. Edoxaban is a new oral direct factor Xa inhibitor that has been recently approved for treating VTE in patients who have already been treated with a parenteral anticoagulant and for the prevention of stroke and non-central nervous system systemic embolism in patients with nonvalvular atrial fibrillation. OBJECTIVES: The purpose of this systematic review was to evaluate the safety and efficacy of edoxaban for VTE prophylaxis after lower limb orthopedic surgery...
November 2, 2016: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/27809799/teicoplanin-based-antimicrobial-therapy-in-staphylococcus-aureus-bone-and-joint-infection-tolerance-efficacy-and-experience-with-subcutaneous-administration
#16
Olivier Peeters, Tristan Ferry, Florence Ader, André Boibieux, Evelyne Braun, Anissa Bouaziz, Judith Karsenty, Emmanuel Forestier, Frédéric Laurent, Sébastien Lustig, Christian Chidiac, Florent Valour
BACKGROUND: Staphylococci represent the first etiologic agents of bone and joint infection (BJI), leading glycopeptides use, especially in case of methicillin-resistance or betalactam intolerance. Teicoplanin may represent an alternative to vancomycin because of its acceptable bone penetration and possible subcutaneous administration. METHODS: Adults receiving teicoplanin for S. aureus BJI were included in a retrospective cohort study investigating intravenous or subcutaneous teicoplanin safety and pharmacokinetics...
November 3, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27800019/adverse-events-in-orthopedic-care-identified-via-the-global-trigger-tool-in-sweden-implications-on-preventable-prolonged-hospitalizations
#17
Hans Rutberg, Madeleine Borgstedt-Risberg, Pelle Gustafson, Maria Unbeck
BACKGROUND: The national incidence of adverse events (AEs) in Swedish orthopedic care has never been described. A new national database has made it possible to describe incidence, nature, preventability and consequences of AEs in Swedish orthopedic care. METHODS: We used national data from a structured two-stage record review with a Swedish modification of the Global Trigger Tool. The sample was 4,994 randomly selected orthopedic admissions in 56 hospitals during 2013 and 2014...
2016: Patient Safety in Surgery
https://www.readbyqxmd.com/read/27790289/challenging-the-knowledge-base-and-skillset-for-providing-surgical-consent-by-orthopedic-and-plastic-surgeons-in-the-netherlands-an-identified-area-of-improvement-in-patient-safety
#18
Wouter K G Leclercq, Sarah Sloot, Bram J Keulers, Saskia Houterman, Johan Legemaate, Margot Veerman, Leslie Thomas, Marc R Scheltinga
BACKGROUND: Successfully completing a surgical informed consent process is an important element of the preoperative consult. A previous study of Dutch general surgeons demonstrated that the implementation of SIC did not meet acceptable standards. However, the quality of the SIC process in the orthopedic surgical or plastic surgical arena is unknown. METHODS: Following ethical approval, an online survey investigating specifics of surgical informed consent was performed among members of the Dutch Scientific Association of Orthopedic Surgeons and the Dutch Society for Plastic Surgery...
2016: Patient Safety in Surgery
https://www.readbyqxmd.com/read/27770801/balance-chiropractic-therapy-for-cervical-spondylotic-radiculopathy-study-protocol-for-a-randomized-controlled-trial
#19
Feng Yang, Wen-Xiong Li, Zhu Liu, Li Liu
BACKGROUND: Cervical spondylosis is a very common disorder and cervical spondylotic radiculopathy (CSR) is the most common form of spinal degenerative disease. Its clinical manifestations focus on pain and numbness of the neck and arm as well as restricted movement of the neck, which greatly affect the patient's life and work. The orthopedic of traditional Chinese medicine (TCM) theory holds that the basic pathologic change in spinal degenerative diseases is the imbalance between the dynamic system and the static system of the cervical spine...
October 22, 2016: Trials
https://www.readbyqxmd.com/read/27713677/intraoperative-anaphylactic-reaction-is-it-the-floseal
#20
Brianne Bordes, David Martin, Brian Schloss, Allan Beebe, Walter Samora, Jan Klamar, David Stukus, Joseph D Tobias
When hemodynamic or respiratory instability occurs intraoperatively, the inciting event must be determined so that a therapeutic plan can be provided to ensure patient safety. Although generally uncommon, one cause of cardiorespiratory instability is anaphylactic reactions. During anesthetic care, these most commonly involve neuromuscular blocking agents, antibiotics, or latex. Floseal is a topical hemostatic agent that is frequently used during orthopedic surgical procedures to augment local coagulation function and limit intraoperative blood loss...
July 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
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