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Patient safety orthopedic

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https://www.readbyqxmd.com/read/28195826/wrong-site-surgery-in-california-2007-2014
#1
Omid Moshtaghi, Yarah M Haidar, Ronald Sahyouni, Afsheen Moshtaghi, Yaser Ghavami, Harrison W Lin, Hamid R Djalilian
Objective The implementation of a universal surgical safety protocol in 2004 was intended to minimize the prevalence of wrong-site surgery (WSS). However, complete elimination of WSS in the operating room continues to be a challenge. The purpose of this study is to evaluate the prevalence and etiology of WSS in the state of California. Study Design A retrospective study of all WSS reports investigated by the California Department of Public Health between 2007 and 2014. Methods Prevalence of overall and specialty-specific WSS, causative factors, and recommendations on further improvement are discussed...
February 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28183145/minimally-invasive-microscopic-posterior-cervical-decompression-simple-safe-and-effective
#2
Pierluigi Vergara
Background and Study Aims Cervical spondylotic myelopathy (CSM) is the most common cause of spinal cord dysfunction in the elderly population. Surgery is usually successful in preventing any deterioration, as well as improving functional status and quality of life. This study assesses the safety and efficacy of minimally invasive microscopic posterior cervical decompression for the treatment of CSM. Materials and Methods A retrospective review of patients with myelopathy from cervical stenosis treated with minimally invasive posterior cervical decompression was performed...
February 9, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28143470/current-use-of-autologous-adipose-tissue-derived-stromal-vascular-fraction-cells-for-orthopedic-applications
#3
REVIEW
Jaewoo Pak, Jung Hun Lee, Kwang Seung Park, Moonhee Park, Lin-Woo Kang, Sang Hee Lee
Autologous adipose stromal vascular fractions (SVFs) containing adipose tissue-derived stem cells (ASCs) are currently being used in clinical settings for various orthopedic applications for human patients. Due to its potential capability of regenerating cartilage, bone, and tendons, autologous adipose SVFs are being tried in treating patients with osteoarthritis (OA), chondromalacia, meniscus tear, osteonecrosis of the femoral head, and tendon injuries. Here, we have reviewed available human clinical studies with regard to patient applications of autologous adipose SVF containing ASCs, specifically assessing effectiveness and safety in the field of orthopedic disorders...
January 31, 2017: Journal of Biomedical Science
https://www.readbyqxmd.com/read/28131017/relationship-between-bone-adaptation-and-in-vivo-mechanical-stimulus-in-biological-reconstructions-after-bone-tumor-a-biomechanical-modeling-analysis
#4
Giordano Valente, Lorenzo Pitto, Enrico Schileo, Sabina Piroddi, Alberto Leardini, Marco Manfrini, Fulvia Taddei
BACKGROUND: Biomechanical interpretations of bone adaptation in biological reconstructions following bone tumors would be crucial for orthopedic oncologists, particularly if based on quantitative observations. This would help plan for surgical treatments, rehabilitative programs and communication with the patients. We aimed to analyze the biomechanical adaptation of a femoral reconstruction after Ewing sarcoma according to an increasingly-used surgical technique, and to relate in-progress bone resorption to the mechanical stimulus induced by different motor activities...
January 21, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28111125/superficial-vancomycin-coating-of-bone-cement-in-orthopedic-revision-surgery-a-safe-technique-to-enhance-local-antibiotic-concentrations
#5
Florian Amerstorfer, Stefan Fischerauer, Patrick Sadoghi, Gerold Schwantzer, Klaus Dieter Kuehn, Andreas Leithner, Mathias Glehr
BACKGROUND: The use of antibiotic-loaded cement has become a well-accepted method to develop high local antibiotic concentrations in revision surgery of infected arthroplasty. A new surgical technique has been established to further increase the local antibiotic concentration and thereby minimizes the risk of reinfection. Our study aim was to investigate the safety of additional superficial vancomycin coating (SVC) by analyzing postoperative joint and serum vancomycin concentrations, as well as the creatinine levels of patients with orthopedic revision surgery...
December 1, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28075437/comparison-of-irrigation-times-using-gravity-and-high-pressure-lavage
#6
Stefano Muscatelli, Andrea Howe, Nathan N O'Hara, Robert V O'Toole, Sheila A Sprague, Gerard P Slobogean
The benefits of high-pressure pulsatile lavage for open fracture irrigation have been controversial based on conflicting experimental animal research. Recently published data definitively demonstrated that irrigation pressure does not affect the incidence of reoperation for the treatment of open fractures. However, proponents of pulsatile lavage argue a faster irrigation time is an important benefit of the high-pressure treatment. The purpose of this study was to determine the difference in irrigation time between gravity and high-pressure lavage...
January 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/28060333/mesenchymal-stromal-cell-culture-and-delivery-in-autologous-conditions-a-smart-approach-for-orthopedic-applications
#7
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/28027388/spinal-anesthesia-in-elderly-patients-undergoing-lumbar-spine-surgery
#8
Noah L Lessing, Charles C Edwards, Charles H Brown, Emily C Ledford, Clayton L Dean, Charles Lin, Charles C Edwards
Spinal anesthesia is increasingly viewed as a reasonable alternative to general anesthesia for lumbar spine surgery. However, the results of spinal anesthesia in elderly patients undergoing lumbar spine decompression and combined decompression and fusion procedures are limited in the literature. The aim of this study was to report a single institution's experience using spinal anesthesia in elderly patients undergoing lumbar spine surgery. A retrospective review was conducted using a prospectively collected database of consecutive lumbar spine surgeries performed under spinal anesthesia in patients 70 years or older at a single center between December 2013 and October 2015...
December 27, 2016: Orthopedics
https://www.readbyqxmd.com/read/28025372/a-pooled-analysis-evaluating-renal-safety-in-placebo-and-active-comparator-controlled-phase-iii-trials-of-multiple-dose-injectable-hp%C3%AE-cd-diclofenac-in-subjects-with-acute-postoperative-pain
#9
Stephen E Daniels, Tong J Tj Gan, Douglas A Hamilton, Neil Singla, Peter G Lacouture, Olufunmibi Johnson, Lauren H Min, Christian R D Reyes, Daniel B Carr
OBJECTIVE : While injectable nonsteroidal anti-inflammatory drugs (NSAIDs) are a key component of postoperative multimodal analgesia, renal safety concerns may limit use in some patients. This study examined the renal safety of injectable HPβCD-diclofenac when given for ≤ 5 days following orthopedic or abdominal/pelvic surgery. METHODS : Pooled analysis of data from two randomized, placebo- and active comparator-controlled phase III trials in 608 total patients was conducted. Renal safety was assessed by examining treatment-emergent adverse events (AEs) and postoperative blood urea nitrogen (BUN) and serum creatinine shifts...
December 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28009731/combining-systems-and-teamwork-approaches-to-enhance-the-effectiveness-of-safety-improvement-interventions-in-surgery-the-safer-delivery-of-surgical-services-s3-program
#10
Peter McCulloch, Lauren Morgan, Steve New, Ken Catchpole, Eleanor Roberston, Mohammed Hadi, Sharon Pickering, Gary Collins, Damian Griffin
IMPORTANCE: Patient safety improvement interventions usually address either work systems or team culture. We do not know which is more effective, or whether combining approaches is beneficial. OBJECTIVE: To compare improvement in surgical team performance after interventions addressing teamwork culture, work systems, or both. DESIGN: Suite of 5 identical controlled before-after intervention studies, with preplanned analysis of pooled data for indirect comparisons of strategies...
January 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28004310/high-body-mass-index-and-use-of-fentanyl-iontophoretic-transdermal-system-in-postoperative-pain-management-results-of-a-pooled-analysis-of-six-phase-3-3b-trials
#11
Eugene R Viscusi, Li Ding, J Bradley Phipps, Loretta M Itri, Philip R Schauer
INTRODUCTION: Postoperative pain management can be challenging in patients with a high body mass index (BMI) especially as a result of poor venous access and delayed ambulation that can result in serious complications. Fentanyl iontophoretic transdermal system (ITS) is a needle-free, patient-controlled analgesic method available for use in acute postoperative pain. The primary objective of these analyses was to determine if there were any differences between patients with high BMI (>40 kg/m(2)) and lower BMIs (<30 kg/m(2) and 35-40 kg/m(2)) in terms of efficacy or safety...
December 21, 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27999499/perineural-liposomal-bupivacaine-for-postoperative-pain-control-in-patients-undergoing-upper-extremity-orthopedic-surgery-a-prospective-and-randomized-pilot-study
#12
José R Soberón, William Ericson-Neilsen, Leslie E Sisco-Wise, Mariella Gastañaduy, David E Beck
BACKGROUND: Upper extremity surgery is commonly performed in the ambulatory setting and is associated with moderate to severe postoperative pain. METHODS: Patients scheduled for upper extremity orthopedic surgery with a peripheral nerve block were randomized to receive either an ultrasound-guided single-injection supraclavicular block or ultrasound-guided median, ulnar, and radial nerve blocks (forearm blocks) performed at the level of the mid to proximal forearm with liposomal bupivacaine (Exparel) combined with a short-acting supraclavicular block...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27977040/anterior-cervical-corpectomy-and-fusion-using-a-synthetic-hydroxyapatite-graft-for-ossification-of-the-posterior-longitudinal-ligament
#13
Toshitaka Yoshii, Takashi Hirai, Kenichiro Sakai, Shinichi Sotome, Mitsuhiro Enomoto, Tsuyoshi Yamada, Hiroyuki Inose, Tsuyoshi Kato, Shigenori Kawabata, Atsushi Okawa
The significant complication rate associated with harvesting autologous iliac bone or fibula has encouraged development of alternative graft substitutes. In this study, the authors investigated the efficacy and safety of synthetic porous hydroxyapatite (HA) combined with local vertebral bone graft for use in anterior cervical corpectomy and fusion (ACCF) for the treatment of patients with ossification of the posterior longitudinal ligament (OPLL). Since 2006, twenty-five OPLL patients underwent ACCF using HA blocks (HA group)...
December 9, 2016: Orthopedics
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
#14
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
#15
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...
January 2017: 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
#16
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
#17
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
#18
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
#19
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
#20
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)...
January 2017: Journal of Hand Surgery
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