Read by QxMD icon Read

Patient safety orthopedic

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
Katarzyna Siennicka, Aleksandra Zolocinska, Karolina Stepien, Natalia Lubina-Dabrowska, Marzena Maciagowska, Ewa Zolocinska, Anna Slysz, Renata Piusinska-Macoch, Slawomir Mazur, Urszula Zdanowicz, Robert Smigielski, Adam Stepien, Zygmunt Pojda
Although mesenchymal stem cells are used in numerous clinical trials, the safety of their application is still a matter of concern. We have analysed the clinical results of the autologous adipose-derived stem cell treatment (stromal vascular fraction (SVF) containing adipose-derived stem cells, endothelial progenitors, and blood mononuclear cells) for orthopedic (cartilage, bone, tendon, or combined joint injuries) and neurologic (multiple sclerosis) diseases. Methods of adipose tissue collection, cell isolation and purification, and resulting cell numbers, viability, and morphology were considered, and patient's age, sex, disease type, and method of cell administration (cell numbers per single application, treatment numbers and frequency, and methods of cell implantation) were analysed and searched for the unwanted clinical effects...
2016: Stem Cells International
Emanuel Raschi, Matteo Bianchin, Walter Ageno, Roberto De Ponti, Fabrizio De Ponti
Since 2008, the direct-acting oral anticoagulants (DOACs) have expanded the therapeutic options of cardiovascular diseases with recognized clinical and epidemiological impact, such as non-valvular atrial fibrillation (NVAF) and venous thromboembolism (VTE), and also in the preventive setting of orthopedic surgical patients. The large body of evidence, not only from pivotal clinical trials but also from 'real-world' postmarketing observational findings (e.g. analytical epidemiological studies and registry data) gathered to date allow for a first attempt at verifying a posteriori whether or not the pharmacological advantages of the DOACs actually translate into therapeutic innovation, with relevant implications for clinicians, regulators and patients...
October 1, 2016: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
Jai Gon Seo, Sang Min Kim, Jung Min Shin, Youngjun Kim, Byung Hoon Lee
INTRODUCTION: Simultaneous bilateral total knee arthroplasty (TKA) has been associated with a high risk of morbidity and mortality. The orthopedic surgeon must, therefore, decide whether bilateral simultaneous TKA is a safe operation to perform and endeavor to decrease the risk of serious complications or even death. METHODS: This retrospective review included 2098 consecutive patients who underwent bilateral simultaneous TKAs by the protocol used in our institution, including the use of extramedullary instruments to minimize medullary canal invasion and overlapping procedures for both knees to decrease operation time...
November 2016: Archives of Orthopaedic and Trauma Surgery
Jason Scalise, Michael Dunbar, David Jacofsky
Given the increasing emphasis in health care on improving outcomes, reproducible results, and creating value for the patient, orthopedic surgery in particular must necessarily continue to progress away from an individualized and a surgeon-specific technical craft and toward a highly automated and computer-integrated process in which surgeon and digitized systems interact to provide the most reproducible and consistent outcomes possible. In doing so, orthopedic surgery would follow the same path that every other highly reliable and safety conscious industry has adopted by absolute necessity...
September 29, 2016: Journal of Knee Surgery
John Schwappach, Sara M Dryden, Kristin M Salottolo
This study was conducted to investigate the safety and efficacy of 3 intraarticular injections of the low-molecular-weight fraction of 5% human serum albumin (LMWF-5A) administered every 2 weeks for knee pain as a result of osteoarthritis. This single-center, randomized, vehicle-controlled, double-blind, phase II study was designed to ensure the safety of multiple intra-articular injections of LMWF-5A and to explore its efficacy in reducing pain as a result of knee osteoarthritis. Patients were randomized 1:1 to receive 3 biweekly intra-articular knee injections of either 4 mL LMWF-5A or vehicle control (saline), administered at weeks 0 (baseline), 2, and 4...
September 29, 2016: Orthopedics
Robert Dettmers, Wouter Brekelmans, Michiel Leijnen, Boudewijn van der Burg, Ewan Ritchie
Infection following orthopedic implants for bone fixation or joint replacement is always serious and may require removal of the osteosynthetic material. Negative pressure wound therapy with instillation and dwell time (NPWTi-d) is an emerging therapy for the treatment of complex wounds, including infected wounds with osteosynthetic material. The purpose of this case study was to evaluate the outcomes of 4 patients (1 man, 3 women; age range 49 to 71 years) with a postoperative wound infection (POWI) following fracture repair and internal fixation...
September 2016: Ostomy/wound Management
Arash Moghaddam, Viola Graeser, Fabian Westhauser, Ulrike Dapunt, Till Kamradt, Stefan M Woerner, Gerhard Schmidmaier
INTRODUCTION: Osteitis is one of the most serious complications in orthopedic surgery. Expert Tibia Nail (ETN) PROtect™ coated with a biodegradable layer of gentamicin-laden polymer was developed for prophylaxis of osteomyelitis. In systemic administration, gentamicin has only a small therapeutic index and serious side effects; it is potentially nephrotoxic as well as ototoxic. It is not yet known if relevant gentamicin concentrations are released into the systemic circulation after implantation of gentamicin-coated nails...
2016: Therapeutics and Clinical Risk Management
Maximilian von Bernstorff, Martina Feierabend, Maurice Jordan, Christopher Glatzel, Ingmar Ipach, Ulf Krister Hofmann
The question of whether patients with musculoskeletal disorders are fit to drive is of paramount importance for them and frequently is directed to the treating orthopedic specialist. Although perioperative braking performance has been increasingly investigated in recent years, scientific data on braking safety in individuals with osteoarthritis (OA) are scarce. This study analyzed the braking performance of 158 patients with OA of the right or left knee or hip and compared the results with radiographic OA grading according to the Kellgren-Lawrence classification scale...
September 19, 2016: Orthopedics
Kyle T Leggott, Matthew Martin, David Sklar, Deborah Helitzer, Randy Rosett, Cameron Crandall, Firoz Vagh, Deana Mercer
INTRODUCTION: To provide insight into how an innovation in healthcare is implemented and diffused, we studied the transition from routine use of general anesthesia to peripheral nerve blocks (PNBs) for ambulatory orthopedic extremity surgery. Rogers' diffusion of innovations (DOI) theory was used as our theoretical framework. We identified themes that would be helpful for others attempting to diffuse innovations into healthcare settings. MATERIAL AND METHODS: A mixed quantitative and qualitative methodology was used...
September 2016: Healthcare
Afshin A Anoushiravani, Zain Sayeed, Mouhanad M El-Othmani, Peter K Wong, Khaled J Saleh
As health care reimbursement models shift from volume-based to value-based models, orthopedic surgeons must provide patients with highly reliable care, while consciously minimizing cost, maintaining quality, and providing timely interventions. An established means of achieving these goals is by implementing a highly reliable care model; however, before such a model can be initiated, a safety culture, robust improvement strategies, and committed leadership are needed. This article discusses interdependent and critical changes required to implement a highly reliable care system...
October 2016: Orthopedic Clinics of North America
Kunpeng Li, Wen Zhang, Bin Li, Hui Xu, Zhong Li, Dawei Luo, Jingtao Zhang, Jinzhu Ma
BACKGROUND: Piezosurgery is a relatively new osteotomy technique using microvibrations of scalpels at ultrasonic frequencies to perform safe and effective osteotomies without damage to adjacent soft tissue, which is widely used in spinal, oral, and maxillofacial surgery. We hypothesized that such a device could also be useful in cervical laminoplasty. The purpose of this study was to compare the safety and efficacy of a piezosurgery device with those of a highspeed drill in cervical laminoplasty...
September 2016: Medicine (Baltimore)
Narges Labibzadeh, Mohsen Emadedin, Roghayeh Fazeli, Fatemeh Mohseni, Seyedeh Esmat Hosseini, Reza Moghadasali, Soura Mardpour, Vajiheh Azimian, Maede Ghorbani Liastani, Ali Mirazimi Bafghi, Mohamadreza Baghaban Eslaminejad, Nasser Aghdami
OBJECTIVE: Nonunion is defined as a minimum of 9 months since injury without any visible progressive signs of healing for 3 months. Recent literature has shown that the application of mesenchymal stromal cells is safe, in vitro and in vivo, for treating long bone nonunion. The present study was performed to investigate the safety of mesenchymal stromal cell (MSC) implantation in combination with platelet lysate (PL) product for treating human long bone nonunion. MATERIALS AND METHODS: In this case series clinical trial, orthopedic surgeons visited eighteen patients with long bone nonunion, of whom 7 complied with the eligibility criteria...
2016: Cell Journal
Satoshi Takayama, Takeshi Yamamoto, Chiduru Tsuchiya, Hideo Noguchi, Junko Sato, Yoshinori Ishii
BACKGROUND: Steri-Strips (3M, Two Harbors, MN, USA) have recently been employed for skin closures after orthopedic surgeries. Here we compare the performance of Steri-Strips and skin staples for wound closure after primary total knee arthroplasties (TKAs). METHODS: A total of 76 consecutive osteoarthritic knees (71 patients) that underwent a primary TKA at our facility were included in this study. Thirty-eight knees received Steri-Strips for wound closure and were evaluated prospectively...
September 6, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Xiaoxuan Li, Zhe Yun, Xiaoxiang Li, Yucai Wang, Tongtao Yang, Lianhe Zheng, Jixian Qian
OBJECTIVE: Although electric bicycle related injuries have become the most common reason for hospitalization from a road crash in China, no study has comprehensively investigated electric bicycle collisions and their impact on orthopedic injuries; such a study may provide evidence to support a new road safety policy. METHODS: A retrospective review of orthopedic injuries from electric bicycle collisions was performed in an urban trauma center. We collected variables including age, gender, location of fracture, presence of open or closed fractures, concomitant vascular, and neurologic injuries...
August 30, 2016: Traffic Injury Prevention
R Seemann, M Münzberg, R Stange, M Rüsseler, M Egerth, B Bouillon, R Hoffmann, M Mutschler
Patient safety has increasingly gained significance as criterion which clinics and doctors will be measured against in terms of ethics and finances. The "human factor" moved into focus regarding the question of how to reduce treatment errors in clinical daily routine. Nevertheless, systematic mediation of interpersonal competences only plays a minor role in the catalogue of requirements for medical specialization and professional training. This is the case not only in orthopedics and traumatology, but in other medical fields as well...
October 2016: Der Unfallchirurg
Jason J Howard
Due to problems with wear particle generation and subsequent loosening using conventional metal-on-polyethylene total hip replacements, there has been a shift toward alternative bearing systems, including metal-on-metal (MoM), for younger, more active patients with degenerative joint disease. Based on positive results from early short-term clinical studies, MoM hip replacements were readily adopted by orthopedic surgeons with thousands being implanted worldwide over the past decade. Unacceptably high revision rates reported by two national joint registries called into question the rigorousness of the regulatory approval process for these implants, particularly with respect to premarket data requirements to prove safety, effectiveness, and the appropriateness of the regulatory pathway chosen...
2016: Medical Devices: Evidence and Research
Mariano E Menendez, David Ring, Andrew Jawa
BACKGROUND: Patient falls are one of the most commonly reported safety incidents in hospitals and an important cause of harm. Despite growing interest in postoperative fall prevention, data on the extent and correlates of falls among elective orthopedic inpatients are sparse and confined to lower limb arthroplasty. We evaluated inpatient fall trends after elective shoulder arthroplasty and identified patient and hospital characteristics associated with the occurrence of falls. METHODS: We used discharge records from the Nationwide Inpatient Sample (2002-2011)...
August 10, 2016: Journal of Shoulder and Elbow Surgery
Stephen J Gleich, Michael E Nemergut, Anthony A Stans, Dawit T Haile, Scott A Feigal, Angela L Heinrich, Christopher L Bosley, Sandeep Tripathi
BACKGROUND AND OBJECTIVES: Ineffective and inefficient patient transfer processes can increase the chance of medical errors. Improvements in such processes are high-priority local institutional and national patient safety goals. At our institution, nonintubated postoperative pediatric patients are first admitted to the postanesthesia care unit before transfer to the PICU. This quality improvement project was designed to improve the patient transfer process from the operating room (OR) to the PICU...
August 2016: Hospital Pediatrics
Giovanni Galeoto, Rita De Santis, Alessandra Marcolini, Alfonso Cinelli, Rossana Cecchi
UNLABELLED: The legislative developments that led to the Three-year Degree of the Health Professions poses any health professional in the position of having to comply with the ethical and legal duty to obtain valid informed consent from the patient prior to treatment. In the present work, attention was focused on the figure of the occupational therapist. MATERIALS AND METHODS: Informed consent forms have been developed according to the specific disease from which the patient undergoing occupational therapy is affected...
April 2016: Giornale Italiano di Medicina del Lavoro Ed Ergonomia
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"