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Interventional Orthopaedics

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https://www.readbyqxmd.com/read/29339298/implementation-and-impact-of-an-audit-and-feedback-antimicrobial-stewardship-intervention-in-the-orthopaedics-department-of-a-tertiary-care-hospital-a-controlled-interrupted-time-series-study
#1
Margarida Tavares, Ana Cláudia Carvalho, José Pedro Almeida, Paulo Andrade, Ricardo São Simão, Pedro Soares, Carlos Alves, Rui Pinto, Arnaud Fontanet, Laurence Watier
A prospective audit and feedback antimicrobial stewardship intervention conducted in the Orthopaedics Department of a University Hospital in Portugal was evaluated by comparing an interrupted time series in an intervention group and a non-intervention (control) group. Monthly antibiotic use (except cefazolin) was measured as World Health Organization- and Anatomical Therapeutic Chemical-defined daily doses (DDD) from January 2012 to September 2016, excluding the 6-month phase of intervention implementation starting on January 1, 2015...
January 12, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29330101/telephone-based-weight-loss-support-for-patients-with-knee-osteoarthritis-a-pragmatic-randomized-controlled-trial
#2
Kate M O'Brien, John Wiggers, Amanda Williams, Elizabeth Campbell, Rebecca K Hodder, Luke Wolfenden, Sze Lin Yoong, Emma K Robson, Robin Haskins, Steven J Kamper, Chris Rissel, Christopher M Williams
OBJECTIVE: To determine the effectiveness of telephone-based weight loss support in reducing the intensity of knee pain in patients with knee osteoarthritis, who are overweight or obese, compared to usual care. DESIGN: We conducted a parallel randomized controlled trial (RCT), embedded within a cohort multiple RCT of patients on a waiting list for outpatient orthopaedic consultation at a tertiary referral hospital in NSW, Australia. Patients with knee osteoarthritis, classified as overweight or obese (body mass index between ≥27kg/m2 and <40kg/m2) were randomly allocated to receive referral to an existing non-disease specific government funded 6-month telephone-based weight management and healthy lifestyle service or usual care...
January 9, 2018: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/29329145/orthopaedic-management-of-leg-length-discrepancy-in-proteus-syndrome-a-case-series
#3
Molly M Crenshaw, Cara G Goerlich, Lauren E Ivey, Julie C Sapp, Kim M Keppler-Noreuil, Allison C Scott, Leslie G Biesecker, Laura L Tosi
INTRODUCTION: Proteus syndrome (PS) is a rare mosaic disorder comprising asymmetric bony and soft tissue overgrowth leading to significant morbidity. Placement of growth inhibition hardware with subsequent epiphyseal arrest improves leg-length and angular deformities in pediatric patients without PS. The purpose of this study was to review the surgical approach and present outcomes, complications, and recommendations in 8 patients with PS and leg-length discrepancy (LLD). METHODS: We conducted a retrospective chart review of 8 patients with PS whose primary reason for surgery was LLD...
January 11, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29310462/do-postoperative-hallux-angles-correlate-with-outcome-in-mp1-fusion-our-experience-with-71-cases
#4
Xavier Paredes-Carnero, Antonio María Fernández-Cebrián, Silvia Villardefrancos-Gil
PURPOSE: To determine if the postoperative alignment of the hallux influences the final clinical outcome of hallux metatarsophalangeal joint (first MTPJ) arthrodesis. METHODS: A total of 71 consecutive cases (hallux rigidus) were studied in stages 3 and 4. They were operated through arthrodesis between 2008 and 2014. The follow-up mean was 7.3 years. The AOFAS (American Orthopaedic Foot and Ankle Society) test was performed preintervention and per annum. In radiology, both the hallux valgus angle and the dorsiflexion angle of the first MTPJ were studied...
January 1, 2018: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/29288172/effectiveness-and-cost-effectiveness-of-a-guided-internet-and-mobile-based-depression-intervention-for-individuals-with-chronic-back-pain-protocol-of-a-multi-centre-randomised-controlled-trial
#5
Jiaxi Lin, Lasse Sander, Sarah Paganini, Sandra Schlicker, David Ebert, Matthias Berking, Jürgen Bengel, Stephanie Nobis, Dirk Lehr, Oskar Mittag, Heleen Riper, Harald Baumeister
INTRODUCTION: Depression often co-occurs with chronic back pain (CBP). Internet and mobile-based interventions (IMIs) might be a promising approach for effectively treating depression in this patient group. In the present study, we will evaluate the effectiveness and cost-effectiveness of a guided depression IMI for individuals with CBP (eSano BackCare-D) integrated into orthopaedic healthcare. METHODS AND ANALYSIS: In this multicentre randomised controlled trial of parallel design, the groups eSano BackCare-D versus treatment as usual will be compared...
December 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/29283898/compliance-with-the-aaos-guidelines-for-treatment-of-osteoarthritis-of-the-knee-a-survey-of-the-american-association-of-hip-and-knee-surgeons
#6
Victor Rex Carlson, Alvin Chua Ong, Fabio Ramiro Orozco, Victor Hugo Hernandez, Rex William Lutz, Zachary Douglas Post
INTRODUCTION: The American Academy of Orthopaedic Surgeons (AAOS) published a series of evidence-based guidelines for treatment of knee osteoarthritis (OA). We studied compliance with these guidelines among orthopaedic surgeons. METHODS: We sent a survey to members of the American Association of Hip and Knee Surgeons. It included five clinical vignettes based on the Kellgren-Lawrence radiographic system for classification of knee OA. Respondents selected treatment currently supported or not supported by the AAOS guidelines...
December 22, 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29276713/participation-in-recreational-athletics-after-operative-fixation-of-tibial-plateau-fractures-predictors-and-functional-outcomes-of-those-getting-back-in-the-game
#7
David N Kugelman, Abdullah M Qatu, Jack M Haglin, Sanjit R Konda, Kenneth A Egol
Background: Tibial plateau fractures can be devastating traumatic injuries to the knee, particularly in active athletes. Purpose/Hypothesis: The purpose of this study was to report on the return to participation in recreational athletics after operatively managed tibial plateau fractures. In addition, this study assessed factors associated with the ability to return to participation in recreational athletics after tibial plateau fractures treated with open reduction internal fixation and compared final outcomes between patients who were able to return to recreational athletics and those who could not...
December 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29261553/local-modalities-for-preventing-surgical-site-infections-an-evidence-based-review
#8
Julia A Katarincic, Amanda Fantry, J Mason DePasse, Ross Feller
Surgical site infections remain a dreaded complication of orthopaedic surgery, affecting both patient economics and quality of life. It is important to note that infections are multifactorial, involving both surgical and patient factors. To decrease the occurrence of infections, surgeons frequently use local modalities, such as methicillin-resistant Staphylococcus aureus screening; preoperative bathing; intraoperative povidone-iodine lavage; and application of vancomycin powder, silver-impregnated dressings, and incisional negative-pressure wound therapy...
January 1, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29260234/evaluation-of-a-multidisciplinary-rehabilitation-programme-for-elderly-patients-with-hip-fracture-a-prospective-cohort-study
#9
Wing-Hoi Cheung, Wan-Yiu Shen, David Lok-Kwan Dai, Kin Bong Lee, Tracy Y Zhu, Ronald Man-Yeung Wong, Kwok-Sui Leung
OBJECTIVE: To investigate the effectiveness and cost of an 18-month multi-disciplinary Comprehensive Fragility Fracture Management Program (CFFMP) for fragility hip fracture patients. DESIGN: Prospective cohort study. PATIENTS: Elderly patients with hip fracture were recruited at their first postoperative follow-up in 2 district hospitals. The intervention group comprised patients from the hospital undergoing CFFMP, and the control group comprised patients from another hospital undergoing conventional care...
December 20, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/29249079/interventional-therapeutic-procedures-in-the-musculoskeletal-system-an-italian-survey-by-the-italian-college-of-musculoskeletal-radiology
#10
Enzo Silvestri, Antonio Barile, Domenico Albano, Carmelo Messina, Davide Orlandi, Angelo Corazza, Luigi Zugaro, Carlo Masciocchi, Luca Maria Sconfienza
PURPOSE: To perform an online survey among all members of the Italian College of Musculoskeletal Radiology to understand how therapeutic musculoskeletal procedures are performed in daily practice in Italy. METHODS: We administered an online survey to all 2405 members about the use of therapeutic musculoskeletal procedures in their institutions asking 16 different questions. Subgroup analysis was performed between general and orthopaedic hospitals with Mann-Whitney U and χ 2 statistics...
December 16, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/29246470/effectiveness-and-costs-of-specialised-physiotherapy-given-via-parkinsonnet-a-retrospective-analysis-of-medical-claims-data
#11
Jan H L Ypinga, Nienke M de Vries, Lieke H H M Boonen, Xander Koolman, Marten Munneke, Aeilko H Zwinderman, Bastiaan R Bloem
BACKGROUND: Parkinson's disease is a complex condition that is best managed by specialised professionals. Trials show that specialised allied health interventions are cost-effective, as compared with usual care. We aimed to study the long-term benefits of specialised physiotherapy using the ParkinsonNet approach in real-world practice. METHODS: We did an observational study, retrospectively analysing a database of health insurance claims that included a representative population of Dutch patients with Parkinson's disease, who were followed for up to 3 years (Jan 1, 2013, to Dec 31, 2015)...
December 12, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/29234561/comparison-of-functional-activities-on-structural-changes-of-the-inferior-patellar-pole
#12
Kelli McKinney, Harvey Wallmann, Patrick Stalcup, Katie DiTommaso
Background: It is well known that eccentric and concentric exercise produce varied amounts of stress on the connective tissues. Diagnostic ultrasound has been used to measure these structural changes by observing fascicle length, angle, and thickness; however, there is a lack of evidence comparing the structural changes as it relates to eccentric, concentric, and stretching protocols. Purpose: The purpose of this study was to compare the acute effects of static stretching, eccentric, concentric, and a combination of eccentric/concentric exercises on structural changes of the muscle tendon unit at the inferior patellar pole utilizing the diagnostic ultrasound...
December 2017: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/29233084/a-model-for-meta-analysis-of-correlated-binary-outcomes-the-case-of-split-body-interventions
#13
Orestis Efthimiou, Dimitris Mavridis, Adriani Nikolakopoulou, Gerta Rücker, Sven Trelle, Matthias Egger, Georgia Salanti
In several areas of clinical research, it is common for trials to assign different sites of the participants' bodies to different interventions. For example, a randomized controlled trial comparing surgical techniques for correcting myopia may randomize each eye of a participant to a different operation. Under such bilateral ('split-body') interventions, the observations from each participant are correlated. It is challenging to account for these correlations at the meta-analysis level, especially when the outcome is rare...
January 1, 2017: Statistical Methods in Medical Research
https://www.readbyqxmd.com/read/29231243/neuromuscular-electrical-stimulation-nmes-for-patellofemoral-pain-syndrome
#14
REVIEW
Ana Luiza C Martimbianco, Maria Regina Torloni, Brenda Ng Andriolo, Gustavo Jm Porfírio, Rachel Riera
BACKGROUND: Patellofemoral pain syndrome, now generally referred to as patellofemoral pain (PFP), is one of the most common orthopaedic disorders, characterised by pain in the anterior or retropatellar knee region. Neuromuscular electrical stimulation (NMES) has been proposed generally as a complementary treatment, associated with other interventions such as exercise, or as a single treatment to increase muscle force, reduce knee pain, and improve function. OBJECTIVES: To assess the effects (benefits and harms) of neuromuscular electrical stimulation for people with patellofemoral pain...
December 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29231235/the-perioperative-use-of-synthetic-and-biological-disease-modifying-antirheumatic-drugs-in-patients-with-rheumatoid-arthritis
#15
Gregory Fleury, Sylvano Mania, Didier Hannouche, Cem Gabay
Disease-modifying antirheumatic drugs (DMARDs) have become essential treatments in the management of patients with inflammatory rheumatic diseases. Their use has resulted in a marked improvement of disease control and a limitation of joint damage, although some patients still require subsequent corrective or joint replacement surgery. Due to their immunosuppressive effects, some DMARDs are associated with an increased risk of infection. The aim of this review is to discuss the available literature on the management of DMARDs during the perioperative period, particularly in the case of orthopaedic surgery...
December 12, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29231159/facet-joint-injections-for-non-specific-low-back-pain-a-feasibility-rct
#16
Saowarat Snidvongs, Rod S Taylor, Alia Ahmad, Simon Thomson, Manohar Sharma, Angela Farr, Deborah Fitzsimmons, Stephanie Poulton, Vivek Mehta, Richard Langford
BACKGROUND: Pain of lumbar facet-joint origin is a common cause of low back pain in adults and may lead to chronic pain and disability, with associated health and socioeconomic implications. The socioeconomic burden includes an inability to return to work resulting in loss of productivity in addition to direct and indirect health-care utilisation costs. Lumbar facet-joints are paired synovial joints between the superior and inferior articular processes of consecutive lumbar vertebrae and between the fifth lumbar vertebra and the sacrum...
December 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29227371/a-quality-improvement-initiative-reduces-cast-complications-in-a-pediatric-hospital
#17
Julie Balch Samora, Walter P Samora, Kevin Dolan, Kevin E Klingele
BACKGROUND: Casts, while frequently used as routine treatment in pediatric orthopaedic practice, are not without complications. At our large tertiary care pediatric hospital, the baseline rate of all casting complications was 5.6 complications per 1000 casts applied (0.56%). We tested the hypothesis that we could use quality improvement (QI) methodology to decrease the overall cast complication rate and improve patient care. METHODS: We initiated a QI program implementing concepts derived from the Institute for Healthcare Improvement models, including Plan-Do-Study-Act cycles, to decrease our cast complication rate...
December 8, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29214615/use-of-ankle-magnetic-resonance-imaging-in-the-active-duty-military-population-the-results-of-a-process-improvement-project
#18
Harold J Goldstein, Richard K Hurley, Andrew J Sheean, Michael Tompkins, Patrick M Osborn
BACKGROUND: Preventing overuse of magnetic resonance imaging (MRI) for diagnosing ankle pathology was the goal of a process improvement project at a military treatment facility. METHODS: Ordering patterns for MRI of nonorthopaedic providers and orthopaedic surgeons were evaluated over 2 separate periods. An educational initiative on appropriate use of MRI in evaluating ankle complaints was conducted between the 2 periods. RESULTS: Between October 2009 and March 2010, 230 ankle MRIs were performed at our institution, compared to 347 ankle MRIs performed between December 2012 and August 2013...
October 2017: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/29213170/prune-belly-syndrome-a-report-of-15-cases-from-sudan
#19
Abdelmoneim E M Kheir, Eltigani M A Ali, Safaa A Medani, Huda S Maaty
Prune belly syndrome is a rare congenital malformation of unknown aetiology, composed of a triad of deficient abdominal wall muscle, cryptorchidism and urinary tract anomalies. The majority of patients have associated pulmonary, skeletal, cardiac, and gastrointestinal defects. This was a prospective, case finding study that was conducted in the main paediatric hospitals in Khartoum state, during the period December 2015 to September 2016. A total of 15 patients with prune belly syndrome were collected. Patients' characteristics were noted including socio-demographic data, laboratory and radiological investigations and any medical or surgical intervention...
2017: Sudanese Journal of Paediatrics
https://www.readbyqxmd.com/read/29212692/the-impact-of-age-on-major-orthopaedic-trauma-an-analysis-of-the-united-kingdom-trauma-audit-research-network-database
#20
COMPARATIVE STUDY
J Herron, R Hutchinson, F Lecky, O Bouamra, A Edwards, M Woodford, W G P Eardley
AIMS: To compare the early management and mortality of older patients sustaining major orthopaedic trauma with that of a younger population with similar injuries. PATIENTS AND METHODS: The Trauma Audit Research Network database was reviewed to identify eligible patients admitted between April 2012 and June 2015. Distribution and severity of injury, interventions, comorbidity, critical care episodes and mortality were recorded. The population was divided into young (64 years or younger) and older (65 years and older) patients...
December 2017: Bone & Joint Journal
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