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Interventional Orthopaedics

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https://www.readbyqxmd.com/read/28922684/-rbc-transfusion-triggers-in-orthopaedic-lower-limb-arthroplasty
#1
Dirk Holten, Peter Zaar, Stefan Kessler
Introduction We implemented a hospital-wide mandatory RBC transfusion trigger checklist based on the haemoglobin level transfusion thresholds recommended by the German federal physicians board. Transfusion triggers, transfusion rates and hospital LOS in orthopaedic lower limb arthroplasty were compared before and after implementation of the transfusion trigger checklist. The goal was to evaluate the effect of this single and easy-to-implement intervention on transfusion rates in orthopaedic lower limb arthroplasty...
September 18, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28904637/the-emerging-trend-of-non-operative-treatment-in-paediatric-type-i-open-forearm-fractures
#2
REVIEW
H Zhang, M Fanelli, C Adams, J Graham, M Seeley
PURPOSE: Open fractures are considered an orthopaedic emergency and are generally an indication for operative debridement. Recent studies have questioned this approach for the management of Gustilo-Anderson Type I open fractures in the paediatric population. This meta-analysis studies the non-operative management of Type I open paediatric forearm fractures. METHODS: An Ovid MEDLINE and PubMed database literature search was performed for studies that involved a quantified number of Gustilo-Anderson Type I open forearm fractures in the paediatric population, which were treated without operative intervention...
August 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28904636/the-orthopaedic-management-of-lower-limb-deformity-in-hypophosphataemic-rickets
#3
A Horn, J Wright, D Bockenhauer, W Van't Hoff, D M Eastwood
BACKGROUND: Many patients with X-linked hypophosphataemic rickets (X-LHPR) demonstrate significant lower limb deformity despite optimal medical management. This study evaluates the use of guided growth by means of hemi-epiphysiodesis to address coronal plane deformity in the skeletally immature child. METHODS: Since 2005, 24 patients with X-LHPR have been referred to our orthopaedic unit for evaluation. All patients had standardised long leg radiographs that were analysed sequentially before and after surgery if any was performed...
August 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28902606/an-evaluation-of-patient-risk-factors-to-determine-eligibility-to-undergo-orthopaedic-surgery-in-a-freestanding-ambulatory-center-a-survey-of-4-242-consecutive-patients
#4
Matthew Siow, Germaine Cuff, Jovan Popovic, Joseph Bosco
INTRODUCTION: The value proposition of surgery at freestanding ambulatory surgery centers (FSASCs) in terms of efficiency, safety, and patient satisfaction is well established and has led to increased FSASC utilization. However, there are comorbid conditions that disqualify certain patients from surgery at FSASCs. Understanding the percentage of patients whose comorbid conditions exclude them from FSASCs is important for the proper planning and utilization of operating room assets. We aim to understand the percentage of excluded patients, and we predict that certain procedures have higher rates of disqualification due to the types of patients who undergo them...
May 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28890435/pain-control-in-thoracic-oncology
#5
Christine Peeters-Asdourian, Gilbert Massard, Paragi H Rana, Paul Van Houtte, Andrew P White, Bogdan Grigoriu, Dominique Lossignol, Mohammed Almalki, Jean Alexiou, Jean-Luc Engelholm, Jean-Paul Sculier
This review of pain management in lung cancer is based on the presentation of four cases of thoracic oncology patients with pain at various stages of their disease. The approach will be multidisciplinary, involving a thoracic oncologist, radiologist, thoracic and orthopaedic spine surgeon, radiation therapist, pain medicine specialist, and palliative care specialist. This multispecialty approach to the management of different painful presentations in thoracic oncology will demonstrate the complexity of each case and the improved patient outcomes which result from the involvement of different disciplines working in concert...
September 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28879606/history-of-clubfoot-treatment-part-iii-twentieth-century-back-to-the-future
#6
REVIEW
Philippe Hernigou
Clubfoot is one of the most common congenital orthopaedic anomalies and was described by Hippocrates in the year 400 BC. From manipulation in antiquity to splint and plaster in the Renaissance the treatment had improved before tenotomy. Many surgical treatments were tested during the nineteenth and twentieth centuries and will be explained in this manuscript; however, the pathology still continues to challenge the paediatric orthopedic surgeon as it has a notorious tendency to relapse, irrespective of whether the foot is treated with conservative or operative means...
September 6, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28875130/ipsilateral-femur-and-tibia-fractures-in-pediatric-patients-a-systematic-review
#7
Jason B Anari, Alexander L Neuwirth, B David Horn, Keith D Baldwin
AIM: To better understand how pediatric floating knee injuries are managed after the wide spread use of new orthopaedic technology. METHODS: We searched EMBASE, COCHRANE and MEDLINE computerized literature databases from the earliest date available in the databases to February 2017 using the following search term including variants and pleural counterparts: Pediatric floating knee. All studies were thoroughly reviewed by multiple authors. Reference lists from all articles were scrutinized to identify any additional studies of interest...
August 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28867040/-brain-plasticity-and-early-rehabilitative-care-for-children-after-neonatal-arterial-cerebral-infarction
#8
M Dinomais, S Marret, C Vuillerot
Currently, in the literature of the evidence based medicine, little data are available to confirm the benefit and the specific procedures of an early intervention for a neonatal arterial ischemic stroke. However, data about the effect of an early physical rehabilitation program on the cerebral plasticity, and preliminary results of clinical studies in children with cerebral palsy strongly suggest the benefit of an early rehabilitation with a multidisciplinary approach. The type of the rehabilitation and its frequency must be determined because a wide variability in the practices exists...
September 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28861195/india-based-knee-osteoarthritis-evaluation-ikare-a-multi-centre-cross-sectional-study-on-the-management-of-knee-pain-and-early-osteoarthritis-in-india
#9
Parag Sancheti, Vijay D Shetty, Mandeep S Dhillon, Sheila A Sprague, Mohit Bhandari
BACKGROUND: Access to early knee osteoarthritis treatment in low and middle income nations is often believed to be limited. We conducted a cross-sectional study in India to assess prior access to treatment among patients presenting with knee pain to specialist orthopaedic clinics. METHODS: The multi-centre, cross-sectional study included patients presenting with knee pain at 3 hospitals in India. Patients who met the inclusion criteria and provided informed consent completed a questionnaire designed to assess patient demographics, socioeconomic status, knee pain, treatment method, and patient's knowledge on osteoarthritis (OA)...
September 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28853767/a-large-animal-model-for-a-failed-two-stage-revision-of-intramedullary-nail-related-infection-by-methicillin-resistant-staphylococcus-aureus
#10
T F Moriarty, T Schmid, V Post, E Samara, S Kates, E M Schwarz, S Zeiter, R G Richards
The treatment of chronic orthopaedic device-associated infection (ODRI) often requires multiple surgeries and prolonged antibiotic therapy. Despite this extensive treatment protocol, the procedure is associated with significant failure rates. Currently, no large animal model is available that recapitulates a failed revision. Therefore, our aim was to establish a large animal model for failed treatment of an ODRI in order to serve as a testbed for future interventional strategies. Adult Swiss Alpine sheep received an intramedullary nail in the tibia and a localised inoculum of either a methicillin-sensitive or methicillin-resistant Staphylococcus aureus (MSSA, MRSA respectively)...
August 30, 2017: European Cells & Materials
https://www.readbyqxmd.com/read/28852355/how-reliable-is-the-acetabular-cup-position-assessment-from-routine-radiographs
#11
Jaime A Carvajal Alba, Heather K Vincent, Jagdeep S Sodhi, Loren L Latta, Hari K Parvataneni
BACKGROUND: Cup position is crucial for optimal outcomes in total hip arthroplasty. Radiographic assessment of component position is routinely performed in the early postoperative period. AIMS: The aims of this study were to determine in a controlled environment if routine radiographic methods accurately and reliably assess the acetabular cup position and to assess if there is a statistical difference related to the rater's level of training. METHODS: A pelvic model was mounted in a spatial frame...
2017: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/28842287/determining-potential-of-pmma-as-a-depot-for-rifampin-to-treat-recalcitrant-orthopaedic-infections
#12
Stefanie M Shiels, David J Tennent, Kevin S Akers, Joseph C Wenke
BACKGROUND: Open fractures are often complicated by infection. In cases of severe soft tissue and vascular injury, systemic antibiotics may be ineffective due to their inability to reach and provide direct antimicrobial activity to the zone of injury. High antibiotic concentrations within the wound can be achieved with reduced systemic toxicity by using local antibiotic delivery. As bacteria associated with musculoskeletal injuries frequently form biofilms, antibiotic selection is important...
August 16, 2017: Injury
https://www.readbyqxmd.com/read/28837458/early-lessons-on-bundled-payment-at-an-academic-medical-center
#13
Lindsay E Jubelt, Keith S Goldfeld, Saul B Blecker, Wei-Yi Chung, John A Bendo, Joseph A Bosco, Thomas J Errico, Anthony K Frempong-Boadu, Richard Iorio, James D Slover, Leora I Horwitz
INTRODUCTION: Orthopaedic care is shifting to alternative payment models. We examined whether New York University Langone Medical Center achieved savings under the Centers for Medicare and Medicaid Services Bundled Payments for Care Improvement initiative. METHODS: This study was a difference-in-differences study of Medicare fee-for-service patients hospitalized from April 2011 to June 2012 and October 2013 to December 2014 for lower extremity joint arthroplasty, cardiac valve procedures, or spine surgery (intervention groups), or for congestive heart failure, major bowel procedures, medical peripheral vascular disorders, medical noninfectious orthopaedic care, or stroke (control group)...
September 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28836493/developing-a-multidisciplinary-rehabilitation-package-following-hip-fracture-and-testing-in-a-randomised-feasibility-study-fracture-in-the-elderly-multidisciplinary-rehabilitation-femur
#14
Nefyn H Williams, Jessica L Roberts, Nafees Ud Din, Joanna M Charles, Nicola Totton, Michelle Williams, Kevin Mawdesley, Claire A Hawkes, Val Morrison, Andrew Lemmey, Rhiannon T Edwards, Zoe Hoare, Aaron W Pritchard, Robert T Woods, Swapna Alexander, Catherine Sackley, Pip Logan, Clare Wilkinson, Jo Rycroft-Malone
BACKGROUND: Proximal femoral fracture is a major health problem in old age, with annual UK health and social care costs of £2.3B. Rehabilitation has the potential to maximise functional recovery and maintain independent living, but evidence of clinical effectiveness and cost-effectiveness is lacking. OBJECTIVES: To develop an enhanced community-based rehabilitation package following surgical treatment for proximal femoral fracture and to assess acceptability and feasibility for a future definitive randomised controlled trial (RCT) and economic evaluation...
August 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28833976/what-contributes-to-action-plan-enactment-examining-characteristics-of-physical-activity-plans
#15
Lena Fleig, Benjamin Gardner, Jan Keller, Sonia Lippke, Sarah Pomp, Amelie U Wiedemann
OBJECTIVES: Individuals with chronic conditions can benefit from formulating action plans to engage in regular physical activity. However, the content and the successful translation of plans into action, so-called plan enactment, are rarely adequately evaluated. The aim of this study was to describe the content of user-specified plans and to examine whether participants were more likely to enact their plans if these plans were highly specific, viable, and instrumental. DESIGN AND METHODS: The study presents secondary analyses from a larger behavioural intervention in cardiac and orthopaedic rehabilitation...
August 18, 2017: British Journal of Health Psychology
https://www.readbyqxmd.com/read/28832389/prospective-evaluation-of-posttraumatic-stress-disorder-and-depression-in-orthopaedic-injury-patients-with-and-without-concomitant-traumatic-brain-injury
#16
Kenleigh Roden-Foreman, Jaicus Solis, Alan Jones, Monica Bennett, Jacob W Roden-Foreman, Evan E Rainey, Michael L Foreman, Ann Marie Warren
OBJECTIVES: Psychological morbidities after injury [eg, posttraumatic stress disorder (PTSD) and depression] are increasingly recognized as a significant determinant of overall outcome. Traumatic brain injury (TBI) negatively impacts outcomes of patients with orthopaedic injury, but the association of concurrent TBI, orthopaedic injury, and symptoms of PTSD and depression has not been examined. This study's objective was to examine symptoms of PTSD and depression in patients with orthopaedic trauma with and without TBI...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28828067/patient-factors-associated-with-delayed-diagnosis-of-developmental-dysplasia-of-the-hip
#17
A W Lindberg, V Bompadre, E K Satchell, A C R Larson, K K White
PURPOSE: Early detection and intervention for developmental dysplasia of the hip (DDH) is important for normal hip development. Previous studies have shown disparities in access to paediatric specialty care among different racial and socioeconomic backgrounds. This study aims to identify whether these factors are related to timely referral for infants with DDH. METHODS: A retrospective cohort study of patients seen and treated for DDH between July 2006 and June 2011 at a single institution were reviewed...
June 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28815160/the-burden-of-spine-fractures-in-india-a-prospective-multicenter-study
#18
Ilyas S Aleem, Dylan DeMarco, Brian Drew, Parag Sancheti, Vijay Shetty, Mandeep Dhillon, Clary J Foote, Mohit Bhandari
STUDY DESIGN: Prospective cohort study. OBJECTIVES: The objectives of this study were (1) to determine the characteristics of patients sustaining spinal trauma in India and (2) to explore the association between patient or injury characteristics and outcomes after spinal trauma. METHODS: In affiliation with the ongoing INternational ORthopaedic MUlticentre Study (INORMUS), 192 patients with spinal injuries were recruited during an 8-week period (November 2011 to June 2012) from 14 hospitals in India and followed for 30-days...
June 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28814909/increasing-medical-student-exposure-to-musculoskeletal-medicine-the-initial-impact-of-the-orthopaedic-surgery-and-sports-medicine-interest-group
#19
Dayne T Mickelson, Philip K Louie, Kenneth R Gundle, Alex W Farnand, Douglas P Hanel
PURPOSE: To investigate the impact of the Orthopaedic Surgery and Sports Medicine Interest Group (OSSMIG) on medical student interest and confidence in core musculoskeletal (MSK) concepts through supplemental education and experiences at a single tertiary, academic institution. METHODS: Medical student OSSMIG members at various levels of training were anonymously surveyed at the beginning and end of the 2014-2015 academic year. RESULTS: Eighteen (N=18) medical student interest group members completed the survey...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28810985/multimedia-campaign-enhances-orthopaedic-patient-perceptions-of-health-care-quality-a-prospective-analysis-of-effect-at-a-military-treatment-facility
#20
Andrew J Sheean, James N Foster, James K Aden, Creighton C Tubb, Anthony E Johnson, Daniel J Stinner
BACKGROUND: The importance of patient satisfaction as a measure of quality has grown with initiatives intended to enhance demand for services, refocus reimbursement paradigms, encourage health care efficiencies, and ultimately improve clinical outcomes. The purpose of our performance improvement project was to (1) characterize the effect of a two-pronged multimedia initiative on patient perceptions of health care quality and satisfaction as assessed by the Army Provider Level Satisfaction Survey (APLSS) and (2) assess for differences in APLSS scores between the surgeons that did and did not participate in the program...
July 2017: Military Medicine
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