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Interventional Orthopaedics

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https://www.readbyqxmd.com/read/29762277/impact-of-clinical-practice-guidelines-on-use-of-intra-articular-hyaluronic-acid-and-corticosteroid-injections-for-knee-osteoarthritis
#1
Nicholas A Bedard, David E DeMik, Natalie A Glass, Robert A Burnett, Kevin J Bozic, John J Callaghan
BACKGROUND: The efficacy of corticosteroid and hyaluronic acid injections for knee osteoarthritis has been questioned. The purpose of this study was to determine the impact of the American Academy of Orthopaedic Surgeons (AAOS) clinical practice guidelines on the use of these injections in the United States and determine if utilization differed by provider specialty. METHODS: Patients with knee osteoarthritis were identified within the Humana database from 2007 to 2015, and the percentage of patients receiving a knee injection relative to the number of patients having an encounter for knee osteoarthritis was calculated and was trended for the study period...
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29758581/-managment-of-acute-low-back-pain-without-trauma-an-algorithm
#2
Carolin Melcher, Bernd Wegener, Volkmar Jansson, Wolf Mutschler, Karl-Georg Kanz, Christof Birkenmaier
BACKGROUND: Low back pain is a common problem for primary care providers, outpatient clinics and A&E departments. The predominant symptoms are those of so-called "unspecific back pain", but serious pathologies can be concealed by the clinical signs. Especially less experienced colleagues have problems in treating these patients, as - despite the multitude of recommendations and guidelines - there is no generally accepted algorithm. METHODS: After a literature search (Medline/Cochrane), 158 articles were selected from 15,000 papers and classified according to their level of evidence...
May 14, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29754593/comparison-of-health-literacy-in-privately-insured-and-public-hospital-orthopaedic-patients
#3
Filip Cosic, Tabitha Porter, Cameron Norsworthy, Rohan Price, Harvinder Bedi
Objective The aim of the present study was to quantify and compare patient health literacy between privately insured and public orthopaedic patients. Methods As part of the present cross-sectional study, elective postoperative orthopaedic patients across two sites were recruited and asked to complete a questionnaire at the first postoperative out-patient review. Patients were divided into three groups: (1) a public group (Public); (2) a private group (Private-pre); and (3) a private group that completed the questionnaire immediately after the out-patient review (Private-post)...
May 14, 2018: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29738400/using-a-validated-middle-age-and-geriatric-risk-tool-to-identify-early-48hr-hospital-mortality-and-associated-cost-of-care
#4
Ariana Lott, Jack Haglin, Hesham Saleh, Jordan Hall, Kenneth A Egol, Sanjit R Konda
OBJECTIVES: 1) Demonstrate that a validated trauma triage score for middle-aged and geriatric patients could identify those at high risk for mortality within the first two days of hospitalization and 2) determine the cost of care for this cohort of patients DESIGN:: Prospective cohort study SETTING:: Single Level 1 Trauma Center PATIENTS:: Patients 55 years and older who were evaluated in the emergency department setting by Orthopaedics or who met American College of Surgeons Tier 1-3 criteria INTERVENTION:: Calculation of validated trauma triage score, Score for Trauma Triage in Geriatric and Middle Aged (STTGMA), using patient's demographic, injury severity, and functional statusMain Outcome Measurements: length of stay, inpatient mortality, time between presentation and time of death, and direct variable costs of hospitalization RESULTS:: A total of 1470 consecutive patients (mean age of 72...
May 3, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29738398/revenue-for-initial-orthopaedic-trauma-care-effects-of-patient-and-injury-characteristics
#5
Christopher D Flanagan, Alexander S Rascoe, David M Wang, Heather Vallier
OBJECTIVE: To characterize the charges and collections associated with the initial inpatient management of trauma patients who undergo operative fracture management DESIGN:: Retrospective SETTING:: Level 1 trauma center PARTICIPANTS:: 440 consecutive adult trauma patients INTERVENTION:: fixation for fracture of the spine, pelvis, acetabulum, and/or femur fractures MAIN OUTCOME MEASUREMENT:: Professional and technical (facility) charges and collections from the initial inpatient management and 6 months of subsequent related care RESULTS:: Patient were predominantly male (74...
May 3, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29735284/music-intervention-to-prevent-delirium-among-older-patients-admitted-to-a-trauma-intensive-care-unit-and-a-trauma-orthopaedic-unit
#6
Kari Johnson, Julie Fleury, Darya McClain
PURPOSE: Evaluate music listening for delirium prevention among patients admitted to a Trauma Intensive Care and Trauma Orthopaedic Unit. The Roy Adaptation Model provided the theoretical framework focusing on modifying contextual stimuli. METHODS: Randomised controlled trial, 40 patients aged 55 and older. INTERVENTION: Participants randomly assigned to receive music listening or usual care for 60 minutes, twice a day, over three days. Pre-recorded self-selected music using an iPod and headsets, with slow tempo, low pitch and simple repetitive rhythms to alter physiologic responses...
May 4, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29734901/the-role-of-selective-peripheral-neurectomy-in-the-treatment-of-upper-limb-spasticity
#7
Li Yenn Yong, Charis H L Wong, Mark Gaston, Wee Leon Lam
BACKGROUND: Management of upper limb spasticity remains challenging. Selective peripheral neurectomy (SPN) is a relatively recent intervention for cases refractory to medical therapy. The aim of this study was to conduct a systematic review looking at the efficacy and outcomes of SPN, in order to clarify the patient selection criteria and surgical technique. METHODS: A search of MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science Core Collection, Open Grey and CINAHL was conducted...
June 2018: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/29732493/-knee-osteoarthritis-and-current-research-for-evidence-are-we-on-the-right-way
#8
Jared Scott, Jake Xavier Checketts, Jarryd G Horn, Craig Cooper, Matt Vassar
PURPOSE: An estimated 85% of research is of limited value or wasted because the wrong research questions are addressed. We sought to identify research gaps using American Academy of Orthopaedic Surgeon (AAOS) clinical practice guidelines Treatment of Osteoarthritis of the Knee and Surgical Management of Osteoarthritis of the Knee. Using these recommendations, we conducted searches of ClinicalTrials.gov to discover the extent to which new and ongoing research addresses areas of deficiency...
May 7, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29731951/advanced-computational-methods-in-bio-mechanics
#9
REVIEW
Waleed M S Al Qahtani, Mohamed I El-Anwar
A novel partnership between surgeons and machines, made possible by advances in computing and engineering technology, could overcome many of the limitations of traditional surgery. By extending surgeons' ability to plan and carry out surgical interventions more accurately and with fewer traumas, computer-integrated surgery (CIS) systems could help to improve clinical outcomes and the efficiency of healthcare delivery. CIS systems could have a similar impact on surgery to that long since realised in computer-integrated manufacturing...
April 15, 2018: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29727872/postoperative-complications-in-equine-elective-clean-orthopaedic-surgery-with-without-antibiotic-prophylaxis
#10
Sabita Diana Stöckle, Klaus Failing, Marc Koene, Kerstin Fey
OBJECTIVE: Retrospective analysis of postoperative complications in equines after clean, orthopaedic surgical procedures in order to detect differences between animals treated with antibiotics and horses without receiving these drugs. MATERIAL AND METHODS: Details on 652 patients, surgical procedures and surgery-associated complications were compiled from horses being operated between June 2011 and January 2015. Antibiotic-receiving patients (n = 259) were tested for differences in complication rates and characteristics to controls (n = 393)...
April 2018: Tierärztliche Praxis. Ausgabe G, Grosstiere/Nutztiere
https://www.readbyqxmd.com/read/29712566/powiff-prospective-study-of-wrist-internal-fixation-of-fracture-a-protocol-for-a-single-centre-superiority-randomised-controlled-trial-to-study-the-efficacy-of-the-vrp-2-0-distal-radius-plate-austofix-versus-the-va-lcp-depuy-synthes-for-distal-radius-fractures
#11
V D Varghese, Peter Smitham, Stuart Howell, Suzanne Edwards, Mark Rickman
BACKGROUND: Distal radial fractures are one of the most common orthopaedic cases that present to the A&E department. Surgical intervention is warranted in displaced intraarticular fractures and fractures with more than the recommended angulation or shortening, and is most commonly treated with volarly placed fixed angle locking plates. The aim of this study is to determine and compare the efficacy of two different plates for surgical treatment of distal radius fractures. The VRP 2...
April 30, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29709523/knee-arthroplasty-patients-predicted-versus-actual-recovery-what-are-their-expectations-about-time-of-recovery-following-surgery-and-how-long-before-they-can-do-the-tasks-they-want-to-do
#12
Karen L Barker, Erin Hannink, Sam Pemberton, Cathy Jenkins
OBJECTIVE: (1) To determine evidence-based guidance for the length of time to return to specific valued functional and leisure activities following knee arthroplasty (KA). (2) To determine what patients feel are the most important functional or leisure activities to recover after KA. (3) To collect information about patients' expectations and compare them to the actual time it takes to return. DESIGN: Prospective longitudinal cohort observational survey SETTING: Specialist orthopaedic hospital PARTICIPANTS: 99 patients with osteoarthritis or rheumatoid arthritis (mean= 69...
April 27, 2018: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29704188/mucolipidosis-type-iii-a-series-of-adult-patients
#13
Esmee Oussoren, David van Eerd, Elaine Murphy, Robin Lachmann, Jan C van der Meijden, Lies H Hoefsloot, Rob Verdijk, George J G Ruijter, Mario Maas, Carla E M Hollak, Janneke G Langendonk, Ans T van der Ploeg, Mirjam Langeveld
BACKGROUND: Mucolipidosis type III α/β or γ (MLIII) are rare autosomal recessive diseases, in which reduced activity of the enzyme UDP-N-acetyl glucosamine-1-phosphotransferase (GlcNAc-PTase) leads to intra-lysosomal accumulation of different substrates. Publications on the natural history of MLIII, especially the milder forms, are scarce. This study provides a detailed description of the disease characteristics and its natural course in adult patients with MLIII. METHODS: In this retrospective chart study, the clinical, biochemical and molecular findings in adult patients with a confirmed diagnosis of MLIII from three treatment centres were collected...
April 27, 2018: Journal of Inherited Metabolic Disease
https://www.readbyqxmd.com/read/29703195/measurement-of-patient-reported-disability-using-whodas-2-0-before-and-after-surgical-intervention-in-madagascar
#14
Michelle C White, Kirsten Randall, Dennis Alcorn, Rachel Greenland, Christine Glasgo, Mark G Shrime
BACKGROUND: Patient reported outcomes (PRO) measure the quality of care from the patient's perspective. PROs are an important measure of surgical outcome and can be used to calculate health gains after surgical treatment. The World Health Organisation Disability Assessment Schedule (WHODAS) 2.0 is a PRO used to evaluate pre and post-operative disability across a range of surgical specialities. In this study, Mercy Ships, a non-governmental organisation (NGO), used WHODAS 2.0 to evaluate patient reported disability in 401 consecutive patients in Madagascar...
April 27, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29694674/local-anaesthetics-and-regional-anaesthesia-versus-conventional-analgesia-for-preventing-persistent-postoperative-pain-in-adults-and-children
#15
REVIEW
Erica J Weinstein, Jacob L Levene, Marc S Cohen, Doerthe A Andreae, Jerry Y Chao, Matthew Johnson, Charles B Hall, Michael H Andreae
BACKGROUND: Regional anaesthesia may reduce the rate of persistent postoperative pain (PPP), a frequent and debilitating condition. This review was originally published in 2012 and updated in 2017. OBJECTIVES: To compare local anaesthetics and regional anaesthesia versus conventional analgesia for the prevention of PPP beyond three months in adults and children undergoing elective surgery. SEARCH METHODS: We searched CENTRAL, MEDLINE, and Embase to December 2016 without any language restriction...
April 25, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29682618/multidisciplinary-approach-to-improve-the-quality-of-below-knee-plaster-casting
#16
John Teudar Williams, Marta Kedrzycki, Yathish Shenava
Problem: In our trauma unit, we noted a high rate of incorrectly applied below-knee casts for ankle fractures, in some cases requiring reapplication. This caused significant discomfort and inconvenience for patients and additional burden on plaster-room services. Our aim was to improve the quality of plaster casts and reduce the proportion that needed to be reapplied. Methods: Our criteria for plaster cast quality were based on the British Orthopaedic Association Casting Standards (2015) and included neutral (plantargrade) ankle position, adequacy of fracture reduction and rate of cast reapplication...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29677918/collecting-patient-reported-outcomes-in-the-wild-opportunities-and-challenges
#17
Federico Cabitza, Linda Greta Dui
Collecting Patient Reported Outcomes (PROs) is generally seen as an effective way to assess the efficacy and appropriateness of medical interventions, from the patients' perspective. In 2016 the Galeazzi Orthopaedic Institute established a digitized program of PROs collection from spine, hip and knee surgery patients. In this work, we re-port the findings from the data analysis of the responses collected so far about the complementarity of PROs with respect to the data reported by the clinicians, and about the main biases that can undermine their validity and reliability...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29664955/efficacy-of-a-biomechanically-based-yoga-exercise-program-in-knee-osteoarthritis-a-randomized-controlled-trial
#18
Alexander B Kuntz, Jaclyn N Chopp-Hurley, Elora C Brenneman, Sarah Karampatos, Emily G Wiebenga, Jonathan D Adachi, Michael D Noseworthy, Monica R Maly
OBJECTIVE: Certain exercises could overload the osteoarthritic knee. We developed an exercise program from yoga postures with a minimal knee adduction moment for knee osteoarthritis. The purpose was to compare the effectiveness of this biomechanically-based yoga exercise (YE), with traditional exercise (TE), and a no-exercise attention-equivalent control (NE) for improving pain, self-reported physical function and mobility performance in women with knee osteoarthritis. DESIGN: Single-blind, three-arm randomized controlled trial...
2018: PloS One
https://www.readbyqxmd.com/read/29664850/idiopathic-toe-walking-prevalence-and-natural-history-from-birth-to-ten-years-of-age
#19
Pähr Engström, Kristina Tedroff
BACKGROUND: Children with idiopathic toe-walking, a common pediatric condition, walk some or all of the time on their toes. This condition often causes parental concern, with repeated medical contacts and a range of interventions including stretching, casts, injection of botulinum toxin A, and surgical procedures. The purpose of this cohort study was to document the natural history of this condition. METHODS: In a population-based cohort of 1,401 healthy 5.5-year-old Swedish children, we found the prevalence of idiopathic toe-walking to be approximately 5% (63 of 1,401)...
April 18, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29661082/endoscopic-resection-of-different-types-of-talocalcaneal-coalition
#20
Wael Aldahshan, Adel Hamed, Faisal Elsherief, Ashraf Mohamed Abdelaziz
BACKGROUND: The purpose of this study was to describe the technique of endoscopic resection of talocalcaneal coalition (TCC) by using 2 posterior portals and to report the outcomes of endoscopic resection of different types and sites of TCC. METHODS: An interventional prospective study was conducted on 20 feet in 18 consecutive patients who were diagnosed by computed tomography to have TCC for which nonoperative treatment had failed and endoscopic resection was performed...
April 1, 2018: Foot & Ankle International
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