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Interventional Orthopaedics

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https://www.readbyqxmd.com/read/28437759/correlation-of-technical-surgical-goals-to-the-gdi-and-investigation-of-post-operative-gdi-change-in-children-with-cerebral-palsy
#1
Christina Bickley, Judi Linton, Nancy Scarborough, Elroy Sullivan, Katy Mitchell, Douglas Barnes
AIM: The purpose of this study was to introduce a standardized set of surgical technical achievement goals (TAGs) as part of a comprehensive outcome assessment model for children with spastic cerebral palsy (CP) undergoing orthopaedic surgical intervention to improve gait. Examination of relationships of these surgical goals to the Gait Deviation Index (GDI) and use of two assessments in tandem provided a thorough picture of technical surgical outcomes. This study also investigated changes in GDI in children with spastic CP after surgery...
April 13, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28430718/trauma-collaborative-care-intervention-effect-on-surgeon-confidence-in-managing-psychosocial-complications-following-orthopaedic-trauma
#2
Stephen Wegener, Eben Carroll, Joshua Gary, Todd McKinley, Robert O'Toole, Debra Sietsema, Renan Castillo, Katherine Frey, Daniel Scharfstein, Yanjie Huang, Susan Collins, Ellen MacKenzie
OBJECTIVES: The impact of the Trauma Collaborative Care (TCC) program on surgeon confidence in managing the psychosocial sequelae of orthopaedic trauma was evaluated as part of a larger prospective, multisite, cluster clinical trial. We compared confidence and perceived resource availability among surgeons practicing in trauma centers that implemented the TCC program with orthopaedic trauma surgeons in similar trauma centers that did not implement the TCC. DESIGN: Prospective cohort design SETTING:: Level 1 Trauma Centers PARTICIPANTS:: Attending surgeons and Fellows...
April 18, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28407199/comprehensive-geriatric-assessment-for-prevention-of-delirium-after-hip-fracture-a-systematic-review-of-randomized-controlled-trials
#3
Lynn Shields, Victoria Henderson, Robert Caslake
OBJECTIVES: To assess the efficacy of comprehensive geriatric assessment (CGA) in prevention of delirium after hip fracture. DESIGN: Systematic review and metaanalysis. SETTING: Ward based models on geriatrics wards and visiting team based models on orthopaedics wards were included. PARTICIPANTS: Four trials (three European, one U.S.; 973 participants) were identified. Two assessed ward-based, and two assessed team-based interventions...
April 13, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28403859/managing-uncertainty-a-qualitative-study-of-surgeons-decision-making-for-one-stage-and-two-stage-revision-surgery-for-prosthetic-hip-joint-infection
#4
Andrew J Moore, Ashley W Blom, Michael R Whitehouse, Rachael Gooberman-Hill
BACKGROUND: Approximately 88,000 primary hip replacements are performed in England and Wales each year. Around 1% go on to develop deep prosthetic joint infection. Between one-stage and two-stage revision arthroplasty best treatment options remain unclear. Our aims were to characterise consultant orthopaedic surgeons' decisions about performing either one-stage or two-stage revision surgery for patients with deep prosthetic infection (PJI) after hip arthroplasty, and to identify whether a randomised trial comparing one-stage with two-stage revision would be feasible...
April 12, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28400667/epidemiology-of-lower-limb-musculoskeletal-trauma-with-associated-vascular-injuries-in-a-tertiary-care-institute-in-india
#5
Nirmal Raj Gopinathan, Siva Swaminathan Santhanam, Balaji Saibaba, Mandeep Singh Dhillon
BACKGROUND: Vascular trauma associated with bony injuries is an orthopaedic emergency. Lack of timely intervention can lead to loss of limb or even life. Inspite of the rising incidence of high speed road traffic accidents in India, there is paucity of literature regarding the demographic pattern, clinical morbidity, management strategies and outcome of arterial injuries associated with lower limb trauma. The aim of this study is to describe the epidemiology and outcome of lower extremity musculoskeletal trauma with associated vascular injuries in a tertiary care institute in India...
March 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28396616/experiences-of-reduced-work-hours-for-nurses-and-assistant-nurses-at-a-surgical-department-a-qualitative-study
#6
Kristina Gyllensten, Gunnar Andersson, Helena Muller
BACKGROUND: There is a shortage of registered nurses in the European Union (EU), and job dissatisfaction and perceived high work-family conflict have been identified as causes of nursing staff turnover. Reducing work hours is an organisational intervention that could have a positive effect on nurses' and assistant nurses' job satisfaction, work-life balance, and willingness to stay in the job. An orthopaedic surgery department at a large hospital in Sweden introduced reduced work hours for nurses and assistant nurses in order to improve the working situation...
2017: BMC Nursing
https://www.readbyqxmd.com/read/28394018/protocol-for-follow-up-of-hip-arthroplasty-in-the-long-term-effect-on-revision-whistler-study
#7
Lindsay K Smith, Erik Lenguerrand, Ashley Blom, Jane Powell, Shea Palmer
Total hip arthroplasty (THA) is highly successful for reducing pain and improving function, providing health-related quality of life benefit. Demand for THA is increasing with associated increase in revision hip surgery. Hip arthroplasty surveillance (long-term follow up) can identify asymptomatically failing THA to prepare for revision surgery, reducing potential for complications or complexity of surgery. However, it is unknown whether the surveillance of THA can be shown to improve the patient outcomes or reduce costs around revision surgery...
April 10, 2017: Musculoskeletal Care
https://www.readbyqxmd.com/read/28385940/the-evolution-of-fracture-clinic-design-the-activity-and-safety-of-the-edinburgh-trauma-triage-clinic-with-one-year-follow-up
#8
T O White, S P Mackenzie, T H Carter, J G Jefferies, O R Prescott, A D Duckworth, J F Keating
AIMS: Fracture clinics are often characterised by the referral of large numbers of unselected patients with minor injuries not requiring investigation or intervention, long waiting times and recurrent unnecessary reviews. Our experience had been of an unsustainable system and we implemented a 'Trauma Triage Clinic' (TTC) in order to rationalise and regulate access to our fracture service. The British Orthopaedic Association's guidelines have required a prospective evaluation of this change of practice, and we report our experience and results...
April 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28379615/use-of-a-novel-extracapsular-bone-anchor-system-for-stabilisation-of-cranial-cruciate-ligament-insufficiency
#9
N M Muro, O I Lanz
OBJECTIVES: To evaluate early clinical experiences using the novel extracapsular bone anchor Ruby system for stabilisation of the cranial cruciate ligament deficient stifle in the dog and report short-term outcome and complications for 17 clinical cases. MATERIALS AND METHODS: Seventeen dogs with cranial cruciate ligament insufficiency were treated using the Ruby system. Dogs were eligible if diagnosed via orthopaedic examination with unilateral or bilateral cranial cruciate ligament instability without any comorbidities...
April 5, 2017: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/28375897/-red-yellow-green-effect-of-an-initiative-to-guide-surgeon-choice-of-orthopaedic-implants
#10
Kanu Okike, Rachael Pollak, Robert V O'Toole, Andrew N Pollak
BACKGROUND: Orthopaedic procedures are expensive, and devices account for a large proportion of the overall costs. Hospitals have employed a variety of strategies to decrease implant costs, but many center on restricting surgeon choice. At our institution, we developed an implant selection tool that guides surgeons toward more cost-effective implants, while minimally restricting choice. The purpose of this study was to assess the effect of this tool on preferred implant usage rates, vendor attitudes toward pricing structure, and hospital implant expenditures...
April 5, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28361017/lower-limb-stress-fractures-in-sport-optimising-their-management-and-outcome
#11
REVIEW
Greg A J Robertson, Alexander M Wood
Stress fractures in sport are becoming increasing more common, comprising up to 10% of all of sporting injuries. Around 90% of such injuries are located in the lower limb. This articles aims to define the optimal management of lower limb stress fractures in the athlete, with a view to maximise return rates and minimise return times to sport. Treatment planning of this condition is specific to the location of the injury. However, there remains a clear division of stress fractures by "high" and "low" risk. "Low risk" stress fractures are those with a low probability of fracture propagation, delayed union, or non-union, and so can be managed reliably with rest and exercise limitation...
March 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28360497/operative-repair-of-proximal-humerus-fractures-in-septuagenarians-and-octogenarians-does-chronologic-age-matter
#12
Abraham Michael Goch, Anthony Christiano, Sanjit Reddy Konda, Philipp Leucht, Kenneth Andrew Egol
BACKGROUND: With an expected doubling of the geriatric population within the next thirty years it is becoming increasingly important to determine who among the elderly population benefit from orthopaedic interventions. This study assesses post-operative outcomes in patients aged seventy or greater who sustained a proximal humerus fracture and were treated surgically as compared to a younger geriatric cohort to determine if there is a chronologic age after which post-operative outcomes significantly decline...
January 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28358777/improving-patient-education-at-a-large-midwest-urban-orthopaedic-center
#13
Kathleen Laude, Susan Weber Buchholz, Mary Rodts
A large Midwest urban orthopaedic center sought to improve dissemination and documentation of its education information given to its patients. A new electronic, partially automated patient education delivery system was implemented that disseminates and documents targeted patient education modules. The program triggers automatic dissemination of general education based on patient demographics. Surgical education modules are disseminated manually. The semiautomated electronic education program successfully placed the center in compliance with Stage 2 Meaningful Use and showed improved dissemination of educational materials...
March 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28358771/orthopaedic-snafus-when-adverse-events-happen-in-orthopaedics
#14
Mary Atkinson Smith, Colleen Walsh, Barbara Levin, Kathyrn Eaten, Melissa Yager
The potential for adverse events exists when treating and managing orthopaedic patients in the intraoperative or postoperative environments, especially when it comes to falls, surgical site infections, venous thromboembolism, and injuries to nerves and blood vessels. Orthopaedic nurses play a vital role in the promotion and use of evidence-based interventions to decrease the incidence of these adverse events, improve quality of care, and minimize the financial burden related to these adverse events.
March 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28353448/predictive-value-of-fever-following-arthroplasty-in-diagnosing-an-early-infection
#15
Tiziana Ascione, Giovanni Balato, Giovanni Boccia, Francesco De Caro
Postoperative fever after orthopaedic surgery is a controversial clinical problem in daily practice because damaged tissue due to surgical intervention can induce the production of proinflammatory cytokines responsible of the systemic inflammatory response syndrome. No current diagnostic marker can differentiate with sufficient accuracy infectious from non-infectious fever in patients undergoing orthopaedic surgery, but early diagnosis of postoperative orthopaedic infections is important in order to rapidly initiate adequate antimicrobial therapy...
March 1, 2017: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/28353050/do-surgeon-expectations-predict-clinically-important-improvements-in-womac-scores-after-tha-and-tka
#16
Hassan M K Ghomrawi, Carol A Mancuso, Allison Dunning, Alejandro Gonzalez Della Valle, Michael Alexiades, Charles Cornell, Thomas Sculco, Matthias Bostrom, David Mayman, Robert G Marx, Geoffrey Westrich, Michael O'Dell, Alvin I Mushlin
BACKGROUND: Failure of THA or TKA to meet a patient's expectations may result in patient disappointment and litigation. However, there is little evidence to suggest that surgeons can consistently anticipate which patients will benefit from those interventions. QUESTIONS/PURPOSES: To determine the ability of surgeons to identify, in advance of surgery, patients who will benefit from THA or TKA and those who will not, where 'benefit' is defined as a clinically important improvement in a validated patient-reported outcomes score...
March 28, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28332761/a-uk-national-survey-of-care-pathways-and-support-offered-to-patients-receiving-revision-surgery-for-prosthetic-joint-infection-in-the-highest-volume-nhs-orthopaedic-centres
#17
Andrew J Moore, Michael R Whitehouse, Rachael Gooberman-Hill, Jason Heddington, Andrew D Beswick, Ashley W Blom, Tim J Peters
BACKGROUND: Deep prosthetic joint infection (PJI) is a devastating complication of joint replacement surgery. It is difficult to treat, and patients often require multiple major revision surgeries to eradicate the infection. Treatment can have negative and long-term impact on patients' quality of life. Understanding current service provision provides valuable information needed to design and evaluate support interventions for patients. AIM: This survey aimed to identify usual care pathways and support in UK National Health Service (NHS) orthopaedic centres for patients receiving revision surgery for PJI after hip or knee replacement...
March 23, 2017: Musculoskeletal Care
https://www.readbyqxmd.com/read/28323807/the-trauma-collaborative-care-study-tccs
#18
Stephen T Wegener, Andrew N Pollak, Katherine P Frey, Robert A Hymes, Kristin R Archer, Clifford B Jones, Rachel B Seymour, Robert V O╩╝Toole, Renan C Castillo, Yanjie Huang, Daniel O Scharfstein, Ellen J MacKenzie
Previous research suggests that the care provided to trauma patients could be improved by including early screening and management of emotional distress and psychological comorbidity. The Trauma Collaborative Care (TCC) program, which is based on the principles of well-established models of collaborative care, was designed to address this gap in trauma center care. This article describes the TCC program and the design of a multicenter study to evaluate its effectiveness for improving patient outcomes after major, high-energy orthopaedic trauma at level 1 trauma centers...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28317236/rehabilitation-of-revision-total-hip-replacement-a-multi-centre-survey-of-current-practice
#19
Meredith Newman, Karen Barker
BACKGROUND: Demand for revision total hip replacement (RTHR) is increasing. Outcomes after RTHR are varied, with reasonable pain relief but smaller gains in function and mobility. Whether sub-optimal rehabilitation contributes to poorer functional outcomes is unclear. Current rehabilitation is not well defined and there is little research into RTHR rehabilitation. AIMS AND OBJECTIVES: To gather information about the current rehabilitation of patients undergoing planned, single-stage revision or re-revision THR surgery...
March 20, 2017: Musculoskeletal Care
https://www.readbyqxmd.com/read/28302377/stair-negotiation-as-a-rehabilitation-intervention-for-enhancing-recovery-following-total-hip-and-knee-replacement-surgery
#20
REVIEW
James P Gavin, Tikki Immins, Thomas Wainwright
BACKGROUND: Total hip replacement (THR) and total knee replacement (TKR) are common orthopaedic procedures. However, an optimal programme for post-operative rehabilitation has yet to be established. Stair negotiation is a challenging, habitual task, regularly used as a post-operative functional outcome measure; yet as a physical rehabilitation intervention it appears to be rarely used. AIM: The review purpose was to investigate the effectiveness of stair climbing as a rehabilitation intervention for THR and TKR patients...
October 20, 2016: International Journal of Orthopaedic and Trauma Nursing
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