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Interventional Orthopaedics

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https://www.readbyqxmd.com/read/29156072/clinical-and-radiologic-outcomes-of-metatarsophalangeal-hemiarthroplasty-a-review-of-12-consecutive-cases
#1
Florian Wanivenhaus, Jacqueline Fust, Matthias Erschbamer, Andreas Schirm
This study examined function, pain, satisfaction, and radiologic outcomes among patients treated with first metatarsophalangeal hemiarthroplasty. Patients were invited to participate in an outcome study conducted with questionnaires on subjective and objective outcomes and clinical and radiographic follow-up. A total of 12 patients (12 feet; mean patient age, 58.8±12.3 years) agreed to participate. Mean follow-up was 22.3±19.8 months. Of these patients, 7 were satisfied with the postoperative result. The mean visual analog scale pain score decreased significantly from 7...
November 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/29146536/analysis-of-an-integral-care-programme-for-hip-fracture-patients-aged-over-65-years
#2
J Franch Parella
OBJECTIVE: To analyse the results of a comprehensive care programme in elderly patients with hip fracture. METHODS: Non-randomised intervention study with patients undergoing hip fracture in Althaia Hospital (Manresa). The care model of the control group was the traditional, with the orthopaedist centralising decisions. By contrast, in the intervention group, a multidisciplinary model was used with the active collaboration, among other professionals, of orthopaedic surgeons and geriatricians...
November 13, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29135720/clinical-outcome-following-total-joint-replacement-and-arthrodesis-for-hallux-rigidus-a-systematic-review
#3
Jasper Stevens, Robin T A L de Bot, Joris P S Hermus, Lodewijk W van Rhijn, Adhiambo M Witlox
BACKGROUND: Hallux rigidus is a common cause of foot pain in the elderly and has a negative impact on quality of life. Several operative treatment options are available for feet that are refractory to conservative treatment. Of these, total joint replacement and arthrodesis of the first metatarsophalangeal joint are the most commonly performed interventions. Nevertheless, it is still not known which intervention results in the best clinical outcome and the fewest complications. METHODS: PubMed/MEDLINE, Embase, and the Cochrane Library were systematically searched for studies assessing outcome with the American Orthopaedic Foot & Ankle Society-Hallux Metatarsophalangeal Interphalangeal (AOFAS-HMI) score, Foot Function Index (FFI), visual analog scale (VAS) for pain, or Short Form-36 (SF-36) in patients who underwent an arthrodesis or total joint replacement for the treatment of symptomatic hallux rigidus...
November 14, 2017: JBJS Reviews
https://www.readbyqxmd.com/read/29133333/barriers-and-facilitators-to-orthopaedic-surgeons-uptake-of-decision-aids-for-total-knee-arthroplasty-a-qualitative-study
#4
Samantha Bunzli, Elizabeth Nelson, Anthony Scott, Simon French, Peter Choong, Michelle Dowsey
OBJECTIVES: The demand for total knee arthroplasty (TKA) is increasing. Differentiating who will derive a clinically meaningful improvement from TKA from others is a key challenge for orthopaedic surgeons. Decision aids can help surgeons select appropriate candidates for surgery, but their uptake has been low. The aim of this study was to explore the barriers and facilitators to decision aid uptake among orthopaedic surgeons. DESIGN: A qualitative study involving face-to-face interviews...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29132430/hospital-choice-in-germany-from-the-patient-s-perspective-a-cross-sectional-study
#5
Werner de Cruppé, Max Geraedts
BACKGROUND: In many countries health policy encourages patients to choose their hospital, preferably by considering information of performance reports. Previous studies on hospital choice mainly have focused on patients undergoing elective surgery. This study examined a representative sample of hospital inpatients across disciplines and treatment interventions in Germany. Its research questions were: How many patients decide where to go for hospital treatment? How much time do patients have before admission? Which sources of information do they use, and which criteria are relevant to their decision? METHODS: Cross-sectional observational study covering 1925 inpatients of 46 departments at 17 hospitals in 2012...
November 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29130872/a-retrospective-comparative-analysis-of-the-use-of-implantable-bone-stimulators-in-nonunions
#6
J Ryan Martin, George Vestermark, Brian Mullis, Jeffrey Anglen
This study details the use of implantable bone stimulators in the setting of nonunion. A retrospective comparative analysis was used to evaluate the efficacy of implantable bone stimulators in achieving union in the setting of atrophic or oligotrophic nonunion by two fellowship-trained orthopaedic trauma surgeons. Initially, 72 patients underwent surgical intervention for nonunion. Twenty-one patients had an implantable bone stimulator placed at the time of nonunion surgery. Thirty-eight patients had a minimum of 1-year follow-up...
October 2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29130608/impact-of-web-based-clinical-practice-guidelines-on-paediatric-fracture-clinics
#7
Mark W Camp, James R Barnes, Mohita Damany, Leo T Donnan
BACKGROUND: In an effort to standardize management and reduce over-treatment of uncomplicated paediatric fractures, the Victorian Pediatric Orthopaedic Network and the Royal Children's Hospital, Melbourne, created publically available web-based paediatric fracture pathways. The aim of this study was to determine the impact of web-based fracture pathways on the clinic volume at a tertiary-care paediatric fracture clinic. METHODS: A comparative retrospective review was performed at a large, urban, tertiary-care children's hospital...
November 12, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29123665/the-characterisation-of-unexplained-pain-after-knee-replacement
#8
Jonathan Ra Phillips, Beverley Hopwood, Rowenna Stroud, Paul A Dieppe, Andrew D Toms
Background: The aims of this study were to characterise the pain experienced by patients with chronic pain after knee replacement (KR), in whom no apparent 'orthopaedic' problem could be identified, and to establish how many have pain sensitisation problems (including neuropathic pain). Methods: A total of 44 patients were prospectively evaluated at a multidisciplinary tertiary referral clinic by an orthopaedic surgeon, pain specialist, rheumatologist and physiotherapist...
November 2017: British Journal of Pain
https://www.readbyqxmd.com/read/29115207/self-evaluated-competence-in-trauma-reception
#9
Kristin Julia Steinthorsdottir, Peter Svenningsen, Rasmus Fabricius, Lars Bo Svendsen, Jens Hillingsø, Martin Sillesen
INTRODUCTION: No formal training requirements exist for trauma teams in Denmark. The aim of this study was to investigate the point prevalence level of training and the self-evaluated competence of doctors involved in trauma care. METHODS: On two nights, all doctors on call at departments involved in trauma care were interviewed and answered a structured questionnaire pertaining to their level of training and self-evaluated level of competence in relevant skills...
November 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/29111811/treatment-of-limb-length-discrepancy-following-total-hip-arthroplasty
#10
Babar Kayani, Jurek Pietrzak, Matthew J Donaldson, Sujith Konan, Fares S Haddad
Limb length discrepancy is the leading cause of patient dissatisfaction following total hip arthroplasty and the most common reason for litigation in the field of orthopaedics. This article provides a systematic, stepwise approach for identifying the aetiology of limb length discrepancy following total hip arthroplasty and provides guidance on the treatment of this complication to optimize postoperative clinical and functional outcomes. This review discusses postoperative history taking, clinical examination, radiographic assessment, conservative treatment, and surgical intervention for the management of patients with established limb length discrepancy following total hip arthroplasty...
November 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29102560/can-a-clinician-scientist-training-program-develop-academic-orthopaedic-surgeons-one-program-s-thirty-year-experience
#11
Aaron M Brandt, Samantha A Rettig, Neel K Kale, Joseph D Zuckerman, Kenneth A Egol
BACKGROUND: Clinician-scientist numbers have been stagnant over the past few decades despite awareness of this trend. Interventions attempting to change this problem have been seemingly ineffective, but research residency positions have shown potential benefit. OBJECTIVE: We sought to evaluate the effectiveness of a clinician-scientist training program (CSTP) in an academic orthopedic residency in improving academic productivity and increasing interest in academic careers...
October 25, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/29101616/a-multifaceted-intervention-to-reduce-guideline-non-adherence-among-prescribing-physicians-in-dutch-hospitals
#12
Jacqueline M Bos, Stephanie Natsch, Patricia M L A van den Bemt, Johan L W Pot, J Elsbeth Nagtegaal, Andre Wieringa, Gert Jan van der Wilt, Peter A G M De Smet, Cornelis Kramers
Background Despite the potential of clinical practice guidelines to improve patient outcomes, adherence to guidelines by prescribers is inconsistent. Objective The aim of the study was to determine whether an approach of introducing an educational programme for prescribers in the hospital combined with audit and feedback by the hospital pharmacist reduces non-adherence of prescribing physicians to key pharmacotherapeutic guidelines. Setting This prospective intervention study with a before-after design evaluated patients at surgical, urological and orthopaedic wards...
December 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29098361/new-agents-in-the-treatment-of-myeloma-bone-disease
#13
REVIEW
Elizabeth S Ring, Michelle A Lawson, John A Snowden, Ingrid Jolley, Andrew D Chantry
Patients with multiple myeloma develop a devastating bone disease driven by the uncoupling of bone remodelling, excess osteoclastic bone resorption and diminished osteoblastic bone formation. The bone phenotype is typified by focal osteolytic lesions leading to pathological fractures, hypercalcaemia and other catastrophic bone events such as spinal cord compression. This causes bone pain, impaired functional status, decreased quality of life and increased mortality. Early in the disease, malignant plasma cells occupy a niche environment that encompasses their interaction with other key cellular components of the bone marrow microenvironment...
November 2, 2017: Calcified Tissue International
https://www.readbyqxmd.com/read/29068288/timing-of-surgical-intervention-for-developmental-dysplasia-of-the-hip-a-randomised-controlled-trial-hip-op
#14
Charlotte L Williams, Susie Weller, Lisa Roberts, Isabel Reading, Andrew Cook, Louisa Little, Wendy Wood, Louise Stanton, Andreas Roposch, Nicholas Mp Clarke
BACKGROUND: Developmental dysplasia of the hip (DDH) is a very common congenital disorder, and late-presenting cases often require surgical treatment. Surgical reduction of the hip may be complicated by avascular necrosis (AVN), which occurs as a result of interruption to the femoral head blood supply during treatment and can result in long-term problems. Some surgeons delay surgical treatment until the ossific nucleus (ON) has developed, whereas others believe that the earlier the reduction is performed, the better the result...
October 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29063881/antimicrobial-prescribing-patterns-of-surgical-speciality-in-a-tertiary-care-hospital-in-india-role-of-persuasive-intervention-for-changing-antibiotic-prescription-behaviour
#15
Chand Wattal, Shilpi Khanna, Neeraj Goel, Jaswinder Kaur Oberoi, B K Rao
BACKGROUND: Inappropriate use of antibiotics globally has been linked to increase in antibiotic resistance. OBJECTIVES: This interventional study assessed the impact of antibiotic prescription feedback and focus group discussions (FGD) on hospital-based prescribers before and after the FGD. STUDY DESIGN: The present study was performed at a tertiary care centre in New Delhi, wherein 45 units from surgical specialities were included for FGD...
July 2017: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/29058226/clinical-guidelines-for-the-prevention-and-treatment-of-osteoporosis-summary-statements-and-recommendations-from-the-italian-society-for-orthopaedics-and-traumatology
#16
Umberto Tarantino, Giovanni Iolascon, Luisella Cianferotti, Laura Masi, Gemma Marcucci, Francesca Giusti, Francesca Marini, Simone Parri, Maurizio Feola, Cecilia Rao, Eleonora Piccirilli, Emanuela Basilici Zanetti, Noemi Cittadini, Rosaria Alvaro, Antimo Moretti, Dario Calafiore, Giuseppe Toro, Francesca Gimigliano, Giuseppina Resmini, Maria Luisa Brandi
BACKGROUND: The Italian Society for Orthopaedics and Traumatology conceived this guidance-which is primarily addressed to Italian orthopedic surgeons, but should also prove useful to other bone specialists and to general practitioners-in order to improve the diagnosis, prevention, and treatment of osteoporosis and its consequences. MATERIALS AND METHODS: Literature reviews by a multidisciplinary team. RESULTS: The following topics are covered: the role of instrumental, metabolic, and genetic evaluations in the diagnosis of osteoporosis; appraisal of the risk of fracture and thresholds for intervention; general strategies for the prevention and treatment of osteoporosis (primary and secondary prevention); the pharmacologic treatment of osteoporosis; the setting and implementation of fracture liaison services for tertiary prevention...
October 20, 2017: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29053500/the-community-orthopaedic-surgeon-taking-trauma-call-pediatric-femoral-shaft-fracture-pearls-and-pitfalls
#17
J Eric Gordon, Charles T Mehlman
Pediatric femoral shaft fractures present many challenging patient care decisions. Nonoperative treatment approaches still dominate care of the youngest age groups while surgical intervention is commonplace in virtually all older children. Treatment is determined primarily by patient age as modified by clinical factors including mechanism of injury, weight, and skeletal maturity. Infants can be successfully treated by placement into a Pavlik harness, whereas children younger than 5 years are most commonly treated by early reduction and spica cast immobilization...
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29053498/the-community-orthopaedic-surgeon-taking-trauma-call-pediatric-forearm-shaft-fracture-pearls-and-pitfalls
#18
Martin J Herman, Matthew Simon, Charles T Mehlman
Pediatric forearm shaft fractures are the third most common fracture in children, and the forearm is the third most mobile joint in the body (with a nearly 180 degree arc of motion). The goals of treatment are aimed squarely at achieving satisfactory anatomic alignment (within defined parameters) as the consequences of malunion can be permanent forearm stiffness and deformity. Nonoperative treatment approaches still dominate care of the youngest age groups while surgical intervention has become increasingly common in older children...
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29051902/trends-in-surgical-practices-for-lateral-epicondylitis-among-newly-trained-orthopaedic-surgeons
#19
Dean Wang, Ryan M Degen, Christopher L Camp, Michael H McGraw, David W Altchek, Joshua S Dines
BACKGROUND: Much controversy exists regarding the optimal surgical intervention for lateral epicondylitis because of a multitude of options available and the lack of comparative studies. Knowledge of the current practice trends would help guide the design of comparative studies needed to determine which surgical technique results in the best outcome. PURPOSE: To review the latest practice trends for the surgical treatment of lateral epicondylitis among newly trained surgeons in the United States utilizing the American Board of Orthopaedic Surgery (ABOS) database...
October 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29044835/screening-and-referral-for-children-with-physical-disabilities
#20
REVIEW
Andrew G Georgiadis, Pam Thomason, Kate Willoughby, H Kerr Graham
The clinical care of children with physical disabilities is a major priority for paediatricians and paediatric orthopaedic surgeons. Cerebral palsy (CP) is the prototypical condition and remains the most common cause of physical disability in developed countries. The incidence is approximately 2 per 1000 live births, translating to between 600 and 700 new children per annum in Australia, with approximately 34 000 children and adults currently living with CP. This figure is predicted to rise inexorably over the next 20 years...
October 17, 2017: Journal of Paediatrics and Child Health
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