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Interventional Orthopaedics

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https://www.readbyqxmd.com/read/28323807/the-trauma-collaborative-care-study-tccs
#1
Stephen T Wegener, Andrew N Pollak, Katherine P Frey, Robert A Hymes, Kristin R Archer, Clifford B Jones, Rachel B Seymour, Robert V OʼToole, 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
#2
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
#3
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
https://www.readbyqxmd.com/read/28302130/comparison-of-distraction-arthroplasty-alone-versus-combined-with-arthroscopic-microfracture-in-treatment-of-post-traumatic-ankle-arthritis
#4
Kaibin Zhang, Yiqiu Jiang, Jing Du, Tianqi Tao, Wang Li, Yang Li, Jianchao Gui
BACKGROUND: This study aims to compare clinical outcomes of distraction arthroplasty alone versus combined with arthroscopic microfracture in treating post-traumatic ankle arthritis. METHODS: The study cohort consisted of 96 patients (96 ankles) who underwent distraction arthroplasty alone or combined with arthroscopic microfracture between May 2005 and April 2012. Patients were divided into the distraction group (n = 46) and the combined group (n = 50)...
March 17, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28291185/efficacy-of-surgical-site-multimodal-drug-injection-following-operative-management-of-femoral-fractures-a-randomized-controlled-trial
#5
Daniel Koehler, J Lawrence Marsh, Matthew Karam, Catherine Fruehling, Michael Willey
BACKGROUND: Multimodal analgesia inclusive of periarticular injection with a local anesthetic agent has been rapidly assimilated, with demonstrated safety and efficacy, into the care of patients undergoing elective lower-extremity arthroplasty. The present study was performed to evaluate the efficacy and safety of a surgical-site, multimodal drug injection for postoperative pain control following operative management of femoral fractures. METHODS: There were 102 patients undergoing operative intervention (plate fixation, intramedullary device, or arthroplasty) for a broad range of femoral fracture patterns who were prospectively randomized either to receive an intraoperative, surgical-site injection into the superficial and deep tissues containing ropivacaine, epinephrine, and morphine or to receive no injection...
March 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28288079/evidence-based-pediatric-orthopaedics-how-safe-is-safe
#6
G Alexander Augustithis, Hannah Margaret Ensor, James S Huntley
BACKGROUND: The aim of minimizing the risks of complications and adverse events is at the center of surgical practice.This study aimed to assess the evidence on which pediatric orthopaedic surgical procedures are described as "safe." In particular, the objective was to ascertain the proportion of studies describing a procedure as "safe," which achieved a 95% upper limit confidence interval of risk of 5% or less for major adverse events. METHOD: A primary search of Journal of Paediatric Orthopaedics 2009 to 2014 for the single term "safe" returned 71 papers appropriate for analysis...
March 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28284470/virtual-fracture-clinic-management-of-fifth-metatarsal-including-jones-fractures-is-safe-and-cost-effective
#7
Kit Brogan, Simon Bellringer, Harold Akehurst, Christopher Gee, Nada Ibrahim, Lucy Cassidy, Ben Rogers, James Gibbs
Virtual clinics have been shown to be safe and cost-effective in many specialties, yet barriers exist to their implementation in orthopaedics. The aims of this study were to look at whether the management of 5th metatarsal fractures using a virtual fracture clinic model is safe, cost effective and avoids adverse outcomes whilst being acceptable to patients using the service. All patients with a fifth metatarsal fracture between September 2013 and September 2015 had a standardised management plan initiated (blackboot, full weightbearing) in the emergency department (ED)...
February 12, 2017: Injury
https://www.readbyqxmd.com/read/28282214/clinical-and-radiographic-outcomes-of-meniscus-surgery-and-future-targets-for-biologic-intervention-a-review-of-data-from-the-moon-group
#8
Robert W Westermann, Morgan Jones, David Wasserstein, Kurt P Spindler
Meniscus injury and treatment occurred with the majority of anterior cruciate ligament reconstructions (ACLR) in the multicenter orthopaedic outcomes (MOON) cohort. We describe the patient reported outcomes, radiographic outcomes and predictors of pain from meniscus injuries and treatment in the setting of ACLR. Patient reported outcomes improve significantly following meniscus repair with ACLR, but differences exist based on the meniscus injury laterally (medial or lateral). Patients undergoing medial meniscus repair have worse patient-reported outcomes and more pain compared to those with uninjured menisci...
March 10, 2017: Connective Tissue Research
https://www.readbyqxmd.com/read/28279852/effectiveness-of-surgical-and-non-surgical-management-of-crouch-gait-in-cerebral-palsy-a-systematic-review
#9
REVIEW
Scott A Galey, Zachary F Lerner, Thomas C Bulea, Seymour Zimbler, Diane L Damiano
BACKGROUND: Cerebral palsy (CP) is a prevalent group of neuromotor disorders caused by early injury to brain regions or pathways that control movement. Patients with CP exhibit a range of functional motor disabilities and pathologic gait patterns. Crouch gait, characterized by increased knee flexion throughout stance, is a common gait pattern in CP that increases energy costs of walking and contributes to ambulatory decline. Our aim was to perform the first systematic literature review on the effectiveness of interventions utilized to ameliorate crouch gait in CP...
February 24, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28276990/how-are-we-measuring-clinically-important-outcome-for-operative-treatments-in-sports-medicine
#10
Benedict U Nwachukwu, R Scott Runyon, Cynthia A Kahlenberg, Elizabeth B Gausden, William W Schairer, Answorth A Allen
OBJECTIVES: Minimal clinically important difference (MCID) and other measures of minimum clinical importance are increasingly recognized as important clinical considerations for evaluating the efficacy of an intervention. As our interpretation of clinical outcome evolves beyond statistical significance, psychometric properties such as MCID will be increasingly important to various stakeholders in the orthopaedic community. The purpose of this study was to: 1) describe the state of clinically important outcome reporting and 2) describe the methods used to derive these psychometric values for sports medicine patients undergoing operative treatments...
February 23, 2017: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/28274008/to-operate-or-not-to-operate-the-mid-shaft-fractures-of-the-clavicle-a-comparative-study-of-functional-outcomes-of-the-two-methods-of-management
#11
Sanath Kumar Shetty, Ragesh Chandran, Arjun Ballal, Lawrence John Mathias, Anoop Hegde, Ashwin Shetty
INTRODUCTION: Fractures of the clavicle are some of the most common fractures which are seen in the adult population. Mid-shaft fractures of the clavicle are considered the most common form of clavicle fractures and about half of them are displaced fractures. They have been managed non-operatively over the years. However, severe displacement and comminution of these fractures have warranted the requirement of operative intervention, due to increased incidence of mal-union, worsening of shoulder functions etc...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28271925/aarhus-regenerative-orthopaedics-symposium-aros
#12
Casper B Foldager, Michael Bendtsen, Lise C Berg, Jan E Brinchmann, Mats Brittberg, Cody Bunger, Jose Canseco, Li Chen, Bjørn B Christensen, Pauline Colombier, Bent W Deleuran, James Edwards, Brian Elmengaard, Jack Farr, Birgitta Gatenholm, Andreas H Gomoll, James H Hui, Rune B Jakobsen, Natasja L Joergensen, Moustapha Kassem, Thomas Koch, Søren Kold, Michael R Krogsgaard, Henrik Lauridsen, Dang Le, Catherine Le Visage, Martin Lind, Jens V Nygaard, Morten L Olesen, Michael Pedersen, Martin Rathcke, James B Richardson, Sally Roberts, Jan H D Rölfing, Daisuke Sakai, Wei Seong Toh, Jill Urban, Myron Spector
The combination of modern interventional and preventive medicine has led to an epidemic of ageing. While this phenomenon is a positive consequence of an improved lifestyle and achievements in a society, the longer life expectancy is often accompanied by decline in quality of life due to musculoskeletal pain and disability. The Aarhus Regenerative Orthopaedics Symposium (AROS) 2015 was motivated by the need to address regenerative challenges in an ageing population by engaging clinicians, basic scientists, and engineers...
December 2016: Acta Orthopaedica
https://www.readbyqxmd.com/read/28265884/d%C3%A3-bridement-and-reconstrucion-improve-postoperative-sagittal-alignment-in-kyphotic-cervical-spinal-tuberculosis
#13
Zhimin Pan, Jiaquan Luo, Limin Yu, Yiwei Chen, Junlong Zhong, Zhiyun Li, Zhaoxun Zeng, Pingguo Duan, Yoon Ha, Kai Cao
BACKGROUND: Cervical spinal tuberculosis is relatively common in some developing countries. It erodes vertebrae and discs, which sometimes results in cervical kyphosis and myelopathy. However, to our knowledge, no studies have evaluated improvements to patient-reported outcomes among patients who undergo surgical cervical sagittal realignment after kyphotic cervical spinal tuberculosis has been treated by débridement and reconstruction. QUESTIONS/PURPOSES: (1) Can a spine with kyphotic cervical spinal tuberculosis be returned to normal alignment and fused successfully? (2) Will patient-reported outcomes be improved with this intervention? (3) Are patient-reported outcomes correlated with realignment? METHODS: Forty-six patients with kyphotic cervical spinal tuberculosis were evaluated in this retrospective study...
March 6, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28265847/can-rheumatologists-predict-eventual-need-for-orthopaedic-intervention-in-patients-with-rheumatoid-arthritis-results-of-a-systematic-review-and-analysis-of-two-uk-inception-cohorts
#14
REVIEW
Elena Nikiphorou, Lewis Carpenter, Sam Norton, Stephen Morris, Alex MacGregor, Josh Dixey, Peter Williams, Patrick Kiely, David Andrew Walsh, Adam Young
PURPOSE OF REVIEW: The structural damage caused by rheumatoid arthritis (RA) can often be mitigated by orthopaedic surgery in late disease. This study evaluates the value of predictive factors for orthopaedic intervention. METHODS: A systematic review of literature was undertaken to identify papers describing predictive factors for orthopaedic surgery in RA. Manuscripts were selected if they met inclusion criteria of cohort study design, diagnosis of RA, follow-up duration/disease duration ≥3 years, any orthopaedic surgical interventions recorded, and then summarised for predictive factors...
March 2017: Current Rheumatology Reports
https://www.readbyqxmd.com/read/28262590/the-implications-of-biologic-therapy-for-elective-foot-and-ankle-surgery-in-patients-with-rheumatoid-arthritis
#15
REVIEW
Ross Diaper, Ernest Wong, Stuart A Metcalfe
INTRODUCTION: Rheumatoid arthritis (RA) is one of a number of inflammatory arthropathies resulting in foot pain and deformity. Patients with this disease may require surgical intervention as part of their management. Many of these patients are now taking biologic agents which pose several risks to patients in the perioperative phase. The surgical team therefore need to be aware of these associated complications and how to manage these cases. AIM: This paper aims to review the current literature about perioperative needs (foot and ankle surgery) associated with patients with rheumatoid arthritis receiving biologic therapy...
January 27, 2017: Foot
https://www.readbyqxmd.com/read/28251059/challenges-of-bone-tissue-engineering-in-orthopaedic-patients
#16
EDITORIAL
Enrique Guerado, Enrique Caso
Bone defects may impede normal biomechanics and the structural stability of bone as an organ. In many cases, the correction of bone defects requires extensive surgical intervention involving the use of bone-grafting techniques and other procedures in which healing is slow, there is a high risk of infection and considerable pain is provoked - with no guarantee of complete correction of the defect. Therefore, the search for surgical alternatives continues to present a major challenge in orthopaedic traumatology...
February 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28245746/cervical-traction-for-managing-neck-pain-a-survey-of-physical-therapists-in-the-united-states
#17
Timothy J Madson, John H Hollman
Study Design Cross-sectional survey. Objective To examine the use of traction by physical therapists for patients with neck pain, including how and when traction is used, the delivery modes and parameters, supplemental interventions, and influence of professional demographics on usage. Background Systematic reviews provide little support for traction in managing neck pain. While traction usage among physical therapists in other countries has been described, usage in the United States has not been examined. Methods A random sample of 4000 Orthopaedic Section members of the American Physical Therapy Association were surveyed...
March 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28244929/can-a-novel-low-cost-simulation-model-be-used-to-teach-anterior-cruciate-ligament-graft-preparation
#18
Christopher M Brusalis, John Todd R Lawrence, Sheena C Ranade, Joy C Kerr, Nicholas Pulos, Lawrence Wells, Theodore J Ganley
BACKGROUND: This study evaluated an anterior cruciate ligament (ACL) graft preparation simulation learning model for use by orthopaedic surgery trainees. METHODS: A simulation model for ACL graft preparation was constructed using shoelace as graft material and a wooden graft preparation board that matched the dimensions of existing products. A 12-minute instructional video targeted at novice learners was created to accompany the simulation model. A prospective randomized controlled trial was conducted on orthopaedic surgery residents divided into 2 groups with equal distributions of postgraduate year (PGY) status...
February 27, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28243441/improving-theatre-turnaround-time
#19
Daniel Fletcher, David Edwards, Stephen Tolchard, Richard Baker, James Berstock
The NHS Institute for Innovation and Improvement has determined that a £7 million saving can be achieved per trust by improving theatre efficiency. The aim of this quality improvement project was to improve orthopaedic theatre turnaround without compromising the patient safety. We process mapped all the stages from application of dressing to knife to skin on the next patient in order to identify potential areas for improvement. Several suggestions arose which were tested in multiple PDSA cycles in a single theatre...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28212252/health-literacy-in-orthopaedic-trauma-patients
#20
Filip Cosic, Lara Kimmel, Elton Edwards
OBJECTIVE: This study aimed to determine the level of health literacy in a postoperative orthopaedic trauma population and to evaluate the efficacy of a simple predischarge discussion strategy, targeted at improving health literacy. DESIGN: A pre-post intervention study was conducted from April 2014 to January 2015. SETTING: Academic Level 1 trauma center. PARTICIPANTS: One hundred ninety consecutive orthopaedic trauma patients with operatively managed lower limb fractures were recruited...
March 2017: Journal of Orthopaedic Trauma
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