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Orthopedic surgeries

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https://www.readbyqxmd.com/read/27926758/association-between-surgeon-scorecard-use-and-operating-room-costs
#1
Corinna C Zygourakis, Victoria Valencia, Christopher Moriates, Christy K Boscardin, Sereina Catschegn, Alvin Rajkomar, Kevin J Bozic, Kent Soo Hoo, Andrew N Goldberg, Lawrence Pitts, Michael T Lawton, R Adams Dudley, Ralph Gonzales
Importance: Despite the significant contribution of surgical spending to health care costs, most surgeons are unaware of their operating room costs. Objective: To examine the association between providing surgeons with individualized cost feedback and surgical supply costs in the operating room. Design, Setting, and Participants: The OR Surgical Cost Reduction (OR SCORE) project was a single-health system, multihospital, multidepartmental prospective controlled study in an urban academic setting...
December 7, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27925642/high-complication-rate-in-young-patients-with-high-energy-intertrochanteric-femoral-fractures
#2
Michael H Amini, John J Feldman, John C Weinlein
Although intertrochanteric femoral fractures in elderly patients are common injuries that have been studied extensively, little has been reported about high-energy intertrochanteric fractures in younger patients. This study examined the injury characteristics and outcomes of high-energy intertrochanteric fractures in patients younger than 65 years treated with either sliding hip screws (SHSs) or cephalomedullary nails (CMNs). A total of 37 patients younger than 65 years (mean age, 45 years) with high-energy intertrochanteric fractures and mean follow-up of 34 weeks were identified; 21 patients were treated with SHSs, and 16 patients were treated with CMNs...
December 7, 2016: Orthopedics
https://www.readbyqxmd.com/read/27925640/diagnosis-and-management-of-distal-clavicle-osteolysis
#3
Steven F DeFroda, Christopher Nacca, Gregory R Waryasz, Brett D Owens
Distal clavicle osteolysis is an uncommon condition that most commonly affects weight lifters and other athletes who perform repetitive overhead activity. Although this condition most commonly presents in young active men, it is becoming increasing more common in women with the rise in popularity of body building and extreme athletics. Distal clavicle osteolysis can be debilitating, especially in those with rigorous training regimens, preventing exercise because of pain with activities such as bench presses and chest flies...
December 7, 2016: Orthopedics
https://www.readbyqxmd.com/read/27925639/outcomes-following-arthroscopic-repair-of-posterior-labral-tears-in-patients-older-than-35-years
#4
Dexter K Bateman, Eric M Black, Mark D Lazarus, Joseph A Abboud
Although the results of arthroscopic management of posterior labral pathology in young athletes have been reported extensively in the literature, the clinical outcomes in older patients are unknown. This retrospective review included patients older than 35 years who underwent arthroscopic posterior labral repair. Functional outcome scores were collected, and subgroup analyses were performed to evaluate the impact of patient-specific factors. Forty-three patients met the inclusion criteria; average follow-up was 36...
December 7, 2016: Orthopedics
https://www.readbyqxmd.com/read/27925637/risk-factors-for-perimegaprosthetic-infections-after-tumor-resection
#5
Marco De Gori, Giorgio Gasparini, Rodolfo Capanna
Periprosthetic joint infection remains one of the most challenging and pervasive complications following megaprosthetic replacement after tumor resection. The authors conducted a systematic review of the literature for clinical studies that reported a risk factor analysis for perimegaprosthetic joint infections. The search included English-language studies published up to July 2015. Eight studies fulfilled the inclusion criteria. Identified factors mostly related to both surgical procedure and hospitalization...
December 7, 2016: Orthopedics
https://www.readbyqxmd.com/read/27921127/pre-authorization-processes-have-no-effect-on-patients-undergoing-knee-mri-in-a-pediatric-setting-when-evaluated-by-specialists
#6
Drew Pierce, J Herman Kan, Megan May, George S Bisset
OBJECTIVE: Pre-authorization processes are often used by medical insurance companies to reduce costs by managing the utilization of advanced diagnostic imaging, and their impact on patient care is unclear. The purpose of our study is to determine if a pre-authorization process increases the rate of surgically significant abnormal knee MRI and surgical referrals compared with patients referred from pediatric orthopedic specialists who do not undergo a pre-authorization process. MATERIALS AND METHODS: A retrospective study was performed; 124 patients were identified who were referred for knee MRI by a pediatric orthopedist...
December 5, 2016: Skeletal Radiology
https://www.readbyqxmd.com/read/27920573/femoral-nerve-blockade-using-various-concentrations-of-local-anesthetic-for-knee-arthroscopy-in-the-pediatric-population
#7
Giorgio Veneziano, Jennifer Tripi, Dmitry Tumin, Mumin Hakim, David Martin, Ralph Beltran, Kevin Klingele, Tarun Bhalla, Joseph D Tobias
BACKGROUND: Femoral nerve blockade (FNB) provides effective postoperative analgesia in children undergoing arthroscopic knee surgery as evidenced by their opioid-sparing effects and decreased postoperative pain scores. Increasing the local anesthetic concentration in peripheral nerve blockade for adults undergoing orthopedic surgery has been shown to be beneficial, increasing block success rate, and providing a longer duration of analgesia. The effect of increasing the concentration of local anesthetic in extremity blocks in children remains largely unexplored...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27920572/home-peripheral-nerve-catheters-the-first-24-months-of-experience-at-a-children-s-hospital
#8
Andrew Gable, Candice Burrier, Jenna Stevens, Sharon Wrona, Kevin Klingele, Tarun Bhalla, David P Martin, Giorgio Veneziano, Joseph D Tobias
CONTEXT: Home peripheral nerve catheters (PNCs) have become common practice for adult patients after major orthopedic surgery. However, use in pediatric patients is a recent application. OBJECTIVES: The purpose of this study was to review the demographics and outcomes of pediatric patients receiving a PNC at our institution. METHODS: This retrospective study included patients from October 2012 through October 2014 undergoing orthopedic procedures with a PNC placed for postoperative pain management...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27917816/effect-of-ankaferd-blood-stopper-on-muscle-healing
#9
Murat Uygun, Osman Y Yavuz, İsmail Uraş, İbrahim G Duman, Hacer Haltaş, Mahmut Kömürcü
PURPOSE: Ankaferd Blood Stopper (ABS), which is a standardized mixture of herbal extracts obtained from five plants, has been proven as an efficient hemostatic agent and is still used in emergency situations. It is not known exactly if decreased bleeding has positive or negative effects on muscle healing and fibrosis, so the purpose of this study was to test the effect of ABS on muscle healing and morphology. METHODS: A total of 66 outbred Wistar rats were divided into three control and three experimental subgroups...
December 1, 2016: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
https://www.readbyqxmd.com/read/27915133/novel-reconstruction-technique-for-an-isolated-plantar-calcaneonavicular-spring-ligament-tear-a-5-case-series-report
#10
Ezequiel Palmanovich, Shay Shabat, Yaron S Brin, Sabri Massrawe, Iftach Hestroni, Meir Nyska
BACKGROUND: It is usually accepted that acquired flatfoot deformity after injury is usually due to partial or complete tear of the posterior tibial tendon (PTT), with secondary failure of the other structures which maintain the medial longitudinal arch, such as the plantar calcaneo-navicular (SPRING) ligament. It is unusual to find an isolated Spring Ligament (SL) tear, with an intact TP tendon. METHODS: The medial arch reconstruction technique of an isolated SL tear in 5 patients is presented discussed in this paper...
November 18, 2016: Foot
https://www.readbyqxmd.com/read/27914844/the-july-effect-in-total-shoulder-arthroplasty
#11
Allison J Rao, Daniel D Bohl, Rachel M Frank, Gregory L Cvetanovich, Gregory P Nicholson, Anthony A Romeo
BACKGROUND: New medical doctors enter their residency fields in July, a time in the hospital in which patient morbidity and mortality rates are perceived to be higher. It remains controversial whether a "July effect" exists in different areas of medicine and surgery, including in orthopedic surgery. The purpose of this study is to test for the July effect in patients undergoing primary total shoulder arthroplasty (TSA). METHODS: Patients who underwent primary TSA from 2005-2012 were identified using the American College of Surgeons National Surgical Quality Improvement Program database...
November 30, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27908650/musculoskeletal-conditions-in-a-pediatric-population-with-ehlers-danlos-syndrome
#12
Courtney M Stern, Michael J Pepin, Joan M Stoler, Dennis E Kramer, Samantha A Spencer, Cynthia J Stein
OBJECTIVE: To describe musculoskeletal conditions in children with Ehlers-Danlos syndrome (EDS). STUDY DESIGN: A retrospective medical record review was performed, which evaluated 205 patients with EDS (ages 6-19 years) seen in sports medicine or orthopedic clinic at a large pediatric hospital over a 5-year period. RESULTS: Female (n = 147) and male (n = 57) patients were identified (mean age 12.7 years). The most common EDS subtype (55...
November 28, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27904933/-metastatic-disease-in-long-bones-review-of-surgical-treatment-options
#13
Franz Liska, Philipp Schmitz, Norbert Harrasser, Peter Prodinger, Hans Rechl, Rüdiger von Eisenhart-Rothe
Surgery in metastatic bone disease is currently the most frequent type of surgery in orthopedic oncology. Improved survival rates and an increasing incidence of bone metastasis have led to an increase in complications caused by metastatic disease, such as pathological fractures or hardware failure after operative treatment. Although surgery of metastatic lesions remains a palliative therapy concept, because of sufficient therapy for the primary carcinomas, tumor-specific-oriented follow-up protocols and a variation in the prognosis for the individual entities, an individually adapted treatment strategy is necessary...
November 30, 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/27904518/testing-the-feasibility-and-safety-of-the-nintendo-wii-gaming-console-in-orthopedic-rehabilitation-a-pilot-randomized-controlled-study
#14
Andreas Ficklscherer, Jonas Stapf, Kay Michael Meissner, Thomas Niethammer, Matthias Lahner, Markus Wagenhäuser, Peter E Müller, Matthias F Pietschmann
INTRODUCTION: The Nintendo Wii game console is already used as an additional training device for e.g. neurological wards. Still there are limited data available regarding orthopedic rehabilitation. The authors' objective was to examine whether the Nintendo Wii is an appropriate and safe tool in rehabilitation after orthopedic knee surgery. MATERIAL AND METHODS: A prospective, randomized, controlled study comparing standard physiotherapy vs. standard physiotherapy plus game console training (Wii group) in patients having anterior cruciate ligament (ACL) repair or knee arthroplasty was conducted...
December 1, 2016: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/27904226/paraplegic-flexion-contracture-of-hip-joints-an-unsolvable-problem
#15
Sailendra Bhattacharyya
Paraplegic flexion contracture of hip joints beyond 90° is a difficult condition to treat for any orthopedic surgeon. There is no fixed protocol of treatment described, by and large it is individualized. A 20 year old female presented with paraplegia for last 15 years due to irrecoverable spinal cord disease with complete sensory and motor loss of both lower extremities and was admitted with acute flexion contracture of both hip joints with trunk resting on thighs. She underwent bilateral proximal femoral resection...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27900711/lacertus-fibrosus-augmentation-for-distal-biceps-brachii-rupture-repair-surgical-technique
#16
M Fontana, A Trimarchi, A Colozza
BACKGROUND: Repair of distal biceps tendon ruptures has become widely accepted. Unfortunately, care of retracted-degenerated injuries remains a challenge for orthopedic surgeons. Complication rates appear to increase when surgery is performed in chronic cases compared to those operated acutely. Multiple techniques for chronic reconstruction with the use of grafts have been described. Recently Morrey, from the Mayo Clinic, proposed a direct anatomic repair of retracted distal biceps tendon ruptures in extreme flexion (60°-90°) to avoid grafting...
December 2016: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/27900707/fluoroscopy-guided-biodegradable-spacer-implantation-using-local-anesthesia-safety-and-efficacy-study-in-patients-with-massive-rotator-cuff-tears
#17
E Gervasi, E Maman, A Dekel, E Cautero
BACKGROUND: The management of massive rotator cuff tears (MRCTs) is challenging and associated with a high failure rates. Studies have shown that advanced age, lower American Society of Anesthesiologists physical status score and concomitant comorbidities are associated with higher risks of death and postoperative complications. This study was designed to assess the safety and efficacy of fluoroscopy-guided biodegradable spacer implantation under local anesthesia, in patients with MRCT and comorbidities completely or partially contraindicating surgeries under general anesthesia...
December 2016: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/27899440/the-elimination-of-transfer-distances-is-an-important-part-of-hospital-design
#18
Sauli Karvonen, Isto Nordback, Jussi Elo, Jouni Havulinna, Heikki-Jussi Laine
OBJECTIVE: The objective of the present study was to describe how a specific patient flow analysis with from-to charts can be used in hospital design and layout planning. BACKGROUND: As part of a large renewal project at a university hospital, a detailed patient flow analysis was applied to planning the musculoskeletal surgery unit (orthopedics and traumatology, hand surgery, and plastic surgery). METHOD: First, the main activities of the unit were determined...
November 29, 2016: HERD
https://www.readbyqxmd.com/read/27896037/functional-evaluation-of-patients-undergoing-multiple-joint-replacements-a-retrospective-study-of-50-patients-with-a-minimum-of-six-months-of-follow-up
#19
Shubhranshu S Mohanty, Nandan Mishra, Prateek Patil, Ajinkya Desale
INTRODUCTION:  Polyarthritis is a challenging condition that an orthopedic surgeon faces in day-to-day practice. Some of the conditions where multiple joints are affected are rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis. Multiple joint afflictions can cause severe impairment in the quality of life, which leads to a significant socioeconomic burden on the family and society. Joint replacement is considered as a treatment when severe joint pain or dysfunction is not alleviated by conservative management...
October 15, 2016: Curēus
https://www.readbyqxmd.com/read/27893757/assessing-the-acetabular-cup-implant-primary-stability-by-impact-analyses-a-cadaveric-study
#20
Adrien Michel, Romain Bosc, Jean-Paul Meningaud, Philippe Hernigou, Guillaume Haiat
BACKGROUND: The primary stability of the acetabular cup (AC) implant is an important determinant for the long term success of cementless hip surgery. However, it remains difficult to assess the AC implant stability due to the complex nature of the bone-implant interface. A compromise should be found when inserting the AC implant in order to obtain a sufficient implant stability without risking bone fracture. The aim of this study is to evaluate the potential of impact signals analyses to assess the primary stability of AC implants inserted in cadaveric specimens...
2016: PloS One
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