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https://www.readbyqxmd.com/read/28422796/waterless-hand-rub-versus-traditional-hand-scrub-methods-for-preventing-the-surgical-site-infection-in-orthopaedic-surgery
#1
Kentaro Iwakiri, Akio Kobayashi, Masahiko Seki, Yoshiyuki Ando, Tadao Tsujio, Masatoshi Hoshino, Hiroaki Nakamura
STUDY DESIGN: A retrospective cohort study with prospectively collected data OBJECTIVE.: The aim of this study was to compare SSI incidences, the cost of hand hygiene agents, and hand hygiene time between the traditional hand scrub and the waterless hand rub protocols before orthopaedic surgery. SUMMARY OF BACKGROUND DATA: Surgical-site-infections (SSI) prolong hospitalization and are a leading nosocomial cause of morbidity as well as a source of excess cost. Recently, a waterless hand rub protocol comprising alcohol based chlorhexidine gluconate for use before surgery was developed, but no studies have yet examined its utility in orthopaedic surgery...
April 18, 2017: Spine
https://www.readbyqxmd.com/read/28412954/does-a-quality-improvement-campaign-accelerate-take-up-of-new-evidence-a-ten-state-cluster-randomized-controlled-trial-of-the-institute-for-health-improvement-s-project-joints
#2
Eric C Schneider, Melony E Sorbero, Ann Haas, M Susan Ridgely, Dmitry Khodyakov, Claude M Setodji, Gareth Parry, Susan S Huang, Deborah S Yokoe, Don Goldmann
BACKGROUND: A decade ago, the Institute for Healthcare Improvement pioneered a quality improvement (QI) campaign, leveraging organizational and personal social networks to disseminate new practices. There have been few rigorous studies of the QI campaign approach. METHODS: Project JOINTS (Joining Organizations IN Tackling SSIs) engaged a network of state-based organizations and professionals in a 6-month QI campaign promoting adherence to three new evidence-based practices known to reduce the risk of infection after joint replacement...
April 17, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28412103/reverse-shoulder-arthroplasty-compared-with-hemiarthroplasty-in-the-treatment-of-acute-proximal-humeral-fractures
#3
Michael van der Merwe, Matthew J Boyle, Christopher M A Frampton, Craig M Ball
BACKGROUND: Complex proximal humeral fractures may require prosthetic replacement of the humeral head. Surgical options include reverse shoulder arthroplasty (RSA) and shoulder hemiarthroplasty; however, the optimal technique remains controversial. The goal of this study was to compare functional outcomes and revision rates of RSA with hemiarthroplasty in patients with acute proximal humeral fractures. MATERIALS AND METHODS: Between January 1, 1999, and December 31, 2014, there were 218 patients who underwent RSA and 427 who underwent hemiarthroplasty for acute proximal humeral fractures identified through New Zealand Joint Registry records...
April 12, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28408203/surgeon-involvement-in-transcatheter-aortic-valve-replacement-in-the-united-states-a-2016-society-of-thoracic-surgeons-survey
#4
Joseph E Bavaria, Richard L Prager, Keith S Naunheim, Mark S Allen, Robert S D Higgins, Vinod H Thourani, Thomas E MacGillivray, Natalie Boden, Joseph F Sabik
BACKGROUND: The Society of Thoracic Surgeons (STS) surveyed cardiothoracic surgeon participants in its Adult Cardiac Surgery Database (ACSD) to learn the extent of surgeon involvement in transcatheter aortic valve replacement (TAVR) procedures. METHODS: An electronic survey was delivered to 2,594 surgeons in June 2016. When the survey closed 2 weeks later, 487 completed surveys had been submitted for a response rate of 18.8%. RESULTS: Among the 487 participants in the ACSD who responded to the survey, 410 (84...
April 6, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28405708/-supramalleolar-osteotomy-in-asymmetric-ankle-osteoarthritis-short-term-clinical-and-radiographic-results
#5
A Barg, M Wiewiorski, J Paul, M Wurm, M Jacxsens, K Nykytina, V Valderrabano
BACKGROUND: The main indication for the supramalleolar osteotomy is asymmetric ankle osteoarthritis with concomitant supramalleolar valgus or varus deformity. The aim of this prospective study was to analyze short-term clinical and radiographic outcomes in patients with asymmetric ankle osteoarthritis. METHODS: A total of 16 patients with asymmetric ankle osteoarthritis and concomitant supramalleolar deformity - 7 patients with valgus deformity, 9 patients with varus deformity - were treated...
April 12, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28405220/intraoperative-complications-during-revision-shoulder-arthroplasty-a-study-using-the-national-joint-registry-dataset
#6
Helen M Ingoe, Philip Holland, Paul Cowling, Lucksy Kottam, Paul N Baker, Amar Rangan
BACKGROUND: The surgical options for revision shoulder arthroplasty and the number of procedures performed are increasing. However, little is known about the risk factors for intraoperative complications associated with this complex surgery. METHODS: The National Joint Registry (NJR) is a surgeon reported database recording information on major joint replacements including revision shoulder arthroplasty. Using multivariable binary logistic regression modelling, we analyzed 1445 revision shoulder arthroplasties reported to the NJR between April 2012 and 2015...
April 2017: Shoulder & Elbow
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
#7
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/28400660/anthropometric-analysis-of-the-hip-joint-in-south-indian-population-using-computed-tomography
#8
Vetrivel Chezian Sengodan, Elangovan Sinmayanantham, J Saravana Kumar
BACKGROUND: Proximal femur has a significant functional modification on erect bipedal posture. Various proximal femoral parameters were analyzed in Western literature. This information was utilized in prosthetic designing. Implants designed for Western people are used in Indian patients undergoing hip surgeries such as internal fixation and replacement arthroplasty. MATERIALS AND METHODS: The study was done among 200 individuals (400 hips) with a normal hip joint after ethical committee clearance...
March 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28390883/is-orthopedic-department-teaching-status-associated-with-adverse-outcomes-of-primary-total-hip-arthroplasty
#9
Matthew R Boylan, Dean C Perfetti, Qais Naziri, Aditya V Maheshwari, Carl B Paulino, Michael A Mont
BACKGROUND: Although resident physicians play a vital role in the US health care system, they are believed to create inefficiencies in the delivery of care. Under the regional component of the Comprehensive Care for Joint Replacement model, teaching hospitals are forced to compete on efficiency and outcomes with nonteaching hospitals. METHODS: We identified 86,021 patients undergoing elective primary total hip arthroplasty in New York State between January 1, 2009, and September 30, 2014...
March 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28390607/endoscopic-middle-ear-exploration-in-pediatric-patients-with-conductive-hearing-loss
#10
John M Carter, Stephen R Hoff
OBJECTIVE: To describe our indications, findings, and outcomes for transcanal endoscopic middle ear exploration in pediatric patients with conductive hearing loss of unknown etiology, without effusions. METHODS: Prospective case series for all pediatric patients undergoing totally endoscopic transcanal middle ear exploration between April 2012 and October 2015 at a pediatric tertiary care referral hospital. Demographic data, operative findings, and hearing results were reviewed...
May 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28390166/application-of-navigated-ultrasound-for-assessment-of-the-anterior-pelvic-plane-in-patients-with-degenerative-hip-diseases
#11
Andrzej Kochman, Adrian Goral, Tobias Martin, Wojciech Marek, Josef Kozak, Monika Morawska-Kochman, Marek Synder
OBJECTIVES: Correct positioning of the acetabular cup is the key for successful total-hip replacement. In common clinical practice, the target alignment of the cup is defined with respect to the anterior pelvic plane. In patients with substantial anterior pelvic plane inclination, this condition may lead to inappropriate distribution of the load on the cup, as most of the forces exerted within the hip joint act along the vertical axis. With the known pelvic inclination, it is possible to readjust the position of the cup with respect to the individual posture of the patient...
April 8, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28378007/do-shorter-lengths-of-stay-increase-readmissions-after-total-joint-replacements
#12
Udai S Sibia, Kip A Waite, Maura A Callanan, Adrian E Park, Paul J King, James H MacDonald
BACKGROUND: Enhanced recovery after surgery protocols for total joint replacements (TJRs) emphasize early discharge, yet the impact on readmissions is not well documented. We evaluate the impact of a one-day length of stay (LOS) discharge protocol on readmissions. METHODS: We conducted a retrospective review of all primary TJRs (hip and knee) from April 2014 to March 2015. Patients who had adequate support to be discharged home were categorized into 2 groups, 1-day (n = 174) vs 2-day (n = 285) LOS groups...
March 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28378003/ultrasound-gel-minimizes-third-body-debris-with-partial-hardware-removal-in-joint-arthroplasty
#13
Aidan C McGrory, Lee Replogle, Donald Endrizzi
Hundreds of thousands of revision surgeries for hip, knee, and shoulder joint arthroplasties are now performed worldwide annually. Partial removal of hardware during some types of revision surgeries may create significant amounts of third body metal, polymer, or bone cement debris. Retained debris may lead to a variety of negative health effects including damage to the joint replacement. We describe a novel technique for the better containment and easier removal of third body debris during partial hardware removal...
March 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28375889/the-main-cause-of-death-following-primary-total-hip-and-knee-replacement-for-osteoarthritis-a-cohort-study-of-26-766-deaths-following-332-734-hip-replacements-and-29-802-deaths-following-384-291-knee-replacements
#14
Linda P Hunt, Yoav Ben-Shlomo, Michael R Whitehouse, Martyn L Porter, Ashley W Blom
BACKGROUND: Patients undergoing primary total joint replacement are selected for surgery and thus (other than having a transiently increased mortality rate postoperatively) have a lower mortality rate than age and sex-matched individuals do. Understanding the causes of death following joint replacement would allow targeted strategies to reduce the risk of death and optimize outcome. We aimed to determine the rates and causes of mortality for patients undergoing primary total hip or knee replacement compared with individuals in the general population who were matched for age and sex...
April 5, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28371783/monocular-vision-and-imu-based-system-for-prosthesis-pose-estimation-during-total-hip-replacement-surgery
#15
Shaojie Su, Yixin Zhou, Zhihua Wang, Hong Chen
The average age of population increases worldwide, so does the number of total hip replacement surgeries. Total hip replacement, however, often involves a risk of dislocation and prosthetic impingement. To minimize the risk after surgery, we propose an instrumented hip prosthesis that estimates the relative pose between prostheses intraoperatively and ensures the placement of prostheses within a safe zone. We create a model of the hip prosthesis as a ball and socket joint, which has four degrees of freedom (DOFs), including 3-DOF rotation and 1-DOF translation...
March 30, 2017: IEEE Transactions on Biomedical Circuits and Systems
https://www.readbyqxmd.com/read/28368089/withdrawn-surgery-for-thumb-trapeziometacarpal-joint-osteoarthritis
#16
REVIEW
Anne Wajon, Toby Vinycomb, Emma Carr, Ian Edmunds, Louise Ada
BACKGROUND: Surgery is used to treat persistent pain and dysfunction at the base of the thumb when conservative management, such as splinting, or medical management, such as oral analgesics, is no longer adequate in reducing disability and pain. This is an update of a Cochrane Review first published in 2005. OBJECTIVES: To assess the effects of different surgical techniques for trapeziometacarpal (thumb) osteoarthritis. SEARCH METHODS: We searched the following sources up to 08 August 2013: CENTRAL (The Cochrane Library 2013, Issue 8), MEDLINE (1950 to August 2013), EMBASE (1974 to August 2013), CINAHL (1982 to August 2013), Clinicaltrials...
April 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28367690/histological-analysis-of-early-osteolysis-in-total-ankle-arthroplasty
#17
Oliver N Schipper, Steven L Haddad, Peter Pytel, Ying Zhou
BACKGROUND: The purpose of this study was to perform a histological comparative analysis of tibiotalar joint samples taken from areas of osteolysis adjacent to total ankle arthroplasties vs control synovial specimens to determine the reaction to and presence of polyethylene (PE) particles. METHODS: A total of 57 pathology samples were identified in the osteolysis group, while 11 were identified in the control group. For each sample, hematoxylin and eosin, Oil Red O (ORO), and macrophage marker CD163-stained slides were created...
April 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28366841/digital-image-correlation-aided-mechanical-characterization-of-the-anteromedial-and-posterolateral-bundles-of-the-anterior-cruciate-ligament
#18
Kaitlyn Mallett, Ellen M Arruda
The anterior cruciate ligament (ACL) is one of the most commonly injured soft tissue structures in the articular knee joint, often requiring invasive surgery for patients to restore pre-injury knee kinematics. There is a pressing need to understand the role of the ACL in knee function, in order to select proper replacements. Digital image correlation (DIC), a non-contact full field displacement measurement technique, is an established tool for evaluating non-biological materials. The application of DIC to soft tissues has been in the nascent stages, largely due to patterning challenges of such materials...
March 30, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28366675/the-dual-regulation-of-substance-p-mediated-inflammation-via-human-synovial-mast-cells-in-rheumatoid-arthritis
#19
Yuki Okamura, Shintaro Mishima, Jun-Ichi Kashiwakura, Tomomi Sasaki-Sakamoto, Shota Toyoshima, Kazumichi Kuroda, Shu Saito, Yasuaki Tokuhashi, Yoshimichi Okayama
BACKGROUND: Neural pathways are thought to be directly involved in the pathogenesis of rheumatoid arthritis (RA). Although synovial mast cells (MCs) are activated by substance P (SP), the role of MCs in neural pathways in RA remains unknown. The aims of this study were to investigate 1) whether tachykinins are produced by synovial MCs and whether production differs in RA and osteoarthritis (OA) patients, and 2) what is the responsible receptor for SP in synovial MCs. METHODS: Synovial tissues were obtained from patients with RA or OA undergoing joint replacement surgery...
March 30, 2017: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/28365529/giant-cell-tumour-of-bone-in-the-denosumab-era
#20
REVIEW
Lizz van der Heijden, P D Sander Dijkstra, Jean-Yves Blay, Hans Gelderblom
Giant cell tumour of bone (GCTB) is an intermediate locally aggressive primary bone tumour, occurring mostly at the meta-epiphysis of long bones. Overexpression of receptor activator of nuclear factor kappa-B ligand (RANKL) by mononuclear neoplastic stromal cells promotes recruitment of numerous reactive multinucleated osteoclast-like giant cells, causing lacunar bone resorption. Preferential treatment is curettage with local adjuvants such as phenol, alcohol or liquid nitrogen. The remaining cavity may be filled with bone graft or polymethylmethacrylate (PMMA) bone cement; benefits of the latter are a lower risk of recurrence, possibility of direct weight bearing and early radiographic detection of recurrences...
March 30, 2017: European Journal of Cancer
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