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current orthopedic practice

Alexander S McLawhorn, Ivan De Martino, Keith A Fehring, Peter K Sculco
Utilization of social media both in the private and professional arenas has grown rapidly in the last decade. The rise of social media use within health care can be viewed as the Internet-based corollary of the patient-centered care movement, in which patient perspectives and values are central to the delivery of quality care. For orthopedic surgeons and their practices, general-purpose online social networks, such as Facebook and Twitter, are convenient platforms for marketing, providing patient education and generating referrals...
October 20, 2016: Current Reviews in Musculoskeletal Medicine
Jeffrey L Carson, Gordon Guyatt, Nancy M Heddle, Brenda J Grossman, Claudia S Cohn, Mark K Fung, Terry Gernsheimer, John B Holcomb, Lewis J Kaplan, Louis M Katz, Nikki Peterson, Glenn Ramsey, Sunil V Rao, John D Roback, Aryeh Shander, Aaron A R Tobian
Importance: More than 100 million units of blood are collected worldwide each year, yet the indication for red blood cell (RBC) transfusion and the optimal length of RBC storage prior to transfusion are uncertain. Objective: To provide recommendations for the target hemoglobin level for RBC transfusion among hospitalized adult patients who are hemodynamically stable and the length of time RBCs should be stored prior to transfusion. Evidence Review: Reference librarians conducted a literature search for randomized clinical trials (RCTs) evaluating hemoglobin thresholds for RBC transfusion (1950-May 2016) and RBC storage duration (1948-May 2016) without language restrictions...
October 12, 2016: JAMA: the Journal of the American Medical Association
Leslie Carlin, Kathryn Sibley, Richard Jenkinson, Pia Kontos, Rhona McGlasson, Hans J Kreder, Susan Jaglal
For older adults with osteoporosis, a fall resulting in hip fracture is a life-changing event from which only one-third fully recover. Current best evidence argues strongly for elderly patients to bear weight on their repaired hip fracture immediately after their surgery to maximize their chances of full or nearly full recovery. Patient stakeholders in Canada have argued that some surgeons fail to issue "weight-bearing-as-tolerated" (WBAT) orders in all eligible cases, protecting their bony repair but contributing to increased mortality and long-term disability rates...
October 6, 2016: Journal of Evaluation in Clinical Practice
Jason R Kang, Aaron T Sin, Emilie V Cheung
Massive irreparable rotator cuff tears cause significant shoulder pain and dysfunction. Physical therapy (PT), arthroscopic debridement with biceps tenotomy (AD-BT), and hemiarthroplasty (HA) are treatments shown to reduce pain and improve quality of life. Reverse total shoulder arthroplasty (RTSA) is a newer surgical treatment option that may offer improved function. A cost-effectiveness analysis of these interventions has never been performed, and no head-to-head comparative effectiveness trials currently exist...
September 29, 2016: Orthopedics
Zain Sayeed, Mouhanad M El-Othmani, Afshin A Anoushiravani, Monique C Chambers, Khaled J Saleh
Within the past 3 decades, a recent trend in the growth of musculoskeletal service lines has been seen nationally. Orthopedics offers an appealing concourse for implementation of service-line care. Within this review, the authors address the components involved in planning and building a musculoskeletal service line. The authors also address methods by which orthopedic surgeons can maintain the efficacy of their service lines by examining how orthopedic surgeons can navigate their service line through recent advents in health care reform...
October 2016: Orthopedic Clinics of North America
Ahmet Akgül, Musa Cirak, Tansu Birinci
Platelet-rich plasma (PRP) is an autologous concentrated preparation of human platelets contained in a small volume of plasma that is characterized by hemostatic and tissue-repairing effects. Being enriched by various kinds of growth factors, and their tissue-repairing effects have made them the focus of attention for use in tissue regeneration. PRP has been safely used and documented in many different fields, including orthopedics, sports injuries, dental and periodontal surgery, and cosmetic, plastic, cardiovascular, general, and maxillofacial surgery...
September 6, 2016: Lymphatic Research and Biology
Spoorthi Thammaiah, Vinaya Manchaiah, Vijayalakshmi Easwar, Rajalakshmi Krishna
The objective of this study was to translate and adapt five English self-report health measures to a South Indian language Kannada. Currently, no systematically developed questionnaires assessing hearing rehabilitation outcomes are available for clinical or research use in Kannada. The questionnaires included for translation and adaptation were the hearing handicap questionnaire, the international outcome inventory - hearing aids, the self-assessment of communication, the participation scale, and the assessment of quality of life - 4 dimensions...
April 20, 2016: Audiology Research
Albrecht Encke, Sylvia Haas, Ina Kopp
BACKGROUND: Venous thromboembolism (VTE) is the third most common cardiovascular condition, after myocardial infarction and stroke. Prophylactic measures in accordance with current guidelines can significantly reduce the risk of VTE and the associated morbidity and mortality. Until now, the German interdisciplinary, evidence- and consensus-based (S3) clinical practice guideline on VTE prophylaxis was based on a complete review of all pertinent literature available in MEDLINE up to January 2008...
August 8, 2016: Deutsches Ärzteblatt International
O Hauschild, N P Südkamp
BACKGROUND: Septic arthritis is a common orthopedic emergency. Immediate establishment of the diagnosis and administration of an adequate therapy is paramount in minimizing morbidity and mortality in this severe condition. OBJECTIVE: The aim of the present review was to evaluate the existing evidence in order to give an overview on current best practice in diagnostics and treatment of septic arthritis in adults and children. RESULTS: Joint infections result from either hematogenous spread or direct inoculation of bacteria into the joint, mostly iatrogenically...
October 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Kelms Amoo-Achampong, Benedict U Nwachukwu, Frank McCormick
BACKGROUND: The utilization of musculoskeletal ultrasound has expanded within the setting of the orthopedic clinic as a cost-effective, point-of-care diagnostic tool for shoulder pathology. In experienced hands, ultrasound exhibits capabilities equivalent to that of magnetic resonance imaging in the diagnosis of many shoulder diseases including full-thickness and partial-thickness rotator cuff tears. Although similarly effective in identifying additional shoulder disease processes, major obstacles to its widespread use include user dependence and intrinsic limitation to extra-articular diagnosis...
August 22, 2016: Physician and Sportsmedicine
Jeffrey J Nepple, Matthew D Milewski, Kevin G Shea
Osteochondritis dissecans (OCD) of the knee remains a relatively common and poorly understood pediatric and adolescent knee condition. Both conservative and surgical treatments have major impact on the lives of young active, athletic patients with knee OCD. OCD has been recently redefined as a "focal, idiopathic alteration of subchondral bone with risk for instability and disruption of adjacent articular cartilage that may result in premature osteoarthritis." The 2011 American Academy of Orthopedic Surgeons Clinical Practice Guidelines found limited evidence for all aspects of the treatment of knee OCD...
October 2016: Journal of Knee Surgery
Bryant Ho, Jeff R Houck, Adolph S Flemister, John Ketz, Irvin Oh, Benedict F DiGiovanni, Judith F Baumhauer
BACKGROUND: The use of patient-reported outcomes continues to expand beyond the scope of clinical research to involve standard of care assessments across orthopedic practices. It is currently unclear how to interpret and apply this information in the daily care of patients in a foot and ankle clinic. We prospectively examined the relationship between preoperative patient-reported outcomes (PROMIS Physical Function, Pain Interference and Depression scores), determined minimal clinical important differences for these values, and assessed if these preoperative values were predictors of improvement after operative intervention...
September 2016: Foot & Ankle International
Bonnie O'Connor, Fran Pollner, Adriane Fugh-Berman
BACKGROUND: Industry payments to surgeons have received public attention, but little is known about the relationships between surgeons and medical device representatives. Medical device representatives ("device reps") have become an integral part of operating room personnel. The effect of their presence on patient care deserves discussion. STUDY DESIGN: We conducted a qualitative, ethnographic study to explore relationships between surgeons and medical device representatives, and characterize industry involvement in the training of surgeons...
2016: PloS One
P Fulín, D Pokorný, M Šlouf, M Nevoralová, T Vacková, J Dybal, N Kaspříková, I Landor
UNLABELLED: PURPOSE OF THE STUDY Ultrahigh molecular weight polyethylene (UHMWPE) is today the most frequently used bearing surface in total joint replacements (TJR) because of its properties, i.e., excellent biocompatibility, good mechanical and tribological performance and high wear resistance. UHMWPE liners are the most loaded TJR components and, therefore, their properties are decisive for TJR longevity. This study had three objectives: 1) to evaluate the oxidative degradation of explanted UHMWPE components; 2) to look for a statistically significant relationship between the extent of oxidative degradation and the durability of joint replacements; and 3) to investigate whether the durability of a TJR was related to the type of sterilisation used in manufacture...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Mark A Pittman, Lalena M Yarris, Michelle D Lall, Jessica L Smith, Charlotte P Wills, Jacob W Ufberg, Cullen B Hegarty, Jeffrey N Love
OBJECTIVES: Fractures comprise 3% of all Emergency Department (ED) visits. Although Emergency Physicians are often responsible for managing most of the initial care of these patients, many report a lack of proficiency and comfort with these skills. The primary objective was to assess how prepared recent Emergency Medicine (EM) residency graduates felt managing closed fractures. Secondary objectives identified whether residency training or independent practice contributed most to the current level of comfort with these procedures, and which fractures were most commonly reduced without orthopedic consultation...
August 1, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Albert H Chao, Noopur Gangopadhyay
BACKGROUND: Limited data exist regarding industry financial relationships in plastic surgery. The Sunshine Act Open Payments Database currently represents the largest repository of these data, but is limited primarily to queries of individual providers. The purpose of this study was to analyze these data and present them in a manner that better delineates these relationships, and to compare plastic surgery with other surgical subspecialties. METHODS: A review of the Open Payments Database was performed for the period from January 1, 2014, to December 31, 2014...
August 2016: Plastic and Reconstructive Surgery
Michael E Neufeld, Nathan N O'Hara, Min Zhan, Yongliang Zhai, Henry M Broekhuyse, Kelly A Lefaivre, Joshua M Abzug, Gerard P Slobogean
The goal of this study was to determine the proportion of patients admitted with a hip fracture to participating American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) hospitals who were treated within the United Kingdom's National Institute for Health and Care Excellence (NICE) time-to-hip-fracture-surgery benchmark. The secondary goals were to identify factors associated with missing the benchmark and to determine whether the benchmark was associated with improved 30-day patient outcomes...
July 25, 2016: Orthopedics
Andrew Moriarity, Jim Kennedy, Joe Baker, Pat Kiely
The primary aim of this study was to analyze the current level of evidence available on the surgical management of Slipped Capital Femoral Epiphysis (SCFE). Secondary aims were to correlate the level of evidence with the impact factor of the journal to evaluate the level of evidence over time, and to evaluate the geographic distribution of the studies. Therapeutic studies published in English between January 1991 and August 2014 that reported on SCFE were identified via electronic search was performed using the databases PubMed, EMBASE, and the Cochrane Library...
June 27, 2016: Orthopedic Reviews
Mehmet Isyar, Ibrahim Yilmaz, Duygu Yasar Sirin, Sercan Yalcin, Olcay Guler, Mahir Mahirogullari
Biological cartilage repair is one of the most important targets for orthopedic surgeons currently. For this purpose, it is mandatory to know how to prepare a chondrocyte culture. In this study, our purpose was to introduce a method enabling orthopedic surgeons to practice their knowledge and skills on molecular experimental setup at cellular level, based on our experiences from previous pilot studies. Thus, we believe it will encourage orthopedic surgeons.
September 2016: Journal of Orthopaedics
Nicholas J Lombardi, Bradford Tucker, Kevin B Freedman, Luke S Austin, Brandon Eck, Matthew Pepe, Fotios P Tjoumakaris
It is standard practice in high school athletic programs for certified athletic trainers to evaluate and treat injured student athletes. In some cases, a trainer refers an athlete to a physician for definitive medical management. This study was conducted to determine the rate of agreement between athletic trainers and physicians regarding assessment of injuries in student athletes. All high school athletes who were injured between 2010 and 2012 at 5 regional high schools were included in a research database...
September 1, 2016: Orthopedics
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