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https://www.readbyqxmd.com/read/29049115/an-evidence-based-approach-to-the-prescription-opioid-epidemic-in-orthopedic-surgery
#1
Ellen M Soffin, Seth A Waldman, Roberta J Stack, Gregory A Liguori
Orthopedic surgery is associated with significant perioperative pain. Providing adequate analgesia is a critical component of patient care and opioids play a vital role in the acute postoperative setting. However, opioid prescribing for patients undergoing orthopedic procedures has recently been identified as a major contributor to the current opioid epidemic. As opioid usage and related morbidity and mortality continue to rise nationwide, opioid-prescribing practices are under increased scrutiny. Here, we update the evidence base and recommendations behind a set of interventions developed at the Hospital for Special Surgery to address the national epidemic at the local level...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28966376/current-concepts-in-sports-injury-rehabilitation
#2
Himmat Dhillon, Sidak Dhilllon, Mandeep S Dhillon
In the modern era, rehabilitation after sports injury has become a domain for specialists, and its evolution has necessarily brought together the sports physiotherapist, the sports physician, and the orthopedic surgeon. The changing profile of sports related injury, as well as limited availability of facilities for rehabilitation in many areas of India, is a matter of concern. Elite sportspersons have some protection, but the average athlete is often left to fend for himself. Key factors in successful sports injury rehabilitation protocols are the application of modern rehabilitation protocols under appropriate supervision, appropriate and well timed surgical interventions, and judicious and need based use of pharmaceutical agents...
September 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28934880/three-dimensional-bioprinting-and-its-potential-in-the-field-of-articular-cartilage-regeneration
#3
Vivian H M Mouser, Riccardo Levato, Lawrence J Bonassar, Darryl D D'Lima, Daniel A Grande, Travis J Klein, Daniel B F Saris, Marcy Zenobi-Wong, Debby Gawlitta, Jos Malda
Three-dimensional (3D) bioprinting techniques can be used for the fabrication of personalized, regenerative constructs for tissue repair. The current article provides insight into the potential and opportunities of 3D bioprinting for the fabrication of cartilage regenerative constructs. Although 3D printing is already used in the orthopedic clinic, the shift toward 3D bioprinting has not yet occurred. We believe that this shift will provide an important step forward in the field of cartilage regeneration. Three-dimensional bioprinting techniques allow incorporation of cells and biological cues during the manufacturing process, to generate biologically active implants...
October 2017: Cartilage
https://www.readbyqxmd.com/read/28922228/anesthesia-capacity-in-ghana-a-teaching-hospital-s-resources-and-the-national-workforce-and-education
#4
Mark A Brouillette, Alfred J Aidoo, Maria A Hondras, Nana A Boateng, Akwasi Antwi-Kusi, William Addison, Alec R Hermanson
BACKGROUND: Quality anesthetic care is lacking in low- and middle-income countries (LMICs). Global health leaders call for perioperative capacity reports in limited-resource settings to guide improved health care initiatives. We describe a teaching hospital's resources and the national workforce and education in this LMIC capacity report. METHODS: A prospective observational study was conducted at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, during 4 weeks in August 2016...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28835024/-occlusion-current-situation-and-prospect-in-view-of-holistic-integrative-medicine
#5
M Q Wang, X D Liu
The rise of holistic integrative medicine (HIM) is an inevitable consequence of modern medical development which emphasizes the change from specialization to integration of the most advanced medical knowledge. It does not mean a simple collection of the medical theories, but means the digestion of those theories for the clinical practical application. Because occlusal therapy is characterized as not only a high level of individualization, but also a relation to many stomatology and other disciplines, such as plastic surgery, orthopedics, neurosciences and psychology...
August 9, 2017: Zhonghua Kou Qiang Yi Xue za Zhi, Zhonghua Kouqiang Yixue Zazhi, Chinese Journal of Stomatology
https://www.readbyqxmd.com/read/28817163/provider-initiated-patient-satisfaction-reporting-yields-improved-physician-ratings-relative-to-online-rating-websites
#6
Benjamin F Ricciardi, Brad S Waddell, Scott R Nodzo, Jeffrey Lange, Allina A Nocon, Spencer Amundsen, T David Tarity, Alexander S McLawhorn
Recently, providers have begun to publicly report the results of patient satisfaction surveys from their practices. However, these outcomes have never been compared with the findings of commercial online physician rating websites. The goals of the current study were to (1) compare overall patient satisfaction ratings for orthopedic surgeons derived from provider-based third-party surveys with existing commercial physician rating websites and (2) determine the association between patient ratings and provider characteristics...
September 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/28817162/determining-when-it-is-safe-to-remove-the-external-fixator-results-from-a-survey-of-the-limb-lengthening-and-reconstruction-society
#7
Christopher A Iobst, Waleed Mohammed, Ryan Colley
Thousands of external fixators are applied for distraction osteogenesis each year. Determining when it is safe to remove the fixator can be difficult. The purpose of this study was to survey an international group of external fixation surgeons to determine their current practice patterns surrounding external fixator removal. A 10-question, open-ended survey was emailed to members of the Limb Lengthening and Reconstruction Society. Responses were recorded, and statistical analysis was performed. Pearson's chi-square test and likelihood ratio were used when indicated...
September 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/28809623/how-to-choose-between-the-implant-materials-steel-and-titanium-in-orthopedic-trauma-surgery-part-2-biological-aspects
#8
S M Perren, P Regazzoni, A A Fernandez
BIOLOGICAL ASPECTS OF STEEL AND TITANIUM AS IMPLANT MATERIAL IN ORTHOPEDIC TRAUMA SURGERY The following case from the ICUC database, where a titanium plate was implanted into a flourishing infection, represents the clinical experience leading to preferring titanium over steel. (Fig. 1) (6). Current opinions regarding biological aspects of implant function. The "street" opinions regarding the biological aspects of the use of steel versus titanium as a surgical trauma implant material differ widely. Statements of opinion leaders range from "I do not see any difference in the biological behavior between steel and titanium in clinical application" to "I successfully use titanium implants in infected areas in a situation where steel would act as foreign body "sustaining" infection...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28801032/physiotherapy-for-patients-with-shoulder-pain-in-primary-care-a-descriptive-study-of-diagnostic-and-therapeutic-management
#9
Y H J M Karel, G G M Scholten-Peeters, M Thoomes-de Graaf, E Duijn, J B van Broekhoven, B W Koes, A P Verhagen
BACKGROUND: Shoulder pain is one of the three main musculoskeletal complaints and more than 50% of the patients have symptoms longer than 6 months. Until now, limited data exist about the content of physiotherapy for patients with shoulder pain in primary care. OBJECTIVE: Describe current physiotherapeutic diagnostic- and therapeutic management, including the use of diagnostic ultrasound, in patients with shoulder pain in primary care. DESIGN AND SETTING: A prospective cohort study in primary care physiotherapy with a 12 week follow-up...
November 28, 2016: Physiotherapy
https://www.readbyqxmd.com/read/28770273/atypical-femur-fractures-a-survey-of-current-practices-in-orthopedic-surgery
#10
P S Schneider, M Wall, J P Brown, A M Cheung, E J Harvey, S N Morin
The results of a self-administered online survey demonstrate that orthopedic surgeons' management practices for AFF are variable. These data will inform the development of clinical practice guidelines. INTRODUCTION: We aimed to determine current AFF treatment practices of orthopedic surgeons to inform clinical practice guideline development. METHODS: A self-administered online survey was developed and sequentially posted on the Orthopaedic Trauma Association (OTA) website from July to August 2015 and the Canadian Orthopaedic Association (COA) website from December 2015 to January 2016...
August 2, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28718058/cultural-biases-in-current-medical-practices-with-a-specific-attention-to-orthopedic-surgery-a-review
#11
Gracia Etienne, Todd P Pierce, Anton Khlopas, Morad Chughtai, Carlos J Lavernia, Teva Y Vogelstein, Craig M Thomas, Charles S Modlin, Michael A Mont
Due to the increasing diversity within the United States population, there is an ever-increasing need for increased education on cultural literacy and tolerance in medical schools and residency programs. The purpose of this article was to review how a person's culture can play a substantive role in effecting and influencing (1) medical diagnosis, (2) patient and health provider medical decision-making, (3) the patient's perception of disease, and (4) the doctor-patient relationships. Many of the decisions we make as orthopedic surgeons must account for the patient's cultural needs, as much of our work impacts patients' daily activities and function...
July 17, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28713807/the-development-of-a-postgraduate-orthopaedic-manual-therapy-residency-program-in-nairobi-kenya
#12
Shala Cunningham, Richard Jackson, Daniel Kangutu Muli, Joni McFelea
INTRODUCTION: There are very few opportunities for long-term, comprehensive postgraduate education in developing countries because of fiscal and human resource constraints. Therefore, physiotherapists have little opportunity following graduation to advance their skills through the improvement of clinical reasoning and treatment planning and application. BACKGROUND: To address the need for sustainable advanced instruction in physiotherapy within the country, a postgraduate Residency program was initiated in Nairobi, Kenya in 2012...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28708567/%C3%AE-defensin-point-of-care-test-for-diagnosis-of-prosthetic-joint-infections-neglected-role-of-laboratory-and-clinical-pathologists
#13
REVIEW
Lorenzo Drago, Marco Toscano, Lorenza Tacchini, Giuseppe Banfi
Periprosthetic joint infection (PJI) is a serious complication that may occur after native joint replacement leading to a severe health and economic burden. Currently, due to several confounding factors, PJI is difficult to diagnose. Today, a multidisciplinary approach is indispensable to correctly define a periprosthetic joint infection; indeed, tissue histology, microbiology cultures and clinical findings are used together to achieve this goal. Analysis of α-defensin is commonly used for PJI diagnosis, as it allows the rapid detection of α-defensin present in the synovial fluid following a microbial infection...
July 14, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28702386/disorders-of-the-long-head-of-the-biceps-tenotomy-versus-tenodesis
#14
Fabiano Rebouças Ribeiro, André Petry Sandoval Ursolino, Vinicius Ferreira Lima Ramos, Fernando Hovaguim Takesian, Antonio Carlos Tenor Júnior, Miguel Pereira da Costa
Disorders of the long head of biceps tendon are common in clinical practice. Their causes could be degenerative, inflammatory, instability (subluxation or luxation) or traumatic. They are generally associated to other diseases of the shoulder, mainly rotator cuff injuries. Currently, there is controversy in the literature regarding the indications for surgical treatment and the choice of the best technique for each case, due to the possibility of esthetic deformity, loss of muscle strength, and residual pain...
May 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28698718/the-holy-grail-of-orthopedic-surgery-mesenchymal-stem-cells-their-current-uses-and-potential-applications
#15
REVIEW
Roberto Berebichez-Fridman, Ricardo Gómez-García, Julio Granados-Montiel, Enrique Berebichez-Fastlicht, Anell Olivos-Meza, Julio Granados, Cristina Velasquillo, Clemente Ibarra
Only select tissues and organs are able to spontaneously regenerate after disease or trauma, and this regenerative capacity diminishes over time. Human stem cell research explores therapeutic regenerative approaches to treat various conditions. Mesenchymal stem cells (MSCs) are derived from adult stem cells; they are multipotent and exert anti-inflammatory and immunomodulatory effects. They can differentiate into multiple cell types of the mesenchyme, for example, endothelial cells, osteoblasts, chondrocytes, fibroblasts, tenocytes, vascular smooth muscle cells, and sarcomere muscular cells...
2017: Stem Cells International
https://www.readbyqxmd.com/read/28673803/residents-and-program-director-perspectives-often-differ-on-optimal-preparation-strategies-and-the-value-of-the-orthopedic-in-training-examination
#16
Christopher L Camp, Ryan M Degen, Arlen D Hanssen, Joshua S Dines, Matthew D Karam, Norman S Turner
OBJECTIVES: The purpose of this work was to compare resident and program director (PD) perspectives on the value of the Orthopaedic In-Training Examination (OITE), resident study habits, and best resources for optimal performance. DESIGN: A national survey of orthopedic surgery residents and PDs. SETTING: Mayo Clinic, Rochester, MN PARTICIPANTS: The survey was completed by 445 (41.5%) eligible orthopedic surgery residents and 37 (77.1%) PDs...
June 30, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28655127/depression-screening-by-physical-therapists-practices-beliefs-barriers
#17
Patricia Fay, Susan L Edmond, Julia K Baron, Michelle Joshi
BACKGROUND: Depression, a common comorbidity encountered in physical therapy (PT) practice, negatively impacts outcomes. There is limited knowledge of PT practice patterns relative to screening for depression. OBJECTIVE: Objectives were to describe beliefs regarding depression, and identify practice patterns and perceived barriers regarding screening for depression among APTA Board Certified Orthopedic Clinical Specialist (OCS) PTs. METHODS: Surveys were distributed to all PT OCSs in the US; 416 responses were analyzed...
June 2, 2017: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/28632733/ponseti-method-in-the-management-of-clubfoot-under-2-years-of-age-a-systematic-review
#18
REVIEW
Balasankar Ganesan, Ameersing Luximon, Adel Al-Jumaily, Suchita Kothe Balasankar, Ganesh R Naik
BACKGROUND: Congenital talipes equinovarus (CTEV), also known as clubfoot, is common congenital orthopedic foot deformity in children characterized by four components of foot deformities: hindfoot equinus, hindfoot varus, midfoot cavus, and forefoot adduction. Although a number of conservative and surgical methods have been proposed to correct the clubfoot deformity, the relapses of the clubfoot are not uncommon. Several previous literatures discussed about the technical details of Ponseti method, adherence of Ponseti protocol among walking age or older children...
2017: PloS One
https://www.readbyqxmd.com/read/28618868/appropriate-use-criteria-for-hyaluronic-acid-in-the-treatment-of-knee-osteoarthritis-in-the-united-states
#19
Arup K Bhadra, Roy Altman, Vinod Dasa, Karen Myrick, Jeffrey Rosen, Vijay Vad, Peter Vitanzo, Michelle Bruno, Hillary Kleiner, Caryn Just
OBJECTIVE: A workgroup of clinical experts has developed an Appropriate Use Criteria (AUC) for the use of hyaluronic acid (HA) in the treatment of osteoarthritis (OA) of the knee. The increasingly broad and varied use of HA injections, lack of published clinical guidance, and limited coverage for their use has created the imperative to establish appropriateness criteria. METHODS: The experts of this workgroup represent rheumatology, orthopedic surgery, physiatry, sports medicine, and nursing clinicians with substantive knowledge of intra-articular HA therapy...
July 2017: Cartilage
https://www.readbyqxmd.com/read/28601486/the-development-of-the-patient-expectations-of-shoulder-surgery-survey
#20
Rinco C T Koorevaar, Tsjitske Haanstra, Esther Van't Riet, Okke F O Lambers Heerspink, Sjoerd K Bulstra
BACKGROUND: Patient satisfaction after a surgical procedure is dependent on meeting preoperative expectations. There is currently no patient expectations survey available for patients undergoing shoulder surgery that is validated, reliable, and easy to use in daily practice. The aim of this study was to develop a Patient Expectations of Shoulder Surgery (PESS) survey. METHODS: In 315 patients, answers to an open-ended question about patient expectations were collected before shoulder surgery to develop the PESS survey...
June 7, 2017: Journal of Shoulder and Elbow Surgery
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