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Journal of the American Academy of Orthopaedic Surgeons

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https://read.qxmd.com/read/30889040/do-more-expensive-total-knee-arthroplasty-prostheses-provide-greater-improvements-in-outcomes-over-less-expensive-prostheses-sold-by-a-physician-owned-distributorship
#1
Keith M Baumgarten, Peter S Chang, Peter A Looby, Matthew J McKenzie, Corey P Rothrock
BACKGROUND: It is unknown whether more expensive total knee prostheses provide better improvements in patient-determined outcomes compared with less expensive prostheses. A physician-owned distributorship (POD) was created with a goal to provide lower cost implants to hospitals as an alternative to higher cost prostheses sold by the large orthopaedic implant companies. The hypothesis was that lower cost total knee prostheses would have equivalent outcomes, while resulting in lower costs to the hospitals purchasing them compared with higher cost industry-supplied knee prostheses...
March 18, 2019: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/30883451/the-authors-reply
#2
(no author information available yet)
No abstract text is available yet for this article.
March 15, 2019: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/30883450/surgical-management-of-patellofemoral-instability-in-the-skeletally-immature-patient
#3
Sumit K Gupta
No abstract text is available yet for this article.
March 15, 2019: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/30889038/ligasure-use-decreases-intraoperative-blood-loss-volume-and-blood-transfusion-volume-in-sarcoma-surgery
#4
Nicole L Levine, Yidan Zhang, Bang H Hoang, Rui Yang, Zachary H Jurkowski, Michael E Roth, Jonathan B Gill, Yungtai Lo, Ruth E Eisenberg, Mikhail Bekarev, Richard Gorlick, David S Geller
INTRODUCTION: The LigaSure system has been successfully used in thoracic and abdominal surgery. However, to date, its use in the resection of sarcomas has not been systematically studied. We aimed to determine whether the use of the LigaSure system reduces blood loss and blood transfusion volumes in sarcoma surgery. METHODS: One hundred forty-two consecutive patients who underwent sarcoma surgeries between July 2010 and October 2016 were included. Conventional electrocautery alone (n = 91) and with LigaSure (n = 51) were compared...
March 12, 2019: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/30889037/fixation-of-anterior-pelvic-ring-injuries
#5
Robert D Wojahn, Michael J Gardner
Treatment of anterior pelvic ring injuries involves both acute stabilization during the initial resuscitation and definitive fixation. Definitive management has evolved substantially over the past 40 years with improved patient mobilization and long-term outcomes. Although its use has recently declined, external fixation remains a favorable option in certain situations. Symphyseal plating is the preferred technique for stabilization of symphyseal diastasis because of superior stability and low morbidity. Ramus screws can be effective for simple ramus fractures but require a careful technique because of the proximity of neurovascular structures...
March 12, 2019: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/30889036/a-comparison-of-patient-centered-outcome-measures-to-evaluate-dysphagia-and-dysphonia-after-anterior-cervical-discectomy-and-fusion
#6
Brett D Rosenthal, Michael H McCarthy, Surabhi Bhatt, Jason W Savage, Kern Singh, Wellington K Hsu, Alpesh A Patel
OF BACKGROUND DATA: Dysphagia and dysphonia are the most common complications after anterior cervical diskectomy and fusion (ACDF). No consensus system exists currently in the spine literature for the classification of these conditions postoperatively. OBJECTIVE: The purpose of this analysis was to evaluate the validity and reliability of the Eating Assessment Tool (EAT-10) in the assessment of dysphagia when compared with the Bazaz score. A secondary goal was to assess the Voice Handicap Index (VHI-10) scores among patients following ACDF...
March 12, 2019: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/30889039/epidemiology-and-perioperative-complications-in-patients-with-sickle-cell-disease-after-orthopaedic-surgery-26-years-experience-at-a-major-academic-center
#7
Joseph Cusano, Emily J Curry, Kiera A Kingston, Elizabeth Klings, Xinning Li
INTRODUCTION: Surgical management of patients with sickle cell disease (SCD) poses a unique challenge to orthopaedic surgeons due to increased operative and perioperative risk. Studies evaluating perioperative complications among patients with SCD undergoing orthopaedic surgery have been limited. We sought to review the clinical characteristics and perioperative complications in our patients with SCD who required orthopaedic surgery. METHODS: Our institution has one of the largest sickle cell centers in the Northeastern United States...
March 11, 2019: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/30865025/proximal-radius-fractures-in-children
#8
Luke T Nicholson, David L Skaggs
Fractures of the proximal radius represent 5% to 10% of all elbow fractures in children. These fractures have many treatment options and have a high risk of complication, particularly loss of forearm rotation. Nonsurgical management of minimally displaced radial neck fractures produces excellent results in most patients. For displaced fractures, numerous methods of closed and percutaneous reduction have been proposed, whereas open reduction has been associated with particularly poor outcome. Many additional factors, including fracture angulation, patient age, associated injury, articular involvement, and internal fixation, may lead to worse outcomes...
March 8, 2019: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/30839327/aaos-systematic-review-management-of-surgical-site-infections
#9
Antonia F Chen, Alex C McLaren
No abstract text is available yet for this article.
March 1, 2019: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/30829899/preoperative-opioid-use-negatively-affects-patient-reported-outcomes-after-primary-total-hip-arthroplasty
#10
Bryant E Bonner, Tiffany N Castillo, David W Fitz, John Z Zhao, Christian Klemt, Young-Min Kwon
BACKGROUND: Opioid use is a public health crisis in the United States and an area of increased focus in orthopaedic surgery. The aim of this study is to investigate whether preoperative opioid use had any effect on patient-reported outcome measures (PROMs) before and after total hip arthroplasty (THA). METHODS: A total of 389 patients with THA with both preoperative and postoperative PROMs were reviewed: (1) 76 patients with preoperative opioid use (24%) and (2) 237 patients without preoperative opioid use (76%)...
February 28, 2019: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/30829898/a-restrictive-hemoglobin-transfusion-threshold-of-less-than-7-g-dl-decreases-blood-utilization-without-compromising-outcomes-in-patients-with-hip-fractures
#11
Raj M Amin, Vincent M DeMario, Matthew J Best, Babar Shafiq, Erik A Hasenboehler, Robert S Sterling, Steven M Frank, Harpal S Khanuja
INTRODUCTION: In patients with hip fracture, a transfusion threshold of hemoglobin (Hb) <8 g/dL is associated with similar or better outcomes than more liberal thresholds. Whether a more restrictive threshold of <7 g/dL Hb produces equivalent outcomes in such patients is unknown. The aim of the study was to examine whether a restrictive threshold of <7 g/dL Hb is safe in this population. METHODS: In January 2015, a blood management program was implemented that uses a restrictive transfusion threshold of <7 g/dL Hb in hemodynamically stable patients and <8 g/dL in patients with symptomatic anemia or a history of coronary artery disease...
February 28, 2019: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/30829986/the-impact-of-patient-reported-penicillin-allergy-on-risk-for-surgical-site-infection-in-total-joint-arthroplasty
#12
Andrea H Stone, Grayson Kelmer, James H MacDonald, Mary R Clance, Paul J King
BACKGROUND: Penicillin (PCN) allergy is reported in 10% to 20% of the population; studies show that only 1% to 3% of patients have a true allergy. Most patients reporting a PCN allergy receive second-line antibiotic prophylaxis preoperatively, which raises concerns about antimicrobial efficacy. Studies also suggest that second-line antibiotics may increase the rate of surgical site infection (SSI). In this study we aim to analyze the effect of PCN allergy on antibiotic type prescribed and SSI in our total joint arthroplasty population...
February 27, 2019: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/30829985/use-of-activity-trackers-in-orthopaedics
#13
Sumeet Garg, Hannah D Quick, Eun Bi Kim, Mark A Erickson
Activity trackers are relatively inexpensive, easily available, and widely used by consumers. There has been increased interest in healthcare practice and research to use activity tracker data. Continuous collection of health variables including step count, heart rate, and calorimetry provides researchers and clinicians data to monitor patients after an intervention and/or encourage physical activity. The purpose of this article is to review the current use of activity trackers in orthopaedics and discuss potential applications in clinical research...
February 27, 2019: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/30807335/surgeon-energy-expenditure-and-substrate-utilization-during-simulated-spine-surgery
#14
Darryl C Whitney, Stephen J Ives, Garrett R Leonard, Douglas J VanderBrook, James P Lawrence
INTRODUCTION: Orthopaedic surgery can be a physically demanding occupation with high rates of fatigue and burnout. Fatigue has been shown to affect surgeon performance with higher rates of errors in fatigued surgeons. The metabolic cost of performing surgery has yet to be quantified. A better understanding of these costs may provide insights into surgeon fatigue and its effect on patient safety. METHODS: Eight subjects performed a one-level lumbar laminectomy and fusion on cadavers...
February 22, 2019: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/30789380/ankle-injuries-in-dancers
#15
J Turner Vosseller, Elizabeth R Dennis, Shaw Bronner
The term dance encompasses a broad range of different styles; much of the orthopaedic literature has focused on ballet dancers. Injury is common in dancers at all levels, and many serious dancers sustain multiple injuries as they progress through their career. Foot and ankle injuries are among the most common injuries experienced by dancers. These injuries include those that are specific to dancers because of the unique physical maneuvers required to effectively perform, but they can also include common injuries that may require relatively different treatment because of the physical demands of the dancer...
February 15, 2019: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/30789379/outcomes-after-hemiarthroplasty-of-the-elbow-for-the-management-of-posttraumatic-arthritis-minimum-2-year-follow-up
#16
Jean-David Werthel, Bradley Schoch, Julie Adams, Scott Steinmann
BACKGROUND: Hemiarthroplasty (HA) of the elbow represents an alternative to total elbow arthroplasty (TEA) without the associated activity restrictions. This study reviews our experience with distal humerus HA with minimum 2-year follow-up. METHODS: Between 2002 and 2012, 16 elbows underwent HA for posttraumatic arthritis of the elbow. Patients were followed for a minimum of 2 years or until revision surgery. Outcome measures included pre- and postoperative Mayo Elbow Performance Scores (MEPSs), complications, and revisions...
February 15, 2019: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/30768484/validation-of-a-novel-surgical-data-capturing-system-after-hip-arthroscopy
#17
Marsalis C Brown, Robert W Westermann, Mia S Hagen, Gregory J Strnad, James T Rosneck, Kurt P Spindler, T Sean Lynch
INTRODUCTION: The purpose of this study is to compare the utility and validity of the OrthoMiDaS (Orthopaedic Minimal Data Set) Episode of Care (OME) database with the current benchmark for recording procedural details, the operative note (OpNote), with regard to disease severity and risk factors for hip arthroscopy cases. METHODS: A convenience sample of the first 100 hip arthroscopy cases for labral tears done at our institution between February and August 2015 were selected for this study...
February 12, 2019: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/30768483/patients-undergoing-revision-microdiskectomy-for-recurrent-lumbar-disk-herniation-experience-worse-clinical-outcomes-and-more-revision-surgeries-compared-with-patients-undergoing-a-primary-microdiskectomy
#18
Michael Nolte, Bryce A Basques, Philip K Louie, Jannat M Khan, Arya Varthi, Justin Paul, Howard S An
INTRODUCTION: Recurrent disk herniation treatment aims to optimize outcomes. This study compares the demographics and patient-reported outcomes of patients who underwent primary or revision lumbar microdiskectomy surgery for recurrent disk herniation. METHODS: A retrospective cohort analysis was performed of consecutive patients who underwent primary or revision lumbar microdiskectomies between January 2008 and December 2015. Patients were divided into two groups: primary (primary) and revision (recurrent)...
February 12, 2019: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/30768482/variation-in-nonsurgical-treatment-recommendations-for-common-upper-extremity-conditions
#19
Lisanne Johanna Henrica Smits, Suzanne Caroline Wilkens, David Ring, Thierry Guillaume Guitton, Neal Chen
BACKGROUND: In orthopaedic surgery, there is known surgeon-to-surgeon variation in recommendations for surgery. Variation in recommendations for nonsurgical treatment of common upper extremity conditions for which surgery is discretionary remains unclear. METHODS: One hundred eighty-three surgeons were included after completing six questions on six scenarios of upper extremity conditions regarding nonsurgical treatment recommendations. For one scenario, we measured the influence of reading a summary of preferred practice before making recommendations...
February 12, 2019: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/30741724/traumatic-brachial-plexopathy-in-athletes-current-concepts-for-diagnosis-and-management-of-stingers
#20
Briggs M Ahearn, Harlan M Starr, John G Seiler
Traumatic upper trunk brachial plexopathy, also known as a stinger or burner, is the most common upper extremity neurologic injury among athletes and most commonly involves the upper trunk. Recent studies have shown the incidence of both acute and recurrent injuries to be higher in patients with certain anatomic changes in the cervical spine. In addition, despite modern awareness, tackling techniques, and protective equipment, some think the incidence to be slowly on the rise in contact athletes. The severity of neurologic injury varies widely but usually does not result in significant loss of playing time or permanent neurologic deficits if appropriate management is undertaken...
February 5, 2019: Journal of the American Academy of Orthopaedic Surgeons
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