The Science of Health-Care Delivery
This article provides an overview of basic concepts involved in systems and organizational theory relevant to orthopaedic surgery. (Source: JBJS)
Source: JBJS - September 20, 2016 Category: Orthopaedics Authors: Sharan, A. D., Weinstein, J. Tags: The Orthopaedic Forum Source Type: research
Bone Lengthening in the Pediatric Upper Extremity
Bone lengthening has been used successfully for several congenital and acquired conditions in the pediatric clavicle, humerus, radius, ulna, and phalanges.
Common indications for bone lengthening include achondroplasia, radial longitudinal deficiency, multiple hereditary exostosis, brachymetacarpia, symbrachydactyly, and posttraumatic and postinfectious growth arrest.
Most authors prefer distraction rates of <1 mm/day for each bone in the upper extremity except the humerus, which can safely be lengthened by 1 mm/day.
Most authors define success by the amount of radiographic bone lengthening, joint motion after len...
Source: JBJS - September 6, 2016 Category: Orthopaedics Authors: Farr, S., Mindler, G., Ganger, R., Girsch, W. Tags: Pediatrics Current Concepts Review Source Type: research
Repairing the Capsule to the Transferred Coracoid Preserves External Rotation in the Modified Latarjet Procedure
Conclusions:
Because the difference in the mid-range stability may not be clinically relevant, we recommend repairing the capsule to the coracoid, as that preserves the range of motion in external rotation.
Clinical Relevance:
Repairing the capsule to the transferred coracoid during the modified Latarjet procedure appears to be beneficial to avoid the limited range of motion in external rotation, but the direct contact of the humeral head and the transferred coracoid might confer a risk of osteoarthritis. Long-term consequences in the clinical setting need to be clarified. (Source: JBJS)
Source: JBJS - September 6, 2016 Category: Orthopaedics Authors: Itoigawa, Y., Hooke, A. W., Sperling, J. W., Steinmann, S. P., Zhao, K. D., Yamamoto, N., Itoi, E., An, K.-N. Tags: Basic Science, Shoulder Scientific Articles Source Type: research
Reversible Intraoperative Neurophysiologic Monitoring Alerts in Patients Undergoing Arthrodesis for Adolescent Idiopathic Scoliosis: What Are the Outcomes of Surgery?
Conclusions:
Notable IONM changes occurred in 5.3% of the patients who underwent arthrodesis for AIS. Those patients had larger preoperative deformity, a longer operative duration, a greater number of levels fused, a higher estimated blood loss, and a greater volume of autologous blood transfused. Return of IONM data guided the surgeon to safely complete the procedure in 34 of 36 patients, with correction similar to that of patients who did not experience an alert.
Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. (Source: JBJS)
Source: JBJS - September 6, 2016 Category: Orthopaedics Authors: Samdani, A. F., Bennett, J. T., Ames, R. J., Asghar, J. K., Orlando, G., Pahys, J. M., Yaszay, B., Miyanji, F., Lonner, B. S., Lehman, R. A., Newton, P. O., Cahill, P. J., Betz, R. R. Tags: Pediatrics, Spine Scientific Articles Source Type: research
Changes in Driving Performance Following Shoulder Arthroplasty
Conclusions:
Driving performance returned to preoperative levels at 6 weeks after shoulder arthroplasty. By 12 weeks postoperatively, patients demonstrated improved driving performance compared with preoperative performance. On the basis of our findings, clinicians can suggest a window of 6 to 12 weeks postoperatively for the gradual return to driving. However, for patients of older age, with less driving experience, or with greater pain, a return to driving at closer to 12 weeks postoperatively should be recommended.
Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of level...
Source: JBJS - September 6, 2016 Category: Orthopaedics Authors: Hasan, S., McGee, A., Garofolo, G., Hamula, M., Oh, C., Kwon, Y., Zuckerman, J. Tags: Shoulder Scientific Articles Source Type: research
Complex Primary Total Knee Arthroplasty: Long-Term Outcomes
Conclusions:
We found increased reoperation and revision rates associated with the use of constrained implants at the time of index total knee arthroplasty. The rate of component revision for any reason at 10 years was >2 times higher in the constrained total knee arthroplasty groups compared with the unconstrained total knee arthroplasty group. At 20 years postoperatively, the component revision rate was >3 times higher.
Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. (Source: JBJS)
Source: JBJS - September 6, 2016 Category: Orthopaedics Authors: Martin, J. R., Beahrs, T. R., Stuhlman, C. R., Trousdale, R. T. Tags: Knee Scientific Articles Source Type: research
Trends in Complication Rates Following Ankle Arthrodesis and Total Ankle Replacement
Conclusions:
The inclusion of new data on patients who underwent surgery between 2005 and 2010 demonstrates increasing utilization and lower complication rates for total ankle replacement compared with ankle arthrodesis. These findings suggest that there have been improvements in the clinical safety of total ankle replacement over time.
Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. (Source: JBJS)
Source: JBJS - September 6, 2016 Category: Orthopaedics Authors: Stavrakis, A. I., SooHoo, N. F. Tags: Foot & Ankle Scientific Articles Source Type: research
Prevalence of and Risk Factors for Hip Resurfacing Revision: A Cohort Study Into the Second Decade After the Operation
Conclusions:
The prevalence and rates of revision for all causes and pseudotumor were high at up to 15 years following MoMHR. Predictors of revision differed between all-cause and pseudotumor-related revisions and were sex-specific. These factors must be appropriately weighted when risk-stratifying patients with MoMHRs for surveillance.
Level of Evidence:
Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence. (Source: JBJS)
Source: JBJS - September 6, 2016 Category: Orthopaedics Authors: Matharu, G. S., Judge, A., Murray, D. W., Pandit, H. G. Tags: Hip Scientific Articles Source Type: research
Ankle Injury Prevention Programs for Soccer Athletes Are Protective: A Level-I Meta-Analysis
Conclusions:
This meta-analysis of studies regarding ankle injury prevention programs identified a significant reduction in the risk of ankle injury. Future high-quality research designs with a low risk of bias are necessary to further evaluate the effectiveness of specific exercises and the optimal timing and age at intervention for the prevention of ankle injuries in the athletic soccer player.
Level of Evidence:
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence. (Source: JBJS)
Source: JBJS - September 6, 2016 Category: Orthopaedics Authors: Grimm, N. L., Jacobs, J. C., Kim, J., Amendola, A., Shea, K. G. Tags: Foot & Ankle, Sports Medicine Scientific Articles Source Type: research
Hyaluronic Acid Injections for Treatment of Advanced Osteoarthritis of the Knee: Utilization and Cost in a National Population Sample
Conclusions:
Despite numerous studies questioning the efficacy and cost-effectiveness of HA injections for osteoarthritis of the knee, HA injections are still utilized for a substantial percentage of patients. Given the paucity of data supporting the effectiveness of HA injections and the current cost-conscious health-care climate, decreasing their use among patients with end-stage knee osteoarthritis may represent a substantial cost reduction that likely does not adversely impact the quality of care. (Source: JBJS)
Source: JBJS - September 6, 2016 Category: Orthopaedics Authors: Weick, J. W., Bawa, H. S., Dirschl, D. R. Tags: Knee Scientific Articles Source Type: research
Hospital Discharge within 2 Days Following Total Hip or Knee Arthroplasty Does Not Increase Major-Complication and Readmission Rates
Conclusions:
Early discharge was not an independent risk factor for 30-day major complications or readmissions following THA or TKA. Rather, increased major complications and readmissions were attributed to patient comorbidities and perioperative variables. Early discharge within the first 2 days postoperatively for risk-stratified patients appears feasible without compromising patient care.
Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence. (Source: JBJS)
Source: JBJS - September 6, 2016 Category: Orthopaedics Authors: Sutton, J. C., Antoniou, J., Epure, L. M., Huk, O. L., Zukor, D. J., Bergeron, S. G. Tags: Hip, Knee Scientific Articles Source Type: research
The Role of Capsular Repair in Latarjet Procedures: Commentary on an article by Yoshiaki Itoigawa, MD, PhD, et al.: "Repairing the Capsule to the Transferred Coracoid Preserves External Rotation in the Modified Latarjet Procedure"
(Source: JBJS)
Source: JBJS - September 6, 2016 Category: Orthopaedics Authors: Zumstein, M. A., Raniga, S. Tags: Basic Science, Shoulder Commentary and Perspective Source Type: research
Is the Complex Primary Total Knee Arthroplasty Glass Half Full or Half Empty?: Commentary on an article by J. Ryan Martin, MD, et al.: "Complex Primary Total Knee Arthroplasty: Long-Term Outcomes"
(Source: JBJS)
Source: JBJS - September 6, 2016 Category: Orthopaedics Authors: Skinner, H. B. Tags: Knee Commentary and Perspective Source Type: research
Discharge within 2 Days After Primary Total Knee or Hip Arthroplasty Is Safe for the Right Patient: Commentary on an article by J. Carl Sutton III, MD, et al.: "Hospital Discharge within 2 Days Following Total Hip or Knee Arthroplasty Does Not Increase Major-Complication and Readmission Rates"
(Source: JBJS)
Source: JBJS - September 6, 2016 Category: Orthopaedics Authors: Everhart, J. S. Tags: Hip, Knee Commentary and Perspective Source Type: research
Surgeons Accuracy in Achieving Their Desired Acetabular Component Orientation
Conclusions:
Surgeons overestimate operative inclination and underestimate anteversion, which is of benefit, as this, on average, helps to achieve the desired radiographic cup orientation. Although the use of visual cues helps, conventional techniques result in a large variability in acetabular component orientation. New and better guides and methods for training need to be developed. (Source: JBJS)
Source: JBJS - September 6, 2016 Category: Orthopaedics Authors: Grammatopoulos, G., Alvand, A., Monk, A. P., Mellon, S., Pandit, H., Rees, J., Gill, H. S., Murray, D. W. Tags: Hip Topics in Training Source Type: research
