The Emperor May Truly Have New Clothes: Commentary on an article by Zahab S. Ahsan, MD, et al.: "Characterizing the Propionibacterium Load in Revision Shoulder Arthroplasty. A Study of 137 Culture-Positive Cases."
(Source: JBJS)
Source: JBJS - January 17, 2017 Category: Orthopaedics Authors: Garrigues, G. Tags: Infection, Shoulder Commentary and Perspective Source Type: research
Aspirin, the Unsung Champion of Deep Venous Thrombosis Chemoprophylaxis: A Historical Perspective: Commentary on an article by Javad Parvizi, MD, FRCS, et al.: "Low-Dose Aspirin Is Effective Chemoprophylaxis Against Clinically Important Venous Thromboembolism Following Total Joint Arthroplasty. A Preliminary Analysis"
(Source: JBJS)
Source: JBJS - January 17, 2017 Category: Orthopaedics Authors: Shaw, J. A. Tags: Hip, Knee Commentary and Perspective Source Type: research
National Institutes of Health Funding to Departments of Orthopaedic Surgery at U.S. Medical Schools
Conclusions:
The percentage increase of NIH funding to departments of orthopaedic surgery from 2005 to 2014 was not significantly greater than that of total NIH extramural research funding. Funding levels to orthopaedic surgery departments lag behind funding to departments of other surgical disciplines. Funding levels may not match the academic potential of orthopaedic faculty, and interventions may be needed to increase NIH grant procurement. (Source: JBJS)
Source: JBJS - January 17, 2017 Category: Orthopaedics Authors: Silvestre, J., Ahn, J., Levin, L. S. Tags: The Orthopaedic Forum Source Type: research
The Ulnar Collateral Ligament Injury: Evaluation and Treatment
Medial elbow pain in the throwing athlete can result from a variety of sources, including medial epicondylitis, valgus extension overload, ulnar collateral ligament (UCL) insufficiency, ulnar neuritis, and others.
Initial treatment following a UCL tear involves a period of rest (no throwing or strenuous use of the elbow) followed by rehabilitation and a graduated throwing program.
UCL reconstruction (UCLR) has become the preferred surgical treatment method for patients with a symptomatic, deficient UCL who wish to return to sports.
Several modifications to the original technique described by Jobe et al. have been pro...
Source: JBJS - January 3, 2017 Category: Orthopaedics Authors: Erickson, B. J., Romeo, A. A. Tags: Elbow Current Concepts Review Source Type: research
ORIF or Arthroplasty for Displaced Femoral Neck Fractures in Patients Younger Than 65 Years Old: An Economic Decision Analysis
Conclusions:
Compared with ORIF, primary THA can be a cost-effective treatment for displaced femoral neck fractures in patients 45 to 65 years of age, with the age cutoff favoring THA decreasing as the medical comorbidity and risk of ORIF fixation failure increase. Hemiarthroplasty has worse outcomes at higher costs and is not recommended in this age group.
Level of Evidence:
Economic and decision analysis Level III. See Instructions for Authors for a complete description of levels of evidence. (Source: JBJS)
Source: JBJS - January 3, 2017 Category: Orthopaedics Authors: Swart, E., Roulette, P., Leas, D., Bozic, K. J., Karunakar, M. Tags: Hip, Trauma Scientific Articles Source Type: research
Reorientational Proximal Femoral Osteotomies for Arthrogrypotic Hip Contractures
Conclusions:
Children with arthrogryposis often have the potential for ambulation if the limb positioning can be optimized. The reorientational hip osteotomy corrects the hip contractures by altering the range of motion but not the total arc of motion.
Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. (Source: JBJS)
Source: JBJS - January 3, 2017 Category: Orthopaedics Authors: van Bosse, H. J. P., Saldana, R. E. Tags: Pediatrics Scientific Articles Source Type: research
Single-Anesthetic Versus Staged Bilateral Total Hip Arthroplasty: A Matched Cohort Study
Conclusions:
In this matched cohort analysis, single-anesthetic bilateral THA was not associated with an increased risk of revision, reoperation, or postoperative complications, while decreasing cost. In our experience, single-anesthetic bilateral THA is a safe procedure that, for certain patients, offers an excellent means to deal with bilateral hip osteoarthritis.
Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. (Source: JBJS)
Source: JBJS - January 3, 2017 Category: Orthopaedics Authors: Houdek, M. T., Wyles, C. C., Watts, C. D., Wagner, E. R., Sierra, R. J., Trousdale, R. T., Taunton, M. J. Tags: Hip Scientific Articles Source Type: research
A Dedicated Orthopaedic Trauma Operating Room Improves Efficiency at a Pediatric Center
Conclusions:
A dedicated orthopaedic trauma operating room in a pediatric trauma center was associated with fewer after-hours procedures, decreased wait time to the surgical procedure, reduced length of hospitalization, and decreased cost. (Source: JBJS)
Source: JBJS - January 3, 2017 Category: Orthopaedics Authors: Brusalis, C. M., Shah, A. S., Luan, X., Lutts, M. K., Sankar, W. N. Tags: Pediatrics, Trauma Scientific Articles Source Type: research
Patient-Reported Outcomes of Periacetabular Osteotomy from the Prospective ANCHOR Cohort Study
Conclusions:
This large, prospective cohort study demonstrated the clinical success of contemporary PAO surgery for the treatment of symptomatic acetabular dysplasia. Patient and disease characteristics demonstrated predictive value that should be considered in surgical decision-making.
Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. (Source: JBJS)
Source: JBJS - January 3, 2017 Category: Orthopaedics Authors: Clohisy, J. C., Ackerman, J., Baca, G., Baty, J., Beaule, P. E., Kim, Y.-J., Millis, M. B., Podeszwa, D. A., Schoenecker, P. L., Sierra, R. J., Sink, E. L., Sucato, D. J., Trousdale, R. T., Zaltz, I., on behalf of the ANCHOR Study Group Tags: Hip Scientific Articles Source Type: research
Return to Function, Complication, and Reoperation Rates Following Primary Pectoralis Major Tendon Repair in Military Service Members
Conclusions:
We demonstrate that 94% of patients were able to return to the full preoperative level of function within active military duty following surgical repair of pectoralis major tendon rupture and 5.4% of patients experienced rerupture after primary repair. Increasing body mass index and active psychiatric diagnoses are significant risk factors for an inability to return to function and postoperative failures.
Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. (Source: JBJS)
Source: JBJS - January 3, 2017 Category: Orthopaedics Authors: Nute, D. W., Kusnezov, N., Dunn, J. C., Waterman, B. R. Tags: Shoulder, Sports Medicine Scientific Articles Source Type: research
Repeat Two-Stage Exchange Arthroplasty for Periprosthetic Knee Infection Is Dependent on Host Grade
Conclusions:
Uncompromised hosts (MSIS type A) with an acceptable wound (MSIS type 1 or 2) had a 70% rate of success (7 of 10) after a repeat 2-stage exchange arthroplasty, whereas type-B2 hosts had a 50% success rate (10 of 20). The repeat 2-stage exchange procedure failed in both type-C3 hosts; thus, alternative salvage procedures should be considered for such patients.
Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. (Source: JBJS)
Source: JBJS - January 3, 2017 Category: Orthopaedics Authors: Fehring, K. A., Abdel, M. P., Ollivier, M., Mabry, T. M., Hanssen, A. D. Tags: Infection, Knee Scientific Articles Source Type: research
Risk-Adjusted Hospital Outcomes in Medicare Total Joint Replacement Surgical Procedures
Conclusions:
Risk-adjusted outcomes demonstrate wide variability and illustrate the need for improvement among poorer-performing hospitals for bundled payments of joint replacement surgical procedures.
Clinical Relevance:
Adverse outcomes are known to occur in the experience of all clinicians and hospitals. The risk-adjusted benchmarking of hospital performance permits the identification of adverse events that are potentially preventable. (Source: JBJS)
Source: JBJS - January 3, 2017 Category: Orthopaedics Authors: Fry, D. E., Pine, M., Nedza, S. M., Locke, D. G., Reband, A. M., Pine, G. Tags: Hip, Knee Scientific Articles Source Type: research
Outcomes of Pectoralis Major Tendon Repair: Does Study Design Matter?: Commentary on an article by Drew W. Nute, MD, et al.: "Return to Function, Complication, and Reoperation Rates Following Primary Pectoralis Major Tendon Repair in Military Service Members"
(Source: JBJS)
Source: JBJS - January 3, 2017 Category: Orthopaedics Authors: Cordasco, F. A. Tags: Shoulder, Sports Medicine Commentary and Perspective Source Type: research
A Risk Factor Out of Control: Commentary on an article by Alon Ben-Ari, MD, et al.: "Preoperative Opioid Use Is Associated with Early Revision After Total Knee Arthroplasty. A Study of Male Patients Treated in the Veterans Affairs System"
(Source: JBJS)
Source: JBJS - January 3, 2017 Category: Orthopaedics Authors: Reich, M. S., Walker, R. H. Tags: Knee Commentary and Perspective Source Type: research
Single Institution Early Experience with the Bundled Payments for Care Improvement Initiative
Abstract:
The Centers for Medicare & Medicaid Services (CMS) implemented the Bundled Payments for Care Improvement (BPCI) initiative in 2011. Through BPCI, organizations enlisted into payment agreements that include both performance and financial accountability for episodes of care. To succeed, BPCI requires quality maintenance and care delivery at lower costs. This necessitates physicians and hospitals to merge interests. Orthopaedic surgeons must assume leadership roles in cost containment, surgical safety, and quality assurance to deliver cost-effective care. Because most orthopaedic surgeons practice independently ...
Source: JBJS - January 3, 2017 Category: Orthopaedics Authors: Iorio, R., Bosco, J., Slover, J., Sayeed, Y., Zuckerman, J. D. Tags: Hip, Knee The Orthopaedic Forum Source Type: research
