The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Mar 2004
Comparative StudyStability analysis of craniovertebral junction fixation techniques.
Craniovertebral arthrodesis in the upper cervical spine is challenging because of the high degree of mobility afforded by this region. A novel method for achieving atlantoaxial fixation with use of polyaxial screws inserted bilaterally into the lateral masses of C1 and transpedicularly into C2 with longitudinal rod connection has recently been introduced. The question remains as to whether this technique provides adequate stability when extended cephalad to include the occiput. The purpose of this study was to determine the primary stability afforded by this novel construct and compare its stability with the current standard of bilateral longitudinal plates combined with C1-C2 transarticular screws. ⋯ Both hardware systems provide equivalent construct stability in the immediate postoperative period when it is critical for the eventual success of a craniovertebral arthrodesis. On the basis of this work, we believe that the decision to use either construct should be determined by clinical rather than biomechanical concerns.
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J Bone Joint Surg Am · Mar 2004
The relationship between surgeon and hospital volume and outcomes for shoulder arthroplasty.
As far as we know, no previous study has determined the relationship between volume and outcomes for shoulder arthroplasty. We hypothesized that surgeons and hospitals with higher caseloads of total shoulder arthroplasties and hemiarthroplasties have better outcomes as measured by decreased mortality rate, shorter length of stay in the hospital, reduced postoperative complications, and routine disposition of patients on discharge. ⋯ Therapeutic study, Level III-2 (retrospective cohort study). See Instructions to Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Mar 2004
Posterior slope of the tibial implant and the outcome of unicompartmental knee arthroplasty.
Laboratory studies have suggested that the sagittal displacements permitted by a knee replacement are influenced by the posterior slope of the tibial implant. The effect of the posterior slope of the tibial implant on the outcome of unicompartmental arthroplasty is not well known. The purpose of the present study was to assess the effect of the posterior slope on the long-term outcome of unicompartmental arthroplasty in knees with intact and deficient anterior cruciate ligaments. ⋯ Prognostic study, Level II-1 (retrospective study). See Instructions to Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Mar 2004
Meta AnalysisTherapeutic effects of hyaluronic acid on osteoarthritis of the knee. A meta-analysis of randomized controlled trials.
The magnitude of the therapeutic effects of intra-articular injection of hyaluronic acid on osteoarthritis of the knee is still in question. The aim of this meta-analysis was to elucidate the therapeutic efficacy and safety of intra-articular injection of hyaluronic acid for osteoarthritis of the knee. ⋯ Therapeutic study, Level II-3b (systematic review; nonhomogeneous Level-I studies). See Instructions to Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Mar 2004
Randomized Controlled Trial Comparative Study Clinical TrialComparison of handheld computer-assisted and conventional paper chart documentation of medical records. A randomized, controlled trial.
Daily documentation and maintenance of medical record quality is a crucial issue in orthopaedic surgery. The purpose of the present study was to determine whether the introduction of a handheld computer could improve both the quantitative and qualitative aspects of medical records. ⋯ Therapeutic study, Level I-1a (randomized controlled trial [significant difference]). See Instructions to Authors for a complete description of levels of evidence.