The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Oct 2013
Multicenter Study Comparative Study Clinical TrialIntraoperative syndesmotic reduction: three-dimensional versus standard fluoroscopic imaging.
The quality of reduction of the syndesmosis is an important factor in the outcome of ankle fractures associated with a syndesmotic injury. The purpose of this study was to directly compare the accuracy of syndesmotic reductions obtained using intraoperative standard fluoroscopic techniques against reductions obtained using three-dimensional imaging of the Iso-C3D fluoroscope. ⋯ The results of our study support previous investigations that have cited high rates of syndesmotic malreductions and demonstrate that the addition of advanced intraoperative imaging techniques does not help to reduce the rate of malreductions in this cohort.
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J Bone Joint Surg Am · Oct 2013
Multicenter StudyEarly follow-up of reverse total shoulder arthroplasty in patients sixty years of age or younger.
Reverse shoulder arthroplasty (RSA) is an accepted treatment that provides reproducible results in the treatment of shoulder arthritis and rotator cuff deficiency. Concerns over the longevity of the prosthesis have resulted in this procedure being reserved for the elderly. There are limited data in the literature with regard to outcomes in younger patients. We report on the early outcomes of RSA in a group of patients who were sixty years or younger and who were followed for a minimum of two years. ⋯ RSA as a reconstructive procedure improved function at the time of short-term follow-up in our young patients with glenohumeral arthritis and rotator cuff deficiency. Objective outcomes in our patient cohort were similar to those in previously reported studies. However, overall satisfaction was much lower in this patient population (81%) compared with that in the older patient population as reported in the literature (90% to 96%).
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J Bone Joint Surg Am · Oct 2013
Clinical TrialPatient-reported outcomes after total knee replacement vary on the basis of preoperative coexisting disease in the lumbar spine and other nonoperatively treated joints: the need for a musculoskeletal comorbidity index.
Although the majority of patients report substantial gains in physical function following primary total knee replacement, the degree of improvement varies widely. To understand the potential role of preoperative pain due to other musculoskeletal conditions on postoperative outcomes, we quantified bilateral knee and hip pain and low back pain before primary total knee replacement and evaluated its association with physical function at six months after total knee replacement. ⋯ Preoperative musculoskeletal pain in the low back and nonoperatively treated lower extremity joints is associated with poorer physical function at six months after total knee replacement. The degree of functional improvement varies with the burden of musculoskeletal pain in other weight-bearing locations.
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J Bone Joint Surg Am · Oct 2013
Comparative Study Clinical TrialComputerized adaptive testing of psychological factors: relation to upper-extremity disability.
Psychological factors are important mediators of the differences between impairment and disability. The most commonly used measures of disability and psychological factors are lengthy and are usually administered as paper questionnaires. The aim of this study was to assess the correlation between perceived disability and psychological factors with use of the user-friendly, web-based Patient Reported Outcomes Measurement Information System initiative, and to compare its correlation with a frequently used, paper-based, pain self-efficacy questionnaire. ⋯ Maladaptive responses to upper-extremity pain are accurately measured by the relatively user-friendly Patient Reported Outcomes Measurement Information System-based computerized adaptive testing questionnaire.