The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Feb 2013
Randomized Controlled TrialEffectiveness of multimodal pain management after bipolar hemiarthroplasty for hip fracture: a randomized, controlled study.
Appropriate pain management affects outcome after hip fracture surgery. Although multimodal pain management is commonly used for pain control for patients undergoing elective surgery, few studies have evaluated its use in those undergoing hip fracture surgery. This prospective randomized study was designed to determine the clinical value of multimodal pain management with preemptive pain medication and intraoperative periarticular multimodal drug injections in patients undergoing bipolar hip hemiarthroplasty. ⋯ Multimodal pain management provides additional pain relief until the fourth postoperative day, improves patient satisfaction at discharge, and reduces total narcotic consumption for postoperative pain management after hip hemiarthroplasty for hip fractures.
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J Bone Joint Surg Am · Feb 2013
Multicenter StudyThe effect of pain after total knee arthroplasty on the contralateral, nonreplaced knee.
Osteoarthritis is associated with a strong biomechanical component. Persistent pain in the index knee after total knee arthroplasty could lead to pain in the contralateral knee. The purpose of the present study was to examine whether a change in the natural history of pain in the contralateral knee was related to postoperative pain in the index knee. ⋯ Pain in the index knee at three months after total knee arthroplasty did not appear to predict a symptomatic increase in pain in the contralateral knee over two years of follow-up in our cohort. The contralateral knee did not require any additional clinical surveillance over and above the patients' reports on their symptoms.
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J Bone Joint Surg Am · Feb 2013
Thickness of subcutaneous fat as a risk factor for infection in cervical spine fusion surgery.
Surgical site infections increase the incidence of morbidity and mortality as well as health-care expenses. The cost of care increases threefold to fourfold as a consequence of surgical site infection after spinal surgery. The aim of the present study was to determine the role of subcutaneous fat thickness in the development of surgical site infection following cervical spine fusion surgery. ⋯ The study demonstrated that the thickness of subcutaneous fat at the surgical site is a factor in the development of surgical site infection following cervical spine fusion and deserves assessment in the preoperative evaluation.
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J Bone Joint Surg Am · Feb 2013
CommentMultimodal approach to pain management following bipolar hemiarthroplasty for femoral neck fracture: i'm a believer!: commentary on an article by Hyun Kang, MD, et al.: "effectiveness of multimodal pain management after bipolar hemiarthroplasty for hip fracture. A randomized, controlled study".
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J Bone Joint Surg Am · Feb 2013
Functional outcome thirty years after median and ulnar nerve repair in childhood and adolescence.
Age at injury is believed to be a factor that strongly influences functional outcome after nerve injury. However, there have been few long-term evaluations of the results of nerve repair and reconstruction in children. Our aim was to evaluate the long-term functional outcome of nerve repair or reconstruction at the forearm level in patients with a complete median and/or ulnar nerve injury at a young age. ⋯ At a median of thirty-one years after a median or ulnar nerve repair at the level of the forearm, nerve function is significantly better in those injured in childhood than in those injured in adolescence, with almost full sensory and motor recovery in individuals injured in childhood.