The Journal of bone and joint surgery. American volume
-
J Bone Joint Surg Am · Apr 2013
Podium disclosures at the 2012 AAOS meeting: an exercise in going through the motions.
Slide-based disclosure of potential conflicts of interest prior to presentations is practiced at most orthopaedic meetings to help audiences critically evaluate the data presented. These slides are often supplemented with a printed disclosure in program guides and occasionally on Internet sites. The fidelity and usefulness of this format have not been investigated. We report the practice of disclosure of potential conflicts of interest during the 2012 American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting to determine if the process is accomplishing its primary goal. ⋯ Slides disclosing potential conflicts of interest were included in 90% of the observed presentations. Despite these slides having been shown, they were ineffective in communicating these disclosures because of deficiencies in timing, format, and content. We recommend that the practice of required slide-based disclosure of potential conflicts of interest should be abandoned and be replaced with a standardized and objective practice of disclosure.
-
J Bone Joint Surg Am · Apr 2013
Comparative StudyComplications following tension-band fixation of patellar fractures with cannulated screws compared with Kirschner wires.
Displaced patellar fractures are commonly stabilized with a modified anterior tension-band construct. The goal of the current study was to compare the incidence of complications after tension-band fixation of the patella with Kirschner wires as compared with cannulated screws. ⋯ Serious complications are uncommon following treatment of patellar fractures with a modified tension-band technique, with use of either Kirschner wires or cannulated screws. In both groups the rate of fixation failure was low, as was the rate of postoperative infection. Symptomatic implants, the most common complication observed, were twice as frequent in patients treated with Kirschner wires.
-
J Bone Joint Surg Am · Apr 2013
Surgical treatment of chronic exertional compartment syndrome of the leg: failure rates and postoperative disability in an active patient population.
Chronic exertional compartment syndrome of the leg is a frequent source of lower-extremity pain in military personnel, competitive athletes, and runners. We are not aware of any previous study in which the authors rigorously evaluated the rates of return to full activity, persistent disability, and surgical revision after operative management of chronic exertional compartment syndrome of the leg in a large, physically active population. ⋯ Chronic exertional compartment syndrome is a substantial contributor to lower-extremity disability in the military population. Nearly half of all service members undergoing fasciotomy reported persistent symptoms, and one in five individuals had unsuccessful surgical treatment.
-
J Bone Joint Surg Am · Apr 2013
Randomized Controlled Trial Comparative StudyVertebral body stenting versus kyphoplasty for the treatment of osteoporotic vertebral compression fractures: a randomized trial.
In the treatment of vertebral compression fractures, vertebral body stenting with an expandable scaffold inserted before application of the bone cement was developed to impede secondary loss of vertebral height encountered in patients treated with balloon kyphoplasty. The purpose of this study was to clarify whether there are relevant differences between balloon kyphoplasty and vertebral body stenting with regard to perioperative and postoperative findings. ⋯ No beneficial effect of vertebral body stenting over balloon kyphoplasty was found among patients with painful osteoporotic vertebral fractures with regard to kyphotic correction, cement leakage, radiation exposure time, or neurologic sequelae. Vertebral body stenting was associated with significantly higher pressures during balloon inflation and more material-related complications.
-
J Bone Joint Surg Am · Apr 2013
Controlled Clinical TrialAntimicrobial peptides and proinflammatory cytokines in periprosthetic joint infection.
Differentiation between septic and aseptic loosening of joint replacements is essential for successful revision surgery, but reliable markers for the diagnosis of low-grade infection are lacking. The present study was performed to assess intra-articular and systemic levels of antimicrobial peptides and proinflammatory cytokines as diagnostic markers for periprosthetic joint infection. ⋯ The present study showed promising results for the use of antimicrobial peptides and other biomarkers in synovial fluid for the diagnosis of periprosthetic joint infection, and analysis of the levels in synovial fluid was more accurate than analysis of serum.