The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Sep 2014
Recurrence of hip instability after reconstructive surgery in patients with cerebral palsy.
Hip instability can cause major problems in children with cerebral palsy, although good outcomes of hip reconstructive surgery for hip instability have been reported. In the present study, we investigated the recurrence of hip instability after reconstructive surgery and the factors influencing this recurrence in patients with cerebral palsy. ⋯ Periodic monitoring and follow-up for the recurrence of hip instability is important in patients with cerebral palsy and a GMFCS level of IV or V.
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J Bone Joint Surg Am · Sep 2014
Randomized Controlled Trial Comparative StudyNonoperative dynamic treatment of acute achilles tendon rupture: the influence of early weight-bearing on clinical outcome: a blinded, randomized controlled trial.
Dynamic rehabilitation has been suggested to be an important part of nonoperative treatment of acute Achilles tendon rupture that results in functional outcome and rerupture rates comparable with those of operative treatment. However, the optimal role of weight-bearing during early rehabilitation remains unclear. The purpose of this study was to compare immediate weight-bearing with non-weight-bearing in a nonoperative dynamic treatment protocol for Achilles tendon rupture. ⋯ The ATRS and heel-rise work results did not differ significantly between the groups. The rerupture rate was 9% overall, and both groups had substantial functional deficits in the injured limb compared with the uninjured limb. Immediate weight-bearing can be recommended as an option in the nonoperative treatment of Achilles tendon rupture.
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J Bone Joint Surg Am · Sep 2014
Observational StudyAllogenic blood transfusion following total hip arthroplasty: results from the nationwide inpatient sample, 2000 to 2009.
The large-scale utilization of allogenic blood transfusion and its associated outcomes have been described in critically ill patients and those undergoing high-risk cardiac surgery but not in patients undergoing elective total hip arthroplasty. The objective of this study was to determine the trends in utilization and outcomes of allogenic blood transfusion in patients undergoing primary total hip arthroplasty in the United States from 2000 to 2009. ⋯ The increase in allogenic blood transfusion among total hip arthroplasty patients is concerning considering the associated increase in surgical complications and adverse events. The risk factors for transfusion and its impact on costs and inpatient outcomes can potentially be used to enhance patient care through optimizing preoperative discussions and effective utilization of blood-conservation methods.
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J Bone Joint Surg Am · Sep 2014
Observational StudyFactors predicting complication and reoperation rates following surgical fixation of proximal humeral fractures.
The purpose of this study was to report complication and reoperation rates following non-arthroplasty fixation of shoulder fractures determined on the basis of observational, population-based data from all inpatient admissions in California over an eleven-year period. ⋯ Surgical fixation of proximal humeral fractures has a low complication and mortality profile. The data provided in this study can serve in counseling patients about risks associated with operative fixation of displaced proximal humeral fractures.
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J Bone Joint Surg Am · Sep 2014
Risk factors for surgical site infection following total joint arthroplasty.
Currently, most hospitals in the United States are obliged to report infections that occur following total joint arthroplasty to the Centers for Disease Control and Prevention through the National Healthcare Safety Network surveillance. The objective of this study was to identify the risk factors of surgical site infections that were reported to the Centers for Disease Control and Prevention from a single institution. ⋯ Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.