The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Sep 2014
Randomized Controlled Trial Comparative StudyPostoperative epidural analgesia compared with intraoperative periarticular injection for pain control following total knee arthroplasty under spinal anesthesia: a randomized controlled trial.
Although epidural analgesia has been used for postoperative pain control after total knee arthroplasty, its usefulness is being reevaluated because of possible adverse effects. Recent studies have proven the efficacy of periarticular analgesic injection and its low prevalence of adverse effects. The present study compares the clinical efficacies of epidural analgesia and periarticular injection after total knee arthroplasty. ⋯ Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Sep 2014
ReviewSurgical attire and the operating room: role in infection prevention.
➤ Although there is some evidence that scrubs, masks, and head coverings reduce bacterial counts in the operating room, there is no evidence that these measures reduce the prevalence of surgical site infection.➤ The use of gloves and impervious surgical gowns in the operating room reduces the prevalence of surgical site infection.➤ Operating-room ventilation plays an unclear role in the prevention of surgical site infection.➤ Exposure of fluids and surgical instruments to the operating-room environment can lead to contamination. Room traffic increases levels of bacteria in the operating room, although the role of this contamination in surgical site infection is unclear.
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J Bone Joint Surg Am · Sep 2014
Randomized Controlled Trial Comparative StudyComparison of closing-wedge and opening-wedge high tibial osteotomy for medial compartment osteoarthritis of the knee: a randomized controlled trial with a six-year follow-up.
Varus deformity increases the risk of progression of medial compartment knee osteoarthritis. The aim of this study was to investigate the clinical and radiographic mid-term results of closing-wedge and opening-wedge high tibial osteotomy when used to treat this condition. ⋯ Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Sep 2014
Assessment of moral reasoning skills in the orthopaedic surgery resident applicant.
Assessing orthopaedic surgery residency applicants is a complex process. One important applicant characteristic not commonly measured during the interview process is moral behavior, a key component of the guidelines of the Accreditation Council for Graduate Medical Education for professionalism competency. We sought to determine whether a relationship exists between the results of residency selection interviews, as measured by match rank order, and moral reasoning skills, as measured by the revised version of the Defining Issues Test (DIT-2). ⋯ Despite a wide range of DIT-2 scores, the interview process did not differentiate applicants based on moral reasoning skills. It remains unclear whether the DIT-2 could (or should) be used as an additional data point to help stratify orthopaedic residency applicants and to predict their performance.