The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Mar 2015
Smaller body size increases the percentage of blood volume lost during posterior spinal arthrodesis.
Our goal was to analyze the relationship between patient size and the proportion of blood volume lost during spinal arthrodesis in patients with a diagnosis of adolescent idiopathic scoliosis, Scheuermann kyphosis, or cerebral palsy. We hypothesized that smaller patients (those with less blood volume) lose a greater proportion of circulating total blood volume during surgery. ⋯ There is an inverse relationship between the proportion of blood volume lost during deformity correction surgery and size in patients with adolescent idiopathic scoliosis, cerebral palsy, or Scheuermann kyphosis.
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J Bone Joint Surg Am · Mar 2015
ReviewEstimating the global incidence of femoral fracture from road traffic collisions: a literature review.
Worldwide, road injuries cause over 1.3 million deaths and many more disabilities annually, disproportionately affecting the young and the poor. Approximately one in ten road injuries involves a femoral shaft fracture that is most effectively treated with surgery. Current femoral shaft fracture incidence according to country and age group is unknown and difficult to measure directly but is critical to designing and evaluating interventions. ⋯ Our results demonstrate a substantial worldwide burden and disparities in femoral shaft fracture incidence between low to middle income and high income countries, and the young are disproportionately affected, underscoring the potential impact of improved access to treatment. We believe that the methodology of this study can be applied to estimate the burden of other diseases, allowing for better direction of global health efforts.
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J Bone Joint Surg Am · Mar 2015
Comparative StudyGeneral compared with spinal anesthesia for total hip arthroplasty.
Total hip arthroplasty may be performed under general or spinal anesthesia. The purpose of the current study was to compare perioperative outcomes between anesthetic types for patients undergoing primary elective total hip arthroplasty. ⋯ General anesthesia was associated with an increased rate of adverse events and mildly increased operating room times.
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J Bone Joint Surg Am · Mar 2015
Randomized Controlled Trial Comparative StudyPain control after simultaneous bilateral total knee arthroplasty: a randomized controlled trial comparing periarticular injection and epidural analgesia.
Periarticular injection is becoming more commonly utilized for pain relief following total knee arthroplasty. However, we are aware of no randomized controlled trial that has investigated the efficacy of periarticular injection for pain relief after simultaneous bilateral total knee arthroplasty. ⋯ Periarticular injection was associated with better pain relief during the first twenty-four hours following simultaneous bilateral total knee arthroplasty and decreased opioid-related side effects compared with epidural analgesia. Periarticular injection may be preferable to epidural analgesia for pain relief after simultaneous bilateral total knee arthroplasty.
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J Bone Joint Surg Am · Mar 2015
Impact of fellowship training on clinical practice of orthopaedic sports medicine.
Approximately 90% of current orthopaedic graduates are engaging in fellowship training, with sports medicine being the most commonly chosen specialty. The purpose of this study was to evaluate the impact of fellowship training on clinical decision-making by fellowship-trained sports medicine surgeons. ⋯ Fellowship has a significantly higher impact than residency on industry-related decision-making. Fellowship-trained sports surgeons should consider seeking additional training in the treatment of multi-ligamentous knee injuries, posterior cruciate ligament injuries, shoulder instability with bone loss, and elbow disorders. The current findings were limited by the relatively small respondent pool, which represented only 26% of sports medicine fellowship programs in the United States.