The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · May 2015
Detection of a traumatic arthrotomy in the pediatric knee using the saline solution load test.
The objective of this study was to quantify the load volume needed for a positive diagnosis of a traumatic arthrotomy in the pediatric knee with use of the saline solution load test (SLT). ⋯ On the basis of our findings, a saline solution load volume of 47 mL is required to detect 90% of superolateral traumatic arthrotomies of 5 mm in the pediatric knee with use of the SLT.
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J Bone Joint Surg Am · May 2015
Randomized Controlled TrialPatient-controlled epidural analgesia or multimodal pain regimen with periarticular injection after total hip arthroplasty: a randomized, double-blind, placebo-controlled study.
The optimal postoperative analgesia after primary total hip arthroplasty remains in question. This randomized, double-blind, placebo-controlled study compared the use of patient-controlled epidural analgesia (PCEA) with use of a multimodal pain regimen including periarticular injection (PAI). We hypothesized that PAI would lead to earlier readiness for discharge, decreased opioid consumption, and lower pain scores. ⋯ PAI did not decrease the time to discharge and was associated with higher pain scores and greater opioid consumption but lower ORSDS scores compared with PCEA. The choice for analgesic regimen may depend on a particular patient's threshold for pain and the potential side effects.
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J Bone Joint Surg Am · May 2015
Randomized Controlled Trial Multicenter Study Comparative StudyVolar locking-plate and Kirschner-wire fixation did not differ in terms of functional outcomes after dorsally displaced distal radial fracture.
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J Bone Joint Surg Am · May 2015
Observational StudyHealth economic implications of perioperative delirium in older patients after surgery for a fragility hip fracture.
Patients who experience a fragility hip fracture are at high risk for perioperative delirium. The purpose of the present study was to evaluate the impact, from a hospital perspective, of perioperative delirium on the length of the hospital stay and episode-of-care costs for elderly patients who underwent surgical treatment of a fragility hip fracture. ⋯ Nearly 50% of elderly patients who underwent surgery for a fragility hip fracture developed perioperative delirium, which was associated with a significant incremental in-hospital length of stay and significant incremental episode-of-care costs. These findings highlight the importance of implementing cost-effective interventions to reduce the prevalence of perioperative delirium in elderly patients with a low-energy hip fracture.
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J Bone Joint Surg Am · May 2015
Rotational Acetabular Osteotomy for Osteoarthritis with Acetabular Dysplasia: Conversion Rate to Total Hip Arthroplasty within Twenty Years and Osteoarthritis Progression After a Minimum of Twenty Years.
We investigated the rate of conversion to total hip arthroplasty by twenty years and radiographic findings at a minimum of twenty years after rotational acetabular osteotomy. ⋯ Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.