The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Nov 2017
Nationwide Analysis of Femoral Neck Fractures in Elderly Patients: A Receding Tide.
Geriatric femoral neck fractures are associated with substantial morbidity and medical cost. We evaluated the incidence and management trends of femoral neck fractures in recent years in the U.S. ⋯ This report identifies the changing trends in clinical practice in the treatment of geriatric femoral neck fractures in the U.S. Treating physicians should be aware of these trends, which include a decreasing national incidence of geriatric femoral neck fractures as well as an increase in the use of THA.
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J Bone Joint Surg Am · Nov 2017
Randomized Controlled TrialContinuous Posterior Lumbar Plexus Nerve Block Versus Periarticular Injection with Ropivacaine or Liposomal Bupivacaine for Total Hip Arthroplasty: A Three-Arm Randomized Clinical Trial.
Debate surrounds the issue of whether peripheral nerve blockade or periarticular infiltration (PAI) should be employed within a contemporary, comprehensive multimodal analgesia pathway for total hip arthroplasty. We hypothesized that patients treated with a continuous posterior lumbar plexus block (PNB) would report less pain and consume less opioid medication than those treated with PAI. ⋯ Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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Hoffa fractures, coronal-plane fractures involving the distal femoral condyles, are unstable, intra-articular fractures. The aim of this study was to define the location and frequency of fracture lines and comminution zones in Hoffa fractures using computed tomography (CT) mapping in both 2-dimensional and 3-dimensional contexts. ⋯ Research in this area is imperative for optimal preoperative planning, such as for the selection of surgical approach and fixation constructs. Our findings lend insight into fracture morphology, which can assist with fracture classification and the design of biomechanical studies, ultimately aiding in treatment.
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J Bone Joint Surg Am · Nov 2017
Rate of Improvement in Clinical Outcomes with Anatomic and Reverse Total Shoulder Arthroplasty.
This study quantifies the rate of improvement after anatomic and reverse total shoulder arthroplasty; a better understanding of the rate of improvement associated with each prosthesis type may better establish patient expectations for recovery. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.