The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Apr 2018
Multicenter Study Observational StudyLower Extremity Motor Function Following Complex Adult Spinal Deformity Surgery: Two-Year Follow-up in the Scoli-RISK-1 Prospective, Multicenter, International Study.
The reported neurologic complication rate following surgery for complex adult spinal deformity (ASD) is variable due to several factors. Most series have been retrospective with heterogeneous patient populations and use of nonuniform neurologic assessments. The aim of this study was to prospectively document lower extremity motor function by means of the American Spinal Injury Association (ASIA) lower extremity motor score (LEMS) before and through 2 years after surgical correction of complex ASD. ⋯ Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Apr 2018
Meta AnalysisRestrictive Versus Liberal Strategy for Red Blood-Cell Transfusion: A Systematic Review and Meta-Analysis in Orthopaedic Patients.
Current guidelines recommend restrictive criteria for red blood-cell transfusion in most clinical settings. However, patients undergoing orthopaedic surgery may require distinct transfusion criteria since benefits and potential harm often vary considerably based on patient characteristics and surgical procedures. We aimed to assess the efficacy and safety of restrictive transfusion in patients undergoing orthopaedic surgery, especially in important subgroups. ⋯ Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Apr 2018
Randomized Controlled Trial Multicenter Study Comparative StudyEffects of a Single Intra-Articular Injection of a Microsphere Formulation of Triamcinolone Acetonide on Knee Osteoarthritis Pain: A Double-Blinded, Randomized, Placebo-Controlled, Multinational Study.
Intra-articular corticosteroids relieve osteoarthritis pain, but rapid systemic absorption limits efficacy. FX006, a novel, microsphere-based, extended-release triamcinolone acetonide (TA) formulation, prolongs TA joint residence and reduces systemic exposure compared with standard TA crystalline suspension (TAcs). We assessed symptomatic benefits and safety of FX006 compared with saline-solution placebo and TAcs. ⋯ Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Apr 2018
Conflict-of-Interest Disclosures to The Journal of Bone & Joint Surgery: The Relevance of Industry-Reported Payments.
Academic journals such as The Journal of Bone & Joint Surgery (JBJS) require disclosures of financial relationships that authors report as potential conflicts of interest. Because industry payments can take various forms, including food and beverage, consulting, or research payments, the purpose of this study was to determine which categories of industry-reported payments were most frequently considered by authors as irrelevant to their specific publication, and therefore not included in their journal disclosures. ⋯ Authors publishing in JBJS were more likely to conclude that industry-reported payments in the OPD for food and beverage and for travel and lodging were irrelevant for specific publications (as disclosed to the journal) than payments for consulting, royalties, research, and ownership interests.
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J Bone Joint Surg Am · Apr 2018
The Use of Emergency Physicians to Deliver Anesthesia for Orthopaedic Surgery in Austere Environments: The Expansion of the Emergency Physician's General Anesthesia Syllabus to Orthopaedic Surgery.
Five billion people, primarily in low-income and middle-income countries, cannot access safe, affordable surgical and anesthesia care, particularly for orthopaedic trauma. The rate-limiting step for many orthopaedic surgical procedures performed in the developing world is the absence of safe anesthesia. Even surgical mission teams providing surgical care are limited by the availability of anesthesiologists. Emergency physicians, who are already knowledgeable in airway management and procedural sedation, may be able to help to fulfill the need for anesthetists in disaster relief and surgical missions. ⋯ Given emergency physicians' baseline training in airway management and sedation, well-supervised and focused extra training under the vigilant supervision of a board-certified anesthesiologist may allow emergency physicians to be able to safely administer anesthesia. Using emergency physicians as anesthetists in this closely supervised setting could increase the number of surgical cases that can be performed in a disaster setting.