The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jul 2018
A Prospective Evaluation of Patient-Reported Opioid Utilization After Nonoperative Treatment of Fractures and Dislocations.
Prescription of opioid analgesics is currently a common practice to relieve pain for musculoskeletal injuries in many regions of the world, especially in the United States and Canada. However, overprescription may underlie opioid misuse. Details on the utilization of prescribed opioids after nonoperative treatment of fractures and dislocations and whether consumption is related to injury location are unknown. ⋯ Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Jul 2018
Preoperative Opioid Use Is Associated with Higher Readmission and Revision Rates in Total Knee and Total Hip Arthroplasty.
Prescription opioid use is epidemic in the U.S. Recently, an association was demonstrated between preoperative opioid use and increased health-care utilization following abdominal surgeries. Given that primary total knee arthroplasty (TKA) and total hip arthroplasty (THA) are 2 of the most common surgical procedures in the U.S., we examined the association of preoperative opioid use with 30-day readmission and early revision rates. ⋯ Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Jul 2018
Randomized Controlled Trial Comparative StudyAdductor Canal Block Compared with Periarticular Bupivacaine Injection for Total Knee Arthroplasty: A Prospective Randomized Trial.
In the last decade, the widespread use of regional anesthesia in total knee arthroplasty has led to improvements in pain control, more rapid functional recovery, and reductions in the length of the hospital stay. The aim of this study was to compare the efficacy of adductor canal blocks (ACB) and periarticular anesthetic injections (PAI), both with bupivacaine, for pain management in 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 · Jul 2018
Comparative StudyValidation Study of the Thumb Ossification Composite Index (TOCI) in Idiopathic Scoliosis: A Stage-to-Stage Correlation with Classic Tanner-Whitehouse and Sanders Simplified Skeletal Maturity Systems.
The new simplified thumb ossification composite index (TOCI) based on ossification of the thumb epiphyses and adductor sesamoid has demonstrated simplicity, excellent reliability, and high accuracy for predicting skeletal maturity, comparable with the Sanders simplified skeletal maturity system (SSMS). It was our belief that, because the terminology of the SSMS system has been commonly used for skeletal maturity prediction in idiopathic scoliosis in publications over the past decade, the clinical applicability of the TOCI system would increase if the stages in the 2 systems were found to be interchangeable and highly correlated. ⋯ The TOCI could serve as a simplified "marker" of skeletal maturity on hand radiographs and minimize the learning-curve problems associated with the SSMS in a busy clinical practice.