The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jan 2020
Multicenter Study Comparative StudyConventional Versus Highly Cross-Linked Polyethylene in Primary Total Knee Replacement: A Comparison of Revision Rates Using Data from the National Joint Registry for England, Wales, and Northern Ireland.
There is evidence to support the use of highly cross-linked polyethylene (HXLPE) in patients undergoing total hip arthroplasty. However, the benefits for those undergoing total knee arthroplasty are uncertain, with conflicting reports based on previous cohort analyses. The purpose of the present study was to compare the revision rates following primary total knee arthroplasty with use of HXLPE as compared with conventional polyethylene (CPE) using data from the National Joint Registry (NJR) for England, Wales and Northern Ireland. ⋯ Therapeutic Level III. See Instructions for Authors for a complete list of levels of evidence.
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J Bone Joint Surg Am · Jan 2020
Impact of Hospital Readmissions Reduction Program Penalties on Hip and Knee Replacement Readmissions: Comparison of Hospitals at Risk of Varying Penalty Amounts.
Little is known about the impact of the U.S. Centers for Medicare & Medicaid Services' Hospital Readmissions Reduction Program (HRRP) expansion to include readmissions following elective primary total hip and knee replacements; the expansion was finalized in 2013 and was implemented in 2014. We examined whether hospitals at risk of relatively large penalties from this expansion experienced greater declines in joint replacement readmissions compared with hospitals at risk of smaller penalties. ⋯ Readmissions and complications following joint replacements are measures of the quality of surgical care. These events have important clinical and economic implications for patients and providers. This study is clinically relevant because it examines whether policy interventions, such as the HRRP, have the potential to reduce these unintended consequences of surgical care.
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J Bone Joint Surg Am · Jan 2020
Arthroscopic Microfracture for Osteochondral Lesions of the Talus: Second-Look Arthroscopic and Magnetic Resonance Analysis of Cartilage Repair Tissue Outcomes.
Arthroscopic microfracture is considered the primary treatment strategy for osteochondral lesions of the talus and has been shown to provide successful outcomes. However, deterioration of clinical outcomes and fibrocartilage infill over time is now a recognized concern. The purpose of the present study was to evaluate the outcomes related to cartilage repair tissue after microfracture with use of second-look arthroscopy and magnetic resonance imaging (MRI) and to compare these findings with functional outcomes. ⋯ Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Jan 2020
Clinical and Radiographic Outcomes After Surgical Treatment of Proximal Humeral Fractures with Head-Split Component.
Head-split fractures are a subgroup of proximal humeral fractures in which the fracture line affects the articular surface. Limited data are available regarding outcomes and risk factors for failure following surgical treatment of this rare fracture type. ⋯ Therapeutic Level IV. See Instructions for Authors for a complete list of levels of evidence.
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J Bone Joint Surg Am · Jan 2020
The Effect of Surgical Approach on Outcomes Following Total Hip Arthroplasty Performed for Displaced Intracapsular Hip Fractures: An Analysis from the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man.
Studies have suggested that the anterolateral approach is preferable to the posterior approach when performing total hip arthroplasty (THA) for a displaced intracapsular hip fracture, because of a perceived reduced risk of reoperations and dislocations. However, this suggestion comes from small studies with short follow-up. We determined whether surgical approach in THAs performed for hip fracture affects revision-free hip survival, patient survival, and intraoperative complications. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.