The Journal of bone and joint surgery. American volume
-
J Bone Joint Surg Am · Feb 2020
Comparative StudyImproving the Diagnosis of Ipsilateral Femoral Neck and Shaft Fractures: A New Imaging Protocol.
Despite increased awareness of ipsilateral femoral neck fractures in patients with high-energy femoral shaft fractures and advanced imaging with thin-cut high-resolution computed tomography (CT), failure of diagnosis remains problematic. The purpose of the present study was to determine if the preoperative diagnosis of ipsilateral femoral neck fractures in patients with high-energy femoral shaft fractures can be improved with magnetic resonance imaging (MRI) compared with radiographic and CT imaging. ⋯ Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.
-
J Bone Joint Surg Am · Feb 2020
Multicenter Study Comparative StudyReconstruction of the Suprascapular Nerve in Brachial Plexus Birth Injury: A Comparison of Nerve Grafting and Nerve Transfers.
Shoulder external rotation recovery in brachial plexus birth injury is often limited. Nerve grafting to the suprascapular nerve and transfer of the spinal accessory nerve to the suprascapular nerve are commonly performed to restore shoulder external rotation, but the optimal surgical technique has not been clearly demonstrated. We investigated whether there was a difference between nerve grafting and nerve transfer in terms of shoulder external rotation recovery or secondary shoulder procedures. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
-
J Bone Joint Surg Am · Feb 2020
Comparative StudyGender Disparities in Financial Relationships Between Industry and Orthopaedic Surgeons.
Recent studies in a number of surgical subspecialties have demonstrated that financial relationships with industry differ between men and women. This study aimed to determine if gender disparities exist in industry relationships with orthopaedic surgeons. ⋯ Male gender, years of experience, Mountain region, and adult reconstructive subspecialty are independent predictors of a higher number of industry payments and payment amount. These disparities in industry payments may contribute to continued inequities in scholarship, academic rank, and leadership opportunities.
-
J Bone Joint Surg Am · Feb 2020
New Long-Term Opioid Prescription-Filling Behavior Arising in the 15 Months After Orthopaedic Surgery.
The opioid crisis is a well-known public health issue. The risk of new long-term opioid prescription-filling behavior has been investigated after certain spinal procedures and total knee and hip arthroplasty. However, this has not been examined after many other common orthopaedic procedures. The purpose of this study was to determine the rates of long-term opioid prescription-filling behavior after common orthopaedic surgical procedures in patients who were not taking opioids preoperatively. ⋯ Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
-
J Bone Joint Surg Am · Feb 2020
Dose-Dependent Association of Gabapentinoids with Pulmonary Complications After Total Hip and Knee Arthroplasties.
Gabapentinoids are commonly prescribed in perioperative multimodal analgesia protocols. Despite widespread use, the optimal dose to reduce opioid consumption while minimizing risks is unknown. We assessed dose-dependent effects of gabapentinoids on opioid consumption and postoperative pulmonary complications following total hip or knee arthroplasty (THA or TKA). We hypothesized that use of a gabapentinoid on the day of THA or TKA is associated with an increased risk of postoperative pulmonary complications in a dose-response fashion compared with the risk for patients who did not receive the drug. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.