The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jul 2013
Reverse total shoulder arthroplasty for primary glenohumeral osteoarthritis in patients with a biconcave glenoid.
The biconcave glenoid in patients with primary glenohumeral osteoarthritis represents a surgical challenge because of the associated static posterior instability of the humeral head and secondary posterior glenoid erosion. The purpose of the present study was to evaluate the clinical and radiographic results of reverse total shoulder arthroplasty for the treatment of primary osteoarthritis in patients with a biconcave glenoid without rotator cuff insufficiency. ⋯ Reverse shoulder arthroplasty for the treatment of primary glenohumeral osteoarthritis in patients with a biconcave glenoid without rotator cuff insufficiency can result in excellent clinical outcomes. Reverse shoulder arthroplasty is a viable surgical option to solve both the problem of severe static posterior glenohumeral instability and severe glenoid erosion.
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J Bone Joint Surg Am · Jul 2013
Comparative StudyCost-effectiveness of low-molecular-weight heparin compared with aspirin for prophylaxis against venous thromboembolism after total joint arthroplasty.
There is controversy regarding the most appropriate strategy to prevent venous thromboembolism following total joint arthroplasty. Our objective was to estimate the lifetime costs, quality-adjusted life-years (QALYs), and costs per QALY gained using low-molecular-weight heparin compared with low-dose aspirin for two weeks after total knee or total hip arthroplasty in patients with no history of venous thromboembolism. ⋯ For patients with no history of venous thromboembolism, aspirin is a cost-effective choice for venous thromboembolism prophylaxis following total hip arthroplasty, but the preferred choice following total knee arthroplasty depends on age and is uncertain for those younger than eighty years old.
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J Bone Joint Surg Am · Jul 2013
Risk factors for thirty-day morbidity and mortality following knee arthroscopy: a review of 12,271 patients from the national surgical quality improvement program database.
Knee arthroscopy is among the most common orthopaedic surgical procedures. However, the incidence and risk factors for postsurgical morbidity and mortality remain poorly defined. ⋯ The incidence of complication following elective knee arthroscopy is low. The data presented here should be useful for providing prognostic information to patients during informed consent. Surgeons should be encouraged to minimize operative time whenever possible, and may wish to delay elective arthroscopy in patients who have had other recent surgical procedures.
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J Bone Joint Surg Am · Jul 2013
Factors associated with use of bone morphogenetic protein during pediatric spinal fusion surgery: an analysis of 4817 patients.
Our goal was to investigate whether the use of recombinant human bone morphogenetic protein (rhBMP, or BMP) during pediatric spinal fusion surgery has been increasing and how patient, surgical, and hospital characteristics influence BMP use. ⋯ Use of BMP during pediatric spinal fusion has increased significantly. Patient factors (age, diagnosis, and insurance), surgical factors (autograft use), and hospital factors (teaching status, bed capacity, and location) influenced the variation in BMP use.