The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Sep 2011
Racial and ethnic diversity in orthopaedic surgery residency programs.
Although the U.S. population is increasingly diverse, the field of orthopaedic surgery has historically been less diverse. The purpose of this study was to quantify the representation of racial and ethnic minorities among orthopaedic surgery residents compared with those in other fields of medicine and to determine how these levels of diversity have changed over time. ⋯ Minority representation in orthopaedic residency programs has increased over time for Asians, Hispanics, and African-Americans. In spite of these gains, orthopaedic surgery has remained the least diverse of the specialty training programs considered in this study. While further efforts are needed to determine the factors underlying this lack of representation, we suggest a series of interventions that can be expected to enhance diversity in orthopaedic residencies as well as in the profession as a whole.
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J Bone Joint Surg Am · Sep 2011
Randomized Controlled Trial Comparative StudyResults of cervical arthroplasty compared with anterior discectomy and fusion: four-year clinical outcomes in a prospective, randomized controlled trial.
The published two-year results of the pivotal U.S. Food and Drug Administration investigational device exemption trial with the use of the Bryan cervical disc arthroplasty compared with anterior cervical discectomy with fusion for treating single-level degenerative cervical disc disease revealed a significantly superior overall success rate in the arthroplasty group. The purpose of this study was to evaluate the midterm safety and effectiveness of the Bryan disc as an alternative to arthrodesis following anterior cervical discectomy. ⋯ The forty-eight-month follow-up data in the present report showed consistent, sustained significantly superior outcomes for cervical spine arthroplasty compared with cervical spine fusion. The arthroplasty cohort continued to show significantly greater improvements in Neck Disability Index, neck pain score, arm pain score, and Short Form-36 physical component score, as well as the primary outcome measure, overall success, at forty-eight months following surgery.
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J Bone Joint Surg Am · Sep 2011
The epidemiology, risk of recurrence, and functional outcome after an acute traumatic posterior dislocation of the shoulder.
Posterior glenohumeral dislocation is less common than anterior dislocation, and less is known about its epidemiology, functional outcome, and complications. The purposes of this study were to determine the epidemiology and demographics of posterior dislocations and to assess the risk of recurrence and the functional outcome after treatment. ⋯ The prevalence of posterior dislocation is low. The most common complication after this injury is recurrent instability, which occurs at an early stage in 17.7% of shoulders within the first year after dislocation. The risk is highest in patients who are less than forty years old, sustain the dislocation during a seizure, and have a large humeral head defect. The risk is lower for most patients who sustain the injury from a traumatic accident, especially if they are older and have a small anterior humeral head defect. There are persistent deficits of shoulder function within the first two years after the injury.
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J Bone Joint Surg Am · Sep 2011
Fresh osteochondral allograft for the treatment of cartilage defects of the talus: a retrospective review.
Osteochondral lesions of the talar dome can cause substantial functional impairment and present a difficult treatment dilemma. Interest has recently focused on fresh osteochondral allografts as a promising treatment alternative. The purpose of this study was to evaluate the clinical outcome of osteochondral lesions of the talus treated with a fresh osteochondral allograft. ⋯ In our experience, transplantation of fresh osteochondral allograft is a viable and effective method for the treatment of osteochondral lesions of the talus as evidenced by improvements in pain and function.