The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Nov 2008
Randomized Controlled Trial Comparative StudyOrthopaedic management improves the rate of early osteoporosis treatment after hip fracture. A randomized clinical trial.
Although osteoporosis is strongly associated with hip fractures, the initiation of osteoporosis treatment following hip fractures occurs at surprisingly low rates of between 5% and 30%. Currently, most patients receiving treatment have been referred back to their primary care physician for osteoporosis management. The purpose of this study was to compare the effect of osteoporosis management initiated by the orthopaedic team and osteoporosis management initiated by the primary care physician on the rates of treatment at six months. ⋯ An active role by orthopaedic surgeons in the management of osteoporosis improves the rate of treatment at six months following a hip fracture.
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J Bone Joint Surg Am · Nov 2008
Knee arthroscopy in England and Ontario: patterns of use, changes over time, and relationship to total knee replacement.
The role of knee arthroscopy in the management of osteoarthritis is unclear. The purpose of this study was to examine patterns of use of knee arthroscopy, overall and by diagnostic and sociodemographic subgroups, in countries with comparable health-care systems. ⋯ Variations in knee arthroscopy rates according to age, sex, income, and diagnosis were identified in both countries. Research to determine if these differences are consistent with need is warranted.
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J Bone Joint Surg Am · Nov 2008
Effect of volume on total hip arthroplasty revision rates in the United States Medicare population.
Fewer short-term complications following total hip arthroplasty have been associated with greater hospital and surgeon procedure volume. It remains unclear if procedure volume is associated with longer-term clinical outcomes and revision rates. We examined the association between hospital and surgeon procedure volume and total hip arthroplasty revision rates in the Medicare population at six months to eight years postoperatively. ⋯ The majority of the total hip arthroplasties in the Medicare population from 1997 to 2004 were not performed by the highest-volume hospitals or surgeons. Our findings suggest that patients of low-volume surgeons have a greater risk of arthroplasty revision at six months but no greater risk of revision at the time of longer-term follow-up. There appeared to be no significant association between hospital volume and the rate of revisions of total hip arthroplasties.
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J Bone Joint Surg Am · Oct 2008
Randomized Controlled Trial Comparative StudyFemoral nerve block for diaphyseal and distal femoral fractures in the emergency department. Surgical technique.
Diaphyseal and distal femoral fractures are painful injuries that are frequently seen in patients requiring a trauma work-up in the hospital emergency department prior to definitive management. The purpose of this study was to determine whether a femoral nerve block administered in the emergency department could provide better pain relief for patients with femoral fractures than currently used pain management practices. ⋯ The acute pain of a diaphyseal or distal femoral fracture can be significantly decreased through the use of a femoral nerve block, which can be administered safely in the hospital emergency department.