The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Apr 2007
The impact of the accreditation council for graduate medical education work-hour regulations on the surgical experience of orthopaedic surgery residents.
The advent of the eighty-hour workweek regulations generated a great deal of controversy over the potential loss of operative experience for general surgery and surgical specialty residents. We believed an investigation to review the operative experience of orthopaedic surgery residents before and after the adoption of the Accreditation Council for Graduate Medical Education duty-hour guidelines would provide important information in this debate. ⋯ Although many aspects of surgical training may be affected by the new work-hour restrictions, our review of the operative experience of orthopaedic surgery residents at a single institution demonstrated no significant differences before and after the implementation of the eighty-hour workweek.
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J Bone Joint Surg Am · Apr 2007
ReviewTiming of tourniquet release in knee arthroplasty. Meta-analysis of randomized, controlled trials.
Some surgeons release the tourniquet before closing the wound to secure hemostasis during knee arthroplasty. We examined whether early tourniquet release could reduce the perioperative blood loss and whether not releasing the tourniquet until after wound closure would increase the risk of early postoperative complications. ⋯ Therapeutic Level II. See Instructions to Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Apr 2007
Randomized Controlled Trial Comparative StudyLateral entry compared with medial and lateral entry pin fixation for completely displaced supracondylar humeral fractures in children. A randomized clinical trial.
Closed reduction and percutaneous pin fixation is the treatment of choice for completely displaced (type-III) extension supracondylar fractures of the humerus in children, although controversy persists regarding the optimal pin-fixation technique. The purpose of this study was to compare the efficacy of lateral entry pin fixation with that of medial and lateral entry pin fixation for the operative treatment of completely displaced extension supracondylar fractures of the humerus in children. ⋯ Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Apr 2007
Fresh stored allografts for the treatment of osteochondral defects of the knee.
Osteochondral allograft reconstruction of articular cartilage defects is a well-established cartilage repair strategy. Currently, fresh osteochondral allograft tissue is commercially available to clinicians approximately thirty days following graft harvest. Little clinical information is available on the outcome of patients who have been treated with fresh allografts stored for several weeks or more. The purpose of this study was to prospectively analyze the clinical outcome and graft morphology of patients who received fresh, hypothermically stored, allograft tissue for the treatment of symptomatic chondral and osteochondral defects of the knee. ⋯ Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.