The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jun 2018
Predictors for Long-Term Hip Survivorship Following Acetabular Fracture Surgery: Importance of Gap Compared with Step Displacement.
Historically, the greatest residual (gap or step) displacement is used to predict clinical outcome following acetabular fracture surgery. Gap and step displacement may, however, impact the outcome to different degrees. We assessed the individual relationship between gap or step displacement and hip survivorship and determined their independent association with conversion to total hip arthroplasty. ⋯ Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Jun 2018
Randomized Controlled TrialLumbar Epidural Corticosteroid Injection Reduces Subacute Pain and Improves Knee Function in the First Six Weeks After Total Knee Arthroplasty: A Double-Blinded Randomized Trial.
Pain control immediately following total knee arthroplasty (TKA) has been a focus for orthopaedists. However, control of subacute pain, which may persist up to 3 months, is usually not optimized. The efficacy of epidural corticosteroids in reducing pain after surgery is documented, but data on their efficacy in controlling subacute pain after TKA are lacking. Our aim was to investigate the efficacy of an epidural corticosteroid in controlling pain in the first 3 months following TKA using a double-blinded randomized clinical trial. ⋯ Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Jun 2018
Vancomycin-Loaded Polymethylmethacrylate Spacers Fail to Eradicate Periprosthetic Joint Infection in a Clinically Representative Mouse Model.
Periprosthetic joint infection (PJI) remains a devastating complication following total joint arthroplasty. Current animal models of PJI do not effectively recreate the clinical condition and thus provide limited help in understanding why treatments fail. We developed a mouse model of the first-stage surgery of a 2-stage revision for PJI involving a 3-dimensionally printed Ti-6Al-4V implant and a mouse-sized cement spacer that elutes vancomycin. ⋯ These data provide what we believe to be the first insight into the effect of antibiotic-loaded cement spacers in a clinically relevant animal model and justify the adjunctive use of intravenous antibiotics when performing a 2-stage revision for PJI.
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J Bone Joint Surg Am · Jun 2018
Analysis of Factors Related to the Sex Diversity of Orthopaedic Residency Programs in the United States.
Women are underrepresented as applicants to and trainees of orthopaedic surgery residencies. Factors that attract women to or deter them from orthopaedic surgery have been previously published; however, there has been no analysis of the programs that train high percentages of female residents and the factors that differentiate them from programs that have low percentages of women. The purpose of this study was to identify and compare these factors between programs with high and low percentages of female residents. ⋯ There are greater percentages of female residents at orthopaedic residency programs with more female faculty members, more women in leadership positions, a women's sports medicine program, and the option to do a research year. Departmental and national leaders may consider these factors when efforts are undertaken to enhance the recruitment of female applicants and improve female interest in orthopaedic surgery as a specialty.
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J Bone Joint Surg Am · May 2018
Five to Ten-Year Outcomes of Operatively Treated Scapular Fractures.
The purpose of this study was to assess the 5 to 10-year clinical and patient-reported functional outcomes after open reduction and internal fixation (ORIF) of intra-articular and extra-articular scapular fractures. ⋯ Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.