The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Apr 2018
Comparative StudyRisk Reduction Compared with Access to Care: Quantifying the Trade-Off of Enforcing a Body Mass Index Eligibility Criterion for Joint Replacement.
Morbidly obese patients with severe osteoarthritis benefit from successful total joint arthroplasty. However, morbid obesity increases the risk of complications. Because of this, some surgeons enforce a body mass index (BMI) eligibility criterion above which total joint arthroplasty is denied. In this study, we investigate the trade-off between avoiding complications and restricting access to care when enforcing BMI-based eligibility criteria for total joint arthroplasty. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Apr 2018
The Effect of an ACL Reconstruction in Controlling Rotational Knee Stability in Knees with Intact and Physiologic Laxity of Secondary Restraints as Defined by Tibiofemoral Compartment Translations and Graft Forces.
The effect of an anterior cruciate ligament (ACL) reconstruction on restoring normal knee kinematics in unstable knees with physiologic laxity of secondary ligamentous restraints remains unknown. The purpose of this study was to determine the stabilizing function of an ACL reconstruction and the resulting ACL graft forces in knees with severely abnormal anterior subluxation due to associated laxity of secondary restraints. ⋯ An ACL reconstruction with a BPTB graft restored normal stability parameters regardless of the integrity of secondary ligamentous restraints.
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J Bone Joint Surg Am · Mar 2018
Randomized Controlled Trial Comparative StudyTeaching Patients How to Reduce a Shoulder Dislocation: A Randomized Clinical Trial Comparing the Boss-Holzach-Matter Self-Assisted Technique and the Spaso Method.
There are many different techniques for reducing acute anterior dislocations of the shoulder, and their use depends on surgeon preference. The objective of this study was to compare the pain experienced by a patient performing a self-reduction technique with the pain felt during a reduction performed by a trained physician. ⋯ Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Mar 2018
Red Flags for Low Back Pain Are Not Always Really Red: A Prospective Evaluation of the Clinical Utility of Commonly Used Screening Questions for Low Back Pain.
Low back pain has a high prevalence and morbidity, and is a source of substantial health-care spending. Numerous published guidelines support the use of so-called red flag questions to screen for serious pathology in patients with low back pain. This paper examines the effectiveness of red flag questions as a screening tool for patients presenting with low back pain to a multidisciplinary academic spine center. ⋯ While a positive response to a red flag question may indicate the presence of serious disease, a negative response to 1 or 2 red flag questions does not meaningfully decrease the likelihood of a red flag diagnosis. Clinicians should use caution when utilizing red flag questions as screening tools.
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J Bone Joint Surg Am · Feb 2018
Minimum Two-Year Follow-up of Anterior Cruciate Ligament Reconstruction in Patients with Generalized Joint Laxity.
The purposes of this investigation were to compare outcomes of anterior cruciate ligament (ACL) reconstruction between patients with generalized joint laxity and those without it and to investigate the effect of generalized joint laxity on outcomes of ACL reconstruction from 2 to 8 years postoperatively. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.