The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Oct 2016
The Michigan Experience with Safety and Effectiveness of Tranexamic Acid Use in Hip and Knee Arthroplasty.
The efficacy of tranexamic acid (TXA) in reducing blood loss and transfusion requirements in total hip and knee arthroplasty has been well established in small controlled clinical trials and meta-analyses. The purpose of the current study was to determine the risks and benefits of TXA use in routine orthopaedic surgical practice on the basis of data from a large, statewide arthroplasty registry. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Oct 2016
Cardiopulmonary Exercise Testing in Patients with Idiopathic Scoliosis.
Scoliosis causes impairment of the respiratory and cardiovascular systems. Traditional pulmonary function tests only examine patients under static conditions. The aim of our study was to investigate the correlation between radiographic parameters and dynamic cardiopulmonary capacity in patients with idiopathic scoliosis. ⋯ Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Sep 2016
ReviewIntra-Articular Cellular Therapy for Osteoarthritis and Focal Cartilage Defects of the Knee: A Systematic Review of the Literature and Study Quality Analysis.
Intra-articular cellular therapy injections constitute an appealing strategy that may modify the intra-articular milieu or regenerate cartilage in the settings of osteoarthritis and focal cartilage defects. However, little consensus exists regarding the indications for cellular therapies, optimal cell sources, methods of preparation and delivery, or means by which outcomes should be reported. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Sep 2016
Are We Prescribing Our Patients Too Much Pain Medication? Best Predictors of Narcotic Usage After Spinal Surgery for Scoliosis.
Physicians play a role in the current prescription drug-abuse epidemic. Surgeons often prescribe more postoperative narcotic pain medication than patients routinely need. Although narcotics are effective for severe, acute, postoperative pain, few evidence-based guidelines exist regarding the routinely required amount and duration of use post-hospital discharge. ⋯ Prognostic Level I. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Sep 2016
ReviewHumeral Shaft Fracture Fixation: Incidence Rates and Complications as Reported by American Board of Orthopaedic Surgery Part II Candidates.
Despite extensive research regarding patient outcomes after operative fixation of humeral shaft fractures by means of open reduction and internal fixation (ORIF) or intramedullary nailing (IMN), no current consensus exists regarding the optimal surgical treatment. The objective of this study was to compare IMN and plate fixation (ORIF) of humeral shaft fractures by using the American Board of Orthopaedic Surgery (ABOS) Part II operative database to analyze incidence rates, changes in management trends over time, early complications, and factors affecting the management choice. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.