The Journal of bone and joint surgery. American volume
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Despite declines in both the incidence of and mortality following hip fracture, there are racial and socioeconomic disparities in treatment access and outcomes. We evaluated the presence and implications of disparities in delivery of care, hypothesizing that race and community socioeconomic characteristics would influence quality of care for patients with a hip fracture. ⋯ Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · May 2016
Systematic Quantification of Stabilizing Effects of Subtalar Joint Soft-Tissue Constraints in a Novel Cadaveric Model.
Distinguishing between ankle instability and subtalar joint instability is challenging because the contributions of the subtalar joint's soft-tissue constraints are poorly understood. This study quantified the effects on joint stability of systematic sectioning of these constraints followed by application of torsional and drawer loads simulating a manual clinical examination. ⋯ If calcaneofibular ligament insufficiency is established, its reconstruction or repair should receive priority over that of other ankle or subtalar periarticular soft-tissue structures.
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J Bone Joint Surg Am · May 2016
ReviewPublication Productivity and Experience: Factors Associated with Academic Rank Among Orthopaedic Surgery Faculty in the United States.
Many factors play a role in academic promotion among orthopaedic surgeons. This study specifically examined the importance of publication productivity metrics, career duration, and sex on academic rank in orthopaedic surgery programs in the United States. ⋯ This analysis demonstrates that a higher h-index and m-index correlate with a higher academic orthopaedic faculty rank. Although female surgeons had a lower median h-index and a shorter median career duration than male surgeons, their m-index was not significantly different, and thus sex was not an independent predictor for senior academic rank. The identified thresholds (h-index of 12 and m-index of 0.51) between junior and senior academic ranks may be considered as factors in promotion considerations.
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J Bone Joint Surg Am · May 2016
Randomized Controlled TrialCombined Intra-Articular and Intravenous Tranexamic Acid Reduces Blood Loss in Total Knee Arthroplasty: A Randomized, Double-Blind, Placebo-Controlled Trial.
In total knee arthroplasty, both intravenous (IV) and intra-articular (IA) administration of tranexamic acid (TXA) have been shown to reduce blood loss in several randomized controlled trials, although routine use of systemic TXA is considerably more common. However, to our knowledge, the additional benefit of IA administration of TXA when combined with IV administration, without the use of a tourniquet, has not been previously investigated. Thus, the aim of this study was to evaluate whether combined IV and IA administration of TXA reduced total blood loss compared with IV-only administration of TXA. ⋯ Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · May 2016
Percent Body Fat Is More Predictive of Function After Total Joint Arthroplasty Than Body Mass Index.
Obesity has an important impact on the future of total joint arthroplasty; however, the definition and influence of obesity on surgical risks and outcomes remain controversial. Our hypothesis was that percent body fat was better than body mass index (BMI) at identifying clinical risks and patient-reported functional outcomes following arthroplasty. ⋯ Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.