The Journal of bone and joint surgery. American volume
-
J Bone Joint Surg Am · Sep 2014
Observational StudyFactors predicting complication and reoperation rates following surgical fixation of proximal humeral fractures.
The purpose of this study was to report complication and reoperation rates following non-arthroplasty fixation of shoulder fractures determined on the basis of observational, population-based data from all inpatient admissions in California over an eleven-year period. ⋯ Surgical fixation of proximal humeral fractures has a low complication and mortality profile. The data provided in this study can serve in counseling patients about risks associated with operative fixation of displaced proximal humeral fractures.
-
J Bone Joint Surg Am · Sep 2014
Risk factors for surgical site infection following total joint arthroplasty.
Currently, most hospitals in the United States are obliged to report infections that occur following total joint arthroplasty to the Centers for Disease Control and Prevention through the National Healthcare Safety Network surveillance. The objective of this study was to identify the risk factors of surgical site infections that were reported to the Centers for Disease Control and Prevention from a single institution. ⋯ Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
-
J Bone Joint Surg Am · Sep 2014
Randomized Controlled Trial Comparative Study Pragmatic Clinical TrialTendon repair compared with physiotherapy in the treatment of rotator cuff tears: a randomized controlled study in 103 cases with a five-year follow-up.
There is limited Level-I evidence that compares operative and nonoperative treatment of rotator cuff tears. We compared outcomes of patients treated with primary tendon repair with outcomes of those treated with physiotherapy and optional secondary tendon repair if needed. ⋯ Although primary repair of small and medium-sized rotator cuff tears was associated with better outcome than physiotherapy treatment, the differences were small and may be below clinical importance. In the physiotherapy treatment group, there were increasing tear sizes and inferior outcomes in one-third of patients who did not undergo repair.
-
J Bone Joint Surg Am · Sep 2014
Comparative StudyMorbid obesity: a significant risk factor for failure of two-stage revision total knee arthroplasty for infection.
Obese patients have a higher risk of complications following primary total knee arthroplasty, including periprosthetic joint infection. However, there is a paucity of data concerning the efficacy of two-stage revision arthroplasty in obese patients. ⋯ Morbid obesity significantly increased the risk of subsequent revision, reoperation, and reinfection following two-stage revision total knee arthroplasty for infection. In addition, these patients had worse pain relief and overall function at intermediate-term clinical follow-up. Although two-stage revision should remain a standard treatment for chronic periprosthetic joint infection in morbidly obese patients, increased failure rates and poorer outcomes should be anticipated.
-
J Bone Joint Surg Am · Sep 2014
Comparative StudyUsage of recombinant human bone morphogenetic protein in cervical spine procedures: analysis of the MarketScan longitudinal database.
Usage of recombinant human bone morphogenetic protein (rhBMP) in anterior cervical discectomy and fusion (ACDF) procedures is controversial. Studies suggest increased rates of dysphagia, hematoma or seroma, and severe airway compromise in anterior cervical spine procedures using rhBMP. The purpose of the present study was to determine and describe national utilization trends and complication rates associated with rhBMP usage in anterior cervical spine procedures. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.