Bulletin of the NYU hospital for joint diseases
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Bull NYU Hosp Jt Dis · Jan 2009
Comparative StudyResurfacing matched to standard total hip arthroplasty by preoperative activity levels - a comparison of postoperative outcomes.
Some studies have suggested that resurfacing patients are generally more active postoperatively than their conventional total hip arthroplasty (THA)counterparts, but controversy remains over whether this is a reflection of preferential use of resurfacing for younger and higher-activity patients. We hypothesized that, when controlling for preoperative activity levels, in addition to relevant clinical and demographic factors, resurfacing provides similar results to conventional hip arthroplasty. ⋯ The results of this study suggest that patients treated with hip resurfacing arthroplasty have a significantly higher postoperative activity level, as compared to those treated with conventional THA, when controlled for preoperative factors.
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Bull NYU Hosp Jt Dis · Jan 2009
Safety reporting in randomized clinical trials - a need for improvement.
The reporting of adverse events (AEs) in randomized clinical trials (RCTs) is often lacking in the publication of trials. Part of the problem is the way safety data are reported in RCTs. Reporting of "time to event," use of standardized incidence ratios for comparison to normal population or disease controls, use of "patient years" when reporting AE, and adequate sample size and power calculations are some of the problems that need to be addressed and improved in RCTs.
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Bull NYU Hosp Jt Dis · Jan 2009
Long-term functional outcome and donor-site morbidity associated with autogenous iliac crest bone grafts utilizing a modified anterior approach.
Prior studies and techniques for harvesting iliac crest bone have shown significant postoperative pain, disability, and poor cosmesis. This retrospective study was conducted to examine bone graft donor-site morbidity by evaluating functional outcomes in patients who have undergone a modified anterior harvesting approach. The medical charts and hospital records of 43 patients were retrospectively reviewed over a 6-year period. ⋯ SMFA scores demonstrated a mean dysfunction score of 48.5 (range, 41.8 to 71.1) and a bother index of mean 47.9 (range, 42.6 to 73.9). Utilizing the anterior approach in iliac crest bone harvesting provides an abundant supply of both cortical and cancellous bone, an aesthetically favorable scar, and decreased postoperative donor-site pain. There were very few complications seen in our cohort as compared to previous studies with very good long-term functional outcomes.
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Bull NYU Hosp Jt Dis · Jan 2009
Computer-assisted navigation in hip resurfacing arthroplasty - a single-surgeon experience.
Hip resurfacing arthroplasty is a technically challenging procedure, and orientation of the femoral component is critical to avoid implant failure. The use of computer-assisted navigation has been shown to decrease the learning curve for beginners in hip resurfacing and to improve the surgeon's ability to produce consistent results. Computer navigation offers real-time feedback, with the opportunity to produce improved repeatability to optimize patient outcomes. ⋯ Twenty-five non-navigated hip resurfacing arthroplasties, performed by the same surgeon, were evaluated as a matching group. Mean operative times for the computer-assisted hip resurfacing were 101 minutes, as compared to 104 minutes in the non-navigated group. We found that in the hands of an experienced hip resurfacing surgeon, the addition of computer-assisted navigation had no effect on the learning curve, but did provide feedback and repeatability to the surgeon.