International orthopaedics
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Adequate comorbidity risk adjustment is central for reliable outcome prediction and provider performance evaluation. The two most commonly employed risk-adjustment methods in orthopaedic surgery were not originally validated in this patient population. We sought (1) to develop a single numeric comorbidity score for predicting inpatient mortality in patients undergoing orthopaedic surgery by combining and reweighting the conditions included in the Charlson and Elixhauser measures, and to compare its predictive performance to each of the separate component scores. We also (2) evaluated the new score separately for spine surgery, adult reconstruction, hip fracture, and musculoskeletal oncology admissions. ⋯ A single numeric comorbidity score combining conditions from the Charlson and Elixhauser models provided better discrimination of inpatient mortality than either of its constituent scores. Future research should test this score in other populations and data settings.
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Since 2003, we have been performing rotational open-wedge osteotomy (ROWO) for older children with severe Legg-Calve-Perthes disease (LCPD). We compared the treatment outcomes before and after the introduction of ROWO for patients aged ≥ eight years, classified in the modified lateral pillar B/C border or C group. ⋯ The application of ROWO combined with NWB in the treatment of older children with severe LCPD improved their outcomes, compared to those obtained by NWB treatment alone.
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Peri-radicular injection is a widely used procedure for treating lumbar radicular pain, but it remains unclear what types of lumbar pathologies respond well to this treatment. We aimed to investigate the efficacy of peri-radicular injection for degenerative lumbar disorders and to determine what types of pathologies respond well to this treatment. ⋯ This study demonstrated that 51.7% of patients with degenerative lumbar pathologies were successfully treated by peri-radicular injection. Efficacy was limited in cases of herniated disc with spinal stenosis, foraminal disc herniation, recurrent disc herniation and failed back surgery with instability.
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The efficacy of immediate full weight bearing in accelerating bone regeneration after medial opening wedge high tibial osteotomy (HTO) was evaluated in patients operated with the Limmed system (locked plate fixation) that allows dynamisation of the site of the osteotomy. ⋯ The Limmed medial opening wedge HTO system with immediate full weight bearing accelerates bone graft substitute osseointegration and bone healing as compared with controls without full weight bearing.