Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Nov 2023
Review Meta AnalysisPearls and pitfalls of PROMIS clinically significant outcomes in orthopaedic surgery.
Patient-Reported Outcome Measurement Information System (PROMIS) was developed as a uniform and generalizable PROM system using item response theory and computer adaptive testing. We aimed to assess the utilization of PROMIS for clinically significant outcomes (CSOs) measurements and provide insights into its use in orthopaedic research. ⋯ PROMIS CSOs are increasingly utilized, especially for lower extremity procedures assessing the PF, PI, and D domains using distribution-based MCID. Using more conservative anchor-based MCIDs and reporting MDCs may strengthen results. Researchers should consider unique pearls and pitfalls when assessing PROMIS CSOs.
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Arch Orthop Trauma Surg · Nov 2023
Review Meta AnalysisThe safety and effectiveness of enhanced recovery after surgery (ERAS) in older patients undergoing orthopedic surgery: a systematic review and meta-analysis.
To systematically review and analyze the safety and effectiveness of ERAS in older patients undergoing orthopedic surgeries. ⋯ The implementation of the ERAS program in older patients undergoing orthopedic surgeries is safe and effective. However, there is still a lack of standardization of protocols across institutions and centers for orthopedic surgery for older patients. Identifying ERAS components that are beneficial to older patients and developing ERAS protocols that are appropriate for older adults may further improve outcomes.
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Arch Orthop Trauma Surg · Nov 2023
Meta Analysis Clinical TrialTranexamic acid administration for the prevention of periprosthetic joint infection and surgical site infection: a systematic review and meta-analysis.
Tranexamic acid (TXA) has been widely utilized to reduce blood loss and allogeneic transfusions in patients who undergo lower limb arthroplasty. In recent years, there have been several articles reporting the incidence of periprosthetic joint infection (PJI) as a primary outcome of TXA administration, but no meta-analysis has been conducted to date. The present systematic review and meta-analysis evaluated the efficacy of TXA administration in preventing PJI and surgical site infection (SSI). ⋯ Level III.
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Arch Orthop Trauma Surg · Nov 2023
Randomized Controlled TrialOxycodone-acetaminophen versus celecoxib for postoperative pain in knee osteoarthritis patients after total knee arthroplasty: a randomized, controlled study.
Oxycodone-acetaminophen is a synergic combination of semisynthetic opioid agonis and analgesic/antipyretic agent, which improves analgesic efficacy. This randomized, controlled study intended to evaluate the analgesic efficacy and tolerance of oxycodone-acetaminophen compared to celecoxib alone in post-total knee arthroplasty (TKA) knee osteoarthritis patients. ⋯ Oxycodone-acetaminophen exerts superior analgesic efficacy, patients' satisfaction, and similar tolerance compared to celecoxib in post-TKA knee osteoarthritis patients.
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Arch Orthop Trauma Surg · Nov 2023
Retrospective clinical and X-ray-based outcome analysis of a short-stem hip arthroplasty taking into account the operative learning curve over 7 years in the 3-year control course.
Self-monitoring is crucial to work progressively with a high-quality standard. A retrospective analysis is a valuable tool for studying the postoperative outcome of a prosthesis and for evaluating the learning process for the surgeon. ⋯ Operative expertise was shown to gain through a learning curve, whereby postoperative results corresponded to the system philosophy of the short hip stem prosthesis. The distal FFR and the distal lateral distance could represent the principle of the prosthesis, which overall could be an interesting approach for verification of a new parameter.