Bmc Musculoskel Dis
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Bmc Musculoskel Dis · Apr 2015
Randomized Controlled Trial Multicenter StudyFunctional outcome and cost-effectiveness of pulsed electromagnetic fields in the treatment of acute scaphoid fractures: a cost-utility analysis.
Physical forces have been widely used to stimulate bone growth in fracture repair. Addition of bone growth stimulation to the conservative treatment regime is more costly than standard health care. However, it might lead to cost-savings due to a reduction of the total amount of working days lost. This economic evaluation was performed to assess the cost-effectiveness of Pulsed Electromagnetic Fields (PEMF) compared to standard health care in the treatment of acute scaphoid fractures. ⋯ This study demonstrates that the desired effects in terms of cost-effectiveness are not met. When comparing the effects of PEMF to standard health care in terms of QALY's, PEMF cannot be considered a cost-effective treatment for acute fractures of the scaphoid bone.
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Bmc Musculoskel Dis · Apr 2015
Comparative StudyBiomechanical evaluation of a new pedicle screw-based posterior dynamic stabilization device (Awesome Rod System)--a finite element analysis.
Pedicle-screw-based posterior dynamic stabilization devices are designed to alleviate the rate of accelerated degeneration of the vertebral level adjacent to the level of spinal fusion. A new pedicle-screw-based posterior dynamic stabilization device- the Awesome Dynamic Rod System was designed with curve cuts on the rods to provide flexibility. The current study was conducted to evaluate the biomechanical properties of this new device. ⋯ The results demonstrate that the Awesome Dynamic Rod System preserved more bridged segment motion than did the traditional rigid rod fixation system except in extension. However, the Awesome Dynamic Rod System bore a greater facet joint contact force in extension. The Awesome Dynamic Rod System did protect the adjacent level of fusion segments, but led to much greater ROM, disc stresses, and facet joint contact forces increasing at the adjacent level of instrumented segments.
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Bmc Musculoskel Dis · Apr 2015
Comparative Study Observational StudyEarly postoperative mortality after simultaneous or staged bilateral primary total hip arthroplasty: an observational register study from the Swedish Hip Arthroplasty Register.
Approximately a fifth of all total hip arthroplasty (THA) patients suffers from bilateral osteoarthritis of the hip. It is unclear whether mortality risks differ between simultaneous bilateral THA and staged bilateral THA. We investigated mortality after simultaneous THA compared with staged bilateral THA in the largest cohort hitherto reported. ⋯ There were no clinically relevant differences in early postoperative mortality between simultaneous and staged bilateral surgery in healthy patients. Advanced age, RA, a high ASA class and male sex increased the risk of death within 90 days. There may be an issue with enhanced risk of implant revision in patients with simultaneous bilateral THA that needs to be explored further.
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Bmc Musculoskel Dis · Mar 2015
Comparative StudyComparison of two surgical approaches for displaced intra-articular calcaneal fractures: sinus tarsi versus extensile lateral approach.
Two common surgical approaches included the sinus tarsi and extensile lateral are used for displaced intra-articular calcaneal fractures. However, few studies have compared outcome of treated by the two approaches. The purpose of this study was to compare the outcome between these two approaches for Sanders type-II and type-III fractures. ⋯ The final clinical and radiographic outcomes between the two approaches for Sanders type-II and type-III intra-articular calcaneal fractures were comparable and equally successful. The selective sinus tarsi approach appears to be an effective and reliable method for the treatment of Sanders type-II and type-III fractures.
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Bmc Musculoskel Dis · Mar 2015
Randomized Controlled Trial Multicenter StudySafety and performance of Hydros and Hydros-TA for knee osteoarthritis: a prospective, multicenter, randomized, double-blind feasibility trial.
Studies have evaluated the concomitant use of hyaluronan (HA) with steroids, anti-inflammatory drugs and analgesic agents in an attempt to magnify the extent and duration of pain relief due to knee osteoarthritis. To date there has not been an intra-articular combination therapy available for relief of knee osteoarthritis symptoms--one that combines the fast acting onset of symptom relief provided by a corticosteroid with the long-lasting symptom relief provided by HA in a single injection. The objective of this study was to evaluate the safety and preliminary performance of two new HA formulations, Hydros (hyaluronan-based hydrogel suspended in hyaluronan solution) and Hydros-TA (HA plus 10 mg of triamcinolone acetonide [TA]) in subjects with knee osteoarthritis. ⋯ A single injection of Hydros or Hydros-TA was well-tolerated and relieved pain associated with knee osteoarthritis over 26 weeks. Data indicate that Hydros-TA had a more rapid pain relief compared to Hydros alone. A Phase 3 trial is underway to confirm these preliminary results.