J Am Acad Orthop Sur
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J Am Acad Orthop Sur · Mar 2007
ReviewCorticosteroid injections in the treatment of trigger finger: a level I and II systematic review.
Trigger finger is a tendinitis (stenosing tenosynovitis) with multiple management approaches. We conducted an evidence-based medicine systematic review of level I and II prospective randomized controlled trials to determine the effectiveness of corticosteroid injection in managing trigger finger. ⋯ This review indicates that the incidence of trigger finger is greatest in women (75%), with an average patient age range of 52 to 62 years. Combined analysis of these four studies shows that corticosteroid injections are effective in 57% of patients.
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Achieving a balanced diversity in orthopaedic residency programs is a critical component in improving the quality of orthopaedic care delivered to all patients. Compared with the demographics of medical school classes, women are notably underrepresented in orthopaedic residency programs, and racial and ethnic minority groups are unevenly represented. Diversifying residency programs positively affects all residents and their ability to deliver care and create positive physician-patient relationships.
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J Am Acad Orthop Sur · Jan 2007
Racial and ethnic disparities in hip and knee joint replacement: a review of research in the Veterans Affairs Health Care System.
Elective total joint arthroplasty is an effective treatment option for end-stage osteoarthritis of the hip and knee. The demand for arthroplasty is anticipated to increase as the proportion of older patients with hip and knee osteoarthritis continues to rise in the United States and worldwide. ⋯ Most of the studies on racial and ethnic disparities in joint arthroplasty utilization have been based on data from the Medicare database. However, Veterans Administration-based studies have recently confirmed these findings and have indicated potential patient-level factors, such as patient perception of and familiarity with joint arthroplasty, that may play a role in this disparity.
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Women and underrepresented minorities make up smaller proportions of orthopaedic residency programs than their numbers in medical school would predict, according to our evaluation of self-reported orthopaedic residency data from 1998 and 2001, as well as information on medical students published in 2002. Based on race, ethnicity, and sex, comparisons were made between students entering and graduating from medical school and those in orthopaedic residency programs. ⋯ The percentage of women and minorities in orthopaedic residency programs remained constant between 1998 and 2001. Further study is necessary to determine whether fewer students of color and women apply to orthopaedic residency programs because of lack of interest, lack of appropriate mentoring and role models, or other factors.
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J Am Acad Orthop Sur · Jan 2007
Current activities in orthopaedic culturally competent care education.
Culturally competent care education, which involves educating physicians on being sensitive to the diverse characteristics and traits of each patient (eg, race, ethnicity, sex, faith background), is vital for the well-being of all patients. All medical disciplines are grappling with the best way to provide culturally competent care education. The Diversity Advisory Board of the American Academy of Orthopaedic Surgeons is charged with advancing diversity in the field of orthopaedic surgery. ⋯ In 2006, the AAOS developed the Cultural Competency Challenge CD-ROM, followed in 2007 by the Culturally Competent Care Guidebook, a companion to the CD-ROM. Culturally competent care legislation has been enacted in California and New Jersey, and legislation is pending in Arizona, Illinois, New York, and Texas, making these resources even more timely. To best care for all patients, each physician must be aware of his or her own identity and be sensitive to the unique realities of each patient with whom the physician comes into contact.