Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jan 2012
Comparative StudyPreoperative patient education reduces in-hospital falls after total knee arthroplasty.
Inpatient hospital falls after orthopaedic surgery represent a major problem, with rates of about one to three falls per 1000 patient days. These falls result in substantial morbidity for the patient and liability for the institution. ⋯ Inpatient falls after TKA may be associated with major complications. Our preoperative patient education reduced these falls and is now mandatory for patients undergoing TKA at our institution.
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Clin. Orthop. Relat. Res. · Jan 2012
Can a high-flexion total knee arthroplasty relieve pain and restore function without premature failure?
High-flexion TKA prostheses are designed to improve flexion and clinical outcomes. Increased knee flexion can increase implant loads and fixation stresses, creating concerns of premature failure. Whether these goals can be achieved without premature failures is unclear. ⋯ Our data were similar to those reported in patients implanted with traditional and other designs of high-flexion TKA. We found no increased incidence of premature failure, although a higher than expected incidence of posterior femoral radiolucent lines merit continued observation. Patients with less preoperative motion were more likely to benefit from a high-flexion TKA.
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Clin. Orthop. Relat. Res. · Jan 2012
Comparative StudyIncidence of patients with lower extremity injuries presenting to US emergency departments by anatomic region, disease category, and age.
The incidence of patients with lower extremity injuries presenting to emergency departments in the United States with respect to specific anatomic regions and disease categories is unknown. Such information might be used for injury prevention, resource allocation, and training priorities. ⋯ Given relatively low-acuity leg problems such as strains and sprains account for a substantial number of emergency department visits pertaining to leg problems, use of telephone triage, scheduled same or next-day urgent care appointments, and other alternatives to the traditional emergency room might result in better use of emergency healthcare resources.
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Clin. Orthop. Relat. Res. · Jan 2012
Comparative StudyPatient-related risk factors for postoperative mortality and periprosthetic joint infection in medicare patients undergoing TKA.
The impact of specific baseline comorbid conditions on the relative risk of postoperative mortality and periprosthetic joint infection (PJI) in elderly patients undergoing TKA has not been well defined. ⋯ We believe this information important when counseling elderly patients regarding the risks of mortality and PJI after TKA and risk-adjusting publicly reported TKA patient outcomes.