Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Feb 2012
Comparative StudyA short tapered stem reduces intraoperative complications in primary total hip arthroplasty.
While short-stem design is not a new concept, interest has surged with increasing utilization of less invasive techniques. Short stems are easier to insert through small incisions. Reliable long-term results including functional improvement, pain relief, and implant survival have been reported with standard tapered stems, but will a short taper perform as well? ⋯ Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Feb 2012
Multicenter Study Comparative StudySimilar outcomes for nail versus plate fixation of three-part proximal humeral fractures.
There is a lack of consensus regarding optimal surgical management of displaced and unstable three-part proximal humeral fractures. ⋯ Level II, therapeutic study (prospective comparative study). See the Guidelines for Authors for a complete description of levels of evidence.
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Intraarticular hip disease is commonly acknowledged as a cause of ipsilateral knee pain. However, this is based primarily on observational rather than high-quality evidence-based studies, and it is unclear whether ipsilateral knee pain improves when hip disease has been treated. ⋯ Level III, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Feb 2012
Does international normalized ratio level predict pulmonary embolism?
Preventing pulmonary embolism is a priority after major musculoskeletal surgery. The literature contains discrepant data regarding the influence of anticoagulation on the incidence of pulmonary embolism after joint arthroplasty. The American College of Chest Physicians guidelines recommend administration of oral anticoagulants (warfarin), aiming for an international normalized ratio (INR) level between 2 and 3. However, recent studies show aggressive anticoagulation (INR > 2) can lead to hematoma formation and increased risk of subsequent infection. ⋯ Level III, therapeutic study. See Instructions to Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Feb 2012
Review Meta AnalysisNonoperative versus operative treatment for thoracolumbar burst fractures without neurologic deficit: a meta-analysis.
Decision-making regarding nonoperative versus operative treatment of patients with thoracolumbar burst fractures in the absence of neurologic deficits is controversial. Lack of evidence-based practice may result in patients being treated inappropriately and being exposed to unnecessary adverse consequences. ⋯ Level II, therapeutic study. See the Guidelines for Authors for a complete description of level of evidence.