Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Apr 2014
How does accounting for worker productivity affect the measured cost-effectiveness of lumbar discectomy?
Back pain attributable to lumbar disc herniation is a substantial cause of reduced workplace productivity. Disc herniation surgery is effective in reducing pain and improving function. However, few studies have examined the effects of surgery on worker productivity. ⋯ Level II, economic and decision analysis. See the Instructions for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Apr 2014
Multicenter StudyRisk factors for revision within 10 years of total knee arthroplasty.
An in-depth understanding of risk factors for revision TKA is needed to minimize the burden of revision surgery. Previous studies indicate that hospital and community characteristics may influence outcomes after TKA, but a detailed investigation in a diverse population is warranted to identify opportunities for quality improvement. ⋯ Level III, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Apr 2014
ReviewTrapeziometacarpal joint stability: the evolving importance of the dorsal ligaments.
Trapeziometacarpal (TMC) arthritis of the thumb is a common source of hand pain and disability. TMC ligamentous instability may play a role in TMC degeneration. However, the relative importance of the TMC ligaments in the etiology of degeneration and the use of surgery to treat instability in early-stage arthritis are unclear. ⋯ The dorsal ligaments are the primary stabilizers of the TMC joint. Ligament reconstruction and metacarpal osteotomy ameliorate ligamentous laxity and relieve pain based on Level IV studies.
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Clin. Orthop. Relat. Res. · Apr 2014
Comparative StudyDual plating of humeral shaft fractures: orthogonal plates biomechanically outperform side-by-side plates.
Single large-fragment plate constructs currently are the norm for internal fixation of middiaphyseal humerus fractures. In cases where humeral size is limited, however, dual small-fragment locking plate constructs may serve as an alternative. The mechanical effects of different possible plate configurations around the humeral diaphysis may be important, but to our knowledge, have yet to be investigated. ⋯ The results presented provide novel biomechanical information for the orthopaedic surgeon considering different treatment options for middiaphyseal humeral fractures.
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Clin. Orthop. Relat. Res. · Apr 2014
Medial open wedge high tibial osteotomy: can delayed or nonunion be predicted?
The opening wedge approach to high tibial osteotomy (HTO) is perceived to have some advantages relative to the closing wedge approach but it may be associated with delayed and nonunions. Because nonunions evolve over months, it would be advantageous to be able to identify risk factors for and early predictors of nonunion after medial opening wedge HTO. ⋯ Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.