Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Feb 2015
Randomized Controlled TrialDo patient race and sex change surgeon recommendations for TKA?
Prior investigations have suggested that physician-related factors may contribute to differential use of TKA among women and ethnic minorities. We sought to evaluate the effect of surgeon bias on recommendations for TKA. ⋯ After orthopaedic surgeons viewed video scenarios of patients with end-stage knee osteoarthritis, patient race and sex were not associated with a different likelihood of a surgical recommendation. Our findings support the notion that patient race and sex may be less influential on decision making when there are strong clinical data to support a decision. Physician bias may have a greater effect on decision making in situations where the indications for surgery are less clear.
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Clin. Orthop. Relat. Res. · Feb 2015
Are custom triflange acetabular components effective for reconstruction of catastrophic bone loss?
Although the introduction of ultraporous metals in the forms of acetabular components and augments has increased the orthopaedic surgeon's ability to reconstruct severely compromised acetabuli, there remain some that cannot be managed readily using cups, augments, or cages. In such situations, allograft-prosthetic composites or custom acetabular components may be called for. However, few studies have reported on the results of these components. ⋯ Level IV, therapeutic study.
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Clin. Orthop. Relat. Res. · Feb 2015
Multicenter StudyIs intralesional treatment of giant cell tumor of the distal radius comparable to resection with respect to local control and functional outcome?
A giant cell tumor is a benign locally aggressive tumor commonly seen in the distal radius with reported recurrence rates higher than tumors at other sites. The dilemma for the treating surgeon is deciding whether intralesional treatment is adequate compared with resection of the primary tumor for oncologic and functional outcomes. More information would be helpful to guide shared decision-making. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Feb 2015
Porous metal acetabular components have a low rate of mechanical failure in THA after operatively treated acetabular fracture.
Total hip arthroplasty (THA) for the treatment of posttraumatic osteoarthritis (OA) after acetabular fracture has been associated with a high likelihood of aseptic loosening, instability, and infection. Porous metal components may help to address the issue of loosening, but there are few data on the use of porous metal acetabular components for posttraumatic OA after acetabular fracture. ⋯ Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Feb 2015
Preoperative erythropoietin alpha reduces postoperative transfusions in THA and TKA but may not be cost-effective.
Preoperative erythropoietin alpha (EPO) has been shown to be effective at reducing postoperative blood transfusions in total hip arthroplasty (THA) and total knee arthroplasty (TKA); however, treatment with EPO is associated with additional costs, and it is not known whether these costs can be justified when weighed against the transfusion reductions achieved in patients who receive the drug. ⋯ Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.