Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jun 2015
ReviewOutcomes of Lumbar Discectomy in Elite Athletes: The Need for High-level Evidence.
Although lumbar discectomy for treatment of lumbar disc herniation in the general population generally improves patients' pain, function, and validated outcomes scores, results of treatment in elite athletes may differ because of the unique performance demands required of competitive athletes. ⋯ A high proportion of elite athletes undergoing lumbar discectomy return to play with variable performance scores on return. Future prospective studies are needed to compare the recovery time, career longevity, and performance for athletes undergoing lumbar discectomy versus nonoperative treatment for lumbar disc herniation.
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Clin. Orthop. Relat. Res. · Jun 2015
ReviewIncidence of Low Back Pain After Lumbar Discectomy for Herniated Disc and Its Effect on Patient-reported Outcomes.
Long-term postdiscectomy degenerative disc disease and low back pain is a well-recognized disorder; however, its patient-centered characterization and quantification are lacking. ⋯ In a systematic literature review and prospective outcomes study, the frequency of same-level disc herniation requiring reoperation was 6%. Two-year recurrent low back pain may occur in 15% to 25% of patients depending on the level of recurrent pain considered clinically important, and this leads to worse PROs at 1 and 2 years postoperatively.
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Clin. Orthop. Relat. Res. · Jun 2015
Comparative StudyIncreased risk of periprosthetic femur fractures associated with a unique cementless stem design.
Postoperative periprosthetic femur fractures are an increasing concern after primary total hip arthroplasty (THA). Identifying and understanding predisposing factors are important to mitigating future risk. Femoral stem design may be one such factor. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Jun 2015
Comparative StudyComparative Epidemiology of Revision Arthroplasty: Failed THA Poses Greater Clinical and Economic Burdens Than Failed TKA.
Revision THA and TKA are growing and important clinical and economic challenges. Healthcare systems tend to combine revision joint replacement procedures into a single service line, and differences between revision THA and revision TKA remain incompletely characterized. These differences carry implications for guiding care and resource allocation. We therefore evaluated epidemiologic trends associated with revision THAs and TKAs. ⋯ These data could prove important for healthcare systems to appropriately allocate resources to hip and knee procedures: the revision burden for THA is 52% greater than for TKA, but revision TKAs are increasing at a faster rate. Likewise, the treating clinician should understand that while both revision THAs and TKAs bear significant clinical and economic costs, patients undergoing revision THA tend to be older, sicker, and have greater costs of care.
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Clin. Orthop. Relat. Res. · Jun 2015
What Are Risk Factors for 30-day Morbidity and Transfusion in Total Shoulder Arthroplasty? A Review of 1922 Cases.
Total shoulder arthroplasty (TSA) is an effective treatment for end-stage glenohumeral joint pathology with good long-term results. Previous descriptions of morbidity and blood transfusion in TSA are limited by preoperative risk factors and postoperative complications considered and single-center studies. ⋯ Level III, therapeutic study.