Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Feb 2017
Comparative StudyThe Frank Stinchfield Award : Total Hip Arthroplasty for Femoral Neck Fracture Is Not a Typical DRG 470: A Propensity-matched Cohort Study.
Hip fractures are a major public health concern. For displaced femoral neck fractures, the needs for medical services during hospitalization and extending beyond hospital discharge after total hip arthroplasty (THA) may be different than the needs after THA performed for osteoarthritis (OA), yet these differences are largely uncharacterized, and the Medicare Severity Diagnosis-Related Groups system does not distinguish between THA performed for fracture and OA. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Feb 2017
One-stage Revision With Catheter Infusion of Intraarticular Antibiotics Successfully Treats Infected THA.
Two-stage revision surgery for infected total hip arthroplasty (THA) is commonly advocated, but substantial morbidity and expense are associated with this technique. In certain cases of infected THA, treatment with one-stage revision surgery and intraarticular infusion of antibiotics may offer a reasonable alternative with the distinct advantage of providing a means of delivering the drug in high concentrations. ⋯ Level IV, therapeutic study.
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Clin. Orthop. Relat. Res. · Feb 2017
Randomized Controlled Trial Multicenter StudyHigh Irritation and Removal Rates After Plate or Nail Fixation in Patients With Displaced Midshaft Clavicle Fractures.
Studies comparing plate with intramedullary nail fixation of displaced midshaft clavicle fractures show faster recovery in the plate group and implant-related complications in both groups after short-term followup (6 or 12 months). Knowledge of disability, complications, and removal rates beyond the first postoperative year will help surgeons in making a decision regarding optimal implant choice. However, comparative studies with followup beyond the first year or two are scarce. ⋯ Level II, therapeutic study.
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Clin. Orthop. Relat. Res. · Feb 2017
Periprosthetic Occult Fractures of the Acetabulum Occur Frequently During Primary THA.
Periprosthetic fractures of the acetabulum occurring during primary THA are rare. Periprosthetic occult fractures are defined as those not identified by the surgeon during the procedure which might be missed on a routine postoperative radiograph. However, it is unclear how frequently these fractures occur and whether their presence affects functional recovery. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Feb 2017
Randomized Controlled Trial Multicenter Study Comparative StudyOtto Aufranc Award: A Multicenter, Randomized Study of Outpatient versus Inpatient Total Hip Arthroplasty.
Length of stay after total hip arthroplasty (THA) has decreased over the last two decades. However, published studies that have examined same-day and early discharge protocols after THA have been done in highly selected patient groups operated on by senior surgeons in a nonrandomized fashion without control subjects. ⋯ Level I, therapeutic study.