Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jul 2020
Can Predictive Modeling Tools Identify Patients at High Risk of Prolonged Opioid Use After ACL Reconstruction?
Machine-learning methods such as the Bayesian belief network, random forest, gradient boosting machine, and decision trees have been used to develop decision-support tools in other clinical settings. Opioid abuse is a problem among civilians and military service members, and it is difficult to anticipate which patients are at risk for prolonged opioid use. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Jul 2020
Multicenter Study Comparative Study Observational StudyWidespread Pain Is Associated with Increased Risk of No Clinical Improvement After TKA in Women.
When conservative treatments do not work, TKA may be the best option for patients with knee osteoarthritis, although a relatively large proportion of individuals do not have clinically important improvement after TKA. Evidence also suggests that women are less likely to benefit from TKA than men, but the reasons are unclear. Widespread pain disproportionately affects women and has been associated with worse outcomes after joint arthroplasty, yet it is unknown if the effect of widespread pain on TKA outcomes differs by patient gender. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Jul 2020
Meta AnalysisWomen Are at Higher Risk for Concussions Due to Ball or Equipment Contact in Soccer and Lacrosse.
There is ample evidence to suggest sex- and gender-based differences in the incidence of sports-related concussions. The mechanisms of concussion may vary between male and female athletes and contribute to this observed difference. Understanding the underlying etiology by pooling data from primary studies across different settings and sport types will inform interventions that can reduce concussion rates. ⋯ Level III, retrospective study.
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Clin. Orthop. Relat. Res. · Jul 2020
Comparative StudyMen Receive Three Times More Industry Payments than Women Academic Orthopaedic Surgeons, Even After Controlling for Confounding Variables.
In 2016, orthopaedic surgeons received nearly USD 300 million from industry, with the top 10% of recipients making more than 95% of the total amount. The degree to which gender may be associated with industry compensation has not been well explored; however, this may be confounded by a number of variables, including academic productivity, experience, and other factors. We wished to explore the variability in payment distribution by gender after controlling for these factors. ⋯ Increased transparency by companies can help guide orthopaedic surgeons who wish to receive industry funding.
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Clin. Orthop. Relat. Res. · Jul 2020
Comparative StudyWhat Proportion of Patients Undergoing Bernese Periacetabular Osteotomy Experience Nonunion, and What Factors are Associated with Nonunion?
The Bernese periacetabular osteotomy (PAO) is one of the most-used surgical techniques to treat symptomatic acetabular dysplasia. Although good functional and radiographic short-term and long-term outcomes have been reported, several complications after PAO have been described. One complication that may compromise clinical results is nonunion of an osteotomy. However, the exact prevalence and risk factors associated with nonunion are poorly elucidated. ⋯ Level III, therapeutic study.