Clinical orthopaedics and related research
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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
Does Universal Insurance and Access to Care Influence Disparities in Outcomes for Pediatric Patients with Osteomyelitis?
Healthcare disparities are an issue in the surgical management of orthopaedic conditions in children. Although insurance expansion efforts may mitigate racial disparities in surgical outcomes, prior studies have not examined these effects on differences in pediatric orthopaedic care. To assess for racial disparities in pediatric orthopaedic care that may persist despite insurance expansion, we performed a case-control study of the outcomes of children treated for osteomyelitis in the TRICARE system, the healthcare program of the United States Department of Defense and a model of universal insurance and healthcare access. ⋯ Level III, prognostic study.
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Clin. Orthop. Relat. Res. · Jul 2020
Resting-state Amplitude of Low-frequency Fluctuation is a Potentially Useful Prognostic Functional Biomarker in Cervical Myelopathy.
Cervical MRI is the standard diagnostic imaging technique for patients with cervical myelopathy. However, the utility of conventional cervical MRI as a predictive biomarker for surgical recovery remains unclear, partly because of the limited information obtained from this anatomically small area. Brain resting-state functional MRI (rs-fMRI) may help identify candidate predictive biomarkers. Two analytical methods that assess local spontaneous brain activity are widely used for rs-fMRI: functional connectivity between two brain regions and amplitude of low-frequency fluctuation (ALFF). In our previous analysis of functional connectivity, we discovered that brain functional connectivity may be a predictive biomarker for neurologic recovery in patients with cervical myelopathy; however, the functional connectivity analysis identified a correlation with only one clinical outcome (the 10-second test). To establish a comprehensive prediction measure, we need to explore other brain biomarkers that can predict recovery of other clinical outcomes in patients with cervical myelopathy. ⋯ Level II, diagnostic study.
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Clin. Orthop. Relat. Res. · Jul 2020
Residency Selection Preferences and Orthopaedic Career Perceptions: A Notable Mismatch.
Despite near-equal enrollment of males and females in medical schools, orthopaedic surgery continues to have one of the lowest percentage of female orthopaedic residents. This suggests there may be factors that specifically influence females to select other specialties. Some of these possible reasons have been explored in other studies; however, in this study, we sought to identify latent or unobserved variables that may be influencing this difference by conducting an explanatory factor analysis of male and female residency preferences. ⋯ Attracting talented residents and attending physicians is important for the success of any medical department. Although orthopaedics attracts some of the most talented students, these students are predominantly male. By identifying the multifactorial areas that may be inadvertently discouraging females from applying, orthopaedic residency programs may be able to better address those issues and attract the best talent of both genders.