Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Oct 2015
Does Integrated Fixation Provide Benefit in the Reconstruction of Posttraumatic Tibial Bone Defects?
Limb salvage in the presence of posttraumatic tibial bone loss can be accomplished using the traditional Ilizarov method of distraction osteogenesis with circular external fixation. Internal fixation placed at the beginning of the consolidation phase, so-called integrated fixation, may allow for earlier removal of the external fixator but introduces concerns about cross-contamination from the additional open procedure and maintenance of bone regenerate stability. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Oct 2015
Observational StudyLow Albumin Levels, More Than Morbid Obesity, Are Associated With Complications After TKA.
Morbid obesity and malnutrition are thought to be associated with more frequent perioperative complications after TKA. However, morbid obesity and malnutrition often are co-occurring conditions. Therefore it is important to understand whether morbid obesity, malnutrition, or both are independently associated with more frequent perioperative complications. In addition, assessing the magnitude of an increase in complications and whether these complications are major or minor is important for both conditions. ⋯ Level III, prognostic study.
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Clin. Orthop. Relat. Res. · Oct 2015
Comparative StudyOrthopaedic Surgeons Receive the Most Industry Payments to Physicians but Large Disparities are Seen in Sunshine Act Data.
Industry payments made to physicians by drug and device manufacturers or group purchasing organizations are now reported to the Centers for Medicare and Medicaid Services (CMS) as a part of the Physician Payments Sunshine Act. Initial reports from the program show that orthopaedic surgeons lead all physician specialties in total and average industry payments. However, before further discussion of these payments and their implications can take place, it remains to be seen whether these figures are a true reflection of the field of orthopaedic surgery in general, rather than the result of a few outlier physicians in the field. In addition, the nature and sources of these funds should be determined to better inform the national dialogue surrounding these payments. ⋯ Level III, Economic and Decision Analysis.
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Clin. Orthop. Relat. Res. · Oct 2015
Patients Undergoing Total Shoulder Arthroplasty on the Dominant Extremity Attain Greater Postoperative ROM.
Total shoulder arthroplasty (TSA) provides excellent functional outcomes and pain relief in appropriately selected patients. Although it is known to affect other shoulder conditions, the role of hand dominance after TSA has not been reported, to our knowledge. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Oct 2015
Fixator-assisted Technique Enables Less Invasive Plate Osteosynthesis in Medial Opening-wedge High Tibial Osteotomy: A Novel Technique.
Opening-wedge high tibial osteotomy is a well-established procedure in the management of medial osteoarthritis of the knee and correction of proximal tibia vara. Recently, surgical approaches using less invasive plate osteosynthesis have been used with the goal of minimizing complications from more extensive soft tissue exposures. However, to our knowledge, less invasive fixator-assisted plate osteosynthesis has not been tested in the setting of opening-wedge high tibial osteotomy. ⋯ Level IV, therapeutic study.