Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jul 2015
Multicenter StudyA History of Treated Periprosthetic Joint Infection Increases the Risk of Subsequent Different Site Infection.
After the successful treatment of periprosthetic joint infection (PJI), patients may present with degenerative joint disease in another joint with symptoms severe enough to warrant arthroplasty. However, it is not known whether patients with a history of treated PJI at one site will have an increased risk of PJI in the second arthroplasty site. ⋯ Level III, prognostic study.
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Clin. Orthop. Relat. Res. · Jul 2015
Network Meta-analysis: Users' Guide for Surgeons: Part II - Certainty.
In the previous article (Network Meta-analysis: Users' Guide for Surgeons-Part I, Credibility), we presented an approach to evaluating the credibility or methodologic rigor of network meta-analyses (NMA), an innovative approach to simultaneously addressing the relative effectiveness of three or more treatment options for a given medical condition or disease state. In the second part of the Users' Guide for Surgeons, we discuss and demonstrate the application of criteria for determining the certainty in effect sizes and directions associated with a given treatment option through an example pertinent to clinical orthopaedics.
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Clin. Orthop. Relat. Res. · Jul 2015
Comparative StudyThe Gown-glove Interface Is a Source of Contamination: A Comparative Study.
The original Charnley-type negative-pressure body exhaust suit reduced infection rates in randomized trials of total joint arthroplasty (TJA) decades ago. However, modern positive-pressure surgical helmet systems have not shown similar benefit, and several recent studies have raised the question of whether these gowning systems result in increased wound contamination and infections. The gown-glove interface may be one source of particle contamination. ⋯ The gown-glove interface is prone to particle contamination and all surgeons should be aware of this area as a potential source of surgical site infection. Although future studies are needed to clarify the link between particle contamination through this route and clinical infection, surgeons should consider using gowning systems that minimize the migration of fomites through the gown-glove interface.
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Clin. Orthop. Relat. Res. · Jul 2015
Twenty Percent of Patients May Remain Colonized With Methicillin-resistant Staphylococcus aureus Despite a Decolonization Protocol in Patients Undergoing Elective Total Joint Arthroplasty.
Staphylococcus aureus is the most commonly isolated organism in periprosthetic joint infection (PJI). Resistant strains such as methicillin-resistant S aureus (MRSA) are on the rise, and many programs have instituted decolonization protocols. There are limited data on the success of S aureus nasal decolonization programs and their impact on PJI. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Jul 2015
Observational StudyTime Seeing a Hand Surgeon Is Not Associated With Patient Satisfaction.
Previous studies, predominantly in the primary care setting, identified time spent with the physician as an important predictor of satisfaction. It is unknown if the same holds true in hand surgery. ⋯ Level II, prognostic study.