Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Dec 2013
Observational StudyCerebral desaturation during shoulder arthroscopy: a prospective observational study.
Patients undergoing arthroscopic shoulder surgery in the beach chair position may be at increased risk for serious neurocognitive complications as a result of cerebral ischemia. ⋯ The degree and duration of cerebral ischemia required to produce neurocognitive dysfunction in this patient population remains undefined; however, cerebral oximetry with near-infrared spectroscopy allows prompt identification and treatment of decreased cerebral perfusion. We believe protocols aimed at detecting and reversing CDE may improve patient safety.
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Clin. Orthop. Relat. Res. · Dec 2013
The value of valgus stress radiographs in the workup for medial unicompartmental arthritis.
High tibial osteotomy and unicompartmental knee arthroplasty are surgical treatment options for unicompartmental knee arthritis; these procedures are indicated for patients who do not have severe arthritis in the lateral compartment. Valgus stress radiographs sometimes are used to make this evaluation, but this test has not been critically evaluated. ⋯ Valgus stress radiographs provided no added benefit to the radiographic assessment of the lateral compartment cartilage and regarding the correctability of the varus deformity.
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Clin. Orthop. Relat. Res. · Dec 2013
Readmission rates in the state of Florida: a reflection of quality?
High readmission rates are viewed by the Centers for Medicare & Medicaid Services as a quality of care determinant but it is unclear whether readmission rates per se reflect quality and the drivers of readmissions after hip arthroplasty remain unclear. ⋯ Patients were more frequently readmitted if their payer was the government, they were discharged to a SNF, or they had a mental health disorder. Infections were the most common reasons for readmission. Our data suggest readmission rates alone do not necessarily reflect quality of care.