Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jul 2011
Comparative StudyDoes high tibial osteotomy affect the success or survival of a total knee replacement?
Whether a previous high tibial osteotomy (HTO) influences the long-term function or survival of a total knee arthroplasty (TKA) is controversial. ⋯ Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Jul 2011
Clinical TrialDoes tranexamic acid save blood in minimally invasive total knee arthroplasty?
Tranexamic acid (TEA) reportedly reduces perioperative blood loss in TKA. However, whether it does so in minimally invasive TKA is not clear. ⋯ Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Jul 2011
ReviewGender and race/ethnicity differences in hip fracture incidence, morbidity, mortality, and function.
Hip fracture is an international public health problem. Worldwide, approximately 1.5 million hip fractures occur per year, with roughly 340,000 in the United States in individuals older than 65 years. In 2050, there will be an estimated 3.9 million fractures worldwide, with more than 700,000 in the United States. However, whether there are disparities in morbidity, mortality, and function between men and women or between races/ethnicities is unclear. ⋯ A PubMed literature review was performed and appropriate articles selected for inclusion in the review. WHERE ARE WE NOW?: Overall, men with hip fracture are younger, are less healthy, and have a higher postoperative mortality and morbidity. African American and Hispanics patients with hip fractures are younger than whites and have a higher incidence of fracture in men. Non-Hispanic black, Hispanic, and Asian race/ethnicity were all associated with higher odds of discharge home but a longer stay when discharged to rehabilitation. WHERE DO WE NEED TO GO?: Expanded knowledge of the influence of gender and race/ethnicity on hip fracture epidemiology, mortality, and outcomes is necessary. HOW DO WE GET THERE?: Additional focused research on gender and racial/ethnic differences in patients with hip fractures is needed. Improving database capture of race/ethnicity data will aid in population studies. Finally, journal editors should require authors to include gender and race/ethnicity data or explain the absence of this information.
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Clin. Orthop. Relat. Res. · Jul 2011
Comparative StudyOrthopaedic Web Links (OWL): a way to find professional orthopaedic information on the internet.
Finding useful high-grade professional orthopaedic information on the Internet is often difficult. Orthopaedic Web Links (OWL) is a searchable database of vetted online orthopaedic resources. OWL uses a subject directory (OWL Directory) and a custom search engine (OWL Web) to provide a list of resources. The most effective way to find readily accessible, full text on-subject material suitable for education of an orthopaedic surgeon or trainee has not been defined. ⋯ The OWL Directory of orthopaedic subjects on the Internet provides a simple browsable category structure to find information. The OWL Web search engine scored higher than Google and resulted in a greater proportion of valid, on-subject, and accessible resources in the search results.
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Clin. Orthop. Relat. Res. · Jul 2011
Emerging ideas: Shared decision making in patients with osteoarthritis of the hip and knee.
Despite the widely reported success of total joint arthroplasty (TJA) in reducing pain and improving quality of life and function for patients with hip or knee osteoarthritis, rates of TJA use vary widely throughout the United States, with broad disparities based on geographic, racial, and socioeconomic factors. Shared decision-making approaches, which require an exchange of information between patients and their physicians, can be helpful in improving patient satisfaction with their treatment decision and appropriate use of TJA. ⋯ Information regarding patient preferences for particular health states and willingness to pay can be combined with evidence-based outcome data in expected-value decision analysis models, which will help inform shared clinical decision making between surgeons and their patients with hip or knee osteoarthritis.