Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Sep 2019
When Should We Wean Bracing for Adolescent Idiopathic Scoliosis?
Current brace weaning criteria for adolescents with idiopathic scoliosis (AIS) are not well defined. Risser Stage 4, ≥ 2 years since the onset of menarche, and no further increase in body height over 6 months are considered justifications for stopping bracing. However, despite adherence to such standards, curve progression still occurs in some patients, and so better criteria for brace discontinuation are needed. ⋯ Level II, prognostic study.
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Clin. Orthop. Relat. Res. · Aug 2019
Are There Gender Differences Among Leaders of Regional Orthopaedic Societies of the United States?
Great efforts are currently being made toward improving gender and racial equity in orthopaedic surgery in the United States. Nonetheless, no research has reported on whether these efforts have increased representation of women and underrepresented minorities in leadership roles in orthopaedic surgery societies. ⋯ The low number of women orthopaedic surgeons holding leadership positions in regional societies are most likely a function of the low overall number of women orthopaedic surgeons, but focused efforts to change the status quo may increase the diversity of leadership in these societies.
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Clin. Orthop. Relat. Res. · Aug 2019
Comparative StudyWhat is the Impact of Social Deprivation on Physical and Mental Health in Orthopaedic Patients?
The complex interrelationship among physical health, mental health, and social health has gained the attention of the medical community in recent years. Poor social health, also called social deprivation, has been linked to more disease and a more-negative impact from disease across a wide variety of health conditions. However, it remains unknown how social deprivation is related to physical and mental health in patients presenting for orthopaedic care. ⋯ Level II, prognostic study.
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Clin. Orthop. Relat. Res. · Jul 2019
What are the Optimal Cutoff Values for ESR and CRP to Diagnose Osteomyelitis in Patients with Diabetes-related Foot Infections?
Distinguishing osteomyelitis from soft-tissue infection of the foot is important because osteomyelitis is associated with more operations, amputation, and prolonged antibiotic exposure. Both erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are routinely ordered inflammatory biomarkers for evaluating foot infection. When initial evaluation is inconclusive, advanced imaging is indicated, and high clinical or radiographic suspicion of osteomyelitis may indicate bone biopsy to identify organisms and antibiotic sensitivity. Although ESR and CRP levels are helpful for distinguishing osteomyelitis from soft-tissue infections in patients with diabetes-related foot infections, parameters regarding optimal cutoff values for those tests have not, to our knowledge, been defined. ⋯ Level III, diagnostic study.
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Clin. Orthop. Relat. Res. · Jul 2019
Comparative StudyThe EQ-5D-5L Is Superior to the -3L Version in Measuring Health-related Quality of Life in Patients Awaiting THA or TKA.
As a generic measure of health-related quality of life among patients awaiting THA or TKA, the three-level version of the EQ-5D (EQ-5D-3L), which has three response levels of severity (no problems, some problems, and extreme problems/unable) to five questions, is widely used. Previous studies indicated that the ceiling effect of the EQ-5D-3L limits its application. The five-level version of the EQ-5D (EQ-5D-5L) was developed to enhance the measurement properties of the tool by adding two levels: slight problems and severe problems. However, only a few small studies have compared the EQ-5D-3L and EQ-5D-5L in patients awaiting THA and TKA. ⋯ Compared with the three-level version, the five-level version of the EQ-5D differentiates between patients awaiting THA and TKA much better based on their mobility, which is a key health aspect or outcome in these patients. Our findings suggest that the EQ-5D-5L is more appropriate for this population.