Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · May 2018
Observational StudyPrimary Shoulder Hemiarthroplasty: What Can Be Learned From 359 Cases That Were Surgically Revised?
Primary shoulder hemiarthroplasty is used to address a range of glenohumeral disorders, including fracture, arthritis, avascular necrosis, and capsulorrhaphy arthropathy; some patients with hemiarthroplasties undergo revision surgery for persistent pain or residual shoulder dysfunction. The literature does not clarify the features of the hemiarthroplasties having repeat surgery in a way that can guide surgeons' efforts to minimize the need for revision. To help address this gap, we analyzed the characteristics of patients from our region for whom we performed surgical revision of a prior humeral hemiarthroplasty QUESTIONS/PURPOSES: (1) What are the common characteristics of shoulder hemiarthroplasties having a revision? (2) What are the common characteristics of the subset of revised shoulder hemiarthroplasties that were performed for fracture? (3) What are characteristics of the subset of all revised hemiarthroplasties that were associated with glenoid bone erosion? ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · May 2018
Is NS-EDTA Effective in Clearing Bacteria From Infected Wounds in a Rat Model?
Irrigation is one of the key procedures in open fracture management to eliminate pathogens and prevent infection. Metal ion deprivation could inhibit bacterial adhesins and weaken adhesion to the host tissue. EDTA in solution can competitively bind to a metal ion and thus might be able to inhibit bacterial adhesins. ⋯ The use of normal-saline EDTA as an irrigation solution may reduce the infection rate of wounds. Future studies in large animals and humans might prove our observation in rat models that normal saline-EDTA has an advantage over normal saline as an irrigation solution.
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Clin. Orthop. Relat. Res. · Apr 2018
Comparative StudyIs Physician Empathy Associated With Differences in Pain and Functional Limitations After a Hand Surgeon Visit?
In prior work we demonstrated that patient-rated physician empathy was the strongest driver of patient satisfaction after a visit to an orthopaedic hand surgeon. Data from the primary care setting suggest a positive association between physician empathy and clinical outcomes, including symptoms of the common cold. It is possible that an empathic encounter could make immediate and measureable changes in a patient's mindset, symptoms, and functional limitations. ⋯ Level II, prognostic study.
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Clin. Orthop. Relat. Res. · Apr 2018
Are Psychosocial Factors Associated With Patient-reported Outcome Measures in Patients With Rotator Cuff Tears? A Systematic Review.
Psychosocial factors are key determinants of health and can influence patient-reported outcomes after rotator cuff tears. However, to our knowledge, a systematic review of published studies has not been conducted to determine the degree of consistency and strength of the relationship between psychosocial factors and patient-reported outcomes in this patient population. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Apr 2018
Do Pain Coping and Pain Beliefs Associate With Outcome Measures Before Knee Arthroplasty in Patients Who Catastrophize About Pain? A Cross-sectional Analysis From a Randomized Clinical Trial.
Pain-coping strategies and appraisals are responses to the pain experience. They can influence patient-reported and physical performance outcome measures in a variety of disorders, but the associations between a comprehensive profile of pain-coping responses and preoperative pain/function and physical performance measures in patients scheduled for knee arthroplasty have not been examined. Patients with moderate to high pain catastrophizing (a pain appraisal approach associated with an exaggerated focus on the threat value of pain) may represent an excellent study population in which to address this knowledge gap. ⋯ Level I, prognostic study.