Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jul 2016
Synovial Cytokines and the MSIS Criteria Are Not Useful for Determining Infection Resolution After Periprosthetic Joint Infection Explantation.
Diagnosing periprosthetic joint infection (PJI) requires a combination of clinical and laboratory parameters, which may be expensive and difficult to interpret. Synovial fluid cytokines have been shown to accurately differentiate septic from aseptic failed total knee (TKA) and hip (THA) arthroplasties. However, after first-stage explantation, there is still no reliable test to rule out PJI before a second-stage reimplantation procedure. ⋯ Level III, diagnostic study.
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Clin. Orthop. Relat. Res. · Jul 2016
The ACS NSQIP Risk Calculator Is a Fair Predictor of Acute Periprosthetic Joint Infection.
Periprosthetic joint infection (PJI) is a severe complication from the patient's perspective and an expensive one in a value-driven healthcare model. Risk stratification can help identify those patients who may have risk factors for complications that can be mitigated in advance of elective surgery. Although numerous surgical risk calculators have been created, their accuracy in predicting outcomes, specifically PJI, has not been tested. ⋯ Level III, diagnostic study.
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Clin. Orthop. Relat. Res. · Jul 2016
Comparative StudySupine and Standing AP Pelvis Radiographs in the Evaluation of Pincer Femoroacetabular Impingement.
Pelvic tilt can affect the presence of the ischial spine sign and crossover sign. Numerous studies of pelvic tilt on radiographic measurements of pincer impingement have shown that increasing anterior tilt is associated with more radiographic signs of pincer impingement. However, to our knowledge, no study has directly compared supine and standing plain radiographs in patients with respect to lateral center-edge (LCE) angle, acetabular inclination, crossover sign, and ischial spine sign. ⋯ Level III, diagnostic study.
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Clin. Orthop. Relat. Res. · Jul 2016
End-of-life Care Planning and Fragility Fractures of the Hip: Are We Missing a Valuable Opportunity?
Approximately 20% of all geriatric patients who sustain low-energy hip fractures will die within 1 year of the injury, and approximately 3% will die during the initial inpatient hospital stay. Accordingly, the event of a geriatric hip fracture might be an apt prompt for discussing end-of-life care: in light of the risk of death after this injury, the topic of mortality certainly is germane. However, it is not clear to what degree physicians and patients engage in end-of-life planning even when faced with a hospital admission for this potentially life-threatening condition. ⋯ Level IV, therapeutic study.