The Journal of the American Academy of Orthopaedic Surgeons
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J Am Acad Orthop Surg · Sep 2019
Comparative StudyAutogenous Iliac Crest Bone Grafting for the Treatment of Fracture Nonunion Is Equally Effective in Elderly and Nonelderly Patients.
Autogenous iliac crest bone graft (ICBG) is considered the benchmark graft for nonunion repair. However, ICBG harvest is invasive and may provide reduced benefit to elderly patients. The purpose of this study was to compare the clinical and functional outcomes of ICBG use in fixation of fracture nonunions between elderly and nonelderly patients. ⋯ The use of ICBG in nonunion repair among elderly patients is as effective as use in younger patients with a long bone nonunion. Concerns of increased postoperative complications and decreased rate of union in elderly patients receiving ICBG for treatment of fracture nonunion should be alleviated. ICBG remains the benchmark graft for nonunion repair among all age groups.
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J Am Acad Orthop Surg · Aug 2019
Comparative StudyLower Complication Rate Following Ankle Fracture Fixation by Orthopaedic Surgeons Versus Podiatrists.
Increased overlap in the scope of practice between orthopaedic surgeons and podiatrists has led to increased podiatric treatment of foot and ankle injuries. However, a paucity of studies exists in the literature comparing orthopaedic and podiatric outcomes following ankle fracture fixation. ⋯ Level III-retrospective cohort study.
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J Am Acad Orthop Surg · Aug 2019
Comparative StudyCurrent Trends in Sex, Race, and Ethnic Diversity in Orthopaedic Surgery Residency.
The representation of minorities among medical students has increased over the past two decades, but diversity among orthopaedic residents lags behind. This phenomenon has occurred despite a recent focus by the American Academy of Orthopaedic Surgeons on the recruitment of minorities and women. ⋯ Recruitment efforts have not reversed the sex, racial, and ethnic disparities in orthopaedic residents. Orthopaedics has the lowest representation of women and minorities among residencies studied. The rate of increase in women lags behind all surgical subspecialties, except for urology.
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J Am Acad Orthop Surg · Aug 2019
Oral Opioids Are Overprescribed in the Opiate-Naive Patient Undergoing Total Joint Arthroplasty.
The opioid epidemic in the United States continues to escalate and contribute to potentially preventable deaths. Because many opioid addictions begin with prescription medication, focus on limiting exposure and decreasing availability are essential. This study identifies the average number of opioid pills consumed following primary total knee and hip arthroplasty (TKA and THA) at our institution in opiate-naive patients to provide an estimate of medication required. We hypothesized that the average number of pills consumed for both TKA and THA was significantly less than the amount prescribed at discharge. ⋯ Pain medication was significantly overprescribed by more than 34% in TKA and 140% in THA. Prescribing practices of narcotic pain medications following total joint arthroplasty result in significantly excess amount of opioids available for potential abuse.
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J Am Acad Orthop Surg · Jul 2019
A 46-year Analysis of Gender Trends in Academic Authorship in Orthopaedic Sports Medicine.
Participation of women in medicine has increased markedly in recent decades, but gender disparities still exist, particularly in academic medicine. To provide insight into the gender gap, specifically in academic orthopaedic sports medicine, we investigated the relationship between gender and authorship in orthopaedic sports literature from 1972 to 2018. ⋯ Level III, Retrospective Cohort Design, Observational Study.