The Journal of the American Academy of Orthopaedic Surgeons
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J Am Acad Orthop Surg · Dec 2015
Body Morphology and Its Associations With Thoracolumbar Trauma Sustained in Motor Vehicle Collisions.
This study investigates the relationship between body mass index (BMI) and the patterns of thoracolumbar spinal fractures sustained by patients in motor vehicle collisions (MVCs). ⋯ This study characterizes the relationship between body morphology and the thoracolumbar injury patterns associated with MVC to improve understanding of the overall morbidity and mortality of these injuries. These results corroborate research demonstrating the unique relationships between patients who are obese and specific patterns of injury and higher injury severity caused by MVCs and establish a rationale for specifically including thoracolumbar spine parameters in crash safety standards.
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J Am Acad Orthop Surg · Aug 2015
The Basics of the Sunshine Act: How It Pertains to the Practicing Orthopaedic Surgeon.
The Physician Payments Sunshine Act is a disclosure law requiring all drug, medical device, and biologics companies to report transfers of value to physicians and teaching hospitals. It was passed into law in 2010 as part of the Affordable Care Act. The first set of data was released via an online public database on September 30, 2014, with subsequent annual reports to come. ⋯ The highest proportion of general payments went to licensing and royalty payments. Orthopaedic surgeons comprised 3.5% of the physicians represented, and they were responsible for more than 20% of total payments. The full impact of the Sunshine Act will not be clear until several years after its implementation.
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J Am Acad Orthop Surg · Apr 2015
Novel developments in the prevention, diagnosis, and treatment of periprosthetic joint infections.
Periprosthetic joint infection (PJI) is one of the most challenging complications compromising the outcome of an otherwise successful operation. Considerable efforts have been invested in the recent years to address paradigm shifts in our understanding of the complex microbiological phenomena that contribute to the pathophysiology of PJI, such as microbial adherence, biofilm formation, and resistance to antibiotics. This article is an introduction to some of the recent advancements in the prevention, diagnosis, and treatment of PJI. It describes how industry, academic researchers, and government are increasing collaboration to address PJI through development of novel technologies, therapeutic strategies, and regulatory science that specifically target the unique biofilm-associated aspects of its pathogenesis.
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J Am Acad Orthop Surg · Oct 2014
ReviewApproach to pain management in chronic opioid users undergoing orthopaedic surgery.
Opioids are commonly used for the management of pain in patients with musculoskeletal disorders; however, national attention has highlighted the potential adverse effects of the use of opioid analgesia in this and other nonmalignant pain settings. Chronic opioid users undergoing orthopaedic surgery represent a particularly challenging patient population in regard to their perioperative pain control and outcomes. ⋯ Patients using high levels of opioids may also require referral to an addiction specialist. Various regional blockade and pharmaceutical options are available to help control perioperative pain, and a multimodal pain management approach may be of particular benefit in chronic opioid users undergoing orthopaedic surgery.
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J Am Acad Orthop Surg · Oct 2014
ReviewVertebroplasty and kyphoplasty for the treatment of osteoporotic vertebral compression fractures.
Vertebroplasty and kyphoplasty have been used to treat osteoporotic compression fractures for many years. In 2009, two randomized controlled trials demonstrated limited effectiveness of vertebroplasty over sham treatment; thus, the American Academy of Orthopaedic Surgeons published evidence-based guidelines recommending "against vertebroplasty for patients who present with an osteoporotic spinal compression fracture." However, several other trials have since been published that contradict these conclusions. A recent meta-analysis cited strong evidence in favor of cement augmentation in the treatment of symptomatic vertebral compression fractures.