JAAOS Global Research & Reviews最新文献_第8页

Graft Selection in Contemporary Anterior Cruciate Ligament Reconstruction 当代前交叉韧带重建中的移植物选择

JAAOS Global Research & Reviews Pub Date : 2021-10-01 DOI: 10.5435/JAAOSGlobal-D-21-00230

Rafael A. Buerba, S. Boden, B. Lesniak

引用次数: 18

Top Three Learning Platforms for Orthopaedic In-Training Knowledge Produce Different Results 排名前三的骨科在职知识学习平台效果不同

JAAOS Global Research & Reviews Pub Date : 2021-08-01 DOI: 10.5435/JAAOSGlobal-D-21-00148

A. Margalit, Patrick Mixa, Louis Day, M. Marrache, Stuart Mitchell, K. Suresh, K. Wang, Samir Sabharwal, T. P. Li, Alexander E. Loeb, Qais Naziri, R. Henn, D. Laporte

{"title":"Top Three Learning Platforms for Orthopaedic In-Training Knowledge Produce Different Results","authors":"A. Margalit, Patrick Mixa, Louis Day, M. Marrache, Stuart Mitchell, K. Suresh, K. Wang, Samir Sabharwal, T. P. Li, Alexander E. Loeb, Qais Naziri, R. Henn, D. Laporte","doi":"10.5435/JAAOSGlobal-D-21-00148","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-21-00148","url":null,"abstract":"Objective: To compare the influence of objective and subjective measures of the three learning programs (OrthoBullets [OB], ResStudy [RS], and Clinical Classroom [CC]) on resident test performance and study platform preference. Methods: Sixty residents from three orthopaedic residencies were included in this study during May 2020. Trauma, pediatrics, and hip/knee reconstruction (joints) were chosen as testing topics. Residents took a standardized pretest of 30 questions per topic, followed by the completion of 50 questions per day for 5 days using one of the three web-based programs, followed by a standardized subject-specific posttest. This cycle was repeated for all the three topics. Bivariate statistics and a mixed-effects linear regression model were used to compare improvements in the scores. Results: Across all learning platforms, topics, and postgraduate year classes, posttest scores were 4.4% higher than the pretest score (73.3% vs. 68.9%, P < 0.001): 6.8% higher with OB, 5.4% with RS, and 1.0% with CC. The score improvement with OB was significantly greater than the score improvement with CC (P < 0.001). In total, 100% of residents reported that using OB would improve their score on the orthopaedic in-training examination, compared with 95% with RS and 67% with CC. Conclusion: OB demonstrated the greatest improvement in scores, followed closely by RS and then CC.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126944463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

The Use of Older Versus Newer Data in the National Surgical Quality Improvement Program Database Influences the Results of Total Hip Arthroplasty Outcomes Studies 国家外科质量改进计划数据库中新旧数据的使用影响全髋关节置换术结果研究的结果

JAAOS Global Research & Reviews Pub Date : 2019-10-01 DOI: 10.5435/JAAOSGlobal-D-19-00108

Blake N. Shultz, A. Galivanche, T. Ottesen, P. Bovonratwet, J. Grauer

{"title":"The Use of Older Versus Newer Data in the National Surgical Quality Improvement Program Database Influences the Results of Total Hip Arthroplasty Outcomes Studies","authors":"Blake N. Shultz, A. Galivanche, T. Ottesen, P. Bovonratwet, J. Grauer","doi":"10.5435/JAAOSGlobal-D-19-00108","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-19-00108","url":null,"abstract":"Introduction: National databases, such as the National Surgical Quality Improvement Program (NSQIP) database, are frequently used for total hip arthroplasty (THA) studies. NSQIP variables and the population included in the database have evolved over time. These changes may influence the results of studies using different periods of data. Methods: THA patients were aggregated from the 2005 to 2010 and 2011 to 2015 NSQIP data sets to define two era groups. Demographic data and 30-day perioperative outcomes were compared between the groups. As an example analysis, multivariate Poisson regression was used to determine the correlation between age and perioperative outcomes for each group. Results: Of 102,411 THA patients identified, 8098 cases were from 2005 to 2010 and 94,313 were from 2011 to 2015. A number of preoperative characteristics and perioperative outcomes were significantly different between the era groups. Multivariate analysis of the 2005 to 2010 group showed that increasing age was significantly associated with urinary tract infection and length of stay (LOS), and multivariate analysis of the 2011 to 2015 group showed that age was significantly associated with urinary tract infection, LOS, 30-day mortality, unplanned reintubation, extended LOS, pneumonia, deep vein thrombosis/thrombophlebitis, blood transfusion, and return to the operating room. Conclusion: Significantly more THA patients were enrolled in the NSQIP in the years between 2005 and 2015. Populations in 2005 to 2010 versus 2011 to 2015 were associated with differences in preoperative characteristics and perioperative outcomes. In an example analysis, it was shown that these differences together lead to different study results and conclusions. This needs to be considered when interpreting and conducting studies using earlier NSQIP data.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130856112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

The Remote Completion Rate of Electronic Patient-Reported Outcome Forms Before Scheduled Clinic Visits—A Proof-of-Concept Study Using Patient-Reported Outcome Measurement Information System Computer Adaptive Test Questionnaires 预约就诊前电子患者报告结果表的远程完成率——一项使用患者报告结果测量信息系统计算机自适应测试问卷的概念验证研究

JAAOS Global Research & Reviews Pub Date : 2019-10-01 DOI: 10.5435/JAAOSGlobal-D-19-00038

Peter Borowsky, Omar M. Kadri, Jason E. Meldau, Jacob W Blanchett, E. Makhni

{"title":"The Remote Completion Rate of Electronic Patient-Reported Outcome Forms Before Scheduled Clinic Visits—A Proof-of-Concept Study Using Patient-Reported Outcome Measurement Information System Computer Adaptive Test Questionnaires","authors":"Peter Borowsky, Omar M. Kadri, Jason E. Meldau, Jacob W Blanchett, E. Makhni","doi":"10.5435/JAAOSGlobal-D-19-00038","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-19-00038","url":null,"abstract":"Introduction: Patient-Reported Outcome Measurement Information System (PROMIS) questionnaires are amenable to remote administration. This study sought to determine remote completion rates of PROMIS questionnaires before clinic visits. Methods: Patients were e-mailed a set of PROMIS forms. Completion rates were analyzed by visit type, provider seen, and patient demographics. Results: Seven hundred forty total appointments were included. Sixty-seven percent of encounters had previsit form completion. High completion rates were found for all visit types (74%, 67%, and 64% for new, return, and postoperative visits, respectively). Women had a higher completion rate than men (71% versus 64%; P = 0.031). White patients (72%; P = 0.001) and patients in the third median household income quartile ($53,725 to $83,088; 72%; P = 0.008) had higher completion rates than their respective counterparts. Conclusion: Most patients remotely completed PROMIS forms. The efficiency and accessibility of PROMIS forms may help improve ease of collection of patient-reported outcomes.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115167765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 15

Path to Prevention of Spinal Trauma in a Low- to Middle-income Country: A Single-center Study in Phnom Penh, Cambodia 在中低收入国家预防脊柱创伤的途径:柬埔寨金边的一项单中心研究

JAAOS Global Research & Reviews Pub Date : 2019-10-01 DOI: 10.5435/JAAOSGlobal-D-19-00080

Melvin C. Makhni, Naazanene M. Vatan, P. Park, Zain A. Kabeer, Meghan Cerpa, Jee-Hye Choi, Joseph M. Lombardi, S. Hong, Yongjung Kim, L. Lenke, R. Lehman, Iv Vycheth, Kee B. Park

{"title":"Path to Prevention of Spinal Trauma in a Low- to Middle-income Country: A Single-center Study in Phnom Penh, Cambodia","authors":"Melvin C. Makhni, Naazanene M. Vatan, P. Park, Zain A. Kabeer, Meghan Cerpa, Jee-Hye Choi, Joseph M. Lombardi, S. Hong, Yongjung Kim, L. Lenke, R. Lehman, Iv Vycheth, Kee B. Park","doi":"10.5435/JAAOSGlobal-D-19-00080","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-19-00080","url":null,"abstract":"This study sought to characterize the epidemiology and outcomes of spinal trauma, with or without a neurologic deficit, at a major government hospital in Phnom Penh, Cambodia. Patient demographics, American Spinal Injury Association (ASIA) score on presentation, location of injury, and cause of injury from 316 patients from September 2013 through December 2016 were compiled. Outcome measures included length of hospitalization and surgical intervention. Falls were the leading cause of spinal injury (50.6%), followed by motor vehicle accidents (29.3%) and other accidents (20.1%). Patients who fell from height had higher surgery rates (P = 0.014), and men had worse ASIA scores (P = 0.0013). Patients with ASIA A-C had a mean age of 38.17 years, whereas the D-E group was on average 42.88 years. Motor vehicle accidents caused the most cervical spine injuries, whereas falls caused more thoracic and lumbar trauma (P = 0.0005). Younger, working men are experiencing more severe spinal injuries, undergoing more surgery, and staying hospitalized longer than other demographics in Phnom Penh. This study characterizes spinal trauma from falls as a public health issue in Cambodia, highlighting the importance of fall injury prevention. Protecting this cohort is an important investment for Cambodia and necessitates workplace reform and safety standard implementation.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122179007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Slipped Capital Femoral Epiphysis in an Adult Patient With Kabuki Syndrome 成人歌舞伎综合征患者股骨头骨骺滑动1例

JAAOS Global Research & Reviews Pub Date : 2019-10-01 DOI: 10.5435/JAAOSGlobal-D-19-00084

Joshua N. Speirs, S. Morris, M. Morrison

{"title":"Slipped Capital Femoral Epiphysis in an Adult Patient With Kabuki Syndrome","authors":"Joshua N. Speirs, S. Morris, M. Morrison","doi":"10.5435/JAAOSGlobal-D-19-00084","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-19-00084","url":null,"abstract":"Introduction: Slipped capital femoral epiphysis (SCFE) is a condition which predominantly occurs in adolescents. SCFE is extremely rare in adults, and nearly all previous reported cases have been associated with an endocrine disorder. Methods: We present a case of a 19-year-old man with Kabuki syndrome who was diagnosed with an unstable SCFE requiring surgical fixation. A literature search on PubMed and Google Scholar was done looking for all published cases of delayed-onset SCFE. All previous reported cases were reviewed to determine the likely cause of the SCFE. Results: No previous cases of SCFE were described in patients with Kabuki syndrome. Literature review revealed 27 articles describing 32 cases of delayed-onset SCFE. Thirty-one of these cases were associated with endocrine disorders or pituitary tumors. Endocrine disorders associated with delayed-onset SCFE included hypothyroidism, hypogonadism, and panhypopituitarism. Pituitary adenomas and craniopharyngiomas were also associated with delayed-onset SCFE. Discussion: This is the first reported case of SCFE in a patient with Kabuki syndrome. Kabuki syndrome is a genetic disorder known to cause delayed growth, resulting in delayed physeal closure, placing the patients at risk of SCFE even into adulthood. The literature search revealed that nearly all previously described delayed-onset SCFE cases were associated with endocrine disorders or pituitary tumors. We recommend that all patients diagnosed with delayed-onset SCFE be evaluated for endocrine disorders, pituitary tumors, and/or genetic disorders which can cause delayed skeletal maturation as these disorders can range from severe endocrine disorders to intracranial tumors.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130604106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6

Antibiotic Impregnated Cement Dowel in a Tibial Stump to Salvage Infected Below-Knee Amputation in a Diabetic 胫骨残端抗生素浸渍水泥销钉挽救糖尿病患者感染的膝下截肢

JAAOS Global Research & Reviews Pub Date : 2019-10-01 DOI: 10.5435/JAAOSGlobal-D-18-00042

S. Sidhu, N. White

引用次数: 0

Pectoralis Major Rupture in an Active Female 一位活跃女性的胸大肌破裂

JAAOS Global Research & Reviews Pub Date : 2019-10-01 DOI: 10.5435/jaaosglobal-d-19-00030

M. Stringer, A. Cockfield, T. Sharpe

引用次数: 7

Looking Through a Different Lens: Patient Satisfaction With Telemedicine in Delivering Pediatric Fracture Care 从不同的角度看:远程医疗在儿童骨折护理中的患者满意度

JAAOS Global Research & Reviews Pub Date : 2019-09-01 DOI: 10.5435/JAAOSGlobal-D-19-00100

Neha Sinha, M. Cornell, Benjamin B. Wheatley, Nicole Munley, M. Seeley

{"title":"Looking Through a Different Lens: Patient Satisfaction With Telemedicine in Delivering Pediatric Fracture Care","authors":"Neha Sinha, M. Cornell, Benjamin B. Wheatley, Nicole Munley, M. Seeley","doi":"10.5435/JAAOSGlobal-D-19-00100","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-19-00100","url":null,"abstract":"Introduction: Telemedicine may transform health care by overcoming geographical and travel-associated barriers to patient care. This study assesses patient satisfaction with telemedicine for fracture care. Methods: Two groups of patients were compared from suburban/rural Pennsylvania. One group reported to a regional medical center for real-time video consultation with a pediatric orthopaedic surgeon facilitated by a physician's assistant. The other group underwent conventional outpatient clinic visits at a tertiary care hospital. The distance between the tertiary care hospital and the regional medical center was 69 miles. New or follow-up fracture patients not living in the vicinity of either medical center were included. A satisfaction survey and questionnaire were administered to both groups at the end of their visit. Results: One hundred sixty-seven patients returned the questionnaires (66 conventional and 101 telemedicine). Telemedicine visits decreased indirect and direct costs (P = 0.032). Travel costs and travel times were lower (P < 0.001) in the telemedicine group. Patient satisfaction was similar. Only 8 of 101 patients in the telemedicine cohort preferred their next visit to be a conventional follow-up. Discussion: Utilization of video consultation and trained physician assistants to provide pediatric orthopaedic care across suburban/rural areas can increase pediatric orthopaedic surgeon access and decrease travel costs while maintaining patient satisfaction.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"313 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124440457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 48

Successful Implementation of an Accelerated Recovery and Outpatient Total Joint Arthroplasty Program at a County Hospital 在县医院成功实施加速康复和门诊全关节置换术项目

JAAOS Global Research & Reviews Pub Date : 2019-09-01 DOI: 10.5435/JAAOSGlobal-D-19-00110

Blake J. Schultz, N. Segovia, Tiffany N. Castillo

{"title":"Successful Implementation of an Accelerated Recovery and Outpatient Total Joint Arthroplasty Program at a County Hospital","authors":"Blake J. Schultz, N. Segovia, Tiffany N. Castillo","doi":"10.5435/JAAOSGlobal-D-19-00110","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-19-00110","url":null,"abstract":"Introduction: Outpatient and accelerated recovery total joint arthroplasty (TJA) programs have become standard for private and academic practices. County hospitals traditionally serve patients with limited access to TJA and psychosocial factors which create challenges for accelerated recovery. The effectiveness of such programs at a county hospital has not been reported. Methods: In 2017, our county hospital implemented an accelerated recovery protocol for all TJA patients. This protocol consisted of standardized, preoperative medical and psychosocial optimization, perioperative spinal anesthesia, tranexamic acid and local infiltration analgesia use, postoperative emphasis on non-narcotic analgesia, and early mobilization. LOS, complications, disposition, and cost were compared between patients treated before and after protocol implementation. Results: In 15 months, 108 primary TJA patients were treated. Compared with the previous 108 TJA patients, LOS dropped from 3.4 to 1.6 days (P < 0.001), more patients discharged home (92% versus 72%, P < 0.001), average hospitalization and procedure-specific costs decreased 24.7% and 22.1%, respectively, and were significantly fewer complications (7% versus 21%, P = 0.007). Conclusions: Implementation of an accelerated recovery TJA program at a County Hospital is novel. This implementation requires careful patient selection and a coordinated multidisciplinary approach and is a safe and cost-effective method of delivering high-quality care to an underserved cohort.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"98 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124858639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 11