Journal of surgical orthopaedic advances最新文献_第2页

Primary Total Knee and Total Hip Arthroplasty in the Rural Patient. 农村患者的初级全膝关节和全髋关节置换术。

Journal of surgical orthopaedic advances Pub Date : 2024-01-01

David A Forgas, Sowmyanarayanan Thuppal, Steven L Scaife, Anthony Sleiman, Youssef El Bitar

{"title":"Primary Total Knee and Total Hip Arthroplasty in the Rural Patient.","authors":"David A Forgas, Sowmyanarayanan Thuppal, Steven L Scaife, Anthony Sleiman, Youssef El Bitar","doi":"","DOIUrl":"","url":null,"abstract":"Rural patients have poorer health indicators, including higher risk of developing osteoarthritis. The objective of this study is to compare rural patients undergoing primary total joint arthroplasty (TJA) at rural hospitals with those undergoing primary TJA at urban hospitals with regards to demographics, comorbidities, and complications and to determine the preferred location of care for rural patients. Data from the Healthcare Cost and Utilization Project National Inpatient Sample between 2016 and 2018 were analyzed. Demographics, comorbidities, inpatient complications, hospital length of stay, inpatient mortality, and discharge disposition were compared between rural patients who underwent TJA at rural hospitals and urban hospitals. Rural patients undergoing primary TJA in rural hospitals were more likely to be women, to be treated in the South, to have Medicaid payer status, to have dementia, diabetes mellitus, lung disease, and postoperative pulmonary complications, and to have a longer hospital length of stay. Those patients were also less likely to have baseline obesity, heart disease, kidney disease, liver disease, cancer, postoperative infection, and cardiovascular complications, and were less likely to be discharged home. Rural patients undergoing primary TJA tend to pursue surgery in their rural hospital when their comorbidity profile is manageable. These patients get their surgery performed in an urban setting when they have the means for travel and cost, and when their comorbidity profile is more complicated, requiring more specialized care, Rural patients are choosing to undergo their primary TJA in urban hospitals as opposed to their local rural hospitals. (Journal of Surgical Orthopaedic Advances 33(2):061-067, 2024).","PeriodicalId":516534,"journal":{"name":"Journal of surgical orthopaedic advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592569","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

Efficacy and Accuracy of Diagnosing Septic Arthritis: How Effective are Current Methods for Timely Diagnosis of Septic Arthritis? 诊断化脓性关节炎的有效性和准确性：目前及时诊断化脓性关节炎的方法有多有效？

Journal of surgical orthopaedic advances Pub Date : 2024-01-01

John G Weeks, Thomas J Revak

{"title":"Efficacy and Accuracy of Diagnosing Septic Arthritis: How Effective are Current Methods for Timely Diagnosis of Septic Arthritis?","authors":"John G Weeks, Thomas J Revak","doi":"","DOIUrl":"","url":null,"abstract":"The diagnosis of septic arthritis requires a reliance on ancillary tests, including synovial fluid white blood cell count (jWBC), percentage of polymorphonuclear leukocytes (%PMN), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). This study evaluated these tests to determine their diagnostic utility in suspected septic arthritis. A retrospective chart review was performed on patients admitted to an urban hospital who underwent arthrocentesis. The authors evaluated the jWBC, %PMN, ESR, and CRP with receiver operating characteristic (ROC) curve analyses. Two hundred sixty-five patients met inclusion criteria. Sixty-three had a culture-positive aspirate. ROC curve analysis resulted in an area under the curve (AUC) of 0.80 for jWBC with cutoff point of 22,563 cells/mm3 and an AUC of 0.71 for %PMN with cutoff point of 90.5%. CRP and ESR had AUC values of 0.62 and 0.61, respectively. The culture-positive cohort had higher elevations in all assessed diagnostic tests. However, AUC data for ESR and CRP showed little diagnostic utility. Additionally, sensitivities and specificities of jWBC and %PMN were too low. Associated cutoff points would result in excessive unnecessary operative intervention. Further studies should incorporate synovial fluid biomarkers into the workup of a suspected septic joint. (Journal of Surgical Orthopaedic Advances 33(2):108-111, 2024).","PeriodicalId":516534,"journal":{"name":"Journal of surgical orthopaedic advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592565","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

Isolated Lateral Plating for Bicondylar Tibial Plateau Fractures: Factors Influencing Decision Making. 双髁胫骨平台骨折的分离式外侧钢板置换术：影响决策的因素。

Journal of surgical orthopaedic advances Pub Date : 2024-01-01

Mandip Singh, Mikel Headford, Krishna Vangipuram Suresh, Thomas Revak

{"title":"Isolated Lateral Plating for Bicondylar Tibial Plateau Fractures: Factors Influencing Decision Making.","authors":"Mandip Singh, Mikel Headford, Krishna Vangipuram Suresh, Thomas Revak","doi":"","DOIUrl":"","url":null,"abstract":"Lateral plating alone has been postulated as an alternative for fixation of bicondylar tibial plateau fractures in attempts to limit morbidity associated with dual plating. Characterization of fracture patterns that may facilitate lateral plating alone for bicondylar tibial plateau fractures is not well established. The authors analyzed radiographic and clinical outcomes of isolated lateral plating in patients with at least 6 months of follow-up. Of 56 patients identified, 37 (66%) had 41 AO Foundation (AO)/Orthopaedic Trauma Association (OTA) C1/C2 fractures with 19 (34%) presenting with 41 C3 fractures. Mean posteromedial articular fracture angle (PMAFA) was 69.9 degrees, with an average of 1.3 medial articular fragments. Only 16 patients (28%) had a PMAFA under 45 degrees. There were no cases of nonunion, and five patients (8.9%) developed wound infection during follow-up. Four patients (7.1%) experienced malreduction over three degrees, and eight patients (14.3%) experienced change in alignment over the follow-up duration, indicating some risk of inadequate fixation with this technique. (Journal of Surgical Orthopaedic Advances 33(2):088-092, 2024).","PeriodicalId":516534,"journal":{"name":"Journal of surgical orthopaedic advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592566","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

Journal of surgical orthopaedic advances Pub Date : 2024-01-01

Joseph Cline, Dmitri Falkner, Tyler Brolin, Richard Smith, Frederick Azar, Thomas Throckmorton

{"title":"Patient-Related Risk Factors Predict Outcomes After Arthroscopic Rotator Cuff Repair.","authors":"Joseph Cline, Dmitri Falkner, Tyler Brolin, Richard Smith, Frederick Azar, Thomas Throckmorton","doi":"","DOIUrl":"","url":null,"abstract":"The objective of this study was to determine if preoperative patient characteristics have an effect on pain and function after primary arthroscopic rotator cuff repair. Seventy-five arthroscopic primary rotator cuff repairs with at least 2 years of follow-up were identified. Studied variables were preoperative tobacco, opioid, and alcohol use; obesity; mood disorders; disability claim; and Workers' Compensation status. Outcome measures included visual analog pain scores, American Shoulder and Elbow Surgeons (ASES) scores, Single Assessment Numeric Evaluation (SANE) scores, range of motion, and strength. Preoperative smoking was significantly associated with worse pain (p = 0.009), ASES (p = 0.004), and SANE (p = 0.011) scores. Opioid use showed no statistically significant difference in pain or functional scores. Alcohol use did predict improved ASES scores at long-term follow-up (p = 0.046). The other variables were not associated with inferior outcomes. Smoking and preoperative opioid use represent modifiable risk factors that can be corrected before surgery to optimize outcomes. (Journal of Surgical Orthopaedic Advances 33(1):005-009, 2024).","PeriodicalId":516534,"journal":{"name":"Journal of surgical orthopaedic advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141181698","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

Indirect Coronal Reduction Technique Using a Volar Locking Plate in Distal Radius Fractures: A Case Series. 桡骨远端骨折中使用沃尔锁定钢板的间接冠状复位技术：病例系列。

Journal of surgical orthopaedic advances Pub Date : 2024-01-01

Nicholas Andring, T David Luo, Suman Medda, Kelly Stumpff, Eben Carroll

引用次数: 0

Superficial Branch of the Radial Nerve Versus Sural Nerve Grafting After Traumatic Adult Brachial Plexus Injury. 成人臂丛神经外伤后的桡神经浅支移植术与硬脑膜神经移植术。

Journal of surgical orthopaedic advances Pub Date : 2024-01-01

Andres A Maldonado, Eric R Wagner, Morad Askari, Robert J Spinner, Allen T Bishop, Alexander Y Shin

引用次数: 0

Recent Trends in Concomitant Distal Clavicle Excision During Rotator Cuff Repair. 肩袖修复术中同时进行锁骨远端切除术的最新趋势。

Journal of surgical orthopaedic advances Pub Date : 2024-01-01

Matthew J Partan, John M Tarazi, Peter B White, Cesar Iturriaga, Randy M Cohn

引用次数: 0

High Resolution MRI Confirms Torsional Injury as Mechanism for Combined Ankle and Common Fibular (Peroneal) Nerve Injuries. 高分辨率磁共振成像证实扭转损伤是踝关节和腓总（腓肠）神经联合损伤的机制。

Journal of surgical orthopaedic advances Pub Date : 2024-01-01

Rohin Singh, Kimberly K Amrami, Robert J Spinner

引用次数: 0

Assessment of Prophylactic Antibiotic Coverage in Culture-positive Traumatic Open Fractures. 评估培养阳性外伤性开放骨折的预防性抗生素覆盖率。

Journal of surgical orthopaedic advances Pub Date : 2024-01-01

Rachel LaBianca Toler, Susan E Hamblin, Lauren E Mangan, J Myles Keck, Austin Ing, Matthew Felbinger, Cory Collinge, Bradley M Dennis

{"title":"Assessment of Prophylactic Antibiotic Coverage in Culture-positive Traumatic Open Fractures.","authors":"Rachel LaBianca Toler, Susan E Hamblin, Lauren E Mangan, J Myles Keck, Austin Ing, Matthew Felbinger, Cory Collinge, Bradley M Dennis","doi":"","DOIUrl":"","url":null,"abstract":"Guidelines provide varying recommendations for the prophylactic antimicrobial treatment of open fractures. This single-center, retrospective cohort study was conducted to determine how well an institutional prophylactic antibiotic protocol covered pathogens associated with open fractures. The authors included adult trauma patients with one or more open fractures and a positive culture from the site of the open fracture, and compared outcomes between patients who were covered by prophylactic antibiotics with patients not covered by prophylactic antibiotics. Of 957 patients evaluated, 75 were included, with 40 patients (53%) covered by the prophylactic antibiotics received. Multidrug-resistant pathogens were isolated in 23 (58%) patients covered versus 26 (74%) patients not covered (p = 0.128). The median time to positive culture was less in patients not covered by initial antibiotics compared with those who were covered (30.2 vs. 102.1 days; p = 0.003). Over half of the patients developed cultures with pathogens that were covered by their initial antibiotic prophylaxis. (Journal of Surgical Orthopaedic Advances 33(2):084-087, 2024).","PeriodicalId":516534,"journal":{"name":"Journal of surgical orthopaedic advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592563","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

Who Benefits from Manipulation under Anesthesia Following Total Knee Arthroplasty? 全膝关节置换术后麻醉下操作对哪些人有益？

Journal of surgical orthopaedic advances Pub Date : 2024-01-01

Matthew L Brown, Kenneth M Vaz, Julie C McCauley, Laura May, Clifford W Colwell

{"title":"Who Benefits from Manipulation under Anesthesia Following Total Knee Arthroplasty?","authors":"Matthew L Brown, Kenneth M Vaz, Julie C McCauley, Laura May, Clifford W Colwell","doi":"","DOIUrl":"","url":null,"abstract":"Arthrofibrosis is a multifactorial process that results in decreased knee range of motion (ROM). Manipulation under anesthesia (MUA) is commonly regarded as the preferred initial treatment of arthrofibrosis following total knee arthroplasty (TKA). There have been no well-controlled studies demonstrating that MUA effectively increases ROM in patients who develop arthrofibrosis after TKA when compared with routine care. The purpose of this study was to determine whether MUA had any advantage over routine care in the treatment of patients who developed arthrofibrosis following TKA. The authors identified patients who underwent primary TKA at the authors' institution between 2010 and 2014 and had flexion ≤ 100 degrees at early follow-up. Knees were grouped based on how the arthrofibrosis was treated: those who underwent MUA and those who received routine care. Knee flexion was captured preoperatively (prior to TKA), at early follow-up (prior to MUA or routine care), and at 1-year follow up. Flexion change from early follow-up to 1 year was calculated. The average flexion at 1-year follow-up was not significantly different between the two groups (106.1 ± 11.7 degrees in the routine care group versus 106.3 ± 12.8 degrees in the MUA group). The MUA group had a greater proportion of patients with flexion gains > 20 degrees at final follow-up when compared with patients who underwent routine care (56% vs. 8%, p < 0.0001). This study demonstrates that patients with decreased ROM at early follow-up after primary TKA can expect greater ROM increase at 1-year follow-up if they undergo MUA compared with patients who undergo routine care. (Journal of Surgical Orthopaedic Advances 33(1):033-036, 2024).","PeriodicalId":516534,"journal":{"name":"Journal of surgical orthopaedic advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141181714","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