Canadian Journal of Surgery最新文献

{"title":"Minimally invasive sacroiliac joint fusion using triangular titanium implants versus nonsurgical management for sacroiliac joint dysfunction: a systematic review and meta-analysis.","authors":"Abdullah A Ghaddaf, Jawaher F Alsharef, Noor K Alsharef, Mawaddah H Alsaegh, Raneem M Alshaban, Amal O Almutairi, Amal H Abualola, Mohammed S Alshehri","doi":"10.1503/cjs.004523","DOIUrl":"10.1503/cjs.004523","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive sacroiliac joint (MISIJ) fusion is a surgical option to relieve SIJ pain. The aim of this systematic review and meta-analysis was to compare MISIJ fusion with triangular titanium implants (TTI) to nonoperative management of SIJ dysfunction.</p><p><strong>Methods: </strong>We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials. We included prospective clinical trials that compared MISIJ fusion to nonoperative management in individuals with chronic low back pain attributed to SIJ dysfunction. We evaluated pain on visual analogue scale, Oswestry Disability Index (ODI) score, health-related quality of life (HRQoL) using the 36-Item Short Form Health Survey (SF-36) physical component (PCS) and mental component summary (MCS) scores, patient satisfaction, and adverse events.</p><p><strong>Results: </strong>A total of 8 articles representing 3 trials that enrolled 423 participants were deemed eligible. There was a significant reduction in pain score with MISIJ fusion compared with nonoperative management (standardized mean difference [SMD] -1.71, 95% confidence interval [CI] -2.03 to -1.39). Similarly, ODI scores (SMD -1.03, 95% CI -1.24 to -0.81), SF-36 PCS scores (SMD 1.01, 95% CI 0.83 to 1.19), SF-36 MCS scores (SMD 0.72, 95% CI 0.54 to 0.9), and patient satisfaction (odds ratio 6.87, 95% CI 3.73 to 12.64) were significantly improved with MISIJ fusion. No significant difference was found between the 2 groups with respect to adverse events (SMD -0.03, 95% CI -0.28 to 0.23).</p><p><strong>Conclusion: </strong>Our analysis showed that MISIJ fusion with TTI shows a clinically important and statistically significant improvement in pain, disability score, HRQoL, and patient satisfaction with a similar adverse event profile to nonoperative management in patients with chronic low back pain attributed to SIJ dysfunction.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"67 1","pages":"E16-E26"},"PeriodicalIF":2.2,"publicationDate":"2024-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10824395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139566857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A scoping review of surgical care for people experiencing homelessness: prevalence, access, and disparities.","authors":"Caroline Hircock, Peter Huan, Christina Pizzola, Madeline McDonald","doi":"10.1503/cjs.004023","DOIUrl":"10.1503/cjs.004023","url":null,"abstract":"<p><strong>Background: </strong>Numerous studies have highlighted the inequitable access to medical and psychiatric care that people experiencing homelessness (PEH) face, yet the surgical needs of this population are not well understood. We sought to assess evidence describing surgical care for PEH and to perform a thematic analysis of the results.</p><p><strong>Methods: </strong>Ovid MEDLINE, Embase, and Web of Science were searched using the terms \"surgery\" AND \"homelessness.\" Grey literature was also searched. We used a stepwise scoping review methodology, followed by thematic analysis using an inductive approach.</p><p><strong>Results: </strong>We included 104 articles in our review. Studies were included from 5 continents; 63% originated in the United States. All surgical specialties were represented with varying surgical conditions and procedures for each. Orthopedic surgery (21%) was the most frequently reported specialty. Themes identified included characteristics of PEH receiving surgical care, homeless-to-housed participants, interaction with the health care system, educational initiatives, barriers and challenges, and interventions and future strategies.</p><p><strong>Conclusion: </strong>We identified significant variation and gaps, representing opportunities for further research and interventions. Further addressing the barriers and challenges that PEH face when accessing surgical care can better address the needs of this population.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"67 1","pages":"E27-E39"},"PeriodicalIF":2.2,"publicationDate":"2024-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10824397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139566875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategies to reduce out-of-pocket medication costs for Canadians with peripheral arterial disease.","authors":"Graham R McClure, William F McIntyre, Peter Belesiotis, Eric Kaplovitch, Noel Chan, Vinai Bhagirath, Gurneet Chahill, Abigail Hayes, Gursharan Sohi, Wendy Bordman, Richard P Whitlock, Sonia S Anand, Emilie P Belley-Côté","doi":"10.1503/cjs.003722","DOIUrl":"10.1503/cjs.003722","url":null,"abstract":"<p><strong>Background: </strong>Given that peripheral arterial disease (PAD) disproportionately affects people of lower socioeconomic status, out-of-pocket expenses for preventive medications are a major barrier to their use. We carried out a cost comparison of drug therapies for PAD to identify prescribing strategies that minimize out-of-pocket expenses for these medications.</p><p><strong>Methods: </strong>Between March and June 2019, we contacted outpatient pharmacies in Hamilton, Ontario, Canada, to assess pricing of pharmacologic therapies at dosages included in the 2016 American College of Cardiology/American Heart Association guideline for management of lower extremity PAD. We also gathered pricing information for supplementary charges, including delivery, pill splitting and blister packaging. We calculated prescription prices with and without dispensing fees for 30-day brand-name and generic prescriptions, and 90-day generic prescriptions.</p><p><strong>Results: </strong>Twenty-four pharmacies, including hospital-based, independent and chain, were included in our sample. In the most extreme scenario, total 90-day medication costs could differ by up to $1377.26. Costs were affected by choice of agent within a drug class, generic versus brand-name drug, quantity dispensed, dispensing fee and delivery cost, if any.</p><p><strong>Conclusion: </strong>By opting for prescriptions for 90 days or as long as possible, selecting the lowest-cost generic drugs available in each drug class, and identifying dispensing locations with lower fees, prescribers can minimize out-of-pocket patient medication expenses. This may help improve adherence to guideline-recommended therapies for the secondary prevention of vascular events in patients with PAD.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"67 1","pages":"E1-E6"},"PeriodicalIF":2.5,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10790711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139086029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A formalized shared decision-making process with individualized decision aids for older patients referred for cardiac surgery.","authors":"Ryan A Gainer, Karen Buth, Jahanara Begum, Gregory M Hirsch","doi":"10.1503/cjs.004922","DOIUrl":"10.1503/cjs.004922","url":null,"abstract":"<p><strong>Background: </strong>Comprehension of risks, benefits and alternative treatment options is poor among patients referred for cardiac surgery interventions. We sought to explore the impact of a formalized shared decision-making (SDM) process on patient comprehension and decisional quality among older patients referred for cardiac surgery.</p><p><strong>Methods: </strong>We developed and evaluated a paper-based decision aid for cardiac surgery within the context of a prospective SDM design. Surgeons were trained in SDM through a Web-based program. We acted as decisional coaches, going through the decision aids with the patients and their families, and remaining available for consultation. Patients (aged ≥ 65 yr) undergoing isolated valve, coronary artery bypass graft (CABG) or CABG and valve surgery were eligible. Participants in the non-SDM phase followed standard care. Participants in the SDM group received a decision aid following cardiac catheterization, populated with individualized risk assessment, personal profile and comorbidity status. Both groups were assessed before surgery on comprehension, decisional conflict, decisional quality, anxiety and depression.</p><p><strong>Results: </strong>We included 98 patients in the SDM group and 97 in the non-SDM group. Patients who received decision aids through a formalized SDM approach scored higher in comprehension (median 15.0, interquartile range [IQR] 12.0-18.0) than those who did not (median 9.0, IQR 7.0-12.0, <i>p</i> < 0.001). Decisional quality was greater in the SDM group (median 82.0, IQR 73.0-91.0) than in the non-SDM group (median 76.0, IQR 62.0-82.0, <i>p</i> < 0.05). Decisional conflict scores were lower in the SDM group (mean 1.76, standard deviation [SD] 1.14) than in the non-SDM group (mean 5.26, SD 1.02, <i>p</i> < 0.05). Anxiety and depression scores showed no significant difference between groups.</p><p><strong>Conclusion: </strong>Institution of a formalized SDM process including individualized decision aids improved comprehension of risks, benefits and alternatives to cardiac surgery, as well as decisional quality, and did not result in increased levels of anxiety.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"67 1","pages":"E7-E15"},"PeriodicalIF":2.5,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10790712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139086028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2023 Canadian Surgery Forum","authors":"R. Brière, Rogeh Habashi, S. Merchant, L. Cadili, Zainab Alhumoud, Rebecca Lau, Nada Gawad, Rahim H. Valji, Patricia Balmes, Jun Guang Kendric Tan, Matthew Lund, T. Lenet, Sahil Sharma, Christine Wang, Julian Wang, Hyo Jin Son, Rajajee Selvam, Alicia Follett, S. Balvardi, Michael Guo, Kala Hickey, Nieve Seguin, Rachel Leong, A. Alaoui, G. Shi, Simran Parmar, Fardowsa Mohamed, Yung Lee, Hanaa N. Mughal, Alisha R. Fernandes, Michal Pillar, Tania Kazi, T. McKechnie, Sara Bolin, Regina Leung, Elizabeth Clement, Kara Nadeau, Victoria H. Chen, Betty Wen, J. Lie, Rebecca Afford, Victoria Archer, Joëlle Labonté, Charbel El-Kefraoui, Tran (Michelle) Au, Raghad AlShammari, Samantha Bird, Marta Karpinski, K. Alibhai, Sarah Mashal, Intekhab Hossain, R. Wigen, Kaitlyn Harding, Odelle N. Ma, J. Drung, Jeremy K.H. Lee, Lily J. Park, Sauleha Farooq, Gordon Best, Riordan Azam, H. Ahn, Simon Laplante, Gladys Bruyninx, I. Georgescu, Gaurav Talwar, Karina Spoyalo, S. Muncner, Christina Schweitzer, U. Jogiat, Y. Patel, Nikkit","doi":"10.1503/cjs.014223","DOIUrl":"https://doi.org/10.1503/cjs.014223","url":null,"abstract":"","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"444 ","pages":"S53 - S136"},"PeriodicalIF":2.5,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139011243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"C-CASE 2023: Promoting Excellence in Surgical Education: Canadian Conference for the Advancement of Surgical Education, Oct. 12-13, 2023, Montréal, Quebec.","authors":"Jeffrey Sioufi, Brandon Hall, Ryan Antel, Sarah Moussa, Mathushan Subasri, Mustafa Fakih, Nehal Islam, Reggie C Hamdy, Sonaina Chopra, Jason M Harley, Amy Keuhl, Ereny Bassilious, Jonathan Sherbino, Elif Bilgic, Mohamed S Bondok, Mostafa Bondok, Liana Martel, Christine Law, Nancy Posel, David Fleiszer, Anser Daud, Tyler Hauer, Noah Carr-Pries, Kalter Hali, Jesse Wolfstadt, Peter Ferguson, Arashk Ghasroddashti, Fatimah Sorefan-Mangou, Rosephine Del Fernandes, Erin Williams, Ken Choi, Boris Zevin, Ethan D Patterson, Sawmmiya Kirupaharan, Steve Mann, Andrea Winthrop, Boris Zevin, Mostafa Bondok, Nibras Ghanmi, Cole Etherington, Youssef Saddiki, Isabelle Lefebvre, Pauline Berthelot, Pierre-Marc Dion, Benjamin Raymond, Jeanne Seguin, Pooyan Sekhavati, Sindeed Islam, Sylvain Boet, Trisha Tee, Puja Pachchigar, Bilal Tarabay, Recai Yilmaz, Nour Abou Hamdan, Chinyelum Agu, Abdulrahman Almansouri, Jason Harley, Rolando Del Maestro, Mostafa Bondok, Mohamed S Bondok, Anne Xuan-Lan Nguyen, Christine Law, Nawaaz Nathoo, Nupura Bakshi, Nina Ahuja, Karim F Damji, Keerat Grewal, Sayed Azher, Matthew Moreno, Reinhard Pekrun, Jeffrey Wiseman, Gerald M Fried, Susanne Lajoie, Ryan Brydges, Allyson Hadwin, Ning-Zi Sun, Elene Khalil, Jason M Harley, Emily Lan-Vy Nguyen, Prachikumari Patel, Hala Muaddi, Nadia Rukavina, Roxana Bucur, Chaya Shwaartz, Nehal Islam, Sarah Moussa, Mathushan Subasri, Moustafa Fakih, Reggie Charles Hamdy, Evan Wong, Aradhana Tewari, Ryan Brydges, Marisa Louridas, Shilpa Balaji, Prachi Patel, Hala Muaddi, Karolina Gaebe, Carla Luzzi, Aileigh Kay, Nadia Rukavina, Markus Selzner, Trevor Reichman, Chaya Shwaartz, Shilpa Balaji, Hala Muaddi, Ali Shahabinezhad, Prachi Patel, Nadia Rukavina, Trevor Reichman, Shiva Jayaraman, Chaya Shwaartz, Joseph Nashed, Luca Ramelli, Owen Kolasky, Tiffany Dickenson, Mike Dullege, Annie Kang, Andrea Winthrop, Steve Mann, Davy Lau, Erika Henkelman, John Jacob, Isabella Watson, Faizal Haji, Charlotte C McEwen, Iqbal Jaffer, Matthew Sibbald, Victoria Blouin, Florence Bénard, Florence Pelletier, Sandy Abdo, Léamarie Meloche-Dumas, Bill Kapralos, Adam Dubrowski, Erica Patocskai, Puja Pachchigar, Chinyelum Agu, Recai Yilmaz, Trisha Tee, Rolando Del Maestro, Ifeoluwa Adedipe, Carolyn Stephens, Merry Ghebretatios, Simon Laplante, Prachi Patel, Shilpa Balaji, Hala Muaddi, Nadia Rukavina, Chaya Shwaartz, Maren Brodovsky, Carolyn Lai, Abdollah Behzadi, Geoffrey Blair, Abdulrahman Almansouri, Nour Abou Hamdan, Recai Yilmaz, Trisha Tee, Puja Pachchigar, Mohammadreza Eskandari, Chinyelum Agu, Bianca Giglio, Neevya Balasubramaniam, Josh Bierbrier, D Louis Collins, Houssem-Eddine Gueziri, Rolando F Del Maestro, Ella Koonar, Fatemeh Ramazani, Robert Hart, Jessica Henley, Sam Roberts, Shamir Chandarana, Wayne Matthews, Christiaan Schrag, Jennifer Matthews, David Mackenzie, Court Cutting, Justin Lui, Éolie Delisle, Tomas Cordoba, Carlos Cordoba, Bianca Giglio, Adrien Lacroix, Julianne Cairns, Ahmad Alsayegh, Mohamed Alhantoobi, Neevya Balasubramaniam, Widad Safih, Meriem Hamel, Rolando Del Maestro, Gizelle Francis, Alexander Moise, Youssef Omar, Kalpesh Hathi, Dorsa Mavedatnia, Elysia Grose, Timothy Philips, Clément Schneider, Denis Corbin, François Lesage, Michel Pellerin, Walid Ben-Ali, Zakaria Tamani, Maxine Joly-Chevrier, Florence Bénard, Léamarie Meloche-Dumas, Laurence Laflamme, Kerianne Boulva, Rami Younan, Adam Dubrowski, Erica Patocskai, Giancarlo Sticca, Joseph Petruccelli, Dominique Dorion, Yasmin Osman, Florence Bénard, Merieme Habti, Léamarie Meloche-Dumas, Xaviery Duranleau, Kerianne Boulva, Ahmad Kaviani, Rami Younan, Adam Dubrowski, Kiara Vessella, Erica Patocskai, Rahim Valji, Simon Turner, Tobi Lam, Melanie Hammond Mobilio, Jacob Hirsh, Dean Lising, Tulin Cil, Edyta Marcon, Carol-Anne Moulton, Alexandra D'Souza, Thomas Milazzo, Shaishav Datta, Chantal Valiquette, Emma Avery, Sophocles Voineskos, Melinda Musgrave, Kyle Wanzel, Jillian Schneidman, Neil Armstrong, George Gerardis, Jennifer Silver, Milène A Azzam, Rachel Fisher, Ilana Banks, Meredith Young, Lily Hp Nguyen, Megan Skakum, B J Hancock, Suyin Lum Min, Fouad Youssef, Richard Keijzer, Melanie Morris, Anna Shawyer, Giuseppe Retrosi","doi":"10.1503/cjs.014523","DOIUrl":"https://doi.org/10.1503/cjs.014523","url":null,"abstract":"","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"66 6 Suppl 2","pages":"S137-S150"},"PeriodicalIF":2.5,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10718643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138797953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of Canadian-produced research on the global orthopedic literature: a bibliometric analysis.","authors":"Julien Dartus, Patrick Devos, Bogdan A Matache, Luc Bédard, Stéphane Pelet, Etienne L Belzile","doi":"10.1503/cjs.007022","DOIUrl":"10.1503/cjs.007022","url":null,"abstract":"<p><strong>Background: </strong>Little is known about the quality and impact of Canadian-produced research relative to that of other developed nations. The purpose of this study was to determine the contribution of Canadian authors to the orthopedic literature globally and nationally as well as Canada's research productivity in orthopedics. We hypothesized that Canada ranks among the most impactful countries in terms of orthopedic research productivity.</p><p><strong>Methods: </strong>We performed a bibliometric analysis to identify articles published between 2001 and 2020 in the category of orthopedics. We identified Canada's global rank in terms of overall productivity and assessed the contributions of individual Canadian authors. We also examined the quality of publications as determined by category normalized citation impact (CNCI) and publication in the top quartile of journals (%Q1) in terms of impact factor. In addition, we calculated the percentage of Canadian publications that were in orthopedics.</p><p><strong>Results: </strong>We identified 10 821 orthopedic publications from 2001 to 2020. Canada placed sixth globally in terms of productivity in orthopedic research. The annual productivity of Canadian orthopedic researchers increased over the study period by a factor of 3.2. In terms of research quality, with a %Q1 of 36.5% and a CNCI of 1.22, Canada outperformed Asian countries and the United States; the latter country had a %Q1 of 35.3% and a CNCI of 1.14 over the study period.</p><p><strong>Conclusion: </strong>The body of Canadian orthopedic literature has grown consistently over the past 20 years. Despite the overall leadership of the United States and other developed nations such as China and Japan, Canada ranks among the most influential countries in terms of the quality and quantity of orthopedic research.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"66 6","pages":"E583-E595"},"PeriodicalIF":2.5,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10713202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138497935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and opportunities in providing high-quality surgical care in Canada.","authors":"David Pace, Steven Quigley, Lesley Johnston","doi":"10.1503/cjs.009723","DOIUrl":"10.1503/cjs.009723","url":null,"abstract":"<p><p>SummaryThe provision of surgical care in Canada requires substantial improvement. In this commentary, we use the US Institute of Medicine's framework for assessing the quality of health care to explore system-wide challenges that affect surgical outcomes in Canada. Challenges include surgical wait times, long travel times for surgery, human resource constraints, equitable access to surgery, limited collection of data about the surgical pathway, a lack of transparency in the reporting of surgical outcomes and a lack of incentives for hospital systems to achieve high-quality outcomes. We propose solutions supported by available literature to help overcome some of these challenges.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"66 6","pages":"E602-E604"},"PeriodicalIF":2.5,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10713200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138497933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Major complications after total hip arthroplasty with the direct anterior approach at a high-volume Ontario tertiary care centre.","authors":"Kristen I Barton, Nicholas J Steiner, Kevin R Boldt, Olawale A Sogbein, Stephen M Tsioros, Lyndsay Somerville, James L Howard, Brent A Lanting","doi":"10.1503/cjs.005223","DOIUrl":"10.1503/cjs.005223","url":null,"abstract":"BACKGROUND The rate of major surgical complications for high-volume orthopedic surgeons using the direct anterior approach (DAA) in Ontario, Canada, is not known. The purpose of this study was to investigate the rate of major surgical complications after total hip arthroplasty (THA) using DAA performed by experienced orthopedic surgeons at a high-volume tertiary care centre in Ontario. METHODS We conducted a retrospective cohort review of primary THA through DAA performed by 2 experienced fellowship-trained surgeons at an academic hospital in London, Ontario, between Jan. 1, 2012, and May 1, 2019. We excluded the first 100 cases to allow for surgeon learning curves. We recorded major surgical complications (intraoperative events, postoperative periprosthetic fractures, dislocation requiring closed or open reduction, implant failure [aseptic loosening or subsidence], early (< 6 wk) deep wound infection requiring irrigation and débridement, late (≥ 6 wk) deep wound infection requiring irrigation and débridement, and wound complications [wound dehiscence, stitch abscess, erythema, hematoma or seroma]) within 1 year of THA. RESULTS A total of 875 primary DAA THA procedures were included. The rates of surgical complications were 0.9% for intraoperative events, 1.5% for postoperative periprosthetic fractures, 0.8% for implant failure, 0.7% for early deep wound infection, 0.1% for late deep wound infection and 3.2% for wound complications; there were no cases of dislocation. The rate of revision for implant failure within 1 year was 0.1%. Male sex was associated with a greater risk of implant failure (p = 0.01), and having a higher body mass index was associated with both increased rates of infection (p < 0.01) and having a wound complication (p < 0.01). CONCLUSION Intraoperative events, postoperative periprosthetic fractures, implant failure, deep wound infection and wound complications accounted for the major surgical complications within 1 year of THA through DAA. The low revision rate suggests that DAA is a safe approach for THA.","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"66 6","pages":"E596-E601"},"PeriodicalIF":2.5,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10713201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138497934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author response to \"The Yukon data are incorrect\".","authors":"Michael H Chaikof","doi":"10.1503/cjs.98973","DOIUrl":"10.1503/cjs.98973","url":null,"abstract":"","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"66 6","pages":"E581"},"PeriodicalIF":2.5,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10699282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138450979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}