The Journal of bone and joint surgery. American volume
-
J Bone Joint Surg Am · Sep 2007
Randomized Controlled Trial Comparative StudyMinimally invasive hip arthroplasty: what role does patient preconditioning play?
The benefits of minimally invasive total hip arthroplasty continue to be debated. The objective of this study was to investigate the role of patient education, accelerated rehabilitation, and improved pain control on the outcome of total hip arthroplasty performed through a small incision. ⋯ This study highlights the importance of factors such as family education, patient preconditioning, preemptive analgesia, and accelerated preoperative and postoperative rehabilitation in influencing the outcome of total hip arthroplasty. The aforementioned factors, and not the surgical technique per se, may play a major role in imparting the better outcome after minimally invasive total hip arthroplasty that has been reported by various investigators.
-
J Bone Joint Surg Am · Sep 2007
Comparative StudyHallux valgus and first ray mobility. A prospective study.
There have been few prospective studies that have documented the outcome of surgical treatment of hallux valgus deformities. The purpose of this investigation was to evaluate the effect of operative treatment of hallux valgus with use of a proximal crescentic osteotomy and distal soft-tissue repair on the first metatarsophalangeal joint. ⋯ A proximal crescentic osteotomy of the first metatarsal combined with distal soft-tissue realignment should be considered in the surgical management of moderate and severe subluxated hallux valgus deformities. First ray mobility was routinely reduced to a normal level without the need for an arthrodesis of the metatarsocuneiform joint. Plantar gapping is not a reliable radiographic indication of hypermobility of the first ray in the sagittal plane.
-
J Bone Joint Surg Am · Sep 2007
Comparative StudyFollow-up on misrepresentation of research activity by orthopaedic residency applicants: has anything changed?
In our previous study, published in 1999, we showed that 18% of research citations listed as published by orthopaedic residency applicants were misrepresented. Since our last report, we sought to determine whether there had been any change in the behavior of applicants wishing to pursue the field of orthopaedic surgery. ⋯ The prevalence of misrepresented research publications from orthopaedic surgery residency applicants increased modestly to 20.6% compared with that found in our original report (18%). As we recommended in our last report, we strongly urge residency programs to require applicants to submit reprints of their publications with their residency applications. Perhaps standardized guidelines should be developed to help to prevent misrepresentation through the Electronic Residency Application Service.
-
J Bone Joint Surg Am · Sep 2007
Clinical and structural outcomes of nonoperative management of massive rotator cuff tears.
The natural history of massive rotator cuff tears is not well known. The purpose of this study was to determine the clinical and structural mid-term outcomes in a series of nonoperatively managed massive rotator cuff tears. ⋯ Patients with a nonoperatively managed, moderately symptomatic massive rotator cuff tear can maintain satisfactory shoulder function for at least four years despite significant progression of degenerative structural joint changes. There is a risk of a reparable tear progressing to an irreparable tear within four years.