The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Oct 2011
Comparative StudyComparison of patient-reported and clinician-assessed outcomes following total knee arthroplasty.
Although the necessity of long-term follow-up after total knee arthroplasty is unquestioned, this task may become burdensome as greater numbers of total knee arthroplasties are performed. We sought to use comparisons with clinician-assessed values to determine whether patients could reliably assess their own outcome with use of a combination of American Knee Society Score and Oxford Knee Score questionnaires and self-reported knee motion. We hypothesized that patients would self-report worse pain and function and a similar range of knee motion than clinicians would. ⋯ Patients' self-reported American Knee Society pain and function subscores were worse than the corresponding clinician assessments, but the two Oxford Knee Scores were similar. Range of knee motion may reasonably be self-assessed by comparison with photographs. Long-term follow-up of patients after total knee arthroplasty may be possible with use of patient-reported measures, alleviating the burden of clinic visits yet maintaining contact, but further studies involving other validated instruments is warranted.
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J Bone Joint Surg Am · Oct 2011
Comparative StudyFixation of the coronoid process in elbow fracture-dislocations.
Terrible triad injuries consist of a posterior dislocation of the elbow, a coronoid fracture, and a radial head fracture. The coronoid plays a pivotal role as an anterior buttress, yet the optimal management of the coronoid fracture remains unknown. We hypothesize that suture lasso fixation of the coronoid fracture leads to fewer complications and improved outcomes compared with screw or suture anchor fixation techniques. ⋯ For terrible triad injuries, greater stability with fewer complications was achieved with use of the suture lasso technique for coronoid fracture fixation.
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J Bone Joint Surg Am · Oct 2011
Comparative StudySurgical treatment for avulsion injuries of the humeral lesser tuberosity apophysis in adolescents.
There is little published information regarding avulsion fractures of the humeral lesser tuberosity in adolescents, and no consensus exists on optimal treatment. The purpose of this study was to investigate the demographics, injury mechanisms, and results of operative treatment of lesser tuberosity avulsion fractures in skeletally immature patients. ⋯ Humeral lesser tuberosity avulsion fractures do occur in adolescents, typically from high-energy sports injuries. Careful physical examination and magnetic resonance imaging (MRI) evaluation aid in achieving a timely diagnosis. Surgical reduction and suture fixation is safe and effective in restoring subscapularis function and return to sports, even in cases of delayed treatment. Full recovery of shoulder external rotation may not be seen until six months postoperatively.
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J Bone Joint Surg Am · Oct 2011
Randomized Controlled Trial Multicenter Study Comparative StudyDuration of symptoms resulting from lumbar disc herniation: effect on treatment outcomes: analysis of the Spine Patient Outcomes Research Trial (SPORT).
The purpose of the present study was to determine if the duration of symptoms affects outcomes following the treatment of intervertebral lumbar disc herniation. ⋯ Increased symptom duration due to lumbar disc herniation is related to worse outcomes following both operative and nonoperative treatment. The relative increased benefit of surgery compared with nonoperative treatment was not dependent on the duration of the symptoms.