The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jul 2012
Obesity, diabetes, and preoperative hyperglycemia as predictors of periprosthetic joint infection: a single-center analysis of 7181 primary hip and knee replacements for osteoarthritis.
Diabetes and obesity are common in patients undergoing joint replacement. Studies analyzing the effects of diabetes and obesity on the occurrence of periprosthetic joint infection have yielded contradictory results, and the combined effects of these conditions are not known. ⋯ Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Jul 2012
Reliability of predictors for screw cutout in intertrochanteric hip fractures.
Following internal fixation of intertrochanteric hip fractures, tip apex distance, fracture classification, position of the screw in the femoral head, and fracture reduction are known predictors for screw cutout, but the reliability of these measurements is unknown. We investigated the reliability of the tip apex distance measurement, the Cleveland femoral head dividing system, the three-grade classification system of Baumgaertner for fracture reduction, and the AO classification system as predictors for screw cutout. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Total hip arthroplasty is a common surgical procedure, but little is known about longitudinal trends in associated adverse outcomes. Our objective was to describe long-term trends in demographics, comorbidities, and adverse outcomes for older patients who underwent primary and revision total hip arthroplasty. ⋯ Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
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Randomized controlled trials continue to be at the pinnacle of the evidence hierarchy. With this unique vantage point, they inform medical practice, clinical guidelines, health policy, and reimbursement. Prior to an emphasis on randomized controlled trials, traditional clinical research consisted primarily of uncontrolled case series and expert opinions. ⋯ From 1975 to 2005, the number of Level-I studies increased over fivefold and comprised >20% of studies published in The Journal of Bone and Joint Surgery (American Volume) (JBJS). With the emergence of comparative effectiveness research, the definition and methods of best evidence may continue to evolve. In conclusion, substantial improvements in both the quantity and the quality of randomized controlled trials in orthopaedic surgery have occurred, although unique considerations still limit their widespread use.