The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Aug 2013
Comparative StudyA cost-utility analysis comparing the cost-effectiveness of simultaneous and staged bilateral total knee arthroplasty.
The safety and efficacy of simultaneous or staged bilateral total knee arthroplasty have long been debated among orthopaedic surgeons. Advocates for simultaneous bilateral total knee arthroplasty posit that the benefits of decreased costs and recovery time, with no difference in functional outcomes, outweigh the economic costs of potential complications. The purpose of the study was to conduct a cost-utility analysis comparing simultaneous bilateral total knee arthroplasty with staged bilateral total knee arthroplasty. ⋯ On the basis of this analysis, simultaneous bilateral total knee arthroplasty is more cost-effective than staged bilateral total knee arthroplasty, with lower costs and better outcomes for the average patient. These data can inform shared medical decision-making when bilateral total knee arthroplasty is indicated.
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J Bone Joint Surg Am · Aug 2013
Outcome of surgical reconstruction after traumatic total brachial plexus palsy.
Double free muscle transfer for the treatment of traumatic total brachial plexus injury provides useful prehensile function. We studied the outcome of this muscle transfer procedure, including the changes in disability and quality-of-life scores. ⋯ Double free muscle transfer yielded satisfactory function and allowed use of the reconstructed hand in activities that required both hands. The improvement in the DASH score was greater than that in the SF-36 score.
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J Bone Joint Surg Am · Aug 2013
Multicenter StudyClinical presentation of posterolateral rotatory instability of the elbow in children.
Posterolateral rotatory instability is a type of ulnohumeral instability seen following elbow trauma. It is caused by a deficiency in the lateral collateral ligament complex that allows the radius and ulna to subluxate as a single unit with respect to the distal part of the humerus. There are few studies on this type of instability in children. Our purpose was to evaluate cases of posterolateral rotatory instability in children to better understand its presentation and manifestation as compared with those in adults. ⋯ Therapeutic level IV. See instructions for authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Aug 2013
Randomized Controlled Trial Multicenter Study Comparative StudyOperative versus nonoperative treatment of displaced intra-articular calcaneal fractures: a prospective, randomized, controlled multicenter trial.
We conducted a prospective, randomized, controlled multicenter trial to compare operative with nonoperative treatment of displaced intra-articular calcaneal fractures. ⋯ Therapeutic level II. See instructions for authors for a complete description of levels of evidence.