The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Dec 2014
Variability in spine surgery procedures performed during orthopaedic and neurological surgery residency training: an analysis of ACGME case log data.
Current spine surgeon training in the United States consists of either an orthopaedic or neurological surgery residency, followed by an optional spine surgery fellowship. Resident spine surgery procedure volume may vary between and within specialties. ⋯ Spine surgery procedure volumes in orthopaedic and neurosurgery residency training programs vary greatly both within and between specialties. Although orthopaedic surgery residents had an increase in the number of spine procedures that they performed from 2009 to 2012, they averaged less than half of the number of spine procedures performed by neurological surgery residents. However, orthopaedic surgery residents appear to have greater exposure to spinal deformity than neurosurgery residents. Furthermore, orthopaedic spine fellowship training provides additional spine surgery case exposure of approximately 300 to 500 procedures; thus, before entering independent practice, when compared with neurosurgery residents, most orthopaedic spine surgeons complete as many spinal procedures or more. Although case volume is not the sole determinant of surgical skills or clinical decision making, variability in spine surgery procedure volume does exist among residency programs in the United States.
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J Bone Joint Surg Am · Dec 2014
Randomized Controlled Trial Comparative StudyComparative study of the treatment outcomes of osteoporotic compression fractures without neurologic injury using a rigid brace, a soft brace, and no brace: a prospective randomized controlled non-inferiority trial.
The efficacy of brace application for the treatment of osteoporotic compression fractures remains unclear. The purpose of this study was to compare the treatment outcomes in patients with osteoporotic compression fractures with regard to whether the patients had no braces, rigid braces, or soft braces. ⋯ Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Dec 2014
Comparative StudyVariations in data collection methods between national databases affect study results: a comparison of the nationwide inpatient sample and national surgical quality improvement program databases for lumbar spine fusion procedures.
There has been an increasing use of national databases to conduct orthopaedic research. Questions regarding the validity and consistency of these studies have not been fully addressed. The purpose of this study was to test for similarity in reported measures between two national databases commonly used for orthopaedic research. ⋯ As database studies become more prevalent in orthopaedic surgery, authors, reviewers, and readers should view these studies with caution. This study shows that two commonly used databases can identify demographically similar patients undergoing a common orthopaedic procedure; however, the databases document markedly different rates of comorbidities and inpatient adverse events. The differences are likely the result of the very different mechanisms through which the databases collect their comorbidity and adverse event data. Findings highlight concerns regarding the validity of orthopaedic database research.
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J Bone Joint Surg Am · Dec 2014
Eccentric rotational acetabular osteotomy for acetabular dysplasia and osteoarthritis: follow-up at a mean duration of twenty years.
The aim of the eccentric rotational acetabular osteotomy is to correct the deficient acetabular coverage in the dysplastic hip in order to limit the development of secondary osteoarthritis. The purpose of this study was to investigate the results in patients managed with an eccentric rotational acetabular osteotomy after a mean of twenty years. ⋯ Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Dec 2014
Blood transfusion in primary total hip and knee arthroplasty. Incidence, risk factors, and thirty-day complication rates.
The aim of this study was to analyze NSQIP (National Surgical Quality Improvement Program) data to better understand the incidence, risk factors, and thirty-day complication rates associated with transfusions in primary total hip and knee arthroplasty. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.