The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Oct 2019
Identifying Technical Procedures in Orthopaedic Surgery and Traumatology That Should Be Integrated in a Simulation-Based Curriculum: A National General Needs Assessment in Denmark.
Simulation-based training is emerging within the orthopaedic field to alleviate the challenges that trainees face such as work-hour restrictions, limited exposure to procedures, and increasing pressures to reduce risk to patients. This training modality has grown increasingly popular over the last 2 decades. However, integration into the curriculum often fails to follow a structured educational plan. The development of simulation-based curricula should follow a structured and stepwise approach that starts with a general needs assessment. This study aimed to identify and prioritize procedures within orthopaedic surgery to be included in a simulation-based curriculum on a national basis. ⋯ This article offers insights into needs assessment and curriculum development of simulation-based training in orthopaedic surgery and traumatology.
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J Bone Joint Surg Am · Oct 2019
Multicenter StudyUse of the United States Medical Licensing Examination Step-1 Score as a Screening Tool for Orthopaedic Surgery Away Rotations.
Orthopaedic surgery has become an increasingly competitive specialty for medical students applying to residency. Aside from residency interviews, away rotations are one of the only opportunities for residency programs to qualitatively evaluate an applicant. The purpose of this study was to determine if residency program directors (PDs) use a minimum United States Medical Licensing Examination (USMLE) Step-1 score as a screening tool for students applying for away rotations at their institution. ⋯ A substantial proportion of orthopaedic surgery residency PDs use the USMLE Step-1 score as a screening tool for students interested in doing away rotations at their programs. If a student's Step-1 score does not meet the program's minimum, the majority of programs still will allow the student to rotate at their institution. Students should take this information into account when selecting away rotations in order to maximize their chances of matching into an orthopaedic surgery program.
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J Bone Joint Surg Am · Oct 2019
Randomized Controlled TrialThe Effect of Prolonged Postoperative Antibiotic Administration on the Rate of Infection in Patients Undergoing Posterior Spinal Surgery Requiring a Closed-Suction Drain: A Randomized Controlled Trial.
Closed-suction drains are frequently used following posterior spinal surgery. The optimal timing of antibiotic discontinuation in this population may influence infection risk, but there is a paucity of evidence. The aim of this study was to determine whether postoperative antibiotic administration for 72 hours (24 hours after drain removal as drains were removed on the second postoperative day) decreases the incidence of surgical site infection compared with postoperative antibiotic administration for 24 hours. ⋯ Therapeutic Level I. See Instructions for Authors for a complete description of Levels of Evidence.
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J Bone Joint Surg Am · Sep 2019
Observational StudyAssociation Between Sagittal Spinal Alignment and Physical Function in the Japanese General Elderly Population: A Japanese Cohort Survey Randomly Sampled from a Basic Resident Registry.
The extension of healthy life expectancy has become increasingly important because of rising health-care costs and decreases in the quality of life in the elderly population. Although reports have surfaced on an association between sagittal spinal alignment and physical performance, such studies on the healthy population are limited. This study investigated the relationship between sagittal spinal alignment and physical function in the general elderly population. ⋯ Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Sep 2019
Observational StudyPreoperative Risk Factors for Opioid Utilization After Total Hip Arthroplasty.
Opioid prescriptions following orthopaedic procedures may contribute to the opioid epidemic in the United States. Risk factors for greater and prolonged opioid utilization following total hip arthroplasty have yet to be fully elucidated. We sought to determine the prevalence of preoperative and postoperative opioid utilization in a cohort of patients who underwent total hip arthroplasty and to identify preoperative risk factors for prolonged utilization of opioids following total hip arthroplasty. ⋯ Opioid prescriptions following orthopaedic procedures are one of the leading causes of chronic opioid use; strategies to reduce the risk of misuse and abuse are needed. At 1 year postoperatively, almost one-quarter of patients who underwent total hip arthroplasty used opioids in the last 90 days of the first postoperative year, which makes understanding risk factors associated with postoperative opioid utilization imperative.