The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Sep 2011
Patient activation and functional recovery in persons undergoing spine surgery.
Despite advances in surgical techniques, outcomes after spine surgery are highly variable. Recent research has highlighted the importance of individuals participating in, and taking responsibility for, their health and recovery. Patient activation, defined as an individual's propensity to engage in adaptive health behaviors leading to improved health outcomes, has been identified as a potentially important factor in this process. Our goal was to determine the association between preoperative patient activation and functional recovery after lumbar spine surgery. ⋯ High patient activation was associated with better recovery after surgery. Increased patient activation may lead to improved functional recovery through increased physical therapy adherence after spine surgery in adults.
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J Bone Joint Surg Am · Sep 2011
Racial and ethnic diversity in orthopaedic surgery residency programs.
Although the U.S. population is increasingly diverse, the field of orthopaedic surgery has historically been less diverse. The purpose of this study was to quantify the representation of racial and ethnic minorities among orthopaedic surgery residents compared with those in other fields of medicine and to determine how these levels of diversity have changed over time. ⋯ Minority representation in orthopaedic residency programs has increased over time for Asians, Hispanics, and African-Americans. In spite of these gains, orthopaedic surgery has remained the least diverse of the specialty training programs considered in this study. While further efforts are needed to determine the factors underlying this lack of representation, we suggest a series of interventions that can be expected to enhance diversity in orthopaedic residencies as well as in the profession as a whole.
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J Bone Joint Surg Am · Sep 2011
Randomized Controlled Trial Multicenter Study Comparative StudyPulsed electromagnetic field stimulation for acute tibial shaft fractures: a multicenter, double-blind, randomized trial.
Tibial shaft fractures are sometimes complicated by delayed union and nonunion, necessitating further surgical interventions. Pulsed electromagnetic field stimulation is an effective treatment for delayed unions and nonunions, but its efficacy in preventing healing complications in patients with acute fractures is largely untested. The purpose of this pragmatic trial was to determine whether adjuvant pulsed electromagnetic field therapy for acute tibial shaft fractures reduces the rate of surgical revision because of delayed union or nonunion. ⋯ Adjuvant pulsed electromagnetic field stimulation does not prevent secondary surgical interventions for delayed union or nonunion and does not improve radiographic union or patient-reported functional outcomes in patients with acute tibial shaft fractures.
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J Bone Joint Surg Am · Sep 2011
CommentRisk factors for complications and mortality after spine surgery assessed with the NSQIP database: where do we go from here? Commentary on an article by Andrew J. Schoenfeld, MD, et al.: "Risk factors for immediate postoperative complications and mortality following spine surgery: a study of 3475 patients from the National Surgical Quality Improvement Program".