The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Feb 2019
Randomized Controlled Trial Multicenter Study Comparative Study Observational StudyOperative Versus Nonoperative Treatment for Adult Symptomatic Lumbar Scoliosis.
The effectiveness of operative compared with nonoperative treatment at initial presentation (no prior fusion) for adult lumbar scoliosis has not, to our knowledge, been evaluated in controlled trials. The goals of this study were to evaluate the effects of operative and nonoperative treatment and to assess the benefits of these treatments to help treating physicians determine whether patients are better managed operatively or nonoperatively. ⋯ Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Feb 2019
Achieving Microsurgical Competency in Orthopaedic Residents Utilizing a Self-Directed Microvascular Training Curriculum.
Education in microvascular surgery is limited by variable experience, a difficult learning curve, and potentially catastrophic complications caused by failed anastomoses. Furthermore, utilization of live-animal training models can be difficult because of lack of access and high maintenance costs. The purpose of this study was to determine the effectiveness and cost of a self-directed microvascular training curriculum utilizing synthetic microvessels and nonliving models in an orthopaedic residency program. ⋯ The implementation of a self-directed curriculum utilizing synthetic microvessels and nonliving models demonstrated significant improvements in resident microvascular skill. This curriculum represents a modest startup cost and low yearly cost per resident.
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J Bone Joint Surg Am · Feb 2019
Randomized Controlled Trial Multicenter Study Comparative StudyPain Coping Skills Training for Patients Who Catastrophize About Pain Prior to Knee Arthroplasty: A Multisite Randomized Clinical Trial.
Pain catastrophizing has been identified as a prognostic indicator of poor outcome following knee arthroplasty. Interventions to address pain catastrophizing, to our knowledge, have not been tested in patients undergoing knee arthroplasty. The purpose of this study was to determine whether pain coping skills training in persons with moderate to high pain catastrophizing undergoing knee arthroplasty improves outcomes 12 months postoperatively compared with usual care or arthritis education. ⋯ Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Feb 2019
Two-Stage Exchange Protocol for Periprosthetic Joint Infection Following Total Knee Arthroplasty in 245 Knees without Prior Treatment for Infection.
For patients undergoing 2-stage exchange for the treatment of periprosthetic joint infection (PJI) following total knee arthroplasty, the long-term risk of reinfection and mechanical failure and long-term clinical outcomes are not well known. The purpose of our study was to determine the long-term clinical results of 2-stage exchange for PJI following total knee arthroplasty. ⋯ Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Jan 2019
Surgeon Type and Outcomes After Inpatient Ankle Arthrodesis and Total Ankle Arthroplasty: A Retrospective Cohort Study Using the Nationwide Premier Healthcare Claims Database.
Two main treatments for end-stage ankle arthritis are ankle arthrodesis and total ankle arthroplasty (TAA). While both procedures can be performed either by a foot and ankle orthopaedic surgeon or a podiatrist (when within a particular state's scope of practice), studies comparing the surgical outcomes of the 2 surgeon types are lacking. Therefore, in this study, we compared outcomes by surgeon type for TAA and for ankle arthrodesis. ⋯ Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.