The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Apr 2019
Randomized Controlled Trial Comparative StudyPedaling-Based Protocol Superior to a 10-Exercise, Non-Pedaling Protocol for Postoperative Rehabilitation After Total Knee Replacement: A Randomized Controlled Trial.
Despite the routine use of physical therapy in the immediate and early postoperative phase for patients who undergo total knee replacement (TKR), there is a paucity of research into the optimal exercise protocols in both the acute inpatient setting and early period after discharge. Pedaling has often been recommended by clinicians after TKR for rehabilitation, but to our knowledge, there has been no investigation into its utility in the acute postoperative setting. Therefore, we performed a randomized controlled trial evaluating the efficacy of pedaling in the acute postoperative period. ⋯ Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Mar 2019
Randomized Controlled Trial Comparative StudyRandomized Trial of Sacroiliac Joint Arthrodesis Compared with Conservative Management for Chronic Low Back Pain Attributed to the Sacroiliac Joint.
Sacroiliac joint pain is increasingly recognized as a cause of low back pain. We compared the safety and effectiveness of minimally invasive sacroiliac joint arthrodesis using triangular titanium implants and conservative management in patients with chronic sacroiliac joint pain. ⋯ 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
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
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 · Jan 2019
Randomized Controlled Trial Multicenter StudyScrew Fixation Versus Hemiarthroplasty for Nondisplaced Femoral Neck Fractures in Elderly Patients: A Multicenter Randomized Controlled Trial.
Elderly patients with a displaced femoral neck fracture treated with hip arthroplasty may have better function than those treated with internal fixation. We hypothesized that hemiarthroplasty would be superior to screw fixation with regard to hip function, mobility, pain, quality of life, and the risk of a reoperation in elderly patients with a nondisplaced femoral neck fracture. ⋯ Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.