The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jan 2015
Review Meta AnalysisIntermediate and long-term quality of life after total knee replacement: a systematic review and meta-analysis.
Total knee replacement is a highly successful and frequently performed operation. Technical outcomes of surgery are excellent, with favorable early postoperative health-related quality of life. This study reviews intermediate and long-term quality of life after surgery. ⋯ Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Dec 2014
ReviewRepair techniques for acute distal biceps tendon ruptures: a systematic review.
There is a lack of consensus regarding the optimal surgical approach and fixation method for distal biceps tendon ruptures. The purpose of this study was to conduct a systematic review comparing the results of the various surgical approaches and repair techniques for acute distal biceps tendon ruptures. ⋯ The complication rate did not differ significantly between one and two-incision distal biceps repairs; however, the bone tunnel and cortical button methods had significantly lower complication rates compared with suture anchors and intraosseous screws. Further studies are needed to determine the optimal number of incisions.
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Blood transfusion after orthopaedic surgery accounts for 10% of all packed red blood-cell transfusions, but use varies substantially across hospitals and surgeons. Transfusions can cause systemic complications, including allergic reactions, transfusion-related acute lung injury, transfusion-associated circulatory overload, graft-versus-host disease, and infections. ⋯ Current clinical evidence does not justify transfusions for a hemoglobin level of >8 g/dL in the absence of symptoms. Studies have also supported the use of this trigger in patients with a history or risk of cardiovascular disease.
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J Bone Joint Surg Am · Sep 2014
ReviewSurgical attire and the operating room: role in infection prevention.
➤ Although there is some evidence that scrubs, masks, and head coverings reduce bacterial counts in the operating room, there is no evidence that these measures reduce the prevalence of surgical site infection.➤ The use of gloves and impervious surgical gowns in the operating room reduces the prevalence of surgical site infection.➤ Operating-room ventilation plays an unclear role in the prevention of surgical site infection.➤ Exposure of fluids and surgical instruments to the operating-room environment can lead to contamination. Room traffic increases levels of bacteria in the operating room, although the role of this contamination in surgical site infection is unclear.
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J Bone Joint Surg Am · Aug 2014
Review Multicenter StudyImpact of Resident Involvement on Orthopaedic Surgery Outcomes: An Analysis of 30,628 Patients from the American College of Surgeons National Surgical Quality Improvement Program Database.
Operative procedural training is a key component of orthopaedic surgery residency. The influence of intraoperative resident participation on the outcomes of surgery has not been studied extensively using large, population-based databases. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.