Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · May 2011
ReviewHip and spine surgery is of questionable value in spina bifida: an evidence-based review.
Although many children with spina bifida and associated scoliosis or dislocated hips undergo spine or hip surgery, the benefits are uncertain. ⋯ The benefits of scoliosis surgery are uncertain (Grade I). Spine surgery, if performed, should be anterior and posterior (Grade B). An all-pedicle approach for scoliosis surgery may be effective (Level I). Hip reduction surgery did not improve walking (Grade B) but may be appropriate in low-level unilateral dislocation (Level I).
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Clin. Orthop. Relat. Res. · May 2011
2010 Mid-America Orthopaedic Association Physician in Training Award: predictors of early adverse outcomes after knee and hip arthroplasty in geriatric patients.
Geriatric patients experience more adverse events owing to early complications after TKA or THA related to preexisting comorbidities. However, associations between patient and surgery variables, including age, BMI, and comorbidities with complications are unclear. Knowing these relationships is necessary for developing risk stratification, defining contraindications, and predicting complications and adverse outcomes. ⋯ Age, type of surgery, anesthesia, and other comorbidities, mainly coronary artery disease and chronic heart failure, were associated with complications and adverse outcomes. We believe these risk factors should be used to counsel patients and make preoperative surgical decisions.
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Clin. Orthop. Relat. Res. · May 2011
Can VEPTR(®) control progression of early-onset kyphoscoliosis? A cohort study of VEPTR(®) patients with severe kyphoscoliosis.
Kyphoscoliosis is considered a relative contraindication to treatment with the Vertical Expandable Prosthetic Titanium Rib (VEPTR(®); Synthes Inc, Paoli, PA). Nevertheless, patients do present with early-onset kyphoscoliosis and thoracic insufficiency syndrome, and no suitable alternative treatments are currently available. However, it is unclear whether VEPTR(®) is reasonable for treating patients with kyphoscoliosis. ⋯ Progression of kyphosis can be minimized during VEPTR(®) treatment by early extension of the construct to the second ribs bilaterally, distal extension of hybrid constructs to the pelvis, use of bilateral hybrid VEPTR(®) implants, and use of redesigned VEPTR(®) constructs that enhance fixation at the upper end. While our early results suggest these devices control progression of kyphosis, longer followup with more patients will be required to confirm the concept in these patients.
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Clin. Orthop. Relat. Res. · May 2011
VEPTR™ growing rods for early-onset neuromuscular scoliosis: feasible and effective.
The Vertical Expandable Prosthetic Titanium Rib (VEPTR™; Synthes North America, West Chester, PA) reportedly controls spinal deformity associated with constrictive chest wall conditions. ⋯ VEPTR™ instrumentation as a spine-to-spine growing-rod construct demonstrated ease of implantation and expansion, with complication rates similar to other reported devices. This study suggests growing constructs using VEPTR™ can be used with relatively few complications and extends the potential uses of this instrumentation system.
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Citation analysis reflects the recognition a work has received in the scientific community by its peers, and is a common method to determine 'classic' works in medical specialties. ⋯ Authors aiming to write a highly cited article in an orthopaedic surgery journal will be favored by language of publication, source journal, country of origin, and introduction of a classification scheme or outcome tool.