Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Nov 2013
Image guided core needle biopsy of musculoskeletal lesions: are nondiagnostic results clinically useful?
The clinical utility of nondiagnostic core needle biopsies is not fully understood. Understanding the clinical and radiologic factors associated with nondiagnostic core needle biopsies may help determine the utility of these nondiagnostic biopsies and guide clinical decision making. ⋯ Nondiagnostic core needle biopsy results in musculoskeletal lesions are not entirely useless. At times, they can be supportive of benign processes and can help avert unnecessary surgical procedures.
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Clin. Orthop. Relat. Res. · Nov 2013
Multicenter StudyValidation of PROMIS ® Physical Function computerized adaptive tests for orthopaedic foot and ankle outcome research.
In 2012, the American Orthopaedic Foot & Ankle Society(®) established a national network for collecting and sharing data on treatment outcomes and improving patient care. One of the network's initiatives is to explore the use of computerized adaptive tests (CATs) for patient-level outcome reporting. ⋯ The PROMIS(®) PF CAT appears to be an excellent method for measuring outcomes for patients with foot and ankle surgery. Further validation of the PROMIS(®) item banks may ultimately provide a valid and reliable tool for measuring patient-reported outcomes after injuries and treatment.
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Clin. Orthop. Relat. Res. · Nov 2013
Randomized Controlled TrialDoes vitamin D improve osteoarthritis of the knee: a randomized controlled pilot trial.
Animal, epidemiologic, and human clinical studies suggest a putative role for vitamin D in osteoarthritis (OA). Inadequate sunlight exposure and lower serum levels of 25(OH)D appear in some reports to be associated with an increased risk for progression of knee OA. ⋯ The results above suggest there is a small but statistically significant clinical benefit to vitamin D treatment in patients with knee OA, although we recommend a long-term study to determine whether these changes are clinically important and whether they will be sustained with time. Further studies with long-term radiologic evaluations are needed.
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Clin. Orthop. Relat. Res. · Nov 2013
Does rewording MRI reports improve patient understanding and emotional response to a clinical report?
Diagnostic MRI reports can be distressing for patients with limited health literacy. Humans tend to prepare for the worst particularly when we are in pain, and words like "tear" can make us feel damaged and in need of repair. Research on words used in provider-patient interactions have shown an affect on response to treatment and coping strategies, but the literature on this remains relatively sparse. ⋯ Emotional response, satisfaction, usefulness, and understanding were all superior in MRI reports reworded for lower reading level and optimal emotional content and optimism. Given that patients increasingly have access to their medical records and diagnostic reports, attention to health literacy and psychologic aspects of the report may help optimize health and patient satisfaction.