Clinical orthopaedics and related research
-
Clin. Orthop. Relat. Res. · Nov 2014
A surgical approach algorithm for transverse posterior wall fractures aids in reduction quality.
Transverse posterior wall fractures are difficult to treat and historically have been associated with stiffness, posttraumatic arthritis, and pain, which correlate with the reduction. The Kocher-Langenbeck approach is used most often, whereas the extended iliofemoral approach has been reserved for more complex injury patterns. The latter approach has substantially more risks. No data to our knowledge exist on the use of sequential anterior and posterior approaches for this pattern. ⋯ Level IV, case series. See the Guidelines for Authors for a complete description of levels of evidence.
-
Clin. Orthop. Relat. Res. · Nov 2014
What are the results using the modified trapdoor procedure to treat chondroblastoma of the femoral head?
Treatment of chondroblastoma in the femoral head is challenging owing to the particular location and its aggressive nature. There is little published information to guide the surgeon regarding the appropriate approach to treating a chondroblastoma in this location. We developed a modified trapdoor procedure to address this issue. The primary modification is that the window surface of the femoral head is covered by the ligamentum teres rather than cartilage as in the traditional procedure. ⋯ Level IV, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.
-
Clin. Orthop. Relat. Res. · Nov 2014
High incidence of hemiarthroplasty for shoulder osteoarthritis among recently graduated orthopaedic surgeons.
Primary glenohumeral osteoarthritis is a common indication for shoulder arthroplasty. Historically, both total shoulder arthroplasty (TSA) and hemi-shoulder arthroplasty (HSA) have been used to treat primary glenohumeral osteoarthritis. The choice between procedures is a topic of debate, with HSA proponents arguing that it is less invasive, faster, less expensive, and technically less demanding, with quality of life outcomes equivalent to those of TSA. More recent evidence suggests TSA is superior in terms of pain relief, function, ROM, strength, and patient satisfaction. We therefore investigated the practice of recently graduated orthopaedic surgeons pertaining to the surgical treatment of this disease. ⋯ Level III, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.
-
Clin. Orthop. Relat. Res. · Nov 2014
Comparative StudyMinorities are less likely to receive autologous blood transfusion for major elective orthopaedic surgery.
Surgeons commonly arrange for patients to perform autologous blood donation before elective orthopaedic surgery. Understanding sociodemographic patterns of use of autologous blood transfusion can help improve quality of care and cost containment. ⋯ Level II, prognostic study. See the Instructions for Authors for a complete description of levels of evidence.