Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Aug 2021
Can Topical Vancomycin Prevent Periprosthetic Joint Infection in Hip and Knee Arthroplasty? A Systematic Review.
Periprosthetic joint infection (PJI) after hip and knee arthroplasty is a leading cause of revision surgery, inferior function, complications, and death. The administration of topical, intrawound vancomycin (vancomycin powder) has appeared promising in some studies, but others have found it ineffective in reducing infection risk; for that reason, a high-quality systematic review of the best-available evidence is needed. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Aug 2021
A Comprehensive Enhanced Recovery Pathway for Rotator Cuff Surgery Reduces Pain, Opioid Use, and Side Effects.
Patients often have moderate to severe pain after rotator cuff surgery, despite receiving analgesics and nerve blocks. There are many suggested ways to improve pain after rotator cuff surgery, but the effects of adopting a pathway that includes formal patient education, a long-acting nerve block, and extensive multimodal analgesia are unclear. ⋯ Level II, therapeutic study.
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Clin. Orthop. Relat. Res. · Aug 2021
Comparative StudyWhat Is the Comparative Ability of 18F-FDG PET/CT, 99mTc-MDP Skeletal Scintigraphy, and Whole-body MRI as a Staging Investigation to Detect Skeletal Metastases in Patients with Osteosarcoma and Ewing Sarcoma?
Skeletal metastases of bone sarcomas are indicators of poor prognosis. Various imaging modalities are available for their identification, which include bone scan, positron emission tomography/CT scan, MRI, and bone marrow aspiration/biopsy. However, there is considerable ambiguity regarding the best imaging modality to detect skeletal metastases. To date, we are not sure which of these investigations is best for screening of skeletal metastasis. ⋯ Level II, diagnostic study.
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Clin. Orthop. Relat. Res. · Aug 2021
What was the Prevalence of COVID-19 in Asymptomatic Patients Undergoing Orthopaedic Surgery in One Large United States City Mid-pandemic?
Many patients with coronavirus disease 2019 (COVID-19) are asymptomatic. The prevalence of COVID-19 in orthopaedic populations will vary depending on the time and place where the sampling is performed. The idea that asymptomatic carriers play a role is generalizable but has not been studied in large populations of patients undergoing elective orthopaedic surgery. We therefore evaluated this topic in one large, metropolitan city in a state that had the ninth-most infections in the United States at the time this study was completed (June 2020). This work was based on a screening and testing protocol that required all patients to be tested for COVID-19 preoperatively. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Aug 2021
More Than One-third of Orthopaedic Applicants Are in the Top 10%: The Standardized Letter of Recommendation and Evaluation of Orthopaedic Resident Applicants.
The American Orthopaedic Association (AOA) released the standardized letter of recommendation (SLOR) form to provide standardized information to evaluators of orthopaedic residency applicants. The SLOR associates numerical data to an applicant's letter of recommendation. However, it remains unclear whether the new letter form effectively distinguishes among orthopaedic applicants, for whom letters are perceived to suffer from "grade inflation." In addition, it is unknown whether letters from more experienced faculty members differ in important ways from those written by less experienced faculty. ⋯ Level III, therapeutic study.