Background: Postoperative pain management in orthopaedic surgery accounts for a substantial portion of opioid medications prescribed the United States. Understanding prescribing habits and patient utilization these following surgical procedure is critical to establishing appropriate protocols that effectively control while minimizing unused distribution. We evaluated elective procedures identify ways improving postoperative opioid-prescribing practices. Methods: performed review data 1,199...

The radiocapitellar line (RCL) is recommended for evaluating alignment in skeletally immature elbows, yet its parameters have not been clearly defined. This study systematically assesses the RCL relationship normal investigating impacts of radiographic view, choice anatomic landmarks, patient age, forearm position, and observer bias on manner which intersects capitellum.On radiographs 20 elbows (age range, 1 to 8 y), 3 pediatric orthopaedic surgeons, blinded clinical history, drew lines...

Background: Despite the frequency of hand and wrist injuries in children, patient-reported outcomes have not been systematically assessed. This study hypothesizes that Pediatric Outcomes Data Collection Instrument (PODCI) can be reliable, responsive, discriminatory assessing impact acute pediatric on function quality life. Methods: Consecutive patients presenting to a clinic with over 3-month period completed PODCI questionnaires at initial follow-up visits. Reliability was assessed Cronbach...

To evaluate the cost-effectiveness of screw fixation versus hemiarthroplasty for nondisplaced femoral neck fractures in low-demand elderly patients.We constructed a Markov decision model using low-demand, 80-year-old patient as base case. Costs, health-state utilities, mortality rates, and transition probabilities were obtained from published literature. The simulation was cycled until all patients deceased to estimate lifetime costs quality-adjusted life years (QALYs). primary outcome...

Risk-factor identification related to chronic opioid use after surgery may facilitate interventions mitigating postoperative consumption. We evaluated the relationship between preceding total hip arthroplasty (THA) and knee (TKA), postoperatively, risk of joint arthroplasty. All primary THAs TKAs performed during a 6-month period were identified. Opioid prescription utilization data (in oxycodone equivalents) determined via survey electronic records. Relationship preoperative continued >90...

<h2>Abstract</h2><h3>Background</h3> A shift toward performance, cost, outcomes, and patient satisfaction has occurred with healthcare reform promoting value-based programs. The purpose of this study was to evaluate the relationship between value treatment in a cohort patients undergoing total knee arthroplasty (TKA) hip (THA). <h3>Methods</h3> Value determined by outcome episodic cost. Measurements included both clinical outcomes patient-reported outcomes. Participating surgeons took part...

Due to the nature of military service, patient-physician relationship in Veterans is unlike that seen civilian life. The structure hypothesized result barriers open communication and patient participation elective care decision-making. Decision quality a measure concordance between chosen treatment aspects medical matter most an informed patient; high decision synonymous with patient-centered care. While past research has examined how age other demographic factors affect Veterans, duration...

There is focus on the direct anterior approach (DAA) for total hip arthroplasty because of perceived postoperative functional improvement. We compared baseline, short-term, and long-term outcomes between DAA posterior focusing baseline function.Multivariate linear logistic regression models were used to analyze prospective data 1457 arthroplasties comparing characteristics, operative time, 90-day reoperation, length stay (LOS), extended LOS (>3 days), facility discharge. The Patient-Reported...

Introduction: Methodological quality may vary among published orthopedic systematic reviews and meta-analyses.Methods: One subspecialty society affiliate journal was chosen for each of the 10 subspecialties with accredited fellowships in US.All meta-analyses these journals 2016 were reviewed.Articles assessed using Preferred Reporting Items Systematic Reviews Meta-Analyses (PRISMA) Assessment Multiple (AMSTAR).Relationship publication methodological analysis variance.Results: A total 97...

We evaluate whether patient exposures such as tobacco use are associated with high systemic or local in vivo oxidative state and increased polyethylene oxidation.We performed a case-control study which evaluated clinical factors among patients whose implants have been identified demonstrating either extreme minimal oxidation by our implant retrieval laboratory. Analysis of more than 2500 tibial inserts from explanted total knee arthroplasty demonstrated wide spectrum oxidation. Components...

Total hip and total knee arthroplasties (THA/TKA) are some of the most common elective surgeries done in United States. Routine histopathologic analysis bone specimens after joint arthroplasty commonly occurs to identify unexpected pathologic findings serves as a quality assurance measure. As indication for THA TKA is osteoarthritis, practice routine may not be routinely warranted. There no clear consensus on cost-effectiveness this practice, literature has questioned both clinical relevance...

Souvent associé au genre poétique, à la fin du xix e siècle, on peut observer une application de philosophie artistique l’orphisme romanesque. Si finalité poète orphique l’époque 1900 était créer œuvre dans laquelle les paroles incarnent facette divin, tel n’est pas le souhait romancier orphique, qui cherche plutôt avertir un lecteur béotien réalité et possibilité d’une expérience mystique — ce afin fournir contrepoint spirituel climat pessimisme engendré par laïcisation décadence société...