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Specialty: Orthopaedics

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Total 785 results found since Jan 2013.

Cardiovascular safety of denosumab across multiple indications: a systematic review and meta ‐analysis of randomized trials
AbstractThe cardiovascular safety of denosumab has not yet been evaluated in a systematic review. This systematic review and meta ‐analysis sought to quantify the number of randomized controlled trials (RCTs) of denosumab (against comparators) reporting cardiovascular adverse events (CAEs) and examine the balance of CAEs between treatment arms. MEDLINE, Embase andclinicaltrials.gov were searched from inception to 26th October 2019 for RCTs of denosumab versus comparators for any indication. Included trials were randomized, enrolled ≥100 participants and reported bone‐related outcomes. Primary outcome for analysis was...
Source: Journal of Bone and Mineral Research - August 10, 2020 Category: Orthopaedics Authors: Alexander H. Seeto, Bo Abrahamsen, Peter R. Ebeling, Alexander J. Rodr íguez Tags: Original Article Source Type: research

Insulin-dependent diabetes mellitus is an independent risk factor for postoperative complications in aseptic revision total hip arthroplasty.
CONCLUSIONS: Insulin dependence is an independent risk factor for numerous short-term postoperative complications following rTHA. When assessing risk and planning perioperative management, surgeons should consider insulin-dependent diabetics as a sub-cohort within the diabetic population. PMID: 32750266 [PubMed - as supplied by publisher]
Source: Hip International - August 3, 2020 Category: Orthopaedics Authors: Selemon NA, Gu A, Malahias MA, Fassihi SC, Chen AZ, Adriani M, Sculco TP, Liu J, Cross MB, Sculco PK Tags: Hip Int Source Type: research

Maintaining sagittal plane balance compromises frontal plane balance during reactive stepping in people post-stroke
Background. Maintaining balance in response to perturbations during walking often requires the use of corrective responses to keep the center of mass within the base of support. The relationship between center of mass and base of support is often quantified using the margin of stability. Although people post-stroke increase the margin of stability following perturbations, control deficits may lead to asymmetries in regulation of margins of stability, which may also cause maladaptive coupling between the sagittal and frontal planes during balance-correcting responses.
Source: Clinical Biomechanics - July 27, 2020 Category: Orthopaedics Authors: Tom J.W. Buurke, Chang Liu, Sungwoo Park, Rob den Otter, James M. Finley Source Type: research

Risk Adjustment for Episode-of-Care Costs After Total Joint Arthroplasty: What is the Additional Cost of Individual Comorbidities and Demographics?
DISCUSSION: Providers participating in alternative payment models should be aware of factors (cardiac history, age, and elevated BMI) associated with increased costs. Further study is needed to determine whether risk adjustment in alternative payment models can prevent problems with access to care for these high-risk patients. PMID: 32701687 [PubMed - as supplied by publisher]
Source: The Journal of the American Academy of Orthopaedic Surgeons - July 25, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Factors associated with fracture after stroke and TIA: a long-term follow-up
ConclusionStroke was positively associated with fracture in patients<  80 years, while TIA was positively associated with fracture in patients ≥ 80 years and females. Dementia and analgesic therapy were also associated with fracture after either stroke or TIA.
Source: Osteoporosis International - July 9, 2020 Category: Orthopaedics Source Type: research

Is there a role for menopausal hormone therapy in the management of postmenopausal osteoporosis?
We present a narrative review of the benefits versus risks of using MHT in the management of postmenopausal osteoporosis. Current literature suggests robust anti-fracture efficacy of MHT in patients unselected for low BMD, regardless of concomitant use with progestogens, but with limited evidence of persisting skeletal benefits following cessation of therapy. Side effects include cardiovascular events, thromboembolic disease, stroke and breast cancer, but the benefit-risk profile differs according to the use of opposed versus unopposed oestrogens, type of oestrogen/progestogen, dose and route of delivery and, for cardiovas...
Source: Osteoporosis International - July 7, 2020 Category: Orthopaedics Source Type: research

Blindness increases the risk for hip fracture and vertebral fracture but not the risk for distal radius fracture: a longitudinal follow-up study using a national sample cohort
ConclusionThe risks for hip fracture and vertebral fracture were significantly higher in the blindness group. However, the risk for distal radius fracture was not related to visual impairment including blindness.
Source: Osteoporosis International - July 5, 2020 Category: Orthopaedics Source Type: research

Increased Prevalence, Complications, and Costs of Smokers Undergoing Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0040-1713128Given a national push toward bundled payment models, the purpose of this study was to examine the prevalence as well as the effect of smoking on early inpatient complications and cost following elective total knee arthroplasty (TKA) in the United States across multiple years. Using the nationwide inpatient sample, all primary elective TKA admissions were identified from 2012 to 2014. Patients were stratified by smoking status through a secondary diagnosis of “tobacco use disorder.” Patient characteristics as well as prevalence, costs, and incidence of complications were compared. ...
Source: Journal of Knee Surgery - June 23, 2020 Category: Orthopaedics Authors: Rajaee, Sean S. Debbi, Eytan M. Paiement, Guy D. Spitzer, Andrew I. Tags: Original Article Source Type: research

Impact of marijuana on venous thromboembolic events: Cannabinoids cause clots in trauma patients
CONCLUSION THC exposure increases the risk of TEC in patients with trauma. Early identification and treatment for TEC is required to improve outcomes in this high-risk subset of trauma patients. LEVEL OF EVIDENCE Prognostic study, level III.
Source: The Journal of Trauma: Injury, Infection, and Critical Care - June 23, 2020 Category: Orthopaedics Tags: 2020 EAST PODIUM PAPER Source Type: research

Discharge to inpatient care facilities following hip fracture surgery: incidence, risk factors, and 30-day post-discharge outcomes.
CONCLUSION: Discharge to inpatient care facilities versus home following hip fracture surgery is associated with higher odds of post-discharge complications, re-operations and readmissions. These results stress the importance of careful patient selection prior to discharge to inpatient care facilities to minimise the risk of complications. PMID: 32538154 [PubMed - as supplied by publisher]
Source: Hip International - June 13, 2020 Category: Orthopaedics Authors: Malik AT, Jain N, Frantz TL, Quatman CE, Phieffer LS, Ly TV, Khan SN Tags: Hip Int Source Type: research

Diagnostic accuracy of different clinical screening criteria for blunt cerebrovascular injuries compared with liberal state of the art computed tomography angiography in major trauma
BACKGROUND Blunt cerebrovascular injuries (BCVI) can significantly impact morbidity and mortality if undetected and, therefore, untreated. Two diagnostic concepts are standard practice in major trauma management: Application of clinical screening criteria (CSC) does or does not recommend consecutive computed tomography angiography (CTA) of head and neck. In contrast, liberal CTA usage integrates into diagnostic protocols for suspected major trauma. First, this study's objective is to assess diagnostic accuracy of different CSC for BCVI in a population of patients diagnosed with BCVI after the use of liberal CTA. Second, ...
Source: The Journal of Trauma: Injury, Infection, and Critical Care - May 29, 2020 Category: Orthopaedics Tags: ORIGINAL ARTICLES Source Type: research

New ischemic lesions on brain magnetic resonance imaging in patients with blunt traumatic cerebrovascular injury
BACKGROUND Patients with blunt cerebrovascular injuries are at risk of thromboembolic stroke. Although primary prevention with antithrombotic therapy is widely used in this setting, its effectiveness is not well defined and requires further investigation. The aim of this study was to evaluate the utility of magnetic resonance imaging (MRI)–detected ischemic brain lesions as a possible future outcome for randomized clinical trials in this patient population. METHODS This prospective observational study included 20 adult blunt trauma patients admitted to a level I trauma center with a screening neck CTA showing extrac...
Source: The Journal of Trauma: Injury, Infection, and Critical Care - May 29, 2020 Category: Orthopaedics Tags: ORIGINAL ARTICLES Source Type: research

Evaluation and management of blunt cerebrovascular injury: A practice management guideline from the Eastern Association for the Surgery of Trauma
BACKGROUND Blunt cerebrovascular injuries (BCVIs) are associated with significant morbidity and mortality. This guideline evaluates several aspects of BCVI diagnosis and management including the role of screening protocols, criteria for screening cervical spine injuries, and the use of antithrombotic therapy (ATT) and endovascular stents. METHODS Using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, a taskforce of the Practice Management Guidelines Committee of the Eastern Association for the Surgery of Trauma performed a systematic review and meta-analysis of currently avail...
Source: The Journal of Trauma: Injury, Infection, and Critical Care - May 29, 2020 Category: Orthopaedics Tags: GUIDELINES Source Type: research

Non-invasive assessment of motor unit activation in relation to motor neuron level and lesion location in stroke and spinal muscular atrophy
The results suggest, that for stroke, information from the brain is modified thereby resulting in motor units firing at their natural frequency. Thus, high spatial resolution electromyography and the chosen parameters facilitate non-invasive, objective differentiation and analysis of the activation patterns of motor units in neuromuscular disorders.
Source: Clinical Biomechanics - May 26, 2020 Category: Orthopaedics Authors: Sybele E. Williams, Kathrin C. Koch, Catherine Disselhorst-Klug Source Type: research

Wheelchair backs that support the spinal curves: Assessing postural and functional changes.
Conclusions: This pilot study demonstrated that a wheelchair back, which supports the seated spinal curves improves upright posture, functional reach, and wheelchair propulsion skills. Further research is necessary to demonstrate statistical findings as well as to assess back height and lateral support. PMID: 32406808 [PubMed - as supplied by publisher]
Source: Journal of Spinal Cord Medicine - May 16, 2020 Category: Orthopaedics Tags: J Spinal Cord Med Source Type: research