Importance: The minimal clinically important difference (MCID) in a patient-reported outcome measure (PROM) is the smallest change that patients perceive as beneficial. Accurate MCIDs are required when PROMs are used to evaluate the value of surgical interventions.
Objective: To use well-defined distribution-based and anchor-based methods to calculate MCIDs in the Hip Disability and Osteoarthritis Outcome Score (HOOS) and in the Knee Injury and Osteoarthritis Outcome Score (KOOS) for veterans undergoing primary total hip arthroplasty or total knee arthroplasty.
Background: Statistical models to preoperatively predict patients' risk of death and major complications after total joint arthroplasty (TJA) could improve the quality of preoperative management and informed consent. Although risk models for TJA exist, they have limitations including poor transparency and/or unknown or poor performance. Thus, it is currently impossible to know how well currently available models predict short-term complications after TJA, or if newly developed models are more accurate.
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February 2018
Case: A thirty-eight-year-old male patient presented with fusiform swelling of the left ring finger after minor trauma. After medical evaluation by the emergency department, primary care service, and rheumatology service, he was referred to the orthopaedic service, where he underwent 2 surgical debridements. Cultures from the second surgery revealed a diagnosis of blastomycosis, and the patient was treated with intravenous amphotericin B followed by oral itraconazole.
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