PROMIS Physical Function Correlates with KOOS, JR in Patients with Knee Pain.

Using Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS PF) computerized adaptive test instead of the Knee injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS, JR) could reduce question burden for patients with knee pain. We aimed to prospectively determine the correlation between PROMIS PF and KOOS, JR to assess whether PROMIS PF could be a useful alternative measure for both research and clinical care of patients with knee pain. This was a cross-sectional study of 88 patients.

A Surgeon Scorecard Is Associated with Improved Value in Elective Primary Hip and Knee Arthroplasty.

Background: Despite increasing interest in total joint arthroplasty registries, evidence of the impact of physician-level performance on the value of care provided to patients undergoing hip and knee arthroplasty is lacking. The purpose of this study was to examine the effectiveness of an unblinded orthopaedic surgeon-specific value scorecard in improving patient outcomes and reducing hospital costs.

Methods: We retrospectively analyzed patient outcomes and hospital costs associated with total joint arthroplasties before and 9 months after the introduction of a Surgeon Value Scorecard at an urban tertiary care center.

Differentiation of idiopathic spinal cord herniation from dorsal arachnoid webs on MRI and CT myelography.

OBJECTIVE Dorsal arachnoid webs (DAWs) and spinal cord herniation (SCH) are uncommon abnormalities affecting the thoracic spinal cord that can result in syringomyelia and significant neurological morbidity if left untreated. Differentiating these 2 entities on the basis of clinical presentation and radiological findings remains challenging but is of vital importance in planning a surgical approach. The authors examined the differences between DAWs and idiopathic SCH on MRI and CT myelography to improve diagnostic confidence prior to surgery.

Health Utility of Early Hemiarthroplasty vs Delayed Total Hip Arthroplasty for Displaced Femoral Neck Fracture in Elderly Patients: A Markov Model.

Background: Treatment for femoral neck fracture among patients aged 65 years or older varies, with many surgeons preferring hemiarthroplasty (HA) over total hip arthroplasty (THA). There is evidence that THA may lead to better functional outcomes, although it also carries greater risk of mortality and dislocation rates.

Methods: We created a Markov decision model to examine the expected health utility for older patients with femoral neck fracture treated with early HA (performed within 48 hours) vs delayed THA (performed after 48 hours).

Effects of management legacies on stream fish and aquatic benthic macroinvertebrate assemblages.

Fish and benthic macroinvertebrate assemblages often provide insight on ecological conditions for guiding management actions. Unfortunately, land use and management legacies can constrain the structure of biotic communities such that they fail to reflect habitat quality. The purpose of this study was to describe patterns in fish and benthic macroinvertebrate assemblage structure, and evaluate relationships between biota and habitat characteristics in the Chariton River system of south-central Iowa, a system likely influenced by various potential management legacies (e.

Aortic arch dissection: a controversy of classification.

Aortic dissections originating in the ascending aorta and descending aorta have been classified as type A and type B dissections, respectively. However, dissections with intimal flap extension into the aortic arch between the innominate and left subclavian arteries are not accounted for adequately in the widely used Stanford classification. This gap has been the subject of controversy in the medical and surgical literature, and there is a tendency among many radiologists to categorize such arch dissections as type A lesions, thus making them an indication for surgery.

Tibial tunnel widening after hamstring tendon anterior cruciate ligament reconstruction: the effect of supplemental aperture fixation with autogenous bone cores.

Background: Tibial tunnel widening is a common phenomenon seen with hamstring anterior cruciate ligament reconstruction. Concern exists that increased tunnel widening can lead to delayed graft incorporation, graft laxity, or difficulties in revision surgery.

Hypothesis: Supplemental aperture fixation with autogenous bone cores or bioabsorbable interference screws will decrease tibial tunnel widening in hamstring anterior cruciate ligament reconstruction.

Comparison of clinical outcomes of reconstruction of the anterior cruciate ligament: autogenous patellar tendon and hamstring grafts.

In this critical review, we summarize the literature comparing the 2 grafts most frequently used in reconstruction of the anterior cruciate ligament--patellar tendon and hamstring autografts. We evaluate the biomechanical properties, comorbidities, and clinical performance of the grafts and focus our review on clinical outcomes reported in prospective randomized studies. Although the overall profile of the autogenous hamstring graft with respect to biomechanics and side effects seems equal or superior to that of the patellar tendon graft, there is little difference in clinical outcomes.

Prophylactic pinning of the contralateral hip in slipped capital femoral epiphysis : evaluation of long-term outcome for the contralateral hip with use of decision analysis.

Background: The risk of a contralateral slip in patients who are first seen with a unilateral slipped capital femoral epiphysis has been reported to be 2335 times higher than the risk of an initial slip. The overall prevalence of bilaterality varies widely throughout the literature, with some reports indicating rates as high as 80%. This finding has led many authors to recommend prophylactic pinning of the contralateral asymptomatic hip in patients presenting with a unilateral slipped capital femoral epiphysis.