Orthopedics

When Is the Surgeon Too Old to Operate? – The New York Times (free)

Related: Perspective: Assessing the Performance of Aging Surgeons (free for a limited period) AND Observational Study: Age and Sex of Surgeons and Mortality of Older Surgical Patients (free study and commentary) AND The Elderly and Driving: When Is It Time to Hit the Brakes? – The New York Times (10 articles per month are free)

 

Related Commentary on Twitter


Injuries Associated With Standing Electric Scooter Use – JAMA Network Open (free)

Invited Commentary: Shareable 2-Wheeled Vehicles—A New Public Health Problem? (free)

 

Related Commentary on Twitter

 


Subacromial decompression surgery for rotator cuff disease – Cochrane Library (free)

Summary: Surgery for rotator cuff disease (free)

Related Studies: Subacromial Decompression vs Diagnostic Arthroscopy for Shoulder Impingement (free study and commentaries) AND Arthroscopic subacromial decompression for subacromial shoulder pain (free study and commentaries)

“The data in this review do not support the use of subacromial decompression in the treatment of rotator cuff disease manifest as painful shoulder impingement.”

 


Review: Overuse Injuries in Sport

6 Jan, 2019 | 21:43h | UTC

Association of Long-term Exercise Training With Risk of Falls, Fractures, Hospitalizations, and Mortality in Older Adults: A Systematic Review and Meta-analysis – JAMA Internal Medicine (link to abstract – $ for full-text)

Commentary: Meta-analysis: long-term exercise cuts fall, injury risk in elders – Univadis (free registration required)

Related Study: Follow-up efficacy of physical exercise interventions on fall incidence and fall risk in healthy older adults: a systematic review and meta-analysis – Sports Medicine Open (free)

 

Related Commentary in Twitter

 


Review: Chronic Lateral Epicondylitis

20 Nov, 2018 | 14:55h | UTC

Graduated compression stockings for prevention of deep vein thrombosis – Cochrane Library (free)

Summary: Graduated compression stockings for prevention of deep vein thrombosis during a hospital stay – Cochrane Library (free)

“There is high-quality evidence that GCS are effective in reducing the risk of DVT in hospitalised patients who have undergone general and orthopaedic surgery”

 


Deep neural network improves fracture detection by clinicians – Proceedings of the National Academy of Sciences (free)

“How to reduce emergency doctor misinterpretation of wrist X-rays for fracture by nearly 50%? Deep learning AI, of course” (via @EricTopol see Tweet)

 


The clinical and cost-effectiveness of corticosteroid injection versus night splints for carpal tunnel syndrome (INSTINCTS trial): an open-label, parallel group, randomised controlled trial – The Lancet (free)

Invited Commentary: Steroid injection or wrist splint for first-time carpal tunnel syndrome? (free)

“A single corticosteroid injection shows superior clinical effectiveness at 6 weeks compared with night-resting splints, making it the treatment of choice for rapid symptom response in mild or moderate carpal tunnel syndrome presenting in primary care.”

 


Should You Have Knee Replacement Surgery? – The New York Times (10 articles per month are free)

“Some experts question whether the surgery is being done too often or too soon on patients who have not adequately explored less invasive approaches.”

 


Effect of Early Surgery vs Physical Therapy on Knee Function Among Patients With Nonobstructive Meniscal Tears: The ESCAPE Randomized Clinical Trial – JAMA (free for a limited period)

Commentary: PT an Alternative to Surgery for Some Meniscal Tears – Physician’s First Watch (free)

Related: Adverse Outcomes After Arthroscopic Partial Meniscectomy (free study, commentary and guideline on the subject)

“Our Dutch multi center RCT demonstrates noninferiority of physical therapy compared with early surgery with arthroscopic partial meniscectomy for improving self-reported knee function in patients with nonobstructive meniscal tears.” (via @RudolfPoolman see Tweet)

 


Guideline for the management of hip and knee osteoarthritis – Royal Australian College of General Practitioners (free PDF)

News Release: Updated osteoarthritis guideline designed to reduce unnecessary imaging and surgery (free)

Commentary: Australia hopes to reduce unnecessary imaging, surgery with updated osteoarthritis guidelines – Health Imaging (free)

““The Guideline for the management of knee and hip osteoarthritis,” offer up exercise and weight loss as a first line defense, and warn against costly treatments using glucosamine, opioids and arthroscopic surgery, said David Hunter, co-chair of the RACGP group responsible for the update.” (from Health Imaging)

 


Effect of Negative Pressure Wound Therapy vs Standard Wound Management on 12-Month Disability Among Adults With Severe Open Fracture of the Lower Limb: The WOLLF Randomized Clinical Trial – JAMA (free for a limited period)

Commentaries: High-tech treatment of open leg wounds no better than using regular dressings – University of Warwick (free) AND Negative-Pressure Therapy No Better for Open Fractures – Medscape (free registration required)

“Negative pressure wound therapy did not improve 12-month disability for patients with severe open fracture of the lower limb compared with standard wound dressing”

 


Percutaneous vertebroplasty for osteoporotic vertebral compression fracture – Cochrane Library (link to abstract – $ for full-text)

Summary: Featured Review: Vertebroplasty for treating spinal fractures due to osteoporosis – Cochrane Library (free)

High quality evidence shows that vertebroplasty does not provide more clinically important benefits than placebo but may cause people harm”.

 


Opioid Wisely – Choosing Wisely Canada (free)

Related Guideline: Guideline for opioid therapy and chronic noncancer pain – Canadian Medical Association Journal (free)

See complete lists from Choosing Wisely U.S. / Choosing Wisely UKChoosing Wisely Australia AND Choosing Wisely Canada

This campaign encourages thoughtful conversation between clinicians and patients to reduce harms associated with opioid prescribing, with recommendations relevant to different specialties.

 


Surgery for trigger finger – Cochrane Library (link to abstract – $ for full-text)

 


Aspirin or Rivaroxaban for VTE Prophylaxis after Hip or Knee Arthroplasty – New England Journal of Medicine (link to abstract – $ for full-text)

Quick Take Video Summary: Preventing VTE after Hip or Knee Arthroplasty (free)

“Among patients who received 5 days of rivaroxaban prophylaxis after total hip or total knee arthroplasty, extended prophylaxis with aspirin was not significantly different from rivaroxaban in the prevention of symptomatic venous thromboembolism”.

 


Sham surgery versus labral repair or biceps tenodesis for type II SLAP lesions of the shoulder: a three-armed randomised clinical trial – British Journal of Sports Medicine (free)

“Neither labral repair nor biceps tenodesis had any significant clinical benefit over sham surgery for patients with SLAP II lesions in the population studied”.

 


Weekend Surgical Care and Postoperative Mortality: A Systematic Review and Meta-Analysis of Cohort Studies (free)

Commentary: Evidence Supports ‘Weekend Effect’ for Mortality after Surgery – Wolters Kluwer, via NewsWise (free)

“The odds of postoperative mortality were 27 percent higher for patients admitted to the hospital on Saturday or Sunday, compared to those hospitalized on a weekday” (from NewsWise).

 


Postsurgical prescriptions for opioid naive patients and association with overdose and misuse: retrospective cohort study – The BMJ (free)

“The duration of treatment rather than dose is more strongly associated with opioid misuse after surgery, concludes this study” (via @bmj_latest see Tweet)

 


Review: Diabetic foot

20 Nov, 2017 | 18:01h | UTC

Choice of implant combinations in total hip replacement: systematic review and network meta-analysis – The BMJ (free)

Commentary: What is the most effective type of hip implant combination for patients undergoing a hip replacement? – University of Bristol (free)

“…there is no evidence that any of the newer hip implant combinations, such as ceramic or uncemented, are better than the widely used small head metal-on-plastic cemented hip combination, which has been commonly used since the 1960s”.

 


Review: Medial elbow pain

12 Oct, 2017 | 17:46h | UTC

Local nerve blocks can improve outcomes for people with hip fracture – NIHR Signal (free)

Original article: Peripheral nerve blocks for hip fractures – Cochrane Library (link to abstract – $ for full-text)

“One case of pneumonia prevented for every 7 hip fracture patients given pain relief with nerve block” (RT @NIHR_DC see Tweet)

 


Review: Cervical Spondylotic Myelopathy

18 Sep, 2017 | 13:53h | UTC

Comprehensive assessment may reduce risk of delirium after hip fracture – NIHR Signal (free)

Original article: Comprehensive Geriatric Assessment for Prevention of Delirium After Hip Fracture: A Systematic Review of Randomized Controlled Trials – Journal of The American Geriatrics society (link to abstract – $ for full-text)

“Comprehensive geriatric assessment reduced the risk of delirium by 20% in patients having hip fracture surgery” (RT @NIHR_DC see Tweet)

 


Osteoarthritis of the Knee Clical Care Standard – Australian Commission on Safety and Quality in Health Care (PDF Guideline and other resources)

Source: Research Review Australia (free resource to find articles of interest)

 


Low molecular weight heparin for prevention of venous thromboembolism in patients with lower-limb immobilization – Cochrane Library (link to abstract – $ for full-text)

“Moderate-quality evidence showed that the use of LMWH in outpatients reduced DVT when immobilization of the lower limb was required, when compared with no prophylaxis or placebo”.

 


Long-Term Effects of Repeated Injections of Local Anesthetic With or Without Corticosteroid for Lumbar Spinal Stenosis: A Randomized Trial – Archives of Physical Medicine and Rehabilitation (free)

Source: ACP Journal Wise ($)

“Epidural injections of corticosteroid plus lidocaine offered no benefits from 6 weeks to 12 months beyond that of injections of lidocaine alone”

 


When surgery is just a stitch-up – The Guardian (RT @Onisillos  see Tweet)

Related article: Use of placebo controls in the evaluation of surgery: systematic review – The BMJ (free)

“With evidence mounting that many minor operations owe their success to the placebo effect, is it time to call a halt to some routine procedures?”