Jbjs reviews 

About: Jbjs reviews is an academic journal published by Journal of Bone and Joint Surgery. The journal publishes majorly in the area(s): Medicine & Arthroplasty. It has an ISSN identifier of 2329-9185. Over the lifetime, 851 publications have been published receiving 9374 citations. The journal is also known as: JBJS Rev & Journal of bone and joint surgery reviews.

Outpatient Total Hip Arthroplasty, Total Knee Arthroplasty, and Unicompartmental Knee Arthroplasty: A Systematic Review of the Literature.

Abstract: Background: The demand for total hip arthroplasty (THA), total knee arthroplasty (TKA), and unicompartmental knee arthroplasty (UKA) is growing rapidly because of the proven success of these procedures and an increase in the aging population. However, resources are limited and health-care budgets are finite. Recently, a number of care providers have started performing these procedures on an outpatient basis, with the patients being discharged from the hospital on the day of surgery. The primary objective of this systematic review was to examine the evidence regarding the safety and feasibility of performing THA, TKA, or UKA on an outpatient basis. Methods: An electronic search of 3 online databases (Embase, MEDLINE, and HealthSTAR) was conducted to identify eligible studies. The reference lists of identified articles were then screened. All studies evaluating outcomes following outpatient THA, TKA, or UKA were included. Eligible articles that included a comparative group were assessed for methodological quality with use of the Cochrane Risk of Bias Assessment Tool for Non-Randomized Studies of Interventions (ACROBAT-NRSI). Non-comparative studies were assessed for quality with use of the Effective Public Health Practice Project (EPHPP) Quality Assessment Instrument. Results: The electronic literature search yielded 805 articles. Following a review of the titles, abstracts and reference lists, 26 articles remained and were assessed for eligibility. Of those, 17 articles (≈79,500 patients) met the inclusion criteria and were included in the review. Although both quality-assessment tools showed that the majority of studies included in the review were of poor quality, there was no increase in readmission rates or perioperative complications among patients who underwent outpatient procedures. Studies assessing satisfaction illustrated a high level of satisfaction for the majority of patients. The average age of the patients in the THA studies ranged from 53.5 to 63 years. The TKA and UKA studies included an older population, with mean ages ranging from 55 to 68 years. The majority of the included studies included a larger percentage of males as compared with females. Of the 17 included studies, 4 were cohort studies with a control group and 13 were case series. All 4 cohort studies indicated that the complication rates and clinical outcomes were similar between the inpatient and outpatient groups. Furthermore, the 3 studies that involved an economic analysis indicated that outpatient arthroplasty is financially advantageous. Conclusions: In selected patients, outpatient THA, TKA, and UKA can be performed safely and effectively. The included studies lacked sufficient internal validity, sample size, methodological consistency, and standardization of protocols and outcomes. There is a need for high-quality prospective cohort and randomized trials to definitively assess the safety and effectiveness of outpatient THA, TKA, and UKA. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

The Value of Preoperative Exercise and Education for Patients Undergoing Total Hip and Knee Arthroplasty: A Systematic Review and Meta-Analysis.

Abstract: Background:Existing evidence regarding the value of preoperative education and/or exercise (prehabilitation) for patients undergoing total joint replacement is conflicting. The purpose of this study was to conduct an updated, comprehensive systematic review with meta-analyses to determine the longit

Total Elbow Arthroplasty: A Systematic Review

Abstract: Background:Most total elbow arthroplasty (TEA) designs aim to replicate anatomy and provide stability in the treatment of the degenerative elbow joint. Given the promising results that have been reported following the use of TEA for the treatment of complex fractures, the indications for this proced

Biological Risk Factors for Nonunion of Bone Fracture.

Abstract: The rate of fracture nonunion averages between 5%[1][1] and 10% for long bones[2][2], and the rate may be increasing with time[3][3]. Nonunion risk is clearly related to the severity of the injury resulting in fracture[4][4]-[10][5]. Randomized clinical trials (RCTs) have also shown that variations

Measuring Value in Orthopaedic Surgery

Abstract: Health-care expenditures currently account for 18% of the United States Gross Domestic Product (GDP)1. Some experts have suggested that an emphasis on value may be an effective strategy to bend the cost curve in health care2,3. However, the value framework is poorly understood4. Most other service industries have shared goals to unite the interest of stakeholders; in the case of health care, however, stakeholders are myriad and their goals are often conflicting5. Under this fragmented system, adopting a patient-oriented definition of value will benefit patients, payers, providers, and suppliers while ensuring the economic sustainability of the health-care system. Thus, in the current review, we have adopted the recommendation proposed by Michael Porter, a Harvard Business School professor and noted health-care policy expert, who defined value as health outcomes achieved per dollar spent6. According to Porter’s definition, value is not a nebulous concept but rather is a measurable economic ratio of outcome to cost (the “value equation”). The numerator …