Orthopedics (all articles) | Page 2 of 38 | Links Medicus Content Curation & Alerts in Medicine

M-A | Prophylactic intravenous tranexamic acid and thromboembolism in non-cardiac surgery

29 Jun, 2023 | 14:03h | UTC

Prophylactic intravenous tranexamic acid and thromboembolism in non-cardiac surgery: a systematic review, meta-analysis and trial sequential analysis – Anaesthesia

RCT | Arthroscopic capsular shift surgery shows no significant pain or functional improvement in atraumatic shoulder instability

29 Jun, 2023 | 13:45h | UTC

Arthroscopic capsular shift surgery in patients with atraumatic shoulder joint instability: a randomised, placebo-controlled trial – British Journal of Sports Medicine (link to abstract – $ for full-text)

Position Statement | Prehospital hemorrhage control and treatment by clinicians

27 Jun, 2023 | 14:02h | UTC

Prehospital Hemorrhage Control and Treatment by Clinicians: A Joint Position Statement – Annals of Emergency Medicine

Cohort Study | Increased revision rates seen in shoulder replacement surgeries by surgeons with less than 10 procedures annually

27 Jun, 2023 | 13:48h | UTC

Summary: This prospective cohort study investigated the correlation between surgeon volume and patient outcomes after elective shoulder replacement surgeries. Utilizing data from 39,281 procedures performed by 638 surgeons in UK public and private hospitals between 2012-20, the study focuses on adults aged 18 years or older.

The results indicate a significant connection between a surgeon’s mean annual volume and risk of adverse patient outcomes. Surgeons performing fewer than 10.4 procedures per year demonstrated a significantly increased risk of revision surgery, with the hazard ratio being almost twice as high as that of the lowest risk surgeons. Higher mean annual surgical volume correlated with lower risks of reoperations, fewer serious adverse events, and shorter hospital stays.

These findings suggest the need for strategic resource planning in surgical services, with considerations given to surgeon’s annual procedure volume to improve patient outcomes after shoulder replacement surgery. It should be noted that the study was limited in scope to surgeries performed within the NHS and private hospitals in England. Furthermore, potential confounding factors like patients’ social circumstances, carer availability, or body mass index were not considered.

Article: Association between surgeon volume and patient outcomes after elective shoulder replacement surgery using data from the National Joint Registry and Hospital Episode Statistics for England: population based cohort study – The BMJ

Editorial: Surgeon volume and patient outcomes in shoulder replacement surgery – The BMJ

News Release: Patients do better when surgeon averages 10 + annual shoulder ops – BMJ Newsroom

RCT | High-dose dual-antibiotic cement doesn’t lower infection rates in hip hemiarthroplasty

26 Jun, 2023 | 00:47h | UTC

Summary: This randomized superiority trial studied the effect of high-dose dual-antibiotic loaded cement versus standard care single-antibiotic loaded cement on deep surgical site infection (SSI) rates in hip hemiarthroplasty patients. This large-scale study, conducted in 26 UK hospitals, included people aged 60 and older with a hip fracture.

The trial randomly allocated 4936 participants to either treatment group. The primary outcome was deep SSI at 90 days post-randomisation. Notably, no significant difference was found between the groups. About 1.7% of participants in the single-antibiotic group and 1.2% in the dual-antibiotic group experienced a deep SSI (adjusted odds ratio 1.43; 95% CI 0.87–2.35; p=0.16). This result contradicts previous findings suggesting that high-dose dual-antibiotic cement could reduce infection rates.

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