Orthopedics

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November 2025
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Effectiveness of various pressures, solutions for wound irrigation of open fractures

Editor's Note Very low pressure irrigation with saline is an acceptable, low-cost alternative for irrigating open fractures, this study finds. Managing open fractures requires wound irrigation and debridement, but the effectiveness of various pressures and solutions remains controversial. Researchers investigated the effects of castile soap versus normal saline irrigation delivered…

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By: Judy Mathias
January 7, 2016
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Psychiatric disorder linked to morbidity after fast-track total joints

Editor's Note In this study, patients with psychiatric disorders (PsDs) requiring psychopharmacological treatments had an increase in postoperative morbidity after fast-track total hip and total knee arthroplasties, regardless of treatment type and preoperative comorbidities. Among PsD patients: Pain, postoperative anemia, and pulmonary complications were the most frequent causes of length…

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By: Judy Mathias
November 19, 2015
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Door openings affect OR pressure during joint arthroplasty

Editor's Note This study from Johns Hopkins Bayview Medical Center, Baltimore, found a significant relationship between OR door openings and room pressure. The OR door was opened, on average, once every 2.5 minutes of surgery. For 77 of 191 knee and hip arthroplasties, the doors were open long enough for…

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By: Judy Mathias
November 18, 2015
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CMS finalizes rule for hip and knee bundled payments

Editor's Note The Centers for Medicare and Medicaid Services (CMS) has finalized the rule that will require hospitals in 67 geographic areas to participate in a test of bundled payments for hip and knee replacements, Modern Healthcare reports. Medicare's average bundled payment ranges from $16,500 to $33,000 for surgery, hospitalization,…

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By: Judy Mathias
November 17, 2015
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Effect of anesthetic management on total joint SSIs

Editor's Note Though recent studies using large databases have concluded that neuraxial compared with general anesthesia is associated with a decreased incidence of SSIs in total joint patients, this 11-year retrospective, controlled study found no difference. The use of peripheral nerve blocks also was not found to influence the incidence…

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By: Judy Mathias
November 10, 2015
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Influence of race on risk of total knee revision

Editor's Note Blacks are at a significantly higher risk of having total knee revision surgery within 5 years than whites, finds a study presented at the American College of Rheumatology Annual Meeting in San Francisco. The risk of revision was 38% higher in blacks. When blacks undergo knee replacement they…

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By: Judy Mathias
November 9, 2015
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Effect of total joint infection control bundle on SSIs

Editor's Note Quality improvement initiatives combined with pulsed xenon ultraviolet room disinfection reduced total knee surgical site infections (SSIs) from four to zero and total hip SSIs from three to zero for a combined prevention of seven SSIs and a savings of $290,990 in 1 year at Trinity Medical Center,…

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By: Judy Mathias
November 3, 2015
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Total knee more effective than nonsurgical treatment, but risks higher

Editor's Note Total knee replacement followed by nonsurgical treatment is more effective than nonsurgical treatment alone in providing pain relief and improving function and quality of life, this study finds. However, clinically relevant improvements were seen in both groups, and the surgical patients had a higher number of serious adverse…

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By: Judy Mathias
October 22, 2015
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FDA launches new features for UDI database

Editor's Note The Food and Drug Administration (FDA) in partnership with the National Library of Medicine on October 19 announced the launch of three new features on AccessGUDID, the public portal to data submitted to the FDA’s Global Unique Device Identification Database (GUDID). Two new APIs (application program interface) and…

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By: Judy Mathias
October 21, 2015
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Differences in 30-day readmission rates after total hips

Editor's Note Researchers found significant differences in the odds of 30-day readmissions after total hip arthroplasties on the basis of race, socioeconomic status, and payer. African American and Hispanic patients had a higher risk of readmissions than white patients. Lower socioeconomic status was linked to higher odds of readmission. Medicare…

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By: Judy Mathias
October 15, 2015
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