TITLE

Are Surgeons' Preferences for Instrumentation Related to Patient Outcomes?

AUTHOR(S)
Wright, James G.; Donaldson, Sandra; Howard, Andrew; Stephens, Derek; Alman, Benjamin; Hedden, Douglas
PUB. DATE
December 2007
SOURCE
Journal of Bone & Joint Surgery, American Volume;Dec2007, Vol. 89-A Issue 12, p2684
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Although many techniques for the surgical treatment of scoliosis have been described we are not aware of any randomized trials that have compared implant systems. The relationship between surgeons' preferences for implants and patient outcomes is unknown. The purpose of the present study was to compare quality of life and curve correction associated with use of the Moss Miami system and the Universal Spine System for spinal fusion in patients with adolescent idiopathic scoliosis. Methods: The present study was a double-blind, randomized clinical trial. All adolescent patients with idiopathic scoliosis who were scheduled for posterior instrumentation and arthrodesis with or without anterior release were screened for eligibility. Patients were randomly allocated to treatment with either the Moss Miami system or the Universal Spine System. The primary outcome measure for this trial was Quality of Life Profile for Spinal Disorders. Results: Of the 129 subjects who were enrolled in the trial, sixty (95%) of sixty-three from the Universal Spine System group and sixty (91%) of sixty-six from the Moss Miami group were included in the final analysis. Two years postoperatively, the total Quality of Life score did not differ by the clinically important value of 5.5 between the two groups (difference, 1.07; 95% confidence interval, 3.67 to 5.82; p = 0.66). The percentage of Cobb angle correction was not significantly different for thoracic curves (55.1% ± 18.3% for the Moss Miami system group, compared with 54.1% ± 18.7% for the Universal Spine System group) (difference, - 1%; 95% confidence interval, - 7%to 5%; p = 0.77) or lumbar curves (45.4% ± 24.6% for the Moss Miami system group, compared with 41.9% ± 26.8% for the Universal Spine System group) (difference, -4%; 95% confidence interval, -16% to 11%; p = 0.57). Although surgeons were more satisfied with the Universal Spine System (difference, 42%; 95% confidence interval, 29% to 55%; p <0.0001), satisfaction ratings were not related to any surgical outcomes. Conclusions: The Moss Miami system and the Universal Spine Systems provided similar quality of life and curve correction. Surgeon preference may be an unreliable means of selecting implants from the patient outcomes perspective.
ACCESSION #
31710465

 

Related Articles

  • Long-term results after a triple arthrodesis of the hindfoot: function and satisfaction in 36 patients. Ingrid de Groot; Max Reijman; Hilco Luning; Jan Verhaar // International Orthopaedics;Apr2008, Vol. 32 Issue 2, p237 

    Abstract  The long-term functional results of a triple arthrodesis of the hindfoot are not well known. In this retrospective cohort study we therefore investigated pain, function and aligment of the tibiotalar joint, patient satisfaction with the procedure and the prevalence of...

  • Biomechanical investigation of a novel ratcheting arthrodesis nail. McCormick, Jeremy J.; Xinning Li; Weiss, Douglas R.; Billiar, Kristen L.; Wixted, John J. // Journal of Orthopaedic Surgery & Research;2010, Vol. 5, p74 

    Background: Knee or tibiotalocalcaneal arthrodesis is a salvage procedure, often with unacceptable rates of nonunion. Basic science of fracture healing suggests that compression across a fusion site may decrease nonunion. A novel ratcheting arthrodesis nail designed to improve dynamic...

  • Lumbar Total Disc Replacement. Tropiano, Patrick; Huang, Russel C.; Girardi, Federico P.; Cammisa Jr., Frank P.; Marnay, Thierry // Journal of Bone & Joint Surgery, American Volume;Mar2006 Supplement 1, Vol. 88-A, p50 

    BACKGROUND: Symptomatic lumbar degenerative disc disease is a challenging entity to treat. The results of arthrodesis may be compromised in the short term by pseudarthrosis and in the long term by pain at the iliac-crest donor site and by junctional degeneration. Total disc replacement has the...

  • Outcome of transpedicular screw fixation and posterior spinal fusion for degenerative spondylolisthesis. Khan, A. M.; Levack, B. // European Journal of Orthopaedic Surgery & Traumatology;Jun2003, Vol. 13 Issue 2, p67 

    Aims. (1) To assess the results of decompression instrumentation and posterior spinal fusion for degenerative spondylolisthesis in a district general hospital. (2) To establish whether this procedure can be performed safely outside a specialised unit. Methods. Thirty-one consecutive patients...

  • Influence of lower limb rotation in navigated alignment analysis: implications for high tibial osteotomies. Kendoff, D.; Citak, M.; Pearle, A.; Gardner, M.; Hankemeier, S.; Krettek, C.; Hüfner, T. // Knee Surgery, Sports Traumatology, Arthroscopy;Sep2007, Vol. 15 Issue 8, p1003 

    Inaccurate coronal plane realignment is a common problem after high tibial osteotomy. It has been shown that lower limb rotation has an effect on the two-dimensional measurement of lower limb alignment. Although alignment errors are known to occur due to limb rotation, the magnitude of this...

  • Knee arthrodesis using circular external fixator in the treatment of infected knee prosthesis: case report. Gunes, Taner; Sen, Cengiz; Erdem, Mehmet // Knee Surgery, Sports Traumatology, Arthroscopy;May2005, Vol. 13 Issue 4, p329 

    A patient (68 years old and male) underwent total knee replacement because of arthrosis, but he subsequently had infection due to a wound problem. Although he underwent early debridement, antibiotherapy, and soft-tissue operation, treatment failed because of improper soft-tissue coverage and...

  • Impact of age and comorbidity burden on mortality and major complications in older adults undergoing orthopaedic surgery: an analysis using the Japanese diagnosis procedure combination database. Chikuda, Hirotaka; Yasunaga, Hideo; Horiguchi, Hiromasa; Takeshita, Katsushi; Sugita, Shurei; Taketomi, Shuji; Fushimi, Kiyohide; Tanaka, Sakae // BMC Musculoskeletal Disorders;2013, Vol. 14 Issue 1, p1 

    Background: The purpose of this study was to examine how complications in older adults undergoing orthopaedic surgery vary as a function of age, comorbidity, and type of surgical procedure. Methods: We abstracted data from the Japanese Diagnosis Procedure Combination database for all patients...

  • Does Smoking Influence Fusion Rates in Posterior Cervical Arthrodesis With Lateral Mass Instrumentation? Eubanks, Jason David; Thorpe, Steven W.; Cheruvu, Vinay K.; Braly, Brett A.; Kang, James D. // Clinical Orthopaedics & Related Research;Mar2011, Vol. 469 Issue 3, p696 

    Background: Smoking is associated with reduced fusion rates after anterior cervical decompression and arthrodesis procedures. Posterior cervical arthrodesis procedures are believed to have a higher fusion rate than anterior procedures. Questions/purposes: We asked whether smoking (1) would...

  • Treatment of Advanced Stages of Hallux Rigidus with Cheilectomy and Phalangeal Osteotomy. O'Malley, Martin Joseph; Basran, Harpreet S.; Gu, Yang; Sayres, Stephanie; Deland, Jonathan T. // Journal of Bone & Joint Surgery, American Volume;4/3/2013, Vol. 95-A Issue 7, p606 

    Background: Surgical treatment of hallux rigidus has usually consisted of cheilectomy for mild to moderate disease and arthrodesis for more advanced disease. The reported failure rate for cheilectomy alone in patients with advanced disease is approximately 37.5%. We reported our results with the...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics