Abstract:
BACKGROUND:Clinical evidence shows knee arthroscopy has little benefit for degenerative conditions and considerable variation in the incidence of knee arthroscopy in Australia has been identified. This study aimed to evaluate a clinician-led evidence-based policy which was implemented in one local health district in New South Wales (NSW) in 2012 to reduce the use of knee arthroscopy for patients aged 50 years or over. METHODS:Trends in rates and volume of knee arthroscopy for patients 50 years or over in NSW between 2004 and 2015 by district were examined. Changes at four hospitals that adopted the policy were assessed by a quasi-experimental before and after study design with control groups, using the generalised estimating equations (GEE) Poisson model. Each case hospital was matched with four control hospitals in terms of the volume of knee arthroscopy surgeries performed in the five years prior to the intervention. RESULTS:Between 2004 and 2015, the number of knee arthroscopies in NSW initially increased and then decreased after 2011, with considerable variation across districts. While an overall reducing trend in NSW was observed between 2011 and 2015 (39%), a 58% reduction (95% CI: 55-62%) was found in the intervention district, including the private sector, being the greatest reduction found in all districts. The GEE Poisson results show that, compared with control hospitals, the number of knee arthroscopy was significantly reduced by 56% (95% CI: 11%-79%) at four hospitals that adopted the policy during the follow-up period (p = 0.02). CONCLUSIONS:Clinicians in one local health district initiated a policy to restrict knee arthroscopy for patients aged 50 years or over, which may explain the greater reduction seen in that district compared to all others, despite an overall decrease noted in the state. A significant reduction found at intervened hospitals proved the effect of the policy, suggesting that the implementation of a simple clinical governance process may help reduce inappropriate surgery.
journal_name
BMC Musculoskelet Disordjournal_title
BMC musculoskeletal disordersauthors
Chen HY,Harris IA,Sutherland K,Levesque JFdoi
10.1186/s12891-018-2043-5subject
Has Abstractpub_date
2018-05-16 00:00:00pages
148issue
1issn
1471-2474pii
10.1186/s12891-018-2043-5journal_volume
19pub_type
杂志文章abstract:BACKGROUND:Quantification of vertebral bone marrow (VBM) water-fat composition has been proposed as advanced imaging biomarker for osteoporosis. Estrogen deficiency is the primary reason for trabecular bone loss in postmenopausal women. By reducing estrogen levels aromatase inhibitors (AI) as part of breast cancer ther...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-019-2916-2
更新日期:2019-11-06 00:00:00
abstract:BACKGROUND:Lateral condylar humerus fractures (LCHFs) are the second most common pediatric distal humerus fractures. Open reduction and internal fixation is recommended for fractures displaced by more than 2 mm. Few studies described using closed reduction and percutaneous pinning (CRPP) for treating fractures with gre...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-020-03738-9
更新日期:2020-10-27 00:00:00
abstract:BACKGROUND:The primary objective of this study was to assess the interobserver and intraobserver agreement on ligamentous injuries on conventional magnetic resonance imaging (MRI) in acute simple elbow dislocation. The secondary objectives were to determine the interobserver agreement on the assessment of joint congrui...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-017-1451-2
更新日期:2017-02-20 00:00:00
abstract:BACKGROUND:Osteotomies in the cervical spine are technically challenging. The purpose of this study was to evaluate the feasibility of the modified pedicle subtraction osteotomy (PSO) technique at C7 to be used for the treatment of cervicothoracic kyphosis secondary to ankylosing spondylitis. METHODS:A total of 120 ce...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-020-3053-7
更新日期:2020-01-14 00:00:00
abstract:BACKGROUND:Our aim was to examine the association between an expert clinician's impression of symptomatic meniscal tears and subsequent MRI in the context of middle-aged and older adults with knee pain. METHODS:Patients older than 45 were eligible for this IRB-approved substudy if they had knee pain, had not undergone...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-016-1010-2
更新日期:2016-04-11 00:00:00
abstract:BACKGROUND:In recent years, the scientific discussion has focused on new strategies to enable a torn anterior cruciate ligament (ACL) to heal into mechanically stable scar tissue. Dynamic intraligamentary stabilization (DIS) was first performed in a pilot study of 10 patients. The purpose of the current study was to ev...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-015-0484-7
更新日期:2015-02-13 00:00:00
abstract:BACKGROUND:Current treatments for the prevention of thromboembolism include heparin and low-molecular weight heparins (LMWHs). A number of studies have suggested that long term administration of these drugs may adversely affect osteoblasts and therefore, bone metabolism. Xarelto™ (Rivaroxaban) is a new anti-thrombotic ...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/1471-2474-12-247
更新日期:2011-10-28 00:00:00
abstract:BACKGROUND:To identify the optimal viewing angles for every proximal screw in PHILOS plate-fixed proximal humeral fractures. METHODS:Three fresh-frozen human cadaveric bodies with six intact shoulders were studied. All three bodies were put in the beach chair position and PHILOS plates were placed on the proximal hume...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-018-2247-8
更新日期:2018-09-07 00:00:00
abstract:BACKGROUND:Exercise programmes have shown to be important for the prevention of fractures in patients with established osteoporosis. However, few studies have evaluated the effect of such programmes for women with low bone mineral density (BMD) (osteoporosis or osteopenia) who have already suffered a fracture. Studies ...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12891-015-0811-z
更新日期:2015-11-14 00:00:00
abstract:BACKGROUND:The incidence of distal radius fracture has increased substantially during the last 50 years according to several studies that estimated the overall incidence in various general populations. The incidence of fracture classified according to severity has not been well documented. The aim of this population-ba...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/1471-2474-8-48
更新日期:2007-05-31 00:00:00
abstract:BACKGROUND:The majority of individuals with spinal muscular atrophy (SMA) experience progressive skeletal deformities which may affect the quality of life and mobility. To date, no studies have evaluated the reliability of tests assessing body posture and joint mobility in SMA patients. The purpose of this study was to...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-018-2389-8
更新日期:2019-02-07 00:00:00
abstract:BACKGROUND:Low-dye (LD) taping is commonly used to reduce rearfoot pronation. No studies have previously investigated the effectiveness of LD taping using both plantar pressure distribution (F-Scan) and 3-D (CODA) analysis of rearfoot motion. METHODS:20 healthy subjects with a navicular drop test exceeding 10 mm parti...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/1471-2474-9-111
更新日期:2008-08-18 00:00:00
abstract:BACKGROUND:Studies exploring the association between physical activity, screen time and sleep and pain usually focus on a limited number of painful body sites. Nevertheless, pain at different body sites is likely to be of different nature. Therefore, this study aims to explore and compare the association between time s...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-017-1557-6
更新日期:2017-05-16 00:00:00
abstract:BACKGROUND:Optimal management for adhesive shoulder capsulitis (frozen shoulder) is currently unclear. We intended to explore whether treatment by intra-articular injections with corticosteroid and distension is more effective than treating with corticosteroids alone or treatment-as-usual in a primary care setting in N...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12891-016-1081-0
更新日期:2016-05-26 00:00:00
abstract:BACKGROUND:There are an overwhelming number of patients suffering from low back pain (LBP) resulting from disc pathology. Although several strategies are being developed pre-clinically, simple strategies to treat the large number of patients currently affected is still needed. One option is to use concentrated bone mar...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-020-3126-7
更新日期:2020-02-28 00:00:00
abstract:BACKGROUND:Even though there are several region-specific functional outcome questionnaires measuring neck disorders that have been developed in English-speaking countries, no Polish version has ever been validated. The purpose of our study was to translate, culturally adapt and validate the Neck Disability Index (NDI) ...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/1471-2474-12-84
更新日期:2011-04-29 00:00:00
abstract:BACKGROUND:Meniscus injury and meniscectomy both entail increased risk of knee osteoarthritis (OA). Thigh muscle weakness is a suggested mediator of OA but there is little evidence of its importance for knee OA development after meniscectomy. This study aimed to examine the association between thigh muscle strength aft...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-019-2875-7
更新日期:2019-11-03 00:00:00
abstract:BACKGROUND:Back, neck and shoulder pain are the most common causes of occupational disability. They reduce health-related quality of life and have a significant economic impact. Many different forms of physical treatment are routinely used. The objective of this study was to estimate the cost of physical treatments whi...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/1471-2474-12-287
更新日期:2011-12-21 00:00:00
abstract:BACKGROUND:Primary total hip arthroplasty (THA) is an effective treatment for hip osteoarthritis, assessed by whatever distribution-based measures of responsiveness. Yet, the group level evaluation has provided very little evidence contributes to our understanding of the large variation of treatment outcome. The object...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/1471-2474-6-48
更新日期:2005-09-06 00:00:00
abstract:BACKGROUND:Duchenne muscular dystrophy (DMD) is a severe neuromuscular disease that affects 1 in 3500 boys. The disease is characterized by progressive muscle degeneration that results from mutations in or loss of the cytoskeletal protein, dystrophin, from the glycoprotein membrane complex, thus increasing the suscepti...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/1471-2474-12-127
更新日期:2011-06-04 00:00:00
abstract:BACKGROUND:Perioperative blood management is an important issue in the treatment of elderly patients at an increased risk of postoperative complications. Accordingly, tranexamic acid (TXA) is widely administered to reduce blood loss and transfusion requirements. In this case-control study, the effect of topical TXA on ...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-019-2615-z
更新日期:2019-05-17 00:00:00
abstract:BACKGROUND:Full-endoscopic lumbar discectomy (FELD) is an alternative to posterior open surgery to treat a high-grade migrated herniated disc. However, because of the complexity of the surgery, success is dependent on the surgeon's skill. Therefore, patients are frequently treated using open discectomy. Anatomical cons...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-020-03891-1
更新日期:2021-01-09 00:00:00
abstract:BACKGROUND:Fractures to the base of the fifth metatarsal are common, but their treatment remains controversial. Especially for Lawrence and Botte (L&B) type II fractures, there is conflicting evidence and consequently no consensus. Further, many authors consider displacement, articular involvement, and number of fragme...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-017-1893-6
更新日期:2017-12-16 00:00:00
abstract:BACKGROUND:Injuries to the hamstring muscles are among the most common in sports and account for significant time loss. Despite being so common, the injury mechanism of hamstring injuries remains to be determined. PURPOSE:To investigate the hamstring injury mechanism by conducting a systematic review. STUDY DESIGN:A ...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-020-03658-8
更新日期:2020-09-29 00:00:00
abstract:BACKGROUND:There is consistent evidence that supervised programs are not superior to home-based programs after total knee arthroplasty (TKA), especially in patients without complications. Home-based exercise programs are effective, but we hypothesize that their effectiveness can be improved by increasing the adherence ...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12891-017-1647-5
更新日期:2017-07-05 00:00:00
abstract:BACKGROUND:Oxidative stress (OxS) has recently been linked with osteoporosis; however, we do not know the influence of OxS as an independent risk factor for this disease. METHODS:We conducted a case-control study in 94 subjects > or =60 years of age, 50 healthy and 44 with osteoporosis. We measured total antioxidant s...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/1471-2474-8-124
更新日期:2007-12-19 00:00:00
abstract:BACKGROUND:The efficacy, safety and tolerability of lumiracoxib, a novel selective cyclooxygenase-2 (COX-2) inhibitor, has been demonstrated in previous studies of patients with osteoarthritis (OA). As it is important to establish the long-term safety and efficacy of treatments for a chronic disease such as OA, the pre...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1471-2474-9-32
更新日期:2008-03-07 00:00:00
abstract:BACKGROUND:Pelvic girdle pain (PGP) is common during pregnancy but the causes remain poorly understood. Generalized joint hypermobility (GJH) is an inherited trait, with joint mobility beyond normal limits and is assumed to be related with PGP. The aim of this project was to study the association between self-reported ...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-020-03486-w
更新日期:2020-07-20 00:00:00
abstract:BACKGROUND:Data about minimally invasive surgery for the treatment of patients with degenerative disc disease (DDD) has been reported. However, no quantitative knowledge about the biomechanical characteristics of the spinous processes in patients with DDD after operation was reported in the literature. METHODS:Fourtee...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-017-1504-6
更新日期:2017-04-04 00:00:00
abstract:BACKGROUND:Current guidelines for the management of patients with specific low back pain pathology suggest non-surgical intervention as first-line treatment, but there is insufficient evidence to make recommendations of the content in the non-surgical intervention. Opinions regarding the dose of non-surgical interventi...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12891-016-1126-4
更新日期:2016-07-11 00:00:00