RESUMO
Orthopedic aid to developing nations is expanding and becoming a unique facet of the specialty. This investigation seeks to compare patient impressions and concerns regarding the care patients receive as part of an itinerant surgical aid trip in 2 nations. In 2013 and 2014, patients from 2 separate nations completed a Likert scale survey assessing impressions of the care they received at the hands of a surgical team from abroad. Mean response scores were calculated and compared using a t test. This is the first investigation to compare patient concerns across 2 nations in a surgical aid trip setting. The results highlight the importance of culture in understanding patients and the impressions of the care they receive.
Assuntos
Artroplastia de Quadril/psicologia , Artroplastia do Joelho/psicologia , Assistência à Saúde Culturalmente Competente/estatística & dados numéricos , Missões Médicas/estatística & dados numéricos , Ortopedia/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Guatemala , Humanos , Cooperação Internacional , Internacionalidade , Masculino , Pessoa de Meia-Idade , Nicarágua , Equipamentos Ortopédicos , Inquéritos e Questionários , Adulto JovemRESUMO
Over the past decade the popularity of foreign medical aid has increased and gained notoriety. Operation Walk is a philanthropic organization dedicated to improving the ambulatory potential of patients in developing countries by providing free surgical treatment for patients who otherwise lack access to care of debilitating bone and joint conditions. During Operation Walk Mooresville's 2013 trip to Guatemala 40 patients prospectively completed a Likert Scale style survey. The 63-question survey assessed patient impressions and concerns regarding the care they receive as part of itinerant surgical aid trips. Mean scores were calculated and then concerns were ranked accordingly. We are aware of no other investigation assessing these sorts of patient centered perspectives for international surgical aid trips.
Assuntos
Missões Médicas , Doenças Musculoesqueléticas/cirurgia , Procedimentos Ortopédicos , Atividades Cotidianas , Adolescente , Adulto , Idoso , Criança , Feminino , Guatemala , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Ortopédicos/efeitos adversos , Procedimentos Ortopédicos/psicologia , Avaliação de Resultados em Cuidados de Saúde , Satisfação do Paciente , Assistência Centrada no Paciente , Qualidade de Vida , Autorrelato , Inquéritos e Questionários , Estados Unidos , Adulto JovemRESUMO
Periacetabular osteotomy has become the procedure of choice in many centers for the treatment of symptomatic hip dysplasia in young patients without severe secondary hip arthritis. Reorientation pelvic osteotomy has the potential for large blood loss and the need for blood transfusion. Between 1996 and 2003, 108 periacetabular osteotomies (107 patients) were performed by one of the authors. There were 84 females and 23 males with an average age of 30 years at the time of surgery. The overall allograft transfusion rate was 20% (21/108). Ninety-four percent (101/108) of the patients received transfusions including autologous blood, intraoperative cell saver, and postoperative allograft transfusion. The average transfusion amount (cell saver and allograft) was 2.14 units per patient. The risk for transfusion between males and females was not significantly different. The data from this study suggest that the vast majority of patients undergoing periacetabular osteotomy will require some form of transfusion, with 20% requiring allograft blood. The need for allograft blood will be minimal if the preoperative hemoglobin is greater than 12 g/dL.
Assuntos
Transfusão de Sangue/estatística & dados numéricos , Osteotomia/métodos , Acetábulo/patologia , Acetábulo/cirurgia , Adolescente , Adulto , Perda Sanguínea Cirúrgica/estatística & dados numéricos , Criança , Feminino , Luxação Congênita de Quadril/cirurgia , Humanos , Doença de Legg-Calve-Perthes/cirurgia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Adulto JovemRESUMO
Some surgeons have suggested that a minimally invasive two-incision approach allows total hip arthroplasty to be done without cutting or damaging any muscle or tendon. To our knowledge that claim has not been supported by any published clinical or basic science data. Our purpose in doing this study was to quantify the extent and location of damage to the abductor and external rotator muscles and tendons after two-incision and mini-posterior total hip arthroplasty. Ten cadavers (20 hips) were studied. In each cadaver one hip randomly was assigned to the two-incision group and the contralateral hip was assigned to the mini-posterior group. After inserting the total hip arthroplasty components the muscle damage was assessed using a technique described previously. Damage to the muscle of the gluteus medius and gluteus minimus was substantially greater with the two-incision technique than with the mini-posterior technique. Every two-incision total hip replacement caused measurable damage to the abductors, the external rotators, or both. Every mini-posterior hip replacement caused the external rotators to detach during the exposure and had additional measurable damage to the abductor muscles and tendon. We do not support the contention that a two-incision total hip arthroplasty is done without cutting muscle or tendon. None of the two-incision hip replacements were done without cutting, reaming, or damaging the gluteus medius or gluteus minimus muscle or external rotators.