Evidence-Based Orthopaedics E-Book , livre ebook

EVIDENCE-BASED ORTHOPAEDICS
The Best Answers to Clinical Questions
First Edition

James G. Wright, MD, MPH, FRCSC
Professor, Departments of Surgery, Public Health Sciences, and Health Policy, Management and Evaluation, University of Toronto, Toronto
Surgeon-in-Chief, Chief of Perioperative Services, and Robert B. Salter Chair of Paediatric Surgical Research, Hospital for Sick Children, Toronto, Ontario, Canada

SECTION EDITORS
Henry Ahn, MD, FRCSC
Department of Surgery, Division of Orthopaedic Surgery, University of Toronto, Toronto
Specialist, Adult Spinal Disorders and Trauma, Division of Orthopaedic Surgery, St. Michael’s Orthopaedic Associates, St. Michael’s Hospital, Toronto, Ontario, Canada

Brent Graham, MD, MSc, FRCSC
Assistant Professor, Department of Surgery, Divisions of Orthopaedic Surgery and Plastic Surgery, University of Toronto, Toronto
Director, Hand Program, University Health Network, Toronto, Ontario, Canada

Andrew Howard, MD, MSc, FRCSC
Associate Professor, Department of Surgery, University of Toronto, Toronto
Pediatric Orthopaedic Surgeon, Department of Orthopaedic Surgery, The Hospital for Sick Children
Director, Office of International Surgery, University of Toronto, Toronto, Ontario, Canada

Hans J. Kreder, MD, MPH, FRCSC
Associate Professor, Departments of Orthopaedic Surgery and Health Policy, Management, and Evaluation, University of Toronto
Marvin Tile Chair and Chief, Division of Orthopaedics, Program Chief, Holland Musculoskeletal Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
Adjunct Scientist, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada

Johnny Tak-Choy Lau, MD, MSc, FRCSC
Assistant Professor, Department of Surgery, University of Toronto
Consultant Orthopaedic Surgeon, Department of Surgery, University Health Network, Toronto Western Division, Toronto, Ontario, Canada

Sheldon S. Lin, MD
Associate Professor, Department of Orthopaedic Surgery, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey, USA
Chief of Foot and Ankle, North Jersey Orthopedic Institute, Newark, New Jersey, USA

Nizar N. Mahomed, MD, ScD, FRCSC
Associate Professor, Smith and Nephew Chair in Orthopaedic Surgery Research, Department of Surgery, University of Toronto
Director, Musculoskeletal Health and Arthritis Program, Department of Surgery, University Health Network, Toronto, Ontario, Canada

Daniel Whelan, MD, MSc, FRCSC
Assistant Professor, Department of Surgery, University of Toronto
Orthopaedic Staff Surgeon, Department of Surgery, St. Michael’s Hospital, Toronto, Ontario, Canada
Copyright © 2009 by Saunders, an imprint of Elsevier Inc.
SAUNDERS
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EVIDENCE-BASED ORTHOPAEDICS: THE BEST ANSWERS TO CLINICAL QUESTIONS
ISBN: 978-1-4160-4444-4
Copyright © 2009 by Saunders, an imprint of Elsevier Inc.
All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Permissions may be sought directly from Elsevier’s Rights Department: phone: (+1) 215 239 3804 (US) or (+44) 1865 843830 (UK); fax: (+44) 1865 853333; e-mail: healthpermissions@elsevier.com . You may also complete your request on-line via the Elsevier website at http://www.elsevier.com/permissions .


NOTICE
Knowledge and best practice in this field are constantly changing. As new research and experience broaden our knowledge, changes in practice, treatment and drug therapy may become necessary or appropriate. Readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of the practitioner, relying on their own experience and knowledge of the patient, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the Editors assumes any liability for any injury and/or damage to persons or property arivsing out of or related to any use of the material contained in this book.
The Publisher
Library of Congress Cataloging-in-Publication Data
Evidence-based orthopaedics: the best answers to clinical questions / [edited by] James G. Wright. – 1st ed.
p.; cm.
Includes bibliographical references.
ISBN 978-1-4160-4444-4
1. Orthopedics-Miscellanea. 2. Evidence-based medicine. I. Wright, James G. (James Gardner), 1957-[DNLM: 1. Orthopedic Procedures-methods. 2. Evidence–Based Medicine-methods. WE 190 E935 2009]
RD732.E95 2009
616.7–dc22
2008034472
Publishing Director: Kim Murphy
Developmental Editor: John Ingram, Faith Brody
Project Manager: Mary Stermel
Designer: Steve Stave
Marketing Manager: Catlina Nolte
Printed in the United States of America
Last digit is the print number: 9 8 7 6 5 4 3 2 1
Dedication
This book is dedicated to all of the orthopaedic surgeons who work so hard to do the right thing for their patients.
Foreword
I am honored to be invited by Dr. Wright to write the foreword to this precedent-setting textbook. Over the last decade the discipline of orthopaedic surgery has advanced primarily because of a much more substantial emphasis on evidence-based decision making in clinical practice. Many orthopaedic journals have focused on the quality of study design in the articles that they have published, and have encouraged authors to pursue higher-level studies. Although there are many questions related to musculoskeletal care that, because of the rarity of the disease or the uniqueness of the clinical circumstances, will never be subjected to randomized controlled trials, many important clinical questions in orthopaedics can be addressed with well-designed Level II and III studies. Although the older orthopaedic literature was replete with reports of retrospective case series, and many book chapters and podium presentations simply reflected the opinion of the author or presenter, much more reliable information is now becoming available on many important clinical questions. This textbook presents a rich sampling of this higher-level evidence in a concise and easy-to-read format that is focused on specific areas of clinical interest. The authors have done an outstanding job of culling the critical studies from the literature and providing the reader with useful clinical insights. Dr. Wright and his collaborators are to be congratulated on providing a compendium of clinically important information that will enable us all to advance the quality of the care of our patients based on scientific principles.

JAMES D. HECKMAN, MD, Boston, Massachusetts, November 20, 2007
Contributors

SECTION EDITORS Henry Ahn, MD, FRCSC, Department of Surgery, Division of Orthopaedic Surgery, University of Toronto, Toronto, Ontario, Canada, Specialist, Adult Spinal Disorders and Trauma, Division of Orthopaedic Surgery, St. Michael’s Orthopaedic Associates, St. Michael’s Hospital, Toronto, Ontario, Canada, Spinal Topics

Brent Graham, MD, MSc, FRCSC, Assistant Professor, Department of Surgery, Divisions of Orthopaedic Surgery and Plastic Surgery, University of Toronto, Toronto, Ontario, Canada, Director, Hand Program, University Health Network, Toronto, Ontario, Canada, Upper Extremity Topics

Andrew Howard, MD, MSc, FRCSC, Associate Professor, Departments of Surgery, University of Toronto, Toronto, Ontario, Canada, Paediatric Orthopaedic Surgeon, Department of Orthopaedic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada, Director, Office of International Surgery, University of Toronto, Toronto, Ontario, Canada, Pediatric Topics

Hans J. Kreder, MD, MPH, FRCSC, Associate Professor, Departments of Orthopaedic Surgery and Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada, Marvin Tile Chair and Chief, Division of Orthopaedics, Program Chief, Holland Musculoskeletal Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada, Adjunct Scientist, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada, Trauma Topics

Johnny Tak-Choy Lau, MD, MSc, FRCSC, Assistant Professor, Department of Surgery, University of Toronto, Toronto, Ont ario, Canada, Consultant Orthopaedic Surgeon, Department of Surgery, University Health Network, Toronto, Western Division, Toronto, Ontario, Canada, Foot and Ankle Topics

Sheldon S. Lin, MD, Associate Professor, Department of Orthopaedic Surgery, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey, USA, Foot and Ankle Topics

Nizar N. Mahomed, MD, ScD, FRCSC, Associate Professor, Smith and Nephew Chair in Orthopaedic Surgery Research, Department of Surgery, University of Toronto, Toronto, Ontario, Canada, Director, Musculoskeletal Health and Arthritis Program, Department of Surgery, University Health Network, Toronto, Ontario, Canada, Arthroplasty Topics

Daniel Whelan, MD, MSc, FRCSC, Assistant Professor, Department of Surgery, University of Toronto, Toronto, Ontario, Canada, Orthopaedic Staff Surgeon, Department of Surgery, St. Michael’s Hospita