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Emre Acaroglu Ankara ARTES Spine and Spinal Cord Center, Ankara, Turkey

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European Spine Study Group Hospital Universitari Vall d’Hebron, Barcelona, Spain

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Another problem in decision-making is the potential influence of complications on the outcomes of treatment, especially surgery. Surgery-related factors like blood loss, surgical time, length of hospital stay and length of overall recovery as well as

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Christof Audretsch BG Trauma Center, Department for Traumatology and Reconstructive Surgery, University of Tübingen, Tübingen, Germany

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Alexander Trulson BG Trauma Center, Department of Trauma Surgery, Murnau am Staffelsee, Germany

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Andreas Höch Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Leipzig, Germany

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Steven C Herath BG Trauma Center, Department for Traumatology and Reconstructive Surgery, University of Tübingen, Tübingen, Germany

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Tina Histing BG Trauma Center, Department for Traumatology and Reconstructive Surgery, University of Tübingen, Tübingen, Germany

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Markus A Küper BG Trauma Center, Department for Traumatology and Reconstructive Surgery, University of Tübingen, Tübingen, Germany

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Working Group on Pelvic Fractures of the German Trauma Society
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are still used today for decision-making and thus are also applied in CT assessment. Furthermore, it is well known that the posterior wall is crucial for biomechanical joint stability. Posterior wall fractures, in general, and the grade of fracture

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Mario Herrera-Pérez Foot and Ankle Unit, Orthopaedic Department, Hospital Universitario de Canarias, Tenerife, Spain
School of Medicine, Universidad de La Laguna, Tenerife, Spain

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Pablo Martín-Vélez Foot and Ankle Unit, Orthopaedic Department, Hospital Universitario de Canarias, Tenerife, Spain

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David González-Martín Foot and Ankle Unit, Orthopaedic Department, Hospital Universitario de Canarias, Tenerife, Spain
School of Medicine, Universidad de La Laguna, Tenerife, Spain

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Miguel Domínguez-Meléndez Foot and Ankle Unit, Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain

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Ahmed E Galhoum Specialty Doctor Trauma and Orthopaedics, George Eliot Hospital NHS Trust, Nuneaton, UK

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Victor Valderrabano Schmerzklinik, Basel, Switzerland
University of Basel, Basel, Switzerland

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Sergio Tejero Foot and Ankle Unit, Hospital Universitario Virgen del Rocío, Sevilla, Spain
School of Medicine, Universidad de Sevilla, Sevilla, Spain

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this surgical treatment. This article provides an updated narrative review on this topic and proposes a clinical score system based on clinical factors to help orthopaedic surgeons in the decision-making process. Methodology First, a narrative

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Jun Zhang Department of Orthopedics, Joint Disease and Sport Medicine Center, Xinqiao Hospital, Army Medical University, Chongqing, China

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Erhu Li Department of Orthopedics, st People’s Hospital of Xining, Xining, Qinghai, China

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Yuan Zhang Department of Orthopedics, Joint Disease and Sport Medicine Center, Xinqiao Hospital, Army Medical University, Chongqing, China

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factors affecting decision-making regarding prosthesis options in rTKA The prerequisite for rational selection of a revision system is to identify the mechanism for pTKA failure, risk factors, individual variables, specific goals, and surgical challenges

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Colby Foster Department of Orthopaedic Surgery, Michigan Medicine, Ann Arbor, Michigan, USA

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Christopher Posada Department of Orthopaedic Surgery, Michigan Medicine, Ann Arbor, Michigan, USA
Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA

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Bryan Pack River Valley Orthopaedics/Orthopaedic Associates of Michigan, Grand Rapids, Michigan, USA

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Brian R. Hallstrom Department of Orthopaedic Surgery, Michigan Medicine, Ann Arbor, Michigan, USA

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Richard E. Hughes Department of Orthopaedic Surgery, Michigan Medicine, Ann Arbor, Michigan, USA
Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
Department of Industrial & Operations Engineering, University of Michigan, Michigan, USA

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addition, financial conflicts of interest may affect the reporting of data relevant to clinical decision-making. For example, Labek et al 1 , 2 showed that revision risk captured by a national arthroplasty registry is substantially higher than reports

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Peter van Schie Department of Orthopaedics, Leiden University Medical Centre, Leiden, The Netherlands
Department of Biomedical Data Sciences, Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands

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Shaho Hasan Department of Orthopaedics, Leiden University Medical Centre, Leiden, The Netherlands

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Leti van Bodegom-Vos Department of Biomedical Data Sciences, Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands

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Jan W Schoones Walaeus Library, Leiden University Medical Centre, Leiden, The Netherlands

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Rob G H H Nelissen Department of Orthopaedics, Leiden University Medical Centre, Leiden, The Netherlands

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Perla J Marang-van de Mheen Department of Biomedical Data Sciences, Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands

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  • In order to improve care for total hip and knee arthroplasties (THA/TKA), hospitals may want to compare their performance with hospitals in other countries. Pooling data across countries also enable early detection of infrequently occurring safety issues. We therefore aimed to assess the between-hospital variation and definitions used for revision, readmission, and complications across countries.

  • PubMed, Embase, Web of Science, Cochrane library, Emcare, and Academic Search Premier were searched from January 2009 to August 2020 for studies reporting on: (i) primary THA/TKA; (ii) revision, readmission, or complications; and (iii) between-hospital variation. Most recent registry reports of Network of Orthopedic Registries of Europe members were also reviewed. Two reviewers independently screened records, extracted data, and assessed the risk of bias using the Integrated quality Criteria for the Review Of Multiple Study designs tool for studies and relevant domains for registries. We assessed agreement for the following domains: (i) outcome definition; (ii) follow-up and starting point; (iii) case-mix adjustment; and (iv) type of patients and hospitals included.

  • Between-hospital variation was reported in 33 (1 high-quality, 13 moderate-quality, and 19 low-quality) studies and 8 registry reports. The range of variation for revision was 0–33% for THA and 0–27% for TKA varying between assessment within hospital admission until 10 years of follow-up; for readmission, 0–40% and 0–32% for THA and TKA, respectively; and for complications, 0–75% and 0–50% for THA and TKA, respectively. Indicator definitions and methodological variables varied considerably across domains.

  • The large heterogeneity in definitions and methods used likely explains the considerable variation in between-hospital variation reported for revision, readmission, and complications , making it impossible to benchmark hospitals across countries or pool data for earlier detection of safety issues. It is necessary to collaborate internationally and strive for more uniformity in indicator definitions and methods in order to achieve reliable international benchmarking in the future.

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Nuri Aydin Istanbul University - Cerrahpasa, Cerrahpasa Medical Faculty, Orthopaedics and Traumatology Department, Istanbul, Turkey

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Mahmut Enes Kayaalp Istanbul University - Cerrahpasa, Cerrahpasa Medical Faculty, Orthopaedics and Traumatology Department, Istanbul, Turkey

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Mustafa Asansu Baltalimani Bone Diseases Training and Research Hospital, Orthopaedics and Traumatology Department, Istanbul, Turkey

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Bedri Karaismailoglu Istanbul University - Cerrahpasa, Cerrahpasa Medical Faculty, Orthopaedics and Traumatology Department, Istanbul, Turkey

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surgical treatment in terms of pain, ROM and function. 9 The surgical treatment options are explained below. Fig. 1 Decision-making for the treatment of locked posterior shoulder dislocations. Table 1. List of treatment options for

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Paul Hoogervorst OLVG Amsterdam, Department of Orthopaedics and Traumatology, Amsterdam

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Peter van Schie OLVG Amsterdam, Department of Orthopaedics and Traumatology, Amsterdam

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Michel PJ van den Bekerom OLVG Amsterdam, Department of Orthopaedics and Traumatology, Amsterdam

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Robinson classification. The location and type of fracture is important in the decision-making as it influences management strategies. This paper focuses on the most common clavicle fractures, which are those in the mid-diaphyseal third (Allman 1 and

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Alli Gokeler University of Groningen, University Medical Center Groningen, Center for Human Movement Science, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands

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Bart Dingenen Rehabilitation Research Institute, Biomedical Research Institute, Faculty of Medicine and Life Sciences, UHasselt, Diepenbeek, Belgium

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Caroline Mouton Département de l’Appareil Locomoteur, Centre Hospitalier de Luxembourg – Clinique d’Eich, 76, rue d’Eich, L-1460 Luxembourg, Luxembourg

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Romain Seil Département de l’Appareil Locomoteur, Centre Hospitalier de Luxembourg – Clinique d’Eich, 76, rue d’Eich, L-1460 Luxembourg, Luxembourg and Sports Medicine Research Laboratory, Luxembourg Institute of Health, 76, rue d’Eich, L-1460 Luxembourg, Luxembourg

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, all stakeholders involved (e.g. surgeon, physical therapist, coach, patient, etc.) in the RTS decision-making process should prioritise a safe RTS, i.e. a RTS with minimal risk of sustaining a re-injury and/or developing long-term complications such as

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Stephen Gates Department of Orthopaedic Surgery, Shoulder Service, University of Texas Southwestern Medical Center, Dallas, Texas, USA

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Brain Sager Department of Orthopaedic Surgery, Shoulder Service, University of Texas Southwestern Medical Center, Dallas, Texas, USA

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Michael Khazzam Department of Orthopaedic Surgery, Shoulder Service, University of Texas Southwestern Medical Center, Dallas, Texas, USA

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information to facilitate intraoperative decision-making and hardware implantation. 40 Accurate glenoid component positioning, especially in the setting of significant deformity such as B2/B3 glenoid, is one of the more difficult intraoperative challenges

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