David Appleby

• MPH, Biostatistics and Epidemiology
• Managing Director at ZOLL Medical Corporation

The objective of this study was to determine the representative outcomes of the intradiscal electrothermal therapy (IDET) procedure in terms of pain relief, reduction of disability, and risk of complications. Meta-analysis, using a random-effects model. A Medline literature search was conducted using search terms associated with the IDET procedure...

The purpose of this study was to determine the cost-effectiveness of knee arthroscopy and anterior cruciate ligament (ACL) reconstruction. Retrospective analysis of prospectively collected data from a single-surgeon, institutional review board-approved outcomes registry included 2 cohorts: surgically treated knee arthroscopy and ACL reconstruction...

Following anatomic double-bundle anterior cruciate ligament (ACL) reconstruction with hamstring tendon autografts, 38 consecutive patients were evaluated with high-speed three-dimensional computed tomography. Scans were performed within 3 days following surgery. The length and width of the reconstructed ACL footprint were measured on axial images....

Our purpose was to determine the optimal treatment of anterior cruciate ligament (ACL) rupture in patients aged 40 years or older. Our method was expected-value decision analysis with sensitivity analysis, which is a systematic tool for quantitating clinical decisions. We evaluated 100 randomly selected individuals aged 40 years or older with regar...

The anterior cruciate ligament (ACL) has 2 anatomic bundles. Standard ACL reconstruction is with a single-bundle graft, but double-bundle reconstruction may better control knee rotational torque, a potential cause of failure after single-bundle reconstruction. The authors investigated outcomes of single-bundle versus double-bundle ACL reconstructio...

The purpose of this study was to evaluate tissue effect (tissue removal plus underlying cell death) of two chondroplasty techniques: mechanical debridement (MD) using a rotary shaver blade and thermal chondroplasty using radiofrequency energy (RFE). Forty-eight human chondromalacic cartilage samples were treated with either MD or RFE. Pre- and post...

Although knee arthroscopy is described as minimally invasive, return to activity has been poorly quantitated. Our purpose is to test the hypothesis that most patients return to unrestricted activity within 4 weeks after knee arthroscopy. After prospective power analysis, 72 consecutive patients who underwent arthroscopic knee partial medial menisce...

Autologous chondrocyte implantation (ACI) is an expensive treatment option for focal cartilage defects, and commercial funding of research is associated with a study reaching a positive conclusion. The purpose of this analysis is to compare outcomes (and levels of evidence) between published ACI outcome studies that were commercially funded and stu...

The purpose of this study is to quantitate the number of surgeries require to become proficient in minimally invasive surgery total knee arthroplasty (TKA). Operative duration is recorded for the first 100 patients having minimally invasive TKA by a single surgeon (J.H.L.). Learning is graphically represented by plotting time by patient number, gen...

The purpose of this study was to evaluate the incidence of lateral trochanteric pain (LTP) following primary total hip arthroplasty (THA) and identify risk factors. From 1993 to 1998, 543 primary THAs were performed for osteoarthritis. Lateral trochanteric pain was identified in 24 (4.4%) of 543 patients. The incidence of LTP with the posterior app...

The use of a urinary bladder catheter in patients having a total hip arthroplasty is controversial. Universal insertion of an indwelling catheter before a total hip arthroplasty, and insertion of a catheter postoperatively as necessary, are accepted variations of care. From 1993 to 1999, 719 patients having primary, unilateral total hip arthroplast...

The validity of preoperative demand matching as an indicator of patient activity following total hip arthroplasty (THA) was evaluated by studying 518 patients (mean age, 67 years; range, 26-92 years) who were assigned to 4 categories of decreasing demand: I (high demand), 68 patients (13%); II, 144 patients (28%); III, 281 patients (54%); and IV (l...

This study evaluated the relationship of the disposition and outcome of patients with displaced femoral neck fractures with the type of surgical treatment. From 1993 to 1996, 186 patients with displaced femoral neck fractures who were 65 years of age or older were treated at one hospital. One hundred and twenty fractures were treated with reduction...

A group of 98 patients who had primary unilateral total knee arthroplasty (TKA) with cemented, posterior-stabilized knee implants for osteoarthritis were matched for age, diagnosis, weight, body mass index, and presence of comorbid conditions. The patients were followed up with clinical, radiographic, and outcome measures including SF-36 scales and...

A total of 55 consecutive cementless total hip arthroplasties were done for osteoarthritis by 1 surgeon, who was not a designer of the implant, using 1 surgical technique and Porous-Coated Anatomic (Howmedica, Rutherford, NJ) hip implants. Of hips, 53 were prospectively evaluated, and 39 were followed for an average of 12.3 years (range, 10-16 year...

During the 1990s, cost reduction programs were developed to decrease the hospital cost of total knee arthroplasty. The purpose of this study was to evaluate the impact of hospital cost reduction programs for total knee arthroplasty on patient outcome at our hospital. We evaluated 159 patients who had undergone unilateral primary total knee arthropl...

The optimal treatment for displaced femoral neck fractures in elderly patients is a matter of controversy. Four surgical options are well supported in the orthopaedic literature: reduction with internal fixation, unipolar hemiarthroplasty, bipolar hemiarthroplasty, and total hip arthroplasty. Based on a review of the outcomes literature regarding t...

The optimal treatment for displaced femoral neck fractures in elderly patients is a matter of controversy. Four surgical options are well supported in the orthopaedic literature: reduction with internal fixation, unipolar hemiarthroplasty, bipolar hemiarthroplasty, and total hip arthroplasty. Based on a review of the outcomes literature regarding t...

The use of a urinary bladder catheter in the perioperative period for patients undergoing total knee arthroplasty is controversial. In the current study, two bladder management protocols were studied. One group of patients had an indwelling catheter inserted into the bladder before total knee arthroplasty. The other group of patients was observed a...

Patients undergoing joint replacement who show signs of ileus in the postoperative period that require insertion of a nasogastric tube (NGT) must be monitored closely to avoid bleeding complications. The diagnosis of postoperative ileus was documented in 40 of 2,526 (1.6%) consecutive joint replacement operations between January 1, 1990, and March...

This study evaluates the impact of a clinical pathway (CP) and a hip implant standardization program (HISP) on the quality and cost of total hip arthroplasty (THA). Two hundred six unilateral THA operations for osteoarthritis were evaluated: 89 operations were performed in 1991 without a CP or HISP (4-year follow-up period); 117 operations were per...