No Wound Healing Complications or Recurrences Were Seen and a High Level of Satisfaction Was Reported in Patients Who Underwent Endoscopic Olecranon Bursectomy for Recalcitrant Olecranon Bursitis.

Purpose: To determine the outcomes of endoscopic olecranon bursectomy for the treatment of recalcitrant olecranon bursitis in one surgeon's practice. Methods: A retrospective analysis was conducted on all patients who underwent an endoscopic olecranon bursectomy for the treatment of recalcitrant olecranon bursitis between January 2018 and May 2021 at one surgeon's practice. Demographic variables as well as causes for olecranon bursitis such as aseptic, septic, and gouty tophi were recorded. In addition, any complications such as infection, recurrence, wound failure, or hospitalizations were documented, with wound dehiscence, recurrence of bursitis, and return to the operating room being the primary outcome measures. During the final phone encounter before finalizing this project, patients were queried to obtain the patient-reported form of the American Shoulder and Elbow Surgeons Elbow Questionnaire, quick Disabilities of the Arm Shoulder and Hand score, and the Single Assessment Numeric Evaluation score. Results: Our study included 28 patients (23 male and 5 female) with an average age of 68 years (ranging from 33-86 years), all of whom had follow-up. The average follow-up was 24.7 months (range 3-42 months). There were 15 cases (54%) of aseptic bursitis, 13 cases (46%) of septic bursitis, and 7 cases (25%) that contained gouty tophi (5 aseptic and 2 septic). Of the 28 patients, 4 experienced complications. These all occurred within 3 months of surgery. One necessitated hospitalization and intravenous antibiotics, 2 were minor infections treated with oral antibiotics, and one was swelling treated successfully with in-office aspiration. Overall, 24 (86%) patients reported no issues at all related to the surgery. There were no instances of recurrence, wound failure, or secondary operations. Of the 20 (71.4%) patients who were reached for patient-reported form of the American Shoulder and Elbow Surgeons Elbow Questionnaire, quick Disabilities of the Arm Shoulder and Hand score, and Single Assessment Numeric Evaluation scores, all 20 patients reported no residual pain or difficulties with daily tasks. Average satisfaction with the procedure was 9.9 of 10 and, on average, patients reported that their elbow functionality was 96% with 100% representing completely normal. Conclusions: In this population, patients who underwent endoscopic olecranon bursectomy experienced no recurrences or wound-healing complications necessitating return to the operating room. In addition, patients reported high function and satisfaction after the procedure. Level of Evidence: Level IV, therapeutic case series.

The Relationship of Race/Ethnicity Concordance to Physician-Patient Communication: A Mixed-Methods Systematic Review.

The concept of race or ethnic concordance between health care provider and patient has emerged as a dimension of the patient-physician relationship that could influence health outcomes for patients from minoritized groups, particularly through differences in the way physicians communicate with patients based on race or ethnicity. However, two decades of study on concordance and physician-patient communication have produced contradictory results. Given the heightened societal awareness of racism and the persistence of health disparities, there is a need for a comprehensive review of the current state of knowledge. This review sets out to determine how communication patterns differ in race/ethnicity concordant versus discordant patient-physician medical encounters. Thirty-three studies employing a range of methodologies were identified. In most analyses, after accounting for covariates, no relationship was found between race/ethnicity concordance and communication variables. Race/ethnicity concordance with their physician does not appear to influence the quality of communication for most patients from minoritized groups. A number of methodological weaknesses were identified in existing research, among them: few studies investigated potential explanatory variables, the heterogeneity of ethnic and cultural experience was over-simplified, there was little consistency in operationalization of communication variables, and the physician-patient dynamic was inadequately conceptualized.

The Relationship of Ethnic, Racial, and Cultural Concordance to Physician-Patient Communication: A Mixed-Methods Systematic Review Protocol.

The concept of racial, ethnic, or cultural concordance between a healthcare provider and a patient has emerged as a dimension of the patient-physician relationship that could influence health outcomes for minoritized patients, particularly through differences in the way physicians communicate with patients of various races and ethnicities. However, two decades of study on concordance and physician-patient communication have produced contradictory results. Although existing systematic reviews have addressed race, ethnicity, and culture as influences on medical encounters, only one review, published in 2006, has examined the effects of this concordance across multiple ethnicities, specifically focusing on physician-patient communication. Given the heightened societal awareness of racism and health disparities in recent years, there is a need for a comprehensive review of the current state of knowledge. This review, therefore, will seek to determine how communication patterns differ in ethnically, racially, and culturally concordant versus discordant patient-provider medical encounters, in the process identifying explanatory and outcome variables associated with those differences.