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Great orthopaedic papers

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15 papers 0 to 25 followers
Atul F Kamath, David G Lewallen, Arlen D Hanssen
BACKGROUND: Severe metaphyseal and meta-diaphyseal bone loss poses important challenges in revision total knee arthroplasty. The best strategy for addressing massive tibial bone loss has not been determined. The purpose of this study was to assess the intermediate-term clinical and radiographic results of porous tibial cone implantation. METHODS: Sixty-six porous tantalum tibial cones (sixty-three patients) were reviewed at a mean follow-up time of seventy months (range, sixty to 106 months)...
February 4, 2015: Journal of Bone and Joint Surgery. American Volume
Mohammad A Helwani, Michael S Avidan, Arbi Ben Abdallah, Dagmar J Kaiser, John C Clohisy, Bruce L Hall, Heiko A Kaiser
BACKGROUND: Many orthopaedic surgical procedures can be performed with either regional or general anesthesia. We hypothesized that total hip arthroplasty with regional anesthesia is associated with less postoperative morbidity and mortality than total hip arthroplasty with general anesthesia. METHODS: This retrospective propensity-matched cohort study utilizing the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database included patients who had undergone total hip arthroplasty from 2007 through 2011...
February 4, 2015: Journal of Bone and Joint Surgery. American Volume
Brian R Hamlin, Anthony M DiGioia, Anton Y Plakseychuk, Tim J Levison
The objective of this study is to compare the effectiveness of intravenous versus topical application of tranexamic acid in patients undergoing knee arthroplasty. All patients who underwent primary knee arthroplasty at our total joint center over a 12-month period were included in the study. One surgeon utilized 1 g of IV TXA at time of incision in all patients (n=373) except those with a documented history of venous thromboembolism (VTE). Two surgeons utilized a topical application of TXA for all patients without exception (n=198) in which the joint was injected after capsular closure with 3 g TXA/100 mL saline...
March 2015: Journal of Arthroplasty
Jiaqi Zhao, Jianquan Zhang, Xiufeng Ji, Xuemei Li, Qirong Qian, Qi Xu
The effect of medullary cavity irrigation on fat emboli during total knee arthroplasty (TKA) was evaluated. Thirty female patients with osteoarthritis were randomly assigned to undergo conventional TKA without irrigation (conventional group) or with medullary canal saline irrigation (irrigation group). The four-chamber view was monitored by transesophageal echocardiography (TEE) and echogenic reflections of fat emboli were observed. The grey-scale score and area ratio of fat emboli were calculated during TKA...
March 2015: Journal of Arthroplasty
David R Anderson, Michael J Dunbar, Eric R Bohm, Etienne Belzile, Susan R Kahn, David Zukor, William Fisher, Wade Gofton, Peter Gross, Stephane Pelet, Mark Crowther, Steven MacDonald, Paul Kim, Susan Pleasance, Nicki Davis, Pantelis Andreou, Philip Wells, Michael Kovacs, Marc A Rodger, Tim Ramsay, Marc Carrier, Pascal-Andre Vendittoli
BACKGROUND: The role of aspirin in thromboprophylaxis after total hip arthroplasty (THA) is controversial. OBJECTIVE: To compare extended prophylaxis with aspirin and dalteparin for prevention of symptomatic venous thromboembolism (VTE) after THA. DESIGN: Multicenter randomized, controlled trial with a noninferiority design based on a minimal clinically important difference of 2.0%. Randomization was electronically generated; patients were assigned to a treatment group through a Web-based program...
June 4, 2013: Annals of Internal Medicine
Klaas Auke Nouta, Wiebe C Verra, Bart G Pijls, Jan W Schoones, Rob G H H Nelissen
BACKGROUND: Less than 1% of all primary TKAs are performed with an all-polyethylene tibial component, although recent studies indicate all-polyethylene tibial components are equal to or better than metal-backed ones. QUESTIONS/PURPOSES: We asked whether the metal-backed tibial component was clinically superior to the all-polyethylene tibial component in primary TKAs regarding revision rates and clinical functioning, and which modifying variables affected the revision rate...
December 2012: Clinical Orthopaedics and related Research
Jing Xu, Lei Xu, Wendong Xu, Yudong Gu, Jianguang Xu
BACKGROUND: There is no consensus on the effects of operative versus nonoperative treatment on the outcomes of midshaft clavicular fractures in adults. We conducted a meta-analysis of randomized clinical studies. MATERIALS AND METHODS: We searched the literature and included studies that investigated the effects of operative versus nonoperative intervention on the outcome of midshaft clavicular fractures. Patient data were pooled by use of standard meta-analytic approaches...
February 2014: Journal of Shoulder and Elbow Surgery
Matthew P Jones, Riaz J K Khan, Richard L Carey Smith
No abstract text is available yet for this article.
June 20, 2012: Journal of Bone and Joint Surgery. American Volume
Mark D Neuman, Jeffrey H Silber, Jay S Magaziner, Molly A Passarella, Samir Mehta, Rachel M Werner
IMPORTANCE: Little is known regarding outcomes after hip fracture among long-term nursing home residents. OBJECTIVE: To describe patterns and predictors of mortality and functional decline in activities of daily living (ADLs) among nursing home residents after hip fracture. DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study of 60,111 Medicare beneficiaries residing in nursing homes who were hospitalized with hip fractures between July 1, 2005, and June 30, 2009...
August 2014: JAMA Internal Medicine
K G Vince
In this paper, we consider wound healing after total knee arthroplasty.
November 2012: Journal of Bone and Joint Surgery. British Volume
A G Rosenberg
Disruption of the extensor mechanism in total knee arthroplasty may occur by tubercle avulsion, patellar or quadriceps tendon rupture, or patella fracture, and whether occurring intra-operatively or post-operatively can be difficult to manage and is associated with a significant rate of failure and associated complications. This surgery is frequently performed in compromised tissues, and repairs must frequently be protected with cerclage wiring and/or augmentation with local tendon (semi-tendinosis, gracilis) which may also be used to treat soft-tissue loss in the face of chronic disruption...
November 2012: Journal of Bone and Joint Surgery. British Volume
E P Su
Fixed flexion deformities are common in osteoarthritic knees that are indicated for total knee arthroplasty. The lack of full extension at the knee results in a greater force of quadriceps contracture and energy expenditure. It also results in slower walking velocity and abnormal gait mechanics, overloading the contralateral limb. Residual flexion contractures after TKA have been associated with poorer functional scores and outcomes. Although some flexion contractures may resolve with time after surgery, a substantial percentage will become permanent...
November 2012: Journal of Bone and Joint Surgery. British Volume
J Parvizi, M R Rasouli
In this paper, we will consider the current role of simultaneous-bilateral TKA. Based on available evidence, it is our opinion that simultaneous bilateral TKA carries a higher risk of morbidity and mortality and should be reserved for select few.
November 2012: Journal of Bone and Joint Surgery. British Volume
T P Schmalzried
The differential diagnosis of the painful total hip arthroplasty (resurfacing or total hip) includes infection, failure of fixation (loosening), tendinitis, bursitis, synovitis, adverse local tissue reaction (ALTR) to cobalt-chromium alloys, and non-hip issues, such as spinal disorders, hernia, gynecologic, and other pelvic pain. Assuming that the hip is the source of pain, the first level question is prosthetic or non-prosthetic pain generator? The second level prosthetic question is septic or aseptic? The third level question (aseptic hips) is well-fixed or loose? ALTR is best diagnosed by cross-sectional imaging...
November 2012: Journal of Bone and Joint Surgery. British Volume
B Adeli, J Parvizi
Periprosthetic joint infection (PJI) is a devastating complication which can follow a total joint arthroplasty (TJA). Although rare, this ongoing threat undermines the success of TJA, a historically reputable procedure. It has haunted the orthopedic community for decades and several ongoing studies have provided insights and new approaches to effectively battle this multilayered problem.
November 2012: Journal of Bone and Joint Surgery. British Volume
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