The Journal of bone and joint surgery. American volume
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The Musculoskeletal Function Assessment is a validated, well-designed, self-administered questionnaire that is useful for determining health status. The modified Merle d'Aubigné clinical hip score is the most generally accepted clinical grading system for evaluating the results of acetabular fracture treatment. The purpose of the present study was to evaluate the relationship between the Musculoskeletal Function Assessment and modified Merle d'Aubigné scores in evaluating the results of acetabular fracture treatment. ⋯ The Musculoskeletal Function Assessment scores for these patients were relatively high compared with those for the normal population, indicating that complete return to a preinjury functional level is uncommon despite a good-to-excellent Merle d'Aubigné clinical score. Furthermore, the ceiling effect demonstrated by the Merle d'Aubigné score (despite its high correlation with the Musculoskeletal Function Assessment score) limits its usefulness as a method for evaluating the outcome of treatment of acetabular fractures. There have been few published clinical studies in which the Musculoskeletal Function Assessment score has been used as an outcome measure, and reference values are lacking. The present study provides initial guideline reference values for use in the evaluation of patients following an acetabular fracture.
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Distal triceps tendon ruptures occur rarely, and the diagnosis is often missed when the injury is acute. The literature provides little guidance regarding treatment or the outcome of treatment of these injuries. The goal of this report was to present our experience with the diagnosis, timing and technique of surgical treatment, and outcome of treatment of distal triceps tendon ruptures in twenty-two patients. None of the ruptures followed joint replacement. ⋯ The diagnosis of distal triceps tendon rupture is often missed when the injury is acute because of swelling and pain. Primary repair of the ruptured tendon is always possible when it is performed within three weeks after the injury. When the diagnosis is in doubt immediately after an injury, the patient should be followed closely and should be reexamined after the swelling and pain have diminished so that treatment can be instituted before the end of this three-week period. Reconstruction of the tendon is a much more complex, challenging procedure, and the postoperative recovery is slower. Thus, we believe that early surgical repair, within three weeks after the injury, is the treatment of choice for distal triceps tendon ruptures. of evidence.
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J Bone Joint Surg Am · Oct 2003
Comparative StudyComparison of simultaneous bilateral with unilateral total knee arthroplasty in terms of perioperative complications.
Previous studies have demonstrated an increased rate of perioperative complications and morbidity following simultaneous bilateral total knee arthroplasty compared with the rate following unilateral total knee arthroplasty. The purpose of this study was to compare the rate of perioperative complications and morbidity associated with simultaneous bilateral total knee arthroplasty with that associated with unilateral total knee arthroplasty. ⋯ The risk of perioperative complications associated with bilateral simultaneous total knee arthroplasty was slightly increased compared with that associated with unilateral total knee arthroplasty, but the mortality rates were similar. Ultimately, the decision to proceed with simultaneous knee replacement should depend on patient preference through informed choice.
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J Bone Joint Surg Am · Oct 2003
Simultaneous revision and contralateral primary total knee arthroplasty.
There is controversy regarding whether simultaneous or staged bilateral total knee arthroplasty should be performed in patients with bilateral gonarthrosis. In addition, revision total knee arthroplasties have been less successful than primary arthroplasties. The purpose of this study was to evaluate the results of simultaneous revision and contralateral primary total knee arthroplasties performed during the same setting. ⋯ We found a favorable outcome in patients who had undergone simultaneous revision and contralateral primary total knee arthroplasties. Despite a lower mean knee score and less motion, most patients seemed to prefer the knee with the revision arthroplasty to the knee with the primary procedure. These results suggest that this combined procedure is a safe and favorable alternative to a staged procedure consisting of revision and subsequent contralateral primary total knee arthroplasty.