The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jul 2005
Meta Analysis Comparative StudyPatellar resurfacing in total knee arthroplasty. A meta-analysis.
Patellar resurfacing during total knee arthroplasty remains controversial. We aimed to evaluate the effectiveness of this technique through an evaluation of the current literature. ⋯ The available evidence indicates that patellar resurfacing reduces the risks of reoperation and anterior knee pain after total knee arthroplasty. The observed effects are clinically important despite their modest magnitude. Additional, carefully designed randomized trials are required to strengthen this claim.
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J Bone Joint Surg Am · Jul 2005
Randomized Controlled Trial Comparative Study Clinical TrialComparison of soap and antibiotic solutions for irrigation of lower-limb open fracture wounds. A prospective, randomized study.
Irrigation of open fracture wounds is a commonly performed procedure, and irrigation additives have been used in an attempt to reduce the risk of infection. In vitro and animal studies have suggested that irrigation with detergent solution is more effective than irrigation with a solution containing antibiotic additives. This study was performed to compare the efficacy of those two solutions in the treatment of open fractures in humans. ⋯ Irrigation of open fracture wounds with antibiotic solution offers no advantages over the use of a nonsterile soap solution, and it may increase the risk of wound-healing problems.
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J Bone Joint Surg Am · Jul 2005
Comparative StudyAssessment of two thoracolumbar fracture classification systems as used by multiple surgeons.
The reproducibility and repeatability of modern systems for classification of thoracolumbar injuries have not been sufficiently studied. We assessed the interobserver and intraobserver reproducibility of the AO (Arbeitsgemeinschaft für Osteosynthesefragen) classification and compared it with that of the Denis classification. Our purpose was to determine whether the newer, AO system had better reproducibility than the older, Denis classification. ⋯ Both the Denis and the AO system for the classification of spine fractures had only moderate reliability and repeatability. The tendency for well-trained spine surgeons to classify the same fracture differently on repeat testing is a matter of some concern.
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J Bone Joint Surg Am · Jul 2005
Pulmonary function in adolescent idiopathic scoliosis relative to the surgical procedure.
The long-term pulmonary function of patients with adolescent idiopathic scoliosis undergoing surgical correction is uncertain. To our knowledge, no report has demonstrated the changes in pulmonary function five years or more following spinal arthrodesis with use of modern segmental spinal instrumentation techniques for the treatment of all types of adolescent idiopathic scoliosis in a similar adolescent population. ⋯ Patients who have had any type of chest cage disruption during the surgical treatment of adolescent idiopathic scoliosis demonstrate no change in the absolute value and a significant decline in the percent-predicted value of pulmonary functions at five years following surgery. Chest cage preservation is recommended to maximize both absolute and percent-predicted pulmonary function values after surgical treatment of adolescent idiopathic scoliosis.
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J Bone Joint Surg Am · Jul 2005
Body mass index as a predictor of complications after operative treatment of acetabular fractures.
Obesity, a growing public health concern, is often thought to be an important risk factor for postoperative complications. We hypothesized that body mass index is predictive of complications after operative treatment of acetabular fractures. ⋯ Body mass index is predictive of complications after operative treatment of acetabular fractures.