The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Apr 2008
Randomized Controlled Trial Comparative StudyIntra-articular block compared with conscious sedation for closed reduction of ankle fracture-dislocations. A prospective randomized trial.
Ankle fracture-dislocations require urgent reduction to protect the soft tissues, to minimize articular injury, and to allow swelling to decrease. Conscious sedation is commonly used to provide analgesia for closed reduction of this injury. We hypothesized that an intra-articular block of the ankle would provide similar analgesia and the ability to reduce the ankle with a lower risk than conscious sedation. ⋯ Compared with conscious sedation, an intra-articular lidocaine block provides a similar degree of analgesia and sufficient analgesia to achieve closed reduction of ankle fracture-dislocations.
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J Bone Joint Surg Am · Apr 2008
Noninvasive quantification of human nucleus pulposus pressure with use of T1rho-weighted magnetic resonance imaging.
Early diagnosis is a challenge in the treatment of degenerative disc disease. A noninvasive biomarker detecting functional mechanics of the disc is needed. T1rho-weighted imaging, a spin-lock magnetic resonance imaging technique, has shown promise for meeting this need in in vivo studies demonstrating the clinical feasibility of evaluating both intervertebral discs and articular cartilage. The objectives of the present study were (1) to quantitatively determine the relationship between T1rho relaxation time and measures of nucleus pulposus mechanics, and (2) to evaluate whether the quantitative relationship of T1rho relaxation time with the degenerative grade and glycosaminoglycan content extend to more severe degeneration. It was hypothesized that the isometric swelling pressure and compressive modulus would be directly correlated with the T1rho relaxation time and the apparent permeability would be inversely correlated with the T1rho relaxation time. ⋯ T1rho-weighted magnetic resonance imaging has a strong potential as a quantitative biomarker of the mechanical function of the nucleus pulposus and of disc degeneration.
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J Bone Joint Surg Am · Apr 2008
The effect of postoperative range of motion on functional activities after posterior cruciate-retaining total knee arthroplasty.
Range of motion is recognized as an important indicator of the success of a total knee replacement; however, an optimal range of motion has yet to be defined. This study was designed to determine the optimal range of motion for knee function after total knee arthroplasty with a posterior cruciate-retaining prosthesis. ⋯ The best functional results following total knee arthroplasty are achieved with 128 degrees to 132 degrees of motion. A postoperative flexion contracture and hyperextension of >or=10 degrees are associated with a poorer outcome except that stair-climbing is improved with more motion.