The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Aug 2010
Influence of obesity on femoral osteolysis five and ten years following total hip arthroplasty.
The most important long-term complication following total hip arthroplasty is periprosthetic femoral osteolysis. A sizeable proportion of patients who undergo arthroplasty are obese. While patient activity, implant type, and quality of fixation are known risk factors for osteolysis, the literature concerning obesity is sparse and controversial. Our primary objective was to evaluate the influence of obesity on the risk of osteolysis five and ten years after primary total hip arthroplasty with a cemented stem. Secondary objectives were to evaluate clinical outcome and patient satisfaction. ⋯ Prognostic Level I. See Instructions to Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Aug 2010
Timing of wound closure in open fractures based on cultures obtained after debridement.
The timing of wound closure in open fractures has remained an inexact science. Numerous recommendations have been made for the management of these injuries regarding the optimal time to perform competent wound closure, with all advice based on subjective parameters. The purpose of this study was to determine the utility of a prospective protocol with use of wound cultures obtained after irrigation and debridement as a guide to the timing of wound closure following an open fracture of an extremity. ⋯ Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Aug 2010
Obesity, age, sex, diagnosis, and fixation mode differently affect early cup failure in total hip arthroplasty: a matched case-control study of 4420 patients.
Studies about the influence of patient characteristics on mechanical failure of cups in total hip replacement have applied different methodologies and revealed inconclusive results. The fixation mode has rarely been investigated. Therefore, we conducted a detailed analysis of the influence of patient characteristics and fixation mode on cup failure risks. ⋯ Therapeutic Level III. See Instructions to Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Aug 2010
Institutional prescreening for detection and eradication of methicillin-resistant Staphylococcus aureus in patients undergoing elective orthopaedic surgery.
Surgical site infection has been identified as one of the most important preventable sources of morbidity and mortality associated with medical treatment. The purpose of the present study was to evaluate the feasibility and efficacy of an institutional prescreening program for the preoperative detection and eradication of both methicillin-resistant and methicillin-sensitive Staphylococcus aureus in patients undergoing elective orthopaedic surgery. ⋯ Therapeutic Level III. See Instructions to Authors for a complete description of levels of evidence.