The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Oct 2012
Transient soft-tissue edema associated with implantation of increasing doses of rhBMP-2 on an absorbable collagen sponge in an ectopic rat model.
Recombinant human bone morphogenetic protein-2 (rhBMP-2) is an osteoinductive protein. However, soft-tissue edema adjacent to the site of rhBMP-2 implantation has been reported. This animal study was designed to examine soft-tissue edema associated with increasing rhBMP-2 doses with implantation on an absorbable collagen sponge (ACS) and with injection directly into muscle. ⋯ Transient peri-implant soft-tissue edema occurred in a dose-dependent manner following implantation of rhBMP-2/ACS in this rat model. The normal dose of rhBMP-2/ACS produced edema similar to that in the controls. Finally, rhBMP-2 solutions injected directly into muscle resulted in minimal soft-tissue edema.
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J Bone Joint Surg Am · Oct 2012
Review Historical ArticlePlaster: our orthopaedic heritage: AAOS exhibit selection.
Plaster has been used for centuries as a stiffening agent to treat fractures and other musculoskeletal conditions that require rest, immobilization, or correction of a deformity. Despite modern metallurgy and internal stabilization, plaster casts and splints remain an important means of external stabilization. Casting is a dying art as modern internal and external fixation replace external immobilization. Proper casting technique is paramount. This manuscript outlines the history and chemistry of immobilization materials and techniques as well as the differences among them and the advantages and disadvantages of each. ⋯ Plaster casts and splints remain an important treatment method for acute and chronic orthopaedic conditions.
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J Bone Joint Surg Am · Oct 2012
Landmarks for rotational alignment of the humeral component during elbow arthroplasty.
The reference points for rotational orientation of the humeral component during elbow arthroplasty typically are on the articular surface or the humeral epicondyles. With bone loss, these landmarks may be compromised. Our purpose was to assess whether the flat posterior humeral cortex proximal to the olecranon fossa is a reliable landmark with which to orient the humeral component during elbow arthroplasty. ⋯ While the PCL is better than the TEA as a reference point, neither is able to accurately identify the FEA because of considerable normal variation. Future studies are needed to evaluate the effectiveness of computer-assisted techniques or a preoperative CT scan of the contralateral, unaffected elbow in identifying rotational landmarks for the elbow undergoing arthroplasty.
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J Bone Joint Surg Am · Oct 2012
Randomized Controlled Trial Comparative StudyDoes subacromial injection of a local anesthetic influence strength in healthy shoulders?: a double-blinded, placebo-controlled study.
Subacromial injection of a local anesthetic is used to eliminate pain as a confounding factor in clinical assessment of abduction strength in shoulders with a suspected rotator cuff tear. If strength remains diminished despite pain relief, a rotator cuff tear is likely. The effect of injecting local anesthetic into the subacromial space on the strength of a normal shoulder is unknown, although it could affect strength by impairing suprascapular or axillary nerve function. We hypothesized that subacromial injection of a local anesthetic could decrease shoulder abduction and/or external rotation strength, resulting in physical examination findings that could mislead the clinician. ⋯ Diagnostic Level I. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Oct 2012
Comparative StudyComparison of ten-year survivorship of hip prostheses with use of conventional polyethylene, metal-on-metal, or ceramic-on-ceramic bearings.
To improve the long-term performance of hip prostheses, alternative bearings with metal-on-metal (MoM) and ceramic-on-ceramic (CoC) couples have been introduced. Although currently the results from the use of these bearings are in the midterm stage, there have been few comparative studies of these different bearings. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.