The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Nov 2012
Comparative StudyTreatment of articular cartilage defects in the goat with frozen versus fresh osteochondral allografts: effects on cartilage stiffness, zonal composition, and structure at six months.
Understanding the effectiveness of frozen as compared with fresh osteochondral allografts at six months after surgery and the resultant consequences of traditional freezing may facilitate in vivo maintenance of cartilage integrity. Our hypothesis was that the state of the allograft at implantation affects its performance after six months in vivo. ⋯ Fresh versus frozen allografts represent the "best versus worst" conditions with respect to chondrocyte viability, but "difficult versus simple" with respect to acquisition and distribution. The outcomes described from these two conditions expand the current understanding of in vivo cartilage remodeling and describe structural properties (initial graft subsidence), which may have implications for impending graft failure.
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J Bone Joint Surg Am · Nov 2012
A biomechanical assessment of soft-tissue damage in the cervical spine following a unilateral facet injury.
Unilateral cervical spine facet injuries encompass a wide spectrum, including subluxations, dislocations, and fractures, and the instability produced varies greatly. The extent of anatomical disruption secondary to a unilateral facet injury is poorly understood, and few biomechanical studies have quantified the associated kinematics. The purpose of this study was to develop an experimental method that reliably produces an impending unilateral facet dislocation (perched facet) in cadaveric cervical spines and to identify the soft-tissue damage and resulting changes in cervical spine range of motion and neutral zone associated with this injury. ⋯ The results from this work provide further insight into the expected injury and associated instability present in a traumatic unilateral facet injury in the cervical spine.
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J Bone Joint Surg Am · Nov 2012
Shoulder arthroscopy simulator performance correlates with resident and shoulder arthroscopy experience.
The technical skills required to perform arthroscopy are multifaceted and require supervised training and repetition. Obtaining this basic arthroscopic skill set can be costly and time-consuming. Simulation may represent a viable training source for basic arthroscopic skills. Our goal was to evaluate the correlation between timed task performance on an arthroscopic shoulder simulator and both resident experience and shoulder arthroscopy experience. ⋯ This study suggests that greater resident clinical experience and shoulder arthroscopy experience are both reflected in improved performance of basic tasks on a shoulder simulator. These findings warrant further investigation to determine if training on a validated arthroscopic shoulder simulator would improve clinical arthroscopic skills.
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J Bone Joint Surg Am · Nov 2012
Hemostatic techniques reduce hospital stay following multilevel posterior cervical spine surgery.
Despite meticulous hemostasis, persistent postoperative drain output following posterior cervical spine procedures often necessitates a prolonged length of hospital stay. We sought to determine if thrombin-soaked absorbable gelatin compressed sponge can decrease postoperative drain output and the length of hospital stay after multilevel posterior cervical spine surgery. ⋯ Therapeutic Level III.
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J Bone Joint Surg Am · Nov 2012
Randomized Controlled Trial Comparative StudyTotal hip replacement versus open reduction and internal fixation of displaced femoral neck fractures: a randomized long-term follow-up study.
Clinical trials with short and intermediate-term follow-up have demonstrated superior results for total hip replacement as compared with internal fixation with regard to hip function and the need for secondary surgery in elderly patients with a displaced intracapsular femoral neck fracture. The aim of the present study was to compare the results of total hip replacement with those of internal fixation over a long-term follow-up period of seventeen years. ⋯ Therapeutic Level I.