The Journal of bone and joint surgery. American volume
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When a total ankle replacement fails, arthrodesis has been advocated as the treatment of choice. With the availability of a wide spectrum of implants, revision arthroplasty may become a viable alternative. ⋯ The medium-term results of revision arthroplasty after a failed total ankle arthroplasty were similar to those after primary arthroplasty. The key to success was firm anchorage of the components to primary bone stock. A single hydroxyapatite component coating should no longer be used for revision total ankle arthroplasty.
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J Bone Joint Surg Am · Jul 2013
Multicenter StudyPatient opinions of screening for intimate partner violence in a fracture clinic setting: P.O.S.I.T.I.V.E.: a multicenter study.
Approximately one-third of injured women presenting to fracture clinics have experienced some form of intimate partner violence in the past year. The aim of the current study was to determine patients' perceptions on screening for intimate partner violence during visits to a surgical fracture clinic. ⋯ Our findings demonstrated that the majority of patients endorse active screening for intimate partner violence in orthopaedic fracture clinics.
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J Bone Joint Surg Am · Jul 2013
Risk factors for nonunion after nonoperative treatment of displaced midshaft fractures of the clavicle.
Identification of patients at higher risk of nonunion after diaphyseal clavicular fractures is desirable to improve patient counseling and enable targeted surgical treatment. ⋯ Thirteen percent of displaced diaphyseal fractures in patients who were at least eighteen years of age did not heal. Smoking was the strongest risk factor, and smoking cessation should be an integral part of treatment. The probability of nonunion in a particular individual can be estimated with use of a statistical model based on known risk factors. This information can be useful when counseling the patient even though nonunion remains difficult to predict accurately in that individual. The number who would need to be treated to prevent a single nonunion can be reduced by identifying those at higher risk.
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J Bone Joint Surg Am · Jul 2013
Long-term performance of ceramic and metal femoral heads on conventional polyethylene in young and active patients: a matched-pair analysis.
Ceramic femoral heads produce less wear of the opposing polyethylene than do metal femoral heads in wear simulation studies. This is a matched-pair analysis of the wear of ceramic and metal femoral heads on conventional polyethylene in uncemented total hip replacements in young, active patients at a minimum of fifteen years of follow-up. ⋯ Ceramic femoral heads produced significantly less wear on conventional polyethylene liners at the time of long-term follow-up than did metal heads in this matched-pair analysis of young and active patients with uncemented fixation.
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J Bone Joint Surg Am · Jul 2013
Risk factors for metastatic disease at presentation with osteosarcoma: an analysis of the SEER database.
Osteosarcoma is the most common primary bone sarcoma and affects all ages. There are substantial differences in management and outcomes for patients who have localized disease compared with distant spread at the time of diagnosis. Our goal was to examine potential risk factors predictive of metastatic disease at presentation. ⋯ Osteosarcoma patients with advanced age, a tumor in the axial skeleton, a larger tumor size, and a residence in a less affluent county were more likely to have metastatic disease at presentation.