The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jun 2012
Randomized Controlled Trial Comparative StudyNeoCart, an autologous cartilage tissue implant, compared with microfracture for treatment of distal femoral cartilage lesions: an FDA phase-II prospective, randomized clinical trial after two years.
Despite introduction of autologous chondrocyte therapy for repair of hyaline articular cartilage injury in 1994, microfracture remains a primary standard of care. NeoCart, an autologous cartilage tissue implant, was compared with microfracture in a multisite prospective, randomized trial of a tissue-engineered bioimplant for treating articular cartilage injuries in the knee. ⋯ This randomized study suggests that the safety of autologous cartilage tissue implantation, with use of the NeoCart technique, is similar to that of microfracture surgery and is associated with greater clinical efficacy at two years after treatment.
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J Bone Joint Surg Am · Jun 2012
Comparative StudyInjury patterns causing isolated foot compartment syndrome.
The true incidence and primary predictors of foot compartment syndrome remain controversial. Our aim was to better define the overall incidence of foot compartment syndrome in relation to the frequency and location of various foot injuries. We hypothesized that (1) the incidence would increase in proportion to the number of anatomic locations of injury, (2) the incidence would be higher in association with hindfoot and crush injuries compared with any other injury categories, and (3) not only would the incidence associated with calcaneal fractures be lower than the often quoted 10% but foot compartment syndrome would also be fairly uncommon after such fractures. ⋯ Our results demonstrate that injuries involving a crush mechanism, either in isolation or in combination with a forefoot injury, should raise suspicion about the possibility that a foot compartment syndrome will develop.
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J Bone Joint Surg Am · Jun 2012
Comparative StudyWhy do medical students choose orthopaedics as a career?
The primary influence on medical students' career choice is their third-year clerkship. However, orthopaedics is not a required rotation in the curriculum of most medical schools. Our goals were to identify factors that motivate students to choose an orthopaedic career and to compare these with the factors that influence students to choose nonorthopaedic disciplines. ⋯ Although faculty contacts and third-year clinical rotations played an important role in student selection of specialty training, they were less influential for those choosing an orthopaedic career than for those choosing other disciplines. Many students choosing orthopaedics made this decision prior to medical school. We believe that increased exposure to positive clinical role models and experiences during medical school would enhance medical students' options for choosing orthopaedic surgery as a career. Anticipated income did not play a deciding role in career selection.
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J Bone Joint Surg Am · Jun 2012
Cylindrical costal osteochondral autograft for reconstruction of large defects of the capitellum due to osteochondritis dissecans.
There is a need to clarify the usefulness of and problems associated with cylindrical costal osteochondral autograft for reconstruction of large defects of the capitellum due to osteochondritis dissecans. ⋯ Cylindrical costal osteochondral autograft was useful for the treatment of advanced osteochondritis dissecans of the humeral capitellum. Functional recovery was rapid after surgery. Additional operations were performed for five of the twenty-six patients, whereas the remaining patients showed essentially full recovery within a year. All patients were satisfied with the results at the time of short-term follow-up.