The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jun 2012
Comparative StudyThe Latarjet procedure for the treatment of recurrence of anterior instability of the shoulder after operative repair: a retrospective case series of forty-nine consecutive patients.
Recurrence of anterior shoulder instability after operative repair is an uncommon but disabling condition for which treatment options have been insufficiently studied. Coracoid transfer as described by Latarjet is a highly successful primary operation for recurrent anterior shoulder instability. The purpose of this study was to verify the hypothesis that this procedure is also effective for treating recurrent glenohumeral instability after previous operative repair. ⋯ Coracoid transfer as described by Latarjet can effectively restore anterior glenohumeral shoulder stability if previous operation(s) have failed to do so. If recurrence is associated with chronic pain, the pain is likely to persist and compromise the subjective outcome.
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J Bone Joint Surg Am · Jun 2012
Comparative StudyLong-term outcomes of lumbar posterior apophyseal end-plate lesions in children and adolescents.
A lesion of the lumbar posterior apophyseal end plate in children and adolescents causes symptoms similar to those associated with a herniated disc. However, the end-plate lesion and the herniated disc differ in terms of pathology. The purpose of this study was to clarify the long-term clinical and radiographic outcomes in children and adolescents who were treated either surgically or conservatively for a lumbar posterior apophyseal end-plate lesion. ⋯ The long-term outcome for patients with a posterior end-plate lesion is favorable, regardless of whether it is treated surgically or nonsurgically.
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J Bone Joint Surg Am · Jun 2012
Comparative StudyActivity levels are higher after osteochondral autograft transfer mosaicplasty than after microfracture for articular cartilage defects of the knee: a retrospective comparative study.
There is limited information regarding direct comparisons of the outcome of osteochondral autograft transfer (OAT) mosaicplasty and microfracture for the treatment of isolated articular cartilage defects of the knee. The purpose of this retrospective comparative study was to compare the general health outcomes, knee function, and Marx Activity Rating Scale scores for patients treated with OAT or microfracture for symptomatic chondral defects of the femoral condyles or trochlea. We hypothesized that the patients in the two treatment groups would have similar clinical outcomes at intermediate-term follow-up. ⋯ In the present retrospective comparative study, the hypothesis that patients treated with microfracture or OAT mosaicplasty for symptomatic articular cartilage defects of the femoral condyles or trochlea would have similar clinical outcomes at intermediate-term follow-up was affirmed for general health outcome and for knee function. However, patients treated with OAT mosaicplasty maintained a superior level of athletic activity compared with those treated with microfracture.
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J Bone Joint Surg Am · Jun 2012
The hook plate technique for fixation of phalangeal avulsion fractures.
Avulsion fractures of the phalanges involve small osseous fragments that are usually attached to structures that are necessary for stability or movement of the joint. Satisfactory healing of the fracture to preserve joint function may require open reduction and internal fixation, which can be difficult because of the small size of the fragments. ⋯ This indirect fixation technique produces stable fixation allowing early active finger motion.