The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · May 2009
Randomized Controlled Trial Comparative StudyPosterior short-segment fixation with or without fusion for thoracolumbar burst fractures. a five to seven-year prospective randomized study.
The impact of fusion as a supplement to short-segment instrumentation for the treatment of thoracolumbar burst fractures is unclear. We conducted a controlled clinical trial to define the effect of fusion on lumbar spine and patient-related functional outcomes. ⋯ Posterolateral bone-grafting is not necessary when a Denis type-B thoracolumbar burst fracture associated with a load-sharing score of
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J Bone Joint Surg Am · May 2009
Multicenter StudySix-year outcomes of anterior lumbar interbody arthrodesis with use of interbody fusion cages and recombinant human bone morphogenetic protein-2.
Twenty-four-month outcomes have been reported for patients with degenerative lumbar disc disease who were treated with stand-alone anterior lumbar interbody arthrodesis with use of dual tapered interbody fusion cages and recombinant human bone morphogenetic protein-2. This report represents an update of the clinical and radiographic results of this treatment at six years. ⋯ The use of dual tapered threaded fusion cages and recombinant human bone morphogenetic protein-2 on an absorbable collagen sponge obtained and maintained intervertebral spinal fusion, improved clinical outcomes, and reduced pain after anterior lumbar interbody arthrodesis in patients with degenerative lumbar disc disease.
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J Bone Joint Surg Am · May 2009
Complication rates following open reduction and internal fixation of ankle fractures.
Ankle fractures are among the most common injuries treated by orthopaedic surgeons. The purpose of the present investigation was to examine the risks of complications after open reduction and internal fixation of ankle fractures in a large population-based study. ⋯ By analyzing a large, diverse patient population, the present study clarifies the risks associated with open reduction and internal fixation of ankle fractures. Open injury, diabetes, and peripheral vascular disease were strong risk factors predicting a complicated short-term postoperative course. Fracture type was a strong predictor of reoperation for ankle fusion or replacement. Hospital volume did not play a significant role in the rates of short-term or intermediate-term complications.
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J Bone Joint Surg Am · May 2009
Heterotopic ossification in high-energy wartime extremity injuries: prevalence and risk factors.
Heterotopic ossification in the extremities remains a common complication in the setting of high-energy wartime trauma, particularly in blast-injured amputees and in those in whom the definitive amputation was performed within the zone of injury. The purposes of this cohort study were to report the experience of one major military medical center with high-energy wartime extremity wounds, to define the prevalence of heterotopic ossification in these patients, and to explore the relationship between heterotopic ossification and other potential independent predictors. ⋯ The prevalence of heterotopic ossification in war-wounded patients is higher than that in civilian trauma. Although trends associated with local wound conditions were identified, the risk factors for the development of heterotopic ossification found in this study suggest that systemic causes predominate.
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J Bone Joint Surg Am · May 2009
The effect of platelet-rich plasma and bone marrow on murine posterolateral lumbar spine arthrodesis with bone morphogenetic protein.
Recombinant human bone morphogenetic protein-2 (rhBMP-2) has had limited success in stimulating osteogenesis at the site of posterolateral lumbar spine arthrodesis when used at the currently approved human dose for anterior lumbar interbody arthrodesis. The objective of the present study was to investigate the effect of co-administration of fresh harvested autologous bone marrow aspirate and platelet-rich plasma on rhBMP-2-mediated in vivo murine posterolateral lumbar spine arthrodesis. ⋯ The present study quantitatively confirmed a synergistic effect of bone marrow cells when added to rhBMP-2 in an in vivo mouse posterolateral lumbar spine fusion model. The volume, area, and density of the fusion mass were significantly increased by augmentation with bone marrow cells.