The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Oct 2008
Randomized Controlled TrialUse of a postoperative lumbar corset after lumbar spinal arthrodesis for degenerative conditions of the spine. A prospective randomized trial.
Lumbosacral corsets and braces have been used to treat a variety of spinal disorders. Although their use after lumbar arthrodesis for degenerative conditions has been reported, there is a lack of evidence on which to base guidelines on their use. The purpose of this study was to evaluate the effect of a postoperative corset on the outcome of lumbar arthrodesis. ⋯ Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Oct 2008
Surgical treatment of main thoracic scoliosis with thoracoscopic anterior instrumentation. a five-year follow-up study.
The surgical outcomes in patients with scoliosis at two years following anterior thoracoscopic spinal instrumentation and fusion have been reported. The purpose of this study was to evaluate the results at five years. ⋯ Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Oct 2008
Randomized Controlled Trial Multicenter StudyComparison of autogenous bone graft and endothermic calcium phosphate cement for defect augmentation in tibial plateau fractures. A multicenter, prospective, randomized study.
Bone graft augmentation is often selected to treat defects associated with unstable tibial plateau fractures. This prospective, randomized, multicenter study was undertaken to determine the efficacy of bioresorbable calcium phosphate cement compared with standard autogenous iliac bone graft in the treatment of these osseous defects. ⋯ Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Oct 2008
Design and implementation of a system-based course in musculoskeletal medicine for medical students.
The amount of time devoted to musculoskeletal medicine in the typical undergraduate curriculum is disproportionately low compared with the frequency of musculoskeletal complaints that occur in a general practice. Consequently, whether because of the quantity or quality of the education, the competence level of graduating physicians regarding musculoskeletal problems is inadequate. Our purposes were to design a self-contained, system-based course in musculoskeletal medicine for medical students in the preclinical years and to measure the level of competence achieved by a class of first-year medical students who took the course. ⋯ The main features of the course were: (1) an emphasis on both cognitive and process-based knowledge; (2) more contact hours and broader content than in previously described courses in musculoskeletal medicine; (3) the use of small groups to focus on problem-solving and physical examination competencies; (4) basic-science content directly related to clinical goals. These features might be used at other institutions that employ a system-based curriculum for the preclinical years to help improve competence in musculoskeletal medicine.
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J Bone Joint Surg Am · Oct 2008
The outcome and structural integrity of arthroscopic rotator cuff repair with use of the double-row suture anchor technique. Surgical technique.
The reported rate of failure after arthroscopic rotator cuff repair has varied widely. The influence of the repair technique on the failure rates and functional outcomes after open or arthroscopic rotator cuff repair remains controversial. The purpose of the present study was to evaluate the functional and anatomic results of arthroscopic rotator cuff repairs performed with the double-row suture anchor technique on the basis of computed tomography or magnetic resonance imaging arthrography in order to determine the postoperative integrity of the repairs. ⋯ Arthroscopic repair of a rotator cuff tear with use of the double-row suture anchor technique results in a much lower rate of failure than has previously been reported in association with either open or arthroscopic repair methods. Patients with an intact rotator cuff repair have better pain relief than those with a failed repair. After repair, large and massive rotator cuff tears result in more postoperative weakness than small tears do.