The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Feb 2004
Randomized Controlled Trial Comparative Study Clinical TrialLigament reconstruction with or without tendon interposition to treat primary thumb carpometacarpal osteoarthritis. A prospective randomized study.
Trapezial excision with ligament reconstruction and trapezial excision with ligament reconstruction combined with tendon interposition have proven to be highly effective techniques for treating primary osteoarthritis of the thumb carpometacarpal joint. To determine whether tendon interposition and proximal migration of the thumb metacarpal affect the objective and subjective outcomes, we compared the long-term outcomes of these two procedures performed in similar patient groups. ⋯ Tendon interposition does not affect the outcome after the ligament reconstruction for the treatment of osteoarthritis of the thumb carpometacarpal joint. Furthermore, proximal migration of the thumb metacarpal does not appear to influence the functional outcome.
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J Bone Joint Surg Am · Feb 2004
The incidence of fractures and dislocations referred for orthopaedic services in a capitated population.
The purpose of this study was to determine the annual incidence rates of non-work-related traumatic fractures and dislocations (excluding head and facial injuries) referred for orthopaedic services in a large population enrolled under a capitated insurance contract. ⋯ Young males had the highest rate of traumatic fractures referred for orthopaedic services. Adolescents of both genders had high rates of traumatic dislocations referred for orthopaedic services. The lifetime risk of a non-work-related fracture referred for orthopaedic services to the age of sixty-five years is approximately equal to that of coronary artery disease.
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J Bone Joint Surg Am · Jan 2004
Multicenter Study Comparative StudyMinimally invasive total knee arthroplasty.
Currently, minimally invasive total knee arthroplasty is defined as an incision length of < 14 cm. However, the length of the incision is not the primary influence on potential postoperative benefits to the patient and should not be the only characteristic of the minimally invasive approach for knee arthroplasty. Some other factors that should also be included in this definition are: 1. ⋯ Extensive open exposure, prolonged patellar eversion, and dislocation of the tibiofemoral joint should evolve into a vastus medialis muscle split with patellar subluxation, retraction but not dislocation of the patella, and avoidance of gross dislocation of the tibiofemoral joint. Developing the techniques of minimally invasive total knee arthroplasty may be difficult and time-consuming, but patient benefits and satisfaction should outweigh the extra effort required. These changes require well-designed clinical studies to further document their effectiveness.
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Scapulothoracic dissociation is an infrequent injury that is often accompanied by neurovascular injuries with a potentially devastating outcome. The aim of this study was to evaluate the functional outcome following scapulothoracic dissociation. ⋯ Prognostic study, Level II-1 (retrospective cohort study). See Instructions to Authors for a complete description of levels of evidence.