Bulletin of the NYU hospital for joint diseases
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Bull NYU Hosp Jt Dis · Jan 2009
Review Case ReportsPeroneal nerve injury with foot drop complicating ankle sprain--a series of four cases with review of the literature.
Foot drop has many etiologies. One rarely mentioned and often neglected reason for foot drop is an acute inversion sprain of the ankle. Over the past 14 years, a collection of 32 cases of foot drop have been compiled in our orthopaedic and physiatric practices. ⋯ Proposed mechanisms for this type of foot drop are discussed, including traction and compression of the common peroneal nerve as it winds around the neck of the fibula, and possible compression by hematoma. Surgical versus conservative treatment is described. The functional impairment associated with foot drop is detailed.
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The distal radioulnar joint (DRUJ) acts in concert with the proximal radioulnar joint to control forearm rotation. The DRUJ is stabilized by the triangular fibrocartilage complex (TFCC). ⋯ TFCC and DRUJ injuries are part of the common pattern of injuries we see with distal radius fractures. While much attention has been paid to the treatment of the distal radius fractures, many of the poor outcomes are due to untreated or unrecognized injuries to the DRUJ and its components.
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Bull NYU Hosp Jt Dis · Jan 2009
Comparative StudyA comparison of total hip resurfacing and total hip arthroplasty - patients and outcomes.
A comparison of pertinent preoperative and postoperative data relative to total hip resurfacing versus total hip arthroplasty (THA) would assist in evaluating current perceptions in outcome. We compared 50 consecutive metal-metal resurfacing replacements in 50 patients with 44 consecutive conventional total hip arthroplasties in 35 patients, who were implanted during the same time period, by the same surgeon, and followed prospectively for 2 to 4 years. The patients undergoing hip resurfacing were 62% male, 9 years younger, and 3.2 inches taller, with a lower mean body mass index and American Society of Anesthesiologists (ASA) grade than patients undergoing total hip arthroplasty. ⋯ There were no differences in postoperative range of motion or dislocation (one each). The preoperative characteristics and general health status of the average patient undergoing resurfacing are more favorable than that of the average patient undergoing conventional total hip arthroplasty. Caution should be applied in attributing differences in outcomes directly to the arthroplasty technology.
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Bull NYU Hosp Jt Dis · Jan 2009
ReviewCan RAPID3, an index without formal joint counts or laboratory tests, serve to guide rheumatologists in tight control of rheumatoid arthritis in usual clinical care?
Tight control of rheumatoid arthritis (RA) may be guided by RAPID3 (routine assessment of patient index data), an index without formal joint counts or laboratory tests, which can be scored on a multidimensional health assessment questionnaire (MDHAQ) in 5 seconds, compared to 42 seconds to score a standard HAQ, 90 seconds to perform a 28-joint count, 114 seconds to score a disease activity score 28 (DAS28), and 106 seconds to score a clinical disease activity index (CDAI). RAPID3 scores are correlated significantly with DAS28 and CDAI (rho > 0.65, p < 0.001), and distinguish active from control treatment similarly to DAS28 and CDAI in clinical trials of methotrexate, lefunomide, adalimumab, abatacept, certolizumab, and infiximab. RAPID3 scores can be used to classify patient disease activity status as high (> 12), moderate (6.1-12), low (3.1-6), and remission (
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Bull NYU Hosp Jt Dis · Jan 2009
The early results of metal-on-metal hip resurfacing - a prospective study at a minimum two-year follow-up.
Hip resurfacing has recently been offered as an attractive alternative to conventional total hip arthroplasty. This report evaluated the short-term functional outcome and longevity of a newer generation resurfacing device and includes the results of 228 consecutive hip resurfacing in 209 patients at a minimum of two-year follow-up. All resurfacing were performed by a single surgeon using a posterior approach. ⋯ The overall survival at 4.6 years was 96.9%. The survival of resurfacing in this study was comparable to that of other published studies of hip resurfacing. Surface hip arthroplasty appears to be an effective alternative to conventional total hip arthroplasty in patients suffering from osteoarthritis.