Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2012
Meta Analysis Comparative StudyRecombinant human bone morphogenetic protein-2 versus autogenous iliac crest bone graft for lumbar fusion: a meta-analysis of ten randomized controlled trials.
Recombinant human bone morphogenetic protein-2 (rhBMP-2) as a substitute for iliac crest bone graft (ICBG) has been increasingly widely used in lumbar fusion. It has been proven non-inferior in fusion success and clinical outcomes when compared with ICBG. However, increasingly, some potentially uncommon and serious complications associated with the use of rhBMP-2 have been of great concern to surgeons. The purpose of this study was to determine whether rhBMP-2 could be considered an effective and, more importantly, a relatively safe substitute for ICBG in lumbar fusion. ⋯ RhBMP-2 was superior to the ICBG for achieving fusion success and avoiding reoperation. However, evidence from the Food and Drug Administration document and subsequent independent studies has demonstrated that original, industry-sponsored trials underestimated rhBMP-2-related adverse events. There are still security risks in the use of rhBMP-2.
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Arch Orthop Trauma Surg · Dec 2012
Comparative StudySurgical management for thoracic spinal tuberculosis in the elderly: posterior only versus combined posterior and anterior approaches.
To compare the clinical outcomes of surgical management by posterior only and combined posterior and anterior approaches for thoracic spinal tuberculosis in the elderly. ⋯ Our study showed that the posterior approach only procedure obtained better clinical outcomes than combined posterior and anterior surgeries. It might be a better surgical treatment for thoracic spinal tuberculosis in aged patients with poor health status, especially for cases in early phase of bone destruction and/or mild and moderate kyphosis.
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Arch Orthop Trauma Surg · Dec 2012
Cementless second-generation hydroxyapatite CaP-coated tibial component: an 8.7-year follow-up.
This is the first study that reports on the mid-term results of 81 patients suffering from arthritis of the knee, treated with a cementless second-generation hydroxyapatite calcium phosphate (CaP)-coated tibial component. ⋯ These findings indicate that the uncemented second-generation hydroxyapatite CaP-coated tibial component performed well at mid-term follow-up, and provides sufficiently stable bone ingrowth fixation.
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Arch Orthop Trauma Surg · Dec 2012
Macroreplantations of the upper extremity: a series of 11 patients.
Micro- or macroreplantation is classified depending on the level of amputation, distal or proximal to the wrist. This study was performed to review our experience in macroreplantation of the upper extremity with special attention to technical considerations and outcomes. ⋯ Level IV.