Journal of orthopaedic surgery and research
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Multicenter Study Comparative Study
Allogeneic morphogenetic protein vs. recombinant human bone morphogenetic protein-2 in lumbar interbody fusion procedures: a radiographic and economic analysis.
Since the introduction of rhBMP-2 (Infuse) in 2002, surgeons have had an alternative substitute to autograft and its related donor site morbidity. Recently, the prevalence of reported adverse events and complications related to the use of rhBMP-2 has raised many ethical and legal concerns for surgeons. Additionally, the cost and decreasing reimbursement landscape of rhBMP-2 use have required identification of a viable alternative. Osteo allogeneic morphogenetic protein (OsteoAMP) is a commercially available allograft-derived growth factor rich in osteoinductive, angiogenic, and mitogenic proteins. This study compares the radiographic fusion outcomes between rhBMP-2 and OsteoAMP allogeneic morphogenetic protein in lumbar interbody fusion spine procedures. ⋯ Results of this study indicate that OsteoAMP is a viable alternative to rhBMP-2 both clinically and economically when used in TLIF and LLIF spine procedures.
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Comparative Study
Delayed drainage versus autotransfusion drainage and routine drainage after total knee arthroplasty: a comparative study.
The purpose of this research is to compare the clinical results of different drainage methods in total knee arthroplasty (TKA). ⋯ Delayed postoperative drainage may reduce blood loss and the chance of allogenic blood transfusion compared with routine drainage and may also reduce the chance of postoperative fever and extra costs compared with autotransfusion.
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Remote ballistic femoral fractures are rare fractures reported in the literature but still debated as to their existence and, indeed, their treatment. This study aimed to prove their existence, understand how they occur and determine which ammunition provides the greatest threat. In addition, fracture patterns, soft tissue disruption and contamination were assessed to aid in treatment planning. ⋯ These fractures occur with civilian ammunition, but cannot prove their existence with military rounds. They result from the expanding temporary cavity affecting the weakest part of the bone, creating a potentially contaminated wedge-shaped fracture, important for surgeons considering operative intervention.
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There is considerable controversy as to which posterior technique is best for the treatment of multi-level cervical spondylotic myelopathy. The aim of this study was to compare the clinical and radiographic results and complications of laminoplasty (LAMP) and laminectomy (LAMT) in the treatment of multi-level cervical spondylotic myelopathy. ⋯ Based on these results, a claim of superiority for laminoplasty or laminectomy was not justified. In deciding between the two procedures, the risks of surgical and neurological complications, and radiologic and clinical outcome, must be taken into consideration if both options are available in multi-level cervical spondylotic myelopathy.
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Multicenter Study
Clinical outcomes of locked plating of distal femoral fractures in a retrospective cohort.
Locked plating (LP) of distal femoral fractures has become very popular. Despite technique suggestions from anecdotal and some early reports, knowledge about risk factors for failure, nonunion (NU), and revision is limited. The purpose of this study was to analyze the complications and clinical outcomes of LP treatment for distal femoral fractures. ⋯ Despite modern fixation techniques, distal femoral fractures often result in persistent disability and worse clinical outcomes. Soft tissue management seems to be important. Submuscular plate insertion reduced the nonunion rate. Preexisting total knee arthroplasty increased the risk of hardware failure. Further studies determining factors that improve outcome are warranted.