Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · May 2000
Bipolar hemiarthroplasty for osteonecrosis of the femoral head. A 7- to 18-year followup.
This study evaluated clinical and radiographic results of bipolar hemiarthroplasties for the treatment of osteonecrosis of the femoral head. Forty-eight hips in 35 patients with a mean age of 37 years who underwent primary bipolar hemiarthroplasties were observed for an average of 11.4 years. Osteonecrosis was associated with corticosteroid use (21 patients), alcohol (six patients), idiopathic (four patients), and other conditions (four patients). ⋯ Radiographic proximal migration greater than 4 mm and osteoarthritic signs of the acetabulum indicated a high risk of groin symptoms. The results were inferior to those previously reported for total hip arthroplasty. Thus, for the treatment of osteonecrosis of the femoral head in which necrotic lesions are wide, the authors no longer use this system and currently use total hip arthroplasty.
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Clin. Orthop. Relat. Res. · May 2000
Historical ArticleHospital for special surgery. A brief review of its development and current position.
On May 1, 1999, the Hospital for Special Surgery was 136 years old. To present a history that does adequate justice to the many people, who have been or still are involved in the making of it, is an impossible task. Nevertheless, this document is important because the hospital, first under the name of Ruptured and Crippled and then under that of Special Surgery has played such an important role in the development of orthopaedics and rheumatology in America during the past century. ⋯ The account begins with a description of the hospital's current situation, physical layout and governance. A terse history of the hospital's origin and subsequent development follows, which includes a more specific description of the growth of its orthopaedic surgical services. Finally, separate records of the 112-year-old Postgraduate Orthopaedic Educational Program and 44-year-old Research Division are presented.
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Clin. Orthop. Relat. Res. · May 2000
Historical ArticleBoston's contributions to the development of orthopaedics in the United States. A brief history.
Since the early part of the nineteenth century, physicians from Boston have had a major impact on orthopaedics in America. Initially, the general surgeons such as John Ball Brown and his son, Buckminster had an impact on orthopaedics, but contributors such as Henry Bigelow and Charles Scudder added greatly to the knowledge and capacity for care. The first orthopaedic ward, Ward I, was located at the Massachusetts General Hospital and began the new era. ⋯ Osgood, Joel Goldthwait, Elliot Brackett, Robert Lovett, and Edward Bradford. These physicians not only treated patients at the Children's, Tufts University, Boston City, the Beth Israel, and the Massachusetts General Hospitals, but assumed the academic responsibilities of a major educational center. More recently the contributors to orthopaedics have included Marius Smith-Petersen, Otto Aufranc, Henry Banks, Edward Cave, Carter Rowe, Joseph Barr, and others who have created a spectacular program for education, research, and clinical care.
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Clin. Orthop. Relat. Res. · May 2000
Historical ArticleHistory and development of trauma care in the United States.
Until recently the development of systems for trauma care in the United States has been inextricably linked to wars. During the Revolutionary War trauma care was based on European trauma principles particularly those espoused by the Hunter brothers. Surgical procedures were limited mostly to soft tissue injuries and amputations. ⋯ The first trauma centers for civilians were started in the United States in 1966. Since 1988 the number of states with mature trauma systems has expanded from two to 35. During the same period, many studies have documented the efficacy of trauma systems in reducing unnecessary mortality and disability.