Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Nov 2010
Comparative StudySite-dependent replacement or internal fixation for postradiation femur fractures after soft tissue sarcoma resection.
High-dose radiation retards bone healing, compromising the surgical results of radiation-induced fractures. Prosthetic replacement has traditionally been reserved as a salvage option but may best achieve the clinical goals of eliminating pain, restoring function and avoiding complications. ⋯ Radiation-induced fractures have poor healing potential. Our data suggest an aggressive approach to fracture treatment with a prosthetic replacement can minimize complications and the need for revision surgery.
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Clin. Orthop. Relat. Res. · Nov 2010
Multicenter StudyRecurrence after and complications associated with adjuvant treatments for sacral giant cell tumor.
The best treatment of giant cell tumor of the sacrum is controversial. It is unclear whether adjuvant treatment with intralesional surgery reduces recurrences or increases morbidity. ⋯ Adjuvants did not change the likelihood of local recurrence when combined with intralesional surgery but the complication rate was high.
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Clin. Orthop. Relat. Res. · Nov 2010
Surgical margins and local control in resection of sacral chordomas.
The treatment of choice in sacral chordoma is surgical resection, although the risk of local recurrence and metastasis remains high. The quality of surgical margins obtained at initial surgery is the primary factor to improve survival reducing the risk of local recurrence, but proximal sacral resections are associated with substantial perioperative morbidity. ⋯ Surgical margins affect the risk of local recurrence. Previous intralesional surgery was associated with a higher rate of local recurrence. Intraoperative contamination did not affect the risk of local recurrence when wide margins were subsequently attained.
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Clin. Orthop. Relat. Res. · Nov 2010
Increased chondrocyte death after steroid and local anesthetic combination.
Hyaline articular cartilage has limited repair and regeneration capacity. Intraarticular administration of glucocorticoid and local anesthetic injections play an important role in the therapy of osteoarthritis. Glucocorticoids and anesthetics reportedly enhance apoptosis in chondrocytes, but effects of the combined use of glucocorticoids and local anesthetics are unknown. ⋯ The combination of glucocorticoids and local anesthetics has an adverse effect on articular chondrocytes, and it raises a question regarding whether concomitant administration should be used in treating osteoarthritis.