Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Apr 2011
Intraoperative molds to create an articulating spacer for the infected knee arthroplasty.
Chronic infections in TKA have been traditionally treated with a two-stage protocol incorporating a temporary antibiotic-loaded cement spacer. The use of a static as opposed to an articulating spacer is controversial. Some surgeons believe a static spacer results in a higher rate of infection eradication, whereas others believe an articulating spacer provides equivalent rates of infection control with improved function between stages and the potential for better eventual range of motion. ⋯ Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Apr 2011
Is intraoperative CT of posterior cervical spine instrumentation cost-effective and does it reduce complications?
Symptomatic multilevel cervical myelopathy is often addressed using posterior decompression using two-dimensional fluoroscopy. Intraoperative three-dimensional fluoroscopy provides more accurate information on the position of instrumentation to prevent screw-related complications. ⋯ Level III, economic and decision analyses. See Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Apr 2011
Two-stage total hip arthroplasty: how often does it control methicillin-resistant infection?
Methicillin-resistant hip infections are increasingly common. Reports of the surgical management of these patients using two-stage THA show variable control of infection, but all reports used static spacers. ⋯ Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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A 10-point Surgical Apgar Score, based on patients' estimated blood loss, lowest heart rate, and lowest mean arterial pressure during surgery, was developed to rate patients' outcomes in general and vascular surgery but has not been tested for patients having orthopaedic surgery. ⋯ Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Apr 2011
Comparative StudyCan implant retention be recommended for treatment of infected TKA?
Retention treatment is reportedly associated with lower infection control rates than two-stage revision. However, the studies on which this presumption are based depend on comparisons of historical rather than concurrent controls. ⋯ Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.