Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Oct 2012
Multicenter StudyExtent of tibiofemoral osteoarthritis before knee arthroplasty: multicenter data from the osteoarthritis initiative.
Knee arthroplasty traditionally is recommended for persons with substantial disability and disabling pain attributable to moderate or severe osteoarthritis (OA). Pain and functional status after arthroplasty may be influenced by the extent of knee OA before surgery and recent evidence suggests persons with less severe knee OA before undergoing TKA have greater pain levels and worse function than persons with more severe knee OA. ⋯ Level I, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Oct 2012
The vascularized fibular graft in precollapse osteonecrosis: is long-term hip preservation possible?
Osteonecrosis of the femoral head (ONFH) is a debilitating condition affecting primarily young patients. Free vascularized fibular grafting (FVFG) may provide a durable means to preserve the femoral head. When used in the precollapse stages of ONFH, this treatment may alter the course of disease. ⋯ Level IV, therapeutic study. See Instructions to Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Oct 2012
Surgical technique: Lateral retinaculum release in knee arthroplasty using a stepwise, outside-in technique.
Lateral release of a tight lateral retinaculum in a TKA is intended to correct patellar maltracking but the widely used inside-out technique has associated risks. We describe an alternate stepwise outside-in technique, with titrated release intended to maximize the chance of preserving the superior lateral genicular artery (SLGA). ⋯ Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Oct 2012
Meta AnalysisIs there really no benefit of vertebroplasty for osteoporotic vertebral fractures? A meta-analysis.
Osteoporotic vertebral compressed fractures (VCFs) are the most common osteoporotic fractures. Although percutaneous vertebroplasty (PVP) reportedly relieves pain and improves function, a recent pooled analysis from two multicenter randomized controlled trials concluded the improvement in pain and disability treated with PVP was similar to those with sham surgery. ⋯ Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Oct 2012
Critically assessing the Haiti earthquake response and the barriers to quality orthopaedic care.
Although numerous authors have described surgical experiences following major disasters, little is known regarding the needs of and barriers to care faced by surgeons during such disasters. ⋯ Organizational and training barriers obstructed orthopaedic care delivery immediately after the Haiti earthquake. Disaster training and outcomes require further study to improve care in future catastrophes.