Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jul 2014
ReviewHip resurfacing versus total hip arthroplasty: a systematic review comparing standardized outcomes.
Metal-on-metal hip resurfacing was developed for younger, active patients as an alternative to THA, but it remains controversial. Study heterogeneity, inconsistent outcome definitions, and unstandardized outcome measures challenge our ability to compare arthroplasty outcomes studies. ⋯ Revisions and reoperations are more frequent and occur earlier with metal-on-metal hip resurfacing, except when discontinued devices are removed from the analyses. Results from the literature may be misleading without consistent definitions, standardized outcome metrics, and accounting for device market status. This is important when clinicians are assessing and communicating patient risk and when selecting which device is most appropriate for individual patients.
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Clin. Orthop. Relat. Res. · Jul 2014
Multicenter Study Comparative StudyComparative study of simple and complex open elbow dislocations.
Open elbow dislocations are rare injuries. Most of the evidence related to these dislocations is found in case reports or in series with closed injuries. We reviewed the experiences of three centers in the treatment of open elbow dislocations. ⋯ Level IV, prognostic study. See Instructions for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Jul 2014
Comparative StudyFixation versus replacement of radial head in terrible triad: is there a difference in elbow stability and prognosis?
Surgical treatment for terrible triad injuries of the elbow (defined as elbow dislocations with concomitant fractures of the radial head and coronoid) remains a challenging clinical problem. Specifically, the question of whether to repair or replace the radial head remains controversial. ⋯ Level III, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Jul 2014
Terrible triad injuries of the elbow: does the coronoid always need to be fixed?
The "terrible triad" of the elbow is a complex injury that can lead to pain, stiffness, and posttraumatic arthritis if not appropriately treated. The primary goal of surgery for these injuries is to restore stability of the joint sufficient to permit early motion. Although most reports recommend repair and/or replacement of all coronoid and radial head fractures when possible, a recent cadaveric study demonstrated that type II coronoid fractures are stable unless the radial head is removed and not replaced. ⋯ Level IV, therapeutic study. See Guidelines to Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Jul 2014
Comparative StudyOpen reduction and internal fixation of radial head fractures: do outcomes differ between simple and complex injuries?
Radial head fractures can occur in isolation or in association with elbow and forearm injuries. Treatment options include nonoperative management, fragment or whole-head excision, open reduction and internal fixation (ORIF), and radial head arthroplasty. However, the evidence supporting ORIF for repairable radial head fractures is inconclusive. ⋯ Level III, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.