Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Mar 2017
Multicenter Study Comparative StudyHow Does the Level of Nerve Root Resection in En Bloc Sacrectomy Influence Patient-Reported Outcomes?
For patients with sacral tumors, who are well enough for surgery, en bloc resection is the preferred treatment. Survival, postoperative complications, and recurrent rates have been described, but patient-reported outcomes often are not included in these studies. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Mar 2017
Comparative StudySurvival in Mesenchymal Chondrosarcoma Varies Based on Age and Tumor Location: A Survival Analysis of the SEER Database.
Studies suggest that mesenchymal chondrosarcoma is associated with a poorer prognosis and a higher proportion of extraskeletal tumors than conventional chondrosarcoma. However, these investigations have been small heterogeneous cohorts, limiting analysis of prognostic factors. ⋯ Level IV, prognostic study.
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Clin. Orthop. Relat. Res. · Mar 2017
Antibacterial and Biocompatible Titanium-Copper Oxide Coating May Be a Potential Strategy to Reduce Periprosthetic Infection: An In Vitro Study.
Periprosthetic infections are devastating for patients and more efficacious preventive strategies are needed. Surface-modified implants using antibacterial coatings represent an option to cope with this problem; however, manufacturing limitations and cytotoxicity have curbed clinical translation. Among metals with antibacterial properties, copper has shown superior in vitro antibacterial performance while maintaining an acceptable cytotoxicity profile. A thin film containing copper could prevent early biofilm formation to limit periprosthetic infections. This pilot study presents the in vitro antibacterial effect, cytotoxicity, and copper ion elution pattern of a thin film of titanium-copper oxide (TiCuO). ⋯ A thin film coating with TiCuO demonstrates high antibacterial activity and low cellular cytotoxicity to human osteoblasts in vitro. Taken together, these properties represent a potential strategy for preventing periprosthetic infection if further work in animal models can confirm these results in vivo.
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Clin. Orthop. Relat. Res. · Mar 2017
Comparative StudyThe Femoro-Epiphyseal Acetabular Roof (FEAR) Index: A New Measurement Associated With Instability in Borderline Hip Dysplasia?
The definition of osseous instability in radiographic borderline dysplastic hips is difficult. A reliable radiographic tool that aids decision-making-specifically, a tool that might be associated with instability-therefore would be very helpful for this group of patients. ⋯ Level III, diagnostic study.
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Clin. Orthop. Relat. Res. · Mar 2017
Comparative StudyIs There Asymmetry Between the Concave and Convex Pedicles in Adolescent Idiopathic Scoliosis? A CT Investigation.
Adolescent idiopathic scoliosis is a complex three-dimensional deformity of the spine characterized by deformities in the sagittal, coronal, and axial planes. Spinal fusion using pedicle screw instrumentation is a widely used method for surgical correction in severe (coronal deformity, Cobb angle > 45°) adolescent idiopathic scoliosis curves. Understanding the anatomic difference in the pedicles of patients with adolescent idiopathic scoliosis is essential to reduce the risk of neurovascular or visceral injury through pedicle screw misplacement. ⋯ There is clinically important asymmetry in the morphologic features of pedicles in individuals with adolescent idiopathic scoliosis. The concave side of the curve compared with the convex side is smaller in height and width periapically. Furthermore, the trajectory of the pedicle is more acute on the convex side of the curve compared with the concave side around the apex of the curve. Knowledge of these anatomic variations is essential when performing scoliosis correction surgery to assist with selecting the correct pedicle screw size and trajectory of insertion to reduce the risk of pedicle wall perforation and neurovascular injury.