Clinical orthopaedics and related research
-
Clin. Orthop. Relat. Res. · Mar 2015
Multilevel en bloc spondylectomy for tumors of the thoracic and lumbar spine is challenging but rewarding.
Over the years, en bloc spondylectomy has proven its efficacy in controlling spinal tumors and improving survival rates. However, there are few reports of large series that critically evaluate the results of multilevel en bloc spondylectomies for spinal neoplasms. ⋯ Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.
-
Clin. Orthop. Relat. Res. · Mar 2015
Differential cytotoxicity of corticosteroids on human mesenchymal stem cells.
Corticosteroids are a common, short-term, local antiinflammatory and analgesic for treating patients with musculoskeletal disorders. Studies have shown the deleterious effects of corticosteroids on chondrocytes, suggesting a potentiation of degenerative joint disease. Mesenchymal stem cells (MSCs) are the direct progenitors of chondrocytes and other musculoskeletal tissue. Additionally, they serve an important antiinflammatory role, which can combat the chronic inflammatory state that mediates degenerative joint disease. Little is known about how corticosteroids interact with this regenerative and reparative cell population. ⋯ Corticosteroids frequently are used by physicians to reduce inflammation in patients with musculoskeletal disorders, but these agents may hinder MSCs' innate regenerative capacity in exchange for temporary analgesia. Our study suggests that choosing dexamethasone may result in less harmful effects when compared with other injectable steroids.
-
Clin. Orthop. Relat. Res. · Mar 2015
Survival of modern knee tumor megaprostheses: failures, functional results, and a comparative statistical analysis.
Modular megaprostheses are now the most common method of reconstruction after segmental resection of the long bones in the lower extremities. Previous studies reported variable outcome and failure rates after knee megaprosthetic reconstructions. ⋯ Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
-
Clin. Orthop. Relat. Res. · Feb 2015
Preoperative erythropoietin alpha reduces postoperative transfusions in THA and TKA but may not be cost-effective.
Preoperative erythropoietin alpha (EPO) has been shown to be effective at reducing postoperative blood transfusions in total hip arthroplasty (THA) and total knee arthroplasty (TKA); however, treatment with EPO is associated with additional costs, and it is not known whether these costs can be justified when weighed against the transfusion reductions achieved in patients who receive the drug. ⋯ Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.