Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Sep 2012
Randomized Controlled Trial Comparative StudyMost effective regimen of tranexamic acid in knee arthroplasty: a prospective randomized controlled study in 240 patients.
The antifibrinolytic tranexamic acid reduces surgical blood loss, but studies have not identified an optimal regimen. ⋯ Single-dose tranexamic acid did not give effective results. The two-dose regimen of POIO was the least amount necessary for effective results. When compared against the control, this regimen produced reduction of drain loss and total blood loss, whereas the IOPO regimen did not. The three-dose regimen of POIOPO produced maximum effective reduction of drain loss and total blood loss.
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Clin. Orthop. Relat. Res. · Sep 2012
Multicenter StudyVarus femoral osteotomy improves sphericity of the femoral head in older children with severe form of Legg-Calvé-Perthes disease.
In the Norwegian prospective study on Legg-Calvé-Perthes disease (LCPD), we found varus femoral osteotomy gave better femoral head sphericity at a mean of 5 years postoperative than physiotherapy in children older than 6.0 years at diagnosis with femoral head necrosis of more than 50%. That study did not include separate analyses for hips with 100% necrosis and those with a percentage of necrosis between 50% and 100%. ⋯ In children aged 6.0 to 10.0 years, in whom the whole femoral head is affected, femoral head sphericity 5 years after femoral osteotomy was better than that after physiotherapy.
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Clin. Orthop. Relat. Res. · Sep 2012
Neer modification of open Bankart procedure: what are the rates of recurrent instability, functional outcome, and arthritis?
Neer modified the Bankart procedure by combining a superoinferior capsular shift with the labral reattachment. The theoretical advantages of the modification were that such a procedure would restore the patient's anatomy and also treat the repeated capsular stretching encountered in anteroinferior instability without limiting external rotation and, thereby reducing the risk of arthritis. ⋯ The open Bankart procedure modified by Neer provided high function scores but a relatively low rate of return to sport and high rate of recurrent instability. Our rate of recurrent instability, similar to that obtained with arthroscopic Bankart procedures, has prompted us to abandon the open procedure.
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Clin. Orthop. Relat. Res. · Sep 2012
High survival of dome pelvic osteotomy in patients with early osteoarthritis from hip dysplasia.
The Chiari osteotomy reportedly has a 60% to 91% survival rate at a minimum 20 years followup. The dome pelvic osteotomy (DPO) has the advantage of allowing a larger weightbearing surface, and congruity in the sagittal plane presumably would reduce the joint contact stress and perhaps increase longevity. ⋯ DPO is a reasonable treatment option for patients with DDH and prearthritis or early osteoarthritis, with high survival at greater than 25 years.
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Clin. Orthop. Relat. Res. · Sep 2012
Biography Historical ArticleBiographical sketch: Georg Clemens Perthes, MD (1869-1927).
This biographical sketch on Georg Perthes corresponds to the historic text, The Classic: On Juvenile Arthritis Deformans (1910), available at DOI 10.1007/s11999-012-2433-1.