Clinical orthopaedics and related research
-
Clin. Orthop. Relat. Res. · Jan 2012
Comparative StudyPlatelet-rich plasma does not reduce blood loss or pain or improve range of motion after TKA.
Numerous reports suggest the application of platelet-rich plasma (PRP) during TKA may decrease postoperative bleeding. Because excessive bleeding can increase postoperative pain and inflammation, use of PRP also reportedly decreases the need for narcotics and increases speed of recovery after TKA. Because previous investigations of PRP and TKA reflect a weak level of medical evidence, we sought to confirm these findings. ⋯ We found no clinically important differences in patients who received an intraoperative application of PRP compared with patients who did not receive PRP and therefore could not confirm the findings of previous studies.
-
Clin. Orthop. Relat. Res. · Dec 2011
Randomized Controlled Trial Comparative StudySuperiority of the Bryan(®) disc prosthesis for cervical myelopathy: a randomized study with 3-year followup.
The current standard of care for cervical myopathy is anterior discectomy and fusion (ACDF). Although well tolerated in the short term, this treatment might ultimately result in progressive degeneration of adjacent motion segments. Artificial disc arthroplasty offers the theoretical advantage of preservation of motion at the operative level with consequent stress reduction at adjacent levels. ⋯ Level II, therapeutic study. See the Guidelines for Authors for a complete description of the levels of evidence.
-
Clin. Orthop. Relat. Res. · Dec 2011
Excessive complications of open intramedullary nailing of midshaft clavicle fractures with the Rockwood Clavicle Pin.
Intramedullary clavicle fixation is a potential alternative to plate fixation. Previous studies documenting the complication rates of intramedullary clavicle fixation have demonstrated variable rates of soft tissue complications and fracture healing. ⋯ Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
-
Clin. Orthop. Relat. Res. · Dec 2011
Surgical technique: static intramedullary nailing of the femur and tibia without intraoperative fluoroscopy.
On a recent mission directed at definitive care for victims of the Haitian earthquake, the orthopaedic team developed a technique for freehand distal locking of femoral and tibial nails without intraoperative fluoroscopy or proximally mounted targeting jigs. ⋯ We describe a simple technique for performing static locked intramedullary nailing of the femur and tibia without fluoroscopy. This technique was successful in most cases and is intended for use with any nailing system only when fluoroscopy or specialized systems for nailing without fluoroscopy are not available.
-
Clin. Orthop. Relat. Res. · Dec 2011
Randomized Controlled TrialFunction plateaus by one year in patients with surgically treated displaced midshaft clavicle fractures.
Based on short-term (1 year or less) followup, primary fixation of displaced midshaft clavicle fractures reportedly results in better function compared with that reported for nonoperative methods. Whether better function persists beyond 1 year is unclear. ⋯ Level I, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.