Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Oct 2011
Perioperative infection rate in patients with osteosarcomas treated with resection and prosthetic reconstruction.
The incidence of perioperative infection after segmental tumor endoprosthetic replacement in previous reports varies from a high of 7.4% to a low of 2.6%. Appropriate antibiotic use for this group is unknown and controversial, whereas the relationship of antibiotic use and perioperative infection is unclear. ⋯ Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Oct 2011
Biography Historical ArticleObituary: Douglas J. Pritchard MD (1937-2011).
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Clin. Orthop. Relat. Res. · Oct 2011
Randomized Controlled TrialTranexamic acid reduces blood loss and blood transfusion after TKA: a prospective randomized controlled trial.
TKA may be associated with considerable blood loss, and transfusion carries substantial risk of immunologic reaction and disease transmission. Blood transfusion also involves additional cost, therefore a reduction in its use is important. Several methods reportedly reduce postoperative blood loss and avoid homologous blood transfusion with traditional TKA approaches, but it is unclear these reductions apply to a minimally invasive technique. ⋯ Level 1, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Oct 2011
Bupivacaine and triamcinolone may be toxic to human chondrocytes: a pilot study.
Intraarticular injections of corticosteroids combined with local anesthetics are commonly used for management of chronic pain symptoms associated with degenerative joint diseases and after arthroscopic procedures. Several studies suggest chondrotoxicity of local anesthetics whereas others report chondroprotective and cytotoxic effects of corticosteroids on cartilage. Given the frequency of use of these agents, it is important to know whether they are in fact toxic. ⋯ Although not necessarily reflecting in vivo conditions, our data suggest physicians should be cognizant of the potential in vitro chondrotoxicity of bupivacaine and triamcinolone when contemplating intraarticular administration.
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Clin. Orthop. Relat. Res. · Sep 2011
A complication-based learning curve from 200 reverse shoulder arthroplasties.
Reported early complication rates in reverse total shoulder arthroplasty have widely varied from 0% to 75% in part due to a lack of standard inclusion criteria. In addition, it is unclear whether revision arthroplasty is associated with a higher rate of complications than primary arthroplasty. ⋯ Level IV, therapeutic study. See the guidelines online for a complete description of level of evidence.