Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Aug 2010
Randomized Controlled TrialThe efficacy of periarticular multimodal drug infiltration in total hip arthroplasty.
Patient-controlled analgesia is a widely used and effective method of controlling pain after THA. This method is associated with substantial undesirable side effects. Local infiltration has been introduced in an attempt to reduce opioid requirements postoperatively, but its ability to reduce pain without complications is still questioned. ⋯ Level I, therapeutic study. See the guidelines online for a complete description of level of evidence.
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Clin. Orthop. Relat. Res. · Aug 2010
Laboratory indicators for early detection and surgical treatment of vibrio necrotizing fasciitis.
Vibrio necrotizing fasciitis is a rare and life-threatening soft tissue infection, with fulminant clinical courses and high mortality rates. However, the lack of specific disease characteristics and diagnostic tools during the initial examination may delay diagnosis. ⋯ Level III Prognostic study. See the Guidelines for Authors for complete descriptions of levels of evidence.
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Clin. Orthop. Relat. Res. · Aug 2010
Immunologic adverse reaction associated with low-carbide metal-on-metal bearings in total hip arthroplasty.
An increased incidence of periprosthetic osteolysis, resulting in loss of biologic fixation, has been reported in contemporary THAs with low-carbide metal-on-metal compared with metal-on-polyethylene couple bearings. Although a hypersensitivity reaction attributable to Co and Cr debris is reportedly a potential cause for failure of THAs with high-carbide bearings, there are no evidence-based data for this reaction in low-carbide metal-on-metal bearings, although such hypersensitivity might be related to osteolysis. ⋯ The conventional histologic and immunohistochemical findings in tissues retrieved from failed THAs with low-carbide metal-on-metal bearings are consistent with a link between hypersensitivity and osteolysis with low-carbide bearing couples.
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Clin. Orthop. Relat. Res. · Jul 2010
Randomized Controlled TrialMedial knee osteoarthritis treated by insoles or braces: a randomized trial.
There is controversial evidence regarding whether foot orthoses or knee braces improve pain and function or correct malalignment in selected patients with osteoarthritis (OA) of the medial knee compartment. However, insoles are safe and less costly than knee bracing if they relieve pain or improve function. ⋯ Level I, therapeutic study. See the Guidelines for Authors for a complete description of level of evidence.
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Pelvic fractures represent major injury. Women of childbearing age who have sustained pelvic fractures question whether they can have children and what type of delivery will be possible. ⋯ Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.