Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jun 2010
ReviewStrategies in biologic augmentation of rotator cuff repair: a review.
Degenerative rotator cuff tears are increasing with the aging population, and healing is not uniform after surgery. Rotator cuffs may show improved healing when biologic factors are added during surgery. ⋯ There is potential application of biologic augmentation to improve healing after rotator cuff repair. However, research in this field is still inconclusive and has not been sufficiently demonstrated to merit regular clinical use. Future human trials can elucidate the use of biologic augmentation in rotator cuff repairs.
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Clin. Orthop. Relat. Res. · May 2010
Randomized Controlled Trial Comparative StudyPostoperative analgesia in TKA: ropivacaine continuous intraarticular infusion.
Postoperative pain control is a challenge in patients undergoing TKA due to side effects and technical limitations of current analgesic approaches. Local anesthetic infiltration through continuous infusion pumps has been shown to reduce postoperative pain in previous studies. ⋯ Level I, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · May 2010
Comparative StudyA useful radiologic method for preoperative joint-line determination in revision total knee arthroplasty.
Intraoperative joint-line determination during revision TKA is difficult and no method exists to plan the position preoperatively. Two questions need to be answered: to which extent does the joint line differ from its anatomic position after revision TKA if it has only been determined intraoperatively, and can the joint line be calculated preoperatively based on the transepicondylar width. Of 22 consecutive patients with complete preoperative (before and after primary TKA) and postoperative (after revision TKA) radiograph documentation, the joint-line position was measured on plane radiographs using the medial epicondyle as a reference. On another set of 45 consecutive patients with no knee disorders other than meniscal lesions, the transepicondylar axis width (TEAW) and the perpendicular distance from the medial and lateral epicondyles to the joint line were measured twice by two independent observers on plane AP radiographs of the knee. Significant joint-line alterations were observed after primary and revision TKA, implicating that a method for preoperative planning is needed. Because a linear correlation between the TEAW and the perpendicular distance from the epicondyles to the joint-line tangent was found, the ratio is useful to calculate the true joint-line position from the TEAW before revision TKA. ⋯ Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · May 2010
Comparative StudyOutcomes of meniscal preservation using all-inside meniscus repair devices.
The thrust of meniscal surgery has now moved toward meniscal preservation. Repair is particularly indicated on the lateral side where the sequelae of resection are severe even in an older patient population. ⋯ Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · May 2010
Case ReportsA new technique for removal of an incarcerated expandable femoral nail.
Removal of intramedullary nails often is relegated to younger surgeons but may be difficult and challenging. We describe difficulties with removal of an incarcerated expandable femoral nail and a new technique for retrograde mobilization of an intramedullary nail through a small infrapatellar incision. No special device was necessary for successful implant removal. ⋯ Level V, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.