Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Oct 2018
Can Machine-learning Techniques Be Used for 5-year Survival Prediction of Patients With Chondrosarcoma?
Several studies have identified prognostic factors for patients with chondrosarcoma, but there are few studies investigating the accuracy of computationally intensive methods such as machine learning. Machine learning is a type of artificial intelligence that enables computers to learn from data. Studies using machine learning are potentially appealing, because of its possibility to explore complex patterns in data and to improve its models over time. ⋯ Level III, prognostic study.
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Clin. Orthop. Relat. Res. · Oct 2018
High Risk of Venous Thromboembolism After Surgery for Long Bone Metastases: A Retrospective Study of 682 Patients.
Previous studies have shown that venous thromboembolism (VTE) is a complication associated with neoplastic disease and major orthopaedic surgery. However, many potential risk factors remain undefined. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Oct 2018
Comparative StudyExternal Beam Irradiation Preferentially Inhibits the Endochondral Pathway of Fracture Healing: A Rat Model.
External beam irradiation is an accepted treatment for skeletal malignancies. Radiation acts on both cancerous and normal cells and, depending on the balance of these effects, may promote or impair bone healing after pathologic fracture. Previous studies suggest an adverse effect of radiation on endochondral ossification, but the existence of differential effects of radiation on the two distinct bone healing pathways is unknown. ⋯ This work suggests that there may be a rationale for compression plating rather than intramedullary nailing of long bone fractures in select circumstances where bony union is desirable, adjunctive radiation treatment is required, and bone stock is sufficient for plate and screw fixation.
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Clin. Orthop. Relat. Res. · Sep 2018
What Factors Are Associated With Implant Breakage and Revision After Intramedullary Nailing for Femoral Metastases?
Actual and impending pathologic fractures of the femur are commonly treated with intramedullary nails because they provide immediate stabilization with a minimally invasive procedure and enable direct weightbearing. However, complications and revision surgery are prevalent, and despite common use, there is limited evidence identifying those factors that are associated with complications. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Sep 2018
Preoperative Denosumab With Curettage and Cryotherapy in Giant Cell Tumor of Bone: Is There an Increased Risk of Local Recurrence?
Denosumab is a monoclonal RANKL antibody, which was originally introduced for the treatment of osteoporosis and bone metastases from solid tumors, but more recently has been used for treatment of giant cell tumor of bone (GCTB). In GCTB, denosumab has been used as a single agent in patients with inoperable tumors; it also has been used before surgery in some patients with the aim to downstage the tumor to facilitate a joint-preserving procedure (curettage) rather than a resection. However, few studies are available evaluating the benefits and risks of denosumab for the latter indication. ⋯ Level III, therapeutic study.