MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'The Orthopedic Clinics of North America' source. Thu, 09 Feb 2012 00:02:44 +0100 http://www.medworm.com/index.php?rid=5617057&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22082626%26dopt%3DAbstract This article addresses the relevant surgical anatomy, pitfalls, and pearls associated with each of these fixation techniques. PMID: 22082626 [PubMed - indexed for MEDLINE] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5617057 Sun, 01 Jan 2012 05:00:00 +0100 5617057 http://www.medworm.com/index.php?rid=5617053&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22082630%26dopt%3DAbstract Authors: Grabowski G, Cornett CA, Kang JD Abstract Vertebral artery and esophageal injuries are rare but feared complications of cervical spine surgery. Appropriate understanding of treatment algorithms for prompt intervention in the event of a vertebral artery injury minimizes the risk of exsanguination and/or profound neurologic consequences. Esophageal injuries are often more subtle, and although intraoperative injuries can sometimes be diagnosed at the time of surgery, they frequently do not present until the week after surgery. They can additionally be seen as a late complication of instrumentation usage and/or failure. Expedient diagnosis and management of these injuries minimize their impact and allow for optimal treatment outcome. PMID: 22082630 [PubMed - indexed for ME... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5617053 Sun, 01 Jan 2012 05:00:00 +0100 5617053 http://www.medworm.com/index.php?rid=5617052&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22082637%26dopt%3DAbstract Authors: Phillips FM, Khan SN PMID: 22082637 [PubMed - indexed for MEDLINE] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5617052 Sun, 01 Jan 2012 05:00:00 +0100 5617052 http://www.medworm.com/index.php?rid=5432470&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22082624%26dopt%3DAbstract Authors: Garrido BJ, Sasso RC Abstract The evolution of occipitocervical fixation and new rigid universal screw-rod construct technology has allowed secure anchorage at each level of the occipitocervical junction with the elimination of rigid external orthoses. Rigid occipitocervical instrumentation constructs have achieved higher fusion rates and less postoperative immobilization-associated complications. Outcomes have improved compared with former nonrigid instrumentation techniques; however, with advances of rigid occipitocervical stabilization capability have come new challenges, risks, and operative techniques. A thorough understanding of the relevant cervical bony and soft tissue anatomy is essential for safe implantation and a successful outcome. PMID: 22082624 [PubMed -... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432470 Tue, 22 Nov 2011 10:38:15 +0100 5432470 http://www.medworm.com/index.php?rid=5432469&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22082625%26dopt%3DAbstract Authors: Jacobson ME, Khan SN, An HS Abstract The atlantoaxial motion segment, which is responsible for half of the rotational motion in the cervical spine, is a complex junction of the first (C1) and second (C2) cervical vertebrae. Destabilization of this joint is multifactorial and can lead to pathologic motion with neurologic sequelae. Posterior spinal fixation of the C1-C2 articulation in the presence of instability has been well described in the literature. Early reports of interspinous/interlaminar wiring have evolved into modern-day pedicle screw/translaminar constructs, with excellent results. The success of a C1-C2 posterior fusion rests on appropriate indications and surgical techniques. PMID: 22082625 [PubMed - in process] (Source: The Orthopedic Clinics of North Ame... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432469 Tue, 22 Nov 2011 10:38:06 +0100 5432469 http://www.medworm.com/index.php?rid=5432468&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22082626%26dopt%3DAbstract This article addresses the relevant surgical anatomy, pitfalls, and pearls associated with each of these fixation techniques. PMID: 22082626 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432468 Tue, 22 Nov 2011 10:37:57 +0100 5432468 http://www.medworm.com/index.php?rid=5432467&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22082627%26dopt%3DAbstract This article details the controversies associated with the different treatment strategies in patients with cervical spondylotic myelopathy. The natural history, incidence, pathophysiology, physical examination, and imaging findings are discussed followed by the indications, techniques, and outcomes of patients treated with posterior cervical decompression via decompressive laminectomy, laminectomy and instrumented fusion, and laminoplasty. PMID: 22082627 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432467 Tue, 22 Nov 2011 10:37:47 +0100 5432467 http://www.medworm.com/index.php?rid=5432466&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22082628%26dopt%3DAbstract Authors: Siemionow KB, Neckrysh S Abstract Cervical spondylotic myelopathy (CSM) is a slowly progressive disease resulting from age-related degenerative changes in the spine that can lead to spinal cord dysfunction and significant functional disability. The degenerative changes and abnormal motion lead to vertebral body subluxation, osteophyte formation, ligamentum flavum hypertrophy, and spinal canal narrowing. Repetitive movement during normal cervical motion may result in microtrauma to the spinal cord. Disease extent and location dictate the choice of surgical approach. Anterior spinal decompression and instrumented fusion is successful in preventing CSM progression and has been shown to result in functional improvement in most patients. PMID: 22082628 [PubMed - in process]... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432466 Tue, 22 Nov 2011 10:37:37 +0100 5432466 http://www.medworm.com/index.php?rid=5432465&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22082629%26dopt%3DAbstract Authors: Kepler CK, Hilibrand AS Abstract Adjacent segment disease (ASD) was described after long-term follow-up of patients treated with cervical fusion. The term describes new-onset radiculopathy or myelopathy referable to a motion segment adjacent to previous arthrodesis and often attributed to alterations in the biomechanical environment after fusion. Evidence suggests that ASD affects between 2% and 3% of patients per year. Although prevention of ASD was one major impetus behind the development of motion-sparing surgery, the literature does not yet clearly distinguish a difference in the rate of ASD between fusion and disk replacement. Surgical techniques during index surgery may reduce the rate of ASD. PMID: 22082629 [PubMed - in process] (Source: The Orthopedic Clinics o... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432465 Tue, 22 Nov 2011 10:37:27 +0100 5432465 http://www.medworm.com/index.php?rid=5432464&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22082630%26dopt%3DAbstract Authors: Grabowski G, Cornett CA, Kang JD Abstract Vertebral artery and esophageal injuries are rare but feared complications of cervical spine surgery. Appropriate understanding of treatment algorithms for prompt intervention in the event of a vertebral artery injury minimizes the risk of exsanguination and/or profound neurologic consequences. Esophageal injuries are often more subtle, and although intraoperative injuries can sometimes be diagnosed at the time of surgery, they frequently do not present until the week after surgery. They can additionally be seen as a late complication of instrumentation usage and/or failure. Expedient diagnosis and management of these injuries minimize their impact and allow for optimal treatment outcome. PMID: 22082630 [PubMed - in process] (S... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432464 Tue, 22 Nov 2011 10:37:18 +0100 5432464 http://www.medworm.com/index.php?rid=5432463&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22082631%26dopt%3DAbstract Authors: Molina CA, Gokaslan ZL, Sciubba DM Abstract The bony spine is overall the third most common site for distant cancer metastasis, with the cervical spine involved in approximately 8 to 20% of metastatic spine disease cases. Diagnosis and management of metastatic spine disease requires disease categorization into the compartment involved, pathology of the lesion, and anatomic region involved. The diagnostic approach should commence with careful physical examination, and the workup should include plain radiographs, magnetic resonance imaging, computed tomography, and bone scintigraphy. Management ranges from palliative nonoperative to aggressive surgical treatment. Optimal management requires proper patient selection to individualize the most appropriate treatment modality. ... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432463 Tue, 22 Nov 2011 10:37:10 +0100 5432463 http://www.medworm.com/index.php?rid=5432462&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22082632%26dopt%3DAbstract Authors: Helgeson MD, Gendelberg D, Sidhu GS, Anderson DG, Vaccaro AR Abstract Although the management of cervical spine trauma is relatively complex, multiple classification systems have attempted to simplify it through the use of descriptive terms. Most historical classification systems failed to yield sufficient prognostic information to guide clinical treatment until the Subaxial Injury Classification system was developed. This classification system takes into account the injury morphology, discoligamentous complex, and the most important prognostic factor, neurologic status. The early results of this classification system have been encouraging and it is expected to improve spinal trauma care through enhancing more uniform nomenclature and communication for surgeons managing sp... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432462 Tue, 22 Nov 2011 10:37:01 +0100 5432462 http://www.medworm.com/index.php?rid=5432461&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22082633%26dopt%3DAbstract Authors: Salari B, McAfee PC Abstract Anterior cervical diskectomy and fusion for neurologic deficits, radicular arm pain, and neck pain refractory to conservative management are successful. The approach and procedure were first described in 1955 and have become the anterior cervical standard of care for orthopedic surgeons and neurosurgeons. Advancements and innovations have addressed disease processes of the cervical spine with motion-preserving technology. The possibility of obtaining anterior cervical decompression while maintaining adjacent segment motion led to the advent of cervical total disk replacement. The Food and Drug Administration has approved 3 cervical devices with other investigational device exemption trials under way. PMID: 22082633 [PubMed - in process] (So... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432461 Tue, 22 Nov 2011 10:36:52 +0100 5432461 http://www.medworm.com/index.php?rid=5432460&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22082634%26dopt%3DAbstract This article focuses on the surgical treatment of complex spinal deformity. PMID: 22082634 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432460 Tue, 22 Nov 2011 10:36:42 +0100 5432460 http://www.medworm.com/index.php?rid=5432459&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22082635%26dopt%3DAbstract This article provides the spine care provider with an understanding of how to appropriately evaluate and manage the most common cervical conditions that require revision cervical spine surgery. PMID: 22082635 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432459 Tue, 22 Nov 2011 10:36:32 +0100 5432459 http://www.medworm.com/index.php?rid=5432458&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22082636%26dopt%3DAbstract This article explains in detail minimally invasive approaches to the posterior spine, the techniques for posterior cervical foraminotomy and arthrodesis via lateral mass screw placement, and anterior cervical foraminotomy. Complications are also discussed. Additionally, illustrated cases are presented detailing the use of minimally invasive surgical techniques. PMID: 22082636 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432458 Tue, 22 Nov 2011 10:36:22 +0100 5432458 http://www.medworm.com/index.php?rid=5432457&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22082637%26dopt%3DAbstract Authors: Phillips FM, Khan SN PMID: 22082637 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432457 Tue, 22 Nov 2011 10:36:12 +0100 5432457 http://www.medworm.com/index.php?rid=5271111&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21944583%26dopt%3DAbstract This article focuses on various aspects of intervertebral disk biology and disruptions that could lead to diseases such as intervertebral disk degeneration. PMID: 21944583 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5271111 Sat, 01 Oct 2011 04:00:00 +0100 5271111 http://www.medworm.com/index.php?rid=5271110&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21944584%26dopt%3DAbstract This article reviews pathways of nutrient supply to these cells; examines factors that may interrupt these pathways, and discusses consequences for disk cell survival, disk degeneration, and disk repair. PMID: 21944584 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5271110 Sat, 01 Oct 2011 04:00:00 +0100 5271110 http://www.medworm.com/index.php?rid=5271109&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21944585%26dopt%3DAbstract This article reviews the main research strategies that have been used to study the genetics of LDD, and the genes that thus far have been identified to influence susceptibility to LDD. With the rapid progress in genomic technologies, further advances in the genetics of LDD are expected in the next few years. PMID: 21944585 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5271109 Sat, 01 Oct 2011 04:00:00 +0100 5271109 http://www.medworm.com/index.php?rid=5271108&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21944586%26dopt%3DAbstract Authors: Inoue N, Espinoza Orías AA Abstract Degenerative changes in the material properties of nucleus pulposus and anulus fibrosus promote changes in viscoelastic properties of the whole disc. Volume, pressure and hydration loss in the nucleus pulposus, disk height decreases and fissures in the anulus fibrosus, are some of the signs of the degenerative cascade that advances with age and affect, among others, spinal function and its stability. Much remains to be learned about how these changes affect the function of the motion segment and relate to symptoms such as low back pain and altered spinal biomechanics. PMID: 21944586 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5271108 Sat, 01 Oct 2011 04:00:00 +0100 5271108 http://www.medworm.com/index.php?rid=5271107&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21944587%26dopt%3DAbstract This article reviews new and evolving MRI disk-imaging techniques, including grading, relaxation-time measurements, diffusion, and contrast perfusion. In addition, high-resolution magic-angle spinning methods to correlate in vitro disk degeneration (with pain, etc) and in vivo spectroscopic results are discussed. With the potential for morphologic and biochemical characterization of the intervertebral disk, MRI shows promise as a tool to quantitatively assess disk health. PMID: 21944587 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5271107 Sat, 01 Oct 2011 04:00:00 +0100 5271107 http://www.medworm.com/index.php?rid=5271106&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21944588%26dopt%3DAbstract Authors: Karppinen J, Shen FH, Luk KD, Andersson GB, Cheung KM, Samartzis D Abstract Degenerative disk disease is a strong etiologic risk factor of chronic low back pain (LBP). A multidisciplinary approach to treatment is often warranted. Patient education, medication, and cognitive behavioral therapies are essential in the treatment of chronic LBP sufferers. Surgical intervention with a rehabilitation regime is sometimes advocated. Prognostic factors related to the outcome of different treatments include maladaptive pain coping and genetics. The identification of pain genes may assist in determining individuals susceptible to pain and in patient selection for appropriate therapy. Biologic therapies show promise, but clinical trials are needed before advocating their use in humans.... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5271106 Sat, 01 Oct 2011 04:00:00 +0100 5271106 http://www.medworm.com/index.php?rid=5271105&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21944589%26dopt%3DAbstract This article summarizes the existing biomechanical and clinical literature on the causes and clinical impact of ASD, as well as possible risk factors. Further, the theoretical advantage of motion-preserving technologies that aim to preserve the adjacent segment is discussed. PMID: 21944589 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5271105 Sat, 01 Oct 2011 04:00:00 +0100 5271105 http://www.medworm.com/index.php?rid=5271104&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21944590%26dopt%3DAbstract This article is a one-to-one comparison of the evolution of total hip and total lumbar disk replacement from "skunk works" to scientific evidence. PMID: 21944590 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5271104 Sat, 01 Oct 2011 04:00:00 +0100 5271104 http://www.medworm.com/index.php?rid=5271103&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21944591%26dopt%3DAbstract This article reviews the current status of stem cell research as applied to the intervertebral disk. PMID: 21944591 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5271103 Sat, 01 Oct 2011 04:00:00 +0100 5271103 http://www.medworm.com/index.php?rid=5271102&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21944592%26dopt%3DAbstract Authors: Woods BI, Vo N, Sowa G, Kang JD Abstract Intervertebral disk degeneration is a common and potentially debilitating disease process affecting millions of Americans and other populations each year. Current treatments address resultant symptoms and not the underlying pathophysiology of disease. This has spawned the development of biologic treatments, such as gene therapy, which attempt to correct the imbalance between catabolism and anabolism within degenerating disk cells. The identification of therapeutic genes and development of successful delivery systems have resulted in significant advances in this novel treatment. Continued investigation of the pathophysiology of disk degeneration, however, and safety mechanisms for the application of gene therapy are required for clin... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5271102 Sat, 01 Oct 2011 04:00:00 +0100 5271102 http://www.medworm.com/index.php?rid=5271101&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21944593%26dopt%3DAbstract Authors: Leung VY, Tam V, Chan D, Chan BP, Cheung KM Abstract Many challenges confront intervertebral disk engineering owing to complexity and the presence of extraordinary stresses. Rebuilding a disk of native function could be useful for removal of the symptoms and correction of altered spine kinematics. Improvement in understanding of disk properties and techniques for disk engineering brings promise to the fabrication of a functional motion segment for the treatment of disk degeneration. Increasing sophistication of techniques available in biomedical sciences will bring its application into clinics. This review provides an account of current progress and challenges of intervertebral disk bioengineering and discusses means to move forward and toward bedside translation. PMID... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5271101 Sat, 01 Oct 2011 04:00:00 +0100 5271101 http://www.medworm.com/index.php?rid=5271100&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21944594%26dopt%3DAbstract Authors: Bae WC, Masuda K Abstract Intervertebral disks are biologically regulated by the maintenance of a balance between the anabolic and catabolic activities of disk cells. Therapeutic agents, initially evaluated using in vitro studies on disk cells and explants, have been used as intradiscal injections in preclinical settings to test in vivo efficacy. These include anabolic growth factors, other biostimulatory agents, and antagonistic agents against matrix-degrading enzymes and cytokines. Additional work is needed to identify patient populations, using methods such as MRI, and to better understand the mechanism of healing. Clinical trials are underway for a few of these agents and other promising candidates are on the horizon. PMID: 21944594 [PubMed - in process] (Source: T... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5271100 Sat, 01 Oct 2011 04:00:00 +0100 5271100 http://www.medworm.com/index.php?rid=5271099&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21944595%26dopt%3DAbstract Authors: Samartzis D, Cheung KM PMID: 21944595 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5271099 Sat, 01 Oct 2011 04:00:00 +0100 5271099 http://www.medworm.com/index.php?rid=5224270&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21742151%26dopt%3DAbstract Authors: Paley D Abstract The aspherical coxa magna femoral head can be made more spherical by intra-articular osteotomy. The Ganz technique of femoral head reduction osteotomy to reduce the size and restore the spherical shape of the femoral head has been performed in 20 patients over the past 5 years. A good or excellent functional and radiographic result was obtained in 14 of the 20. A fair result (decreased pain but no improvement in range of motion) occurred in 3, and a poor result (stiffness and pain) occurred in 3. The preliminary results of this technique are therefore very promising. PMID: 21742151 [PubMed - indexed for MEDLINE] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5224270 Fri, 01 Jul 2011 04:00:00 +0100 5224270 http://www.medworm.com/index.php?rid=5036767&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21742138%26dopt%3DAbstract Authors: Price CT, Joseph B PMID: 21742138 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5036767 Thu, 30 Jun 2011 23:00:00 +0100 5036767 http://www.medworm.com/index.php?rid=5036766&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21742139%26dopt%3DAbstract Authors: Perry DC, Hall AJ The incidence of Perthes disease varies markedly both between countries and within countries down to a local level. The disease is more common in white than in Asian or black African children. The disease is associated with deprivation; with a steep disease gradient across social class groups. This epidemiology alongside the lack of concordance in twins suggests a strong environmental etiology, with little evidence to suggest a genetic predisposition. Children are frequently short, with a growth pattern described as "rostral-sparing". A propensity to associated congenital anomalies suggests an intrauterine cause. PMID: 21742139 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5036766 Thu, 30 Jun 2011 23:00:00 +0100 5036766 http://www.medworm.com/index.php?rid=5036765&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21742140%26dopt%3DAbstract This article focuses on the current knowledge of the pathophysiology, classifications, and natural history of LCPD. Although the cause of LCPD remains largely unknown, some insight has been gained on its pathophysiology through experimental studies using animal models of ischemic necrosis. The few available clinical studies on the natural history of LCPD suggest that femoral head deformity is well tolerated in short and intermediate terms, but 50% of patients develop disabling arthritis in the sixth decade of life. PMID: 21742140 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5036765 Thu, 30 Jun 2011 23:00:00 +0100 5036765 http://www.medworm.com/index.php?rid=5036764&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21742141%26dopt%3DAbstract Authors: Dimeglio A, Canavese F Imaging in Legg-Calvé-Perthes disease should help assess the severity and the stage of the disease, detect severe forms earlier, and provide guidance to therapy. However, due to the complexity of the disease, not all examinations can be performed at the same time with the same goals. The scope of this work is to provide an overview of all imaging techniques available today, and to help understand when to use a particular examination. Advantages and limitations of plain radiographs, bone scintigraphy, magnetic resonance imaging, arthrography, computed tomography, and ultrasonography are identified. PMID: 21742141 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5036764 Thu, 30 Jun 2011 23:00:00 +0100 5036764 http://www.medworm.com/index.php?rid=5036763&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21742142%26dopt%3DAbstract Authors: Joseph B The shape of the femoral head at the time when Perthes disease heals is the most important determinant of the risk for degenerative arthritis; hence, the shape of the femoral head and congruence of the hip are the most useful outcome measures. Although several prognostic factors that predict femoral head deformation may be identified during the course of Perthes disease, only two prognostic factors may be identified early enough to institute preventive intervention: femoral head extrusion and the age at onset of the disease. Femoral head extrusion is the only factor that may be influenced by treatment. PMID: 21742142 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5036763 Thu, 30 Jun 2011 23:00:00 +0100 5036763 http://www.medworm.com/index.php?rid=5036762&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21742143%26dopt%3DAbstract Authors: Joseph B, Price CT The aim of treatment of Perthes in the early part of the disease is to prevent the femoral head from getting deformed by muscular forces and weight-bearing stresses transmitted across the acetabular margin. To achieve this, femoral head extrusion must be preempted in children who are older than 8 years at onset of the disease by ensuring containment as soon as the disease is diagnosed. In children younger than 8 years in whom femoral head extrusion occurs, containment must be obtained by the early stage of fragmentation. PMID: 21742143 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5036762 Thu, 30 Jun 2011 23:00:00 +0100 5036762 http://www.medworm.com/index.php?rid=5036761&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21742144%26dopt%3DAbstract This article identifies the various methods of containment and the technical aspects of each method. Choice of method depends on the experience of the surgeon and the psychosocial needs of the patient and family. Failure is more commonly a result of inappropriate patient selection for a particular method, delay in management, or technical errors rather than to the method that was selected. PMID: 21742144 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5036761 Thu, 30 Jun 2011 23:00:00 +0100 5036761 http://www.medworm.com/index.php?rid=5036760&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21742145%26dopt%3DAbstract This article summarizes the definition of hinge abduction, pathoanatomy of hinge segment, assessment of hinge abduction, determination of reducible and irreducible hinge abduction, and treatment strategies for containable and uncontainable hips in the transitional stage. PMID: 21742145 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5036760 Thu, 30 Jun 2011 23:00:00 +0100 5036760 http://www.medworm.com/index.php?rid=5036759&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21742146%26dopt%3DAbstract Authors: de Gheldere A, Eastwood DM Failure of the enlarged and deformed anterolateral portion of the femoral head to roll into the acetabulum during abduction alters hip joint mechanics. The resultant hinge abduction is associated with pain, and the patient often has restricted movement. A valgus osteotomy removes the deformed portion of the femoral head away from the weight-bearing area and ensures there is pain-free congruent range of movement around the weight-bearing position. The concomitant improvement in lever arm function and leg length results in a better gait pattern. In immature patients, abolition of hinge abduction allows the lateral acetabular ossification center to grow more normally. PMID: 21742146 [PubMed - in process] (Source: The Orthopedic Clinics of North Amer... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5036759 Thu, 30 Jun 2011 23:00:00 +0100 5036759 http://www.medworm.com/index.php?rid=5036758&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21742147%26dopt%3DAbstract Authors: Reinker KA Hinge abduction occurs early in the fragmentation stage of Legg-Calvé-Perthes disease and should be suspected when abduction and internal rotation are lost. It can be confirmed by an AP radiograph in abduction and internal rotation in which the ossific nucleus is not covered by the acetabulum. An arthrogram can then yield greater information regarding the reversibility of the hinge abduction. Hinge abduction should be considered a contraindication to containment by redirectional pelvic or femoral varus osteotomy. However, good results have been reported with acetabular augmentation via shelf procedures or Chiari osteotomies. Valgus femoral osteotomies have also been beneficial in the treatment of the Legg-Calvé-Perthes hip with hinge abduction. PMID: 21742147 ... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5036758 Thu, 30 Jun 2011 23:00:00 +0100 5036758 http://www.medworm.com/index.php?rid=5036757&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21742148%26dopt%3DAbstract Authors: Hosny GA Articular hip distraction can be applied either by using a monolateral articulated distractor or a circular fixator. The fixator should be aligned such that its axis is aligned with the transverse axis of the hip joint. Following distraction, the range of motion is maintained with regular physiotherapy. It is a useful salvage procedure in older children with hip stiffness, when other methods of containment are not applicable. PMID: 21742148 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5036757 Thu, 30 Jun 2011 23:00:00 +0100 5036757 http://www.medworm.com/index.php?rid=5036756&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21742149%26dopt%3DAbstract This article outlines an approach to these patients. PMID: 21742149 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5036756 Thu, 30 Jun 2011 23:00:00 +0100 5036756 http://www.medworm.com/index.php?rid=5036755&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21742150%26dopt%3DAbstract This article describes the Morscher osteotomy-a unique femoral neck-lengthening technique. The outcomes of this successful and predictable technique are resolution of symptoms of fatigue and hip discomfort; the absence of nonunion, infection, or hardware failure; and restoration of normal proximal femoral morphology and biomechanics. PMID: 21742150 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5036755 Thu, 30 Jun 2011 23:00:00 +0100 5036755 http://www.medworm.com/index.php?rid=5036754&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21742151%26dopt%3DAbstract Authors: Paley D The aspherical coxa magna femoral head can be made more spherical by intra-articular osteotomy. The Ganz technique of femoral head reduction osteotomy to reduce the size and restore the spherical shape of the femoral head has been performed in 20 patients over the past 5 years. A good or excellent functional and radiographic result was obtained in 14 of the 20. A fair result (decreased pain but no improvement in range of motion) occurred in 3, and a poor result (stiffness and pain) occurred in 3. The preliminary results of this technique are therefore very promising. PMID: 21742151 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5036754 Thu, 30 Jun 2011 23:00:00 +0100 5036754 http://www.medworm.com/index.php?rid=5036753&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21742152%26dopt%3DAbstract This article outlines the range of deformities possible in a Perthes hip, and treatment strategies to surgically address these deformities. For Perthes disease good preoperative clinical and radiographic assessment is essential, and intraoperative assessment vital. PMID: 21742152 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5036753 Thu, 30 Jun 2011 23:00:00 +0100 5036753 http://www.medworm.com/index.php?rid=5036752&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21742153%26dopt%3DAbstract This article focuses on the results and unique technical considerations of resurfacing and THA for patients who have severe hip osteoarthritis after resolved Legg-Calvé-Perthes disease. PMID: 21742153 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5036752 Thu, 30 Jun 2011 23:00:00 +0100 5036752 http://www.medworm.com/index.php?rid=5036751&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21742154%26dopt%3DAbstract This article presents a current pathophysiological model of Perthes disease, reviews experimental strategies in pharmaceutical treatments, and suggests future areas for research. PMID: 21742154 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5036751 Thu, 30 Jun 2011 23:00:00 +0100 5036751 http://www.medworm.com/index.php?rid=5036750&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21742155%26dopt%3DAbstract Authors: Herrera-Soto JA, Price CT Core decompression may be used as adjunct for treatment in some cases of Legg-Calvé-Perthes disease (LCPD). The primary application is for patients with onset at 12 years of age or older. We recommend classifying these older patients as idiopathic juvenile osteonecrosis and treating them similarly to adults with avascular necrosis. Juvenile osteonecrosis may benefit from core decompression combined with shelf acetabuloplasty during the early stages of necrosis. Younger children with LCPD may benefit from decompression by fenestration of the femoral head. Experience in adult-onset osteonecrosis and our early experience suggest that some patients may benefit from these adjunctive treatments. PMID: 21742155 [PubMed - in process] (Source: The Orthope... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5036750 Thu, 30 Jun 2011 23:00:00 +0100 5036750 http://www.medworm.com/index.php?rid=5036749&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21742156%26dopt%3DAbstract Authors: Joseph B, Price CT PMID: 21742156 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5036749 Thu, 30 Jun 2011 23:00:00 +0100 5036749 http://www.medworm.com/index.php?rid=4935704&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21435487%26dopt%3DAbstract Authors: Amstutz HC PMID: 21435487 [PubMed - indexed for MEDLINE] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4935704 Thu, 31 Mar 2011 23:00:00 +0100 4935704 http://www.medworm.com/index.php?rid=4935703&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21435489%26dopt%3DAbstract Authors: Amstutz HC, Takamura KM, Le Duff MJ The results of metal-on-metal hip Conserve® Plus resurfacings with up to 14 years of follow-up with and without risk factors of small component size and/or large femoral defects were compared as performed with either first- or second-generation surgical techniques. There was a 99.7% survivorship at ten years for ideal hips (large components and small defects) and a 95.3% survivorship for hips with risk factors optimized technique has measurably improved durability in patients with risk factors at the 8-year mark. The lessons learned can help offset the observed learning curve of resurfacing. PMID: 21435489 [PubMed - indexed for MEDLINE] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4935703 Thu, 31 Mar 2011 23:00:00 +0100 4935703 http://www.medworm.com/index.php?rid=4681204&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21435487%26dopt%3DAbstract Authors: Amstutz HC PMID: 21435487 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4681204 Thu, 31 Mar 2011 23:00:00 +0100 4681204 http://www.medworm.com/index.php?rid=4681203&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21435488%26dopt%3DAbstract Authors: Jacobs JJ, Ebramzadeh E PMID: 21435488 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4681203 Thu, 31 Mar 2011 23:00:00 +0100 4681203 http://www.medworm.com/index.php?rid=4681202&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21435489%26dopt%3DAbstract Authors: Amstutz HC, Takamura KM, Le Duff MJ The results of metal-on-metal hip Conserve® Plus resurfacings with up to 14 years of follow-up with and without risk factors of small component size and/or large femoral defects were compared as performed with either first- or second-generation surgical techniques. There was a 99.7% survivorship at ten years for ideal hips (large components and small defects) and a 95.3% survivorship for hips with risk factors optimized technique has measurably improved durability in patients with risk factors at the 8-year mark. The lessons learned can help offset the observed learning curve of resurfacing. PMID: 21435489 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4681202 Thu, 31 Mar 2011 23:00:00 +0100 4681202 http://www.medworm.com/index.php?rid=4681201&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21435490%26dopt%3DAbstract Authors: Shimmin AJ, Baré JV Total hip arthroplasty (THA) results in good outcomes in function and risk for revision in older patients. However, in young, active patients, it results in an increased rate of revision and poorer outcomes. Modern metal-on-metal hip resurfacing arthroplasty (HRA) is described as an appropriate treatment of hip osteoarthritis in young, active patients. The selection of an appropriate prosthesis is critical for this patient demographic. This review compares the functional results of THA and HRA and focuses on range of motion, activity level, groin pain, patient satisfaction, restoration of normal hip anatomy, and gait. PMID: 21435490 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4681201 Thu, 31 Mar 2011 23:00:00 +0100 4681201 http://www.medworm.com/index.php?rid=4681200&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21435491%26dopt%3DAbstract This study highlights the excellent radiographic survivorship profile of the Conserve® Plus socket. PMID: 21435491 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4681200 Thu, 31 Mar 2011 23:00:00 +0100 4681200 http://www.medworm.com/index.php?rid=4681199&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21435492%26dopt%3DAbstract Authors: Le Duff MJ, Amstutz HC The evolution of patient sporting activities after hip resurfacing has not yet been studied. A scoring algorithm to quantify sporting activity was developed to compare type of activity, frequency, duration, and overall activity level in the early postoperative period and at mid- to long-term follow-up. Quantification of sporting activity is a challenging undertaking but should become a useful tool to study the relationship between failure rates and the use of prosthesis. PMID: 21435492 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4681199 Thu, 31 Mar 2011 23:00:00 +0100 4681199 http://www.medworm.com/index.php?rid=4681198&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21435493%26dopt%3DAbstract This study sought to investigate the relationship between bearing surface wear rates of metal components and serum metal ion analysis and also to quantify the incidence of excessive increases in serum metal ion concentrations post-hip resurfacing arthroplasty. PMID: 21435493 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4681198 Thu, 31 Mar 2011 23:00:00 +0100 4681198 http://www.medworm.com/index.php?rid=4681197&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21435494%26dopt%3DAbstract This study reports the presence and significance of neck narrowing in the first 500 consecutive Conserve® Plus metal-on-metal hip resurfacings in 431 patients. PMID: 21435494 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4681197 Thu, 31 Mar 2011 23:00:00 +0100 4681197 http://www.medworm.com/index.php?rid=4681196&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21435495%26dopt%3DAbstract Authors: Hayter CL, Potter HG, Su EP Conventional radiography is the primary imaging modality to evaluate the condition of hip resurfacing implants and the preferred method of assessing implant stability over time. Radiographs assess the angle of inclination of the femoral and acetabular components, implant stability, and femoral neck narrowing. Ultrasonography detects solid or soft tissue masses adjacent to the implant. Magnetic resonance imaging (MRI) detects osteolysis and complications in the periprosthetic soft tissues such as wear-induced synovitis, periprosthetic collections, neurovascular compression, and quality of the muscle and tendons of the rotator cuff of the hip. For pain after hip resurfacing, early use of optimized MRI is recommended. PMID: 21435495 [PubMed - in pr... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4681196 Thu, 31 Mar 2011 23:00:00 +0100 4681196 http://www.medworm.com/index.php?rid=4681195&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21435496%26dopt%3DAbstract This article determines the incidence and cause of the complications commonly associated with metal-on-metal hip resurfacing implants and the proposed methods to prevent these complications. The literature available in PubMed was reviewed. Complication rates after hip resurfacing are low, and the procedure has shown both safety and efficacy in the hands of surgeons trained in specialized centers. Proper surgical technique can further reduce the incidence of femoral neck fracture, component loosening, and abnormal wear of the prosthesis. A more systematic detection of adverse local tissue reactions is needed to provide accurate assessments of their prevalence. PMID: 21435496 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4681195 Thu, 31 Mar 2011 23:00:00 +0100 4681195 http://www.medworm.com/index.php?rid=4681194&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21435497%26dopt%3DAbstract Authors: Gross TP, Liu F The purpose of this study was to compare clinical and radiological outcomes of the first 191 fully porous-coated hip resurfacing arthroplasties with 96 hybrid hip resurfacing arthroplasties performed during the same period at a minimum 2-year follow-up to evaluate the initial fixation of uncemented femoral resurfacing components. The results of this study indicate that fully porous-coated femoral resurfacing components can routinely achieve reliable fixation and provide similar initial results as have been achieved with cemented fixation. Long-term results are needed to determine which type of fixation is superior for the femoral hip resurfacing component. PMID: 21435497 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4681194 Thu, 31 Mar 2011 23:00:00 +0100 4681194 http://www.medworm.com/index.php?rid=4681193&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21435498%26dopt%3DAbstract Authors: Ebramzadeh E, Campbell PA, Takamura KM, Lu Z, Sangiorgio SN, Kalma JJ, De Smet KA, Amstutz HC Metal-on-metal total hip replacements (THRs) and hip resurfacings are coming under increasing scrutiny in light of concerns that they fail because of high wear and elevated metal ions. The aim of this study was to investigate the modes of failure in a collection of 433 metal-on-metal THRs and hip resurfacings and to examine the correlations between the reasons for revision and a range of patient and implant variables considered relevant to implant wear. PMID: 21435498 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4681193 Thu, 31 Mar 2011 23:00:00 +0100 4681193 http://www.medworm.com/index.php?rid=4681192&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21435499%26dopt%3DAbstract Authors: Beaulé PE, Kim PR, Hamdi A, Fazekas A The current study measured ion release among large-head metal-on-metal hip bearings. Twenty-six patients with a modular, Profemur® TL with A-Class® big femoral head total hip replacement were matched (gender, femoral size, BMI) with a group of 26 patients with the Conserve® Plus implant hip resurfacing. Compared with HR patients, THR patients had higher median serum cobalt ion levels at 6 months (3.26 vs 1.12 μg/L, P = .002) 1 year (4.51 vs 1.02, P = .002), and 2 years (3.77 vs 1.22, P<.001) following surgery. No differences in chromium ions were observed. Further research is required to determine the clinical significance of elevated serum cobalt ions. PMID: 21435499 [PubMed - in process] (Source: The Orthopedic Clinics of Nor... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4681192 Thu, 31 Mar 2011 23:00:00 +0100 4681192 http://www.medworm.com/index.php?rid=4681191&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21435500%26dopt%3DAbstract Authors: De Smet KA, Van Der Straeten C, Van Orsouw M, Doubi R, Backers K, Grammatopoulos G This retrospective, consecutive case series of a single surgeon performed between 2001 and 2010 assesses the outcome following revision of metal-on-metal hip resurfacing arthroplasties (N = 113). Mean time to revision was 31 months (0-101) after primary hip resurfacing. Malpositioning of the components with associated wear-induced soft tissue fluid collections was the most frequent factor leading to failure of a hip resurfacing arthroplasty. The mid-term outcome of the revisions was satisfactory; complications occurred in 11 patients (9.7%). Six of these patients underwent a re-revision. PMID: 21435500 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4681191 Thu, 31 Mar 2011 23:00:00 +0100 4681191 http://www.medworm.com/index.php?rid=4681190&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21435501%26dopt%3DAbstract Authors: Schmalzried TP With experience in metal-metal resurfacing, several opportunities to improve resurfacing technology have been identified. There is a need for better education on hip resurfacing in residency training programs. The majority of short-term complications associated with resurfacing are related to surgical technique or component position. Innovations to improve acetabular component position and femoral-acetabular mating are needed. Although the majority of high wear and adverse local tissue reactions (ALTR) can be prevented by proper component positioning, the variable exposure to metal particles and ions associated with metal-metal resurfacing components continues to be a concern and bearing surface technology will evolve. PMID: 21435501 [PubMed - in process] (... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4681190 Thu, 31 Mar 2011 23:00:00 +0100 4681190 http://www.medworm.com/index.php?rid=4386631&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21095429%26dopt%3DAbstract Authors: Russell GV PMID: 21095429 [PubMed - indexed for MEDLINE] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4386631 Sat, 01 Jan 2011 00:00:00 +0100 4386631 http://www.medworm.com/index.php?rid=4208666&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21095429%26dopt%3DAbstract Authors: Russell GV PMID: 21095429 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4208666 Tue, 30 Nov 2010 05:41:30 +0100 4208666 http://www.medworm.com/index.php?rid=4208665&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21095430%26dopt%3DAbstract This article discusses the social and physical environment in which orthopedic surgeons evaluate obese patients. Special attention should be paid in both the inpatient and outpatient arenas to the different emotional and physical needs with which obese patients present in contrast to their lean counterparts. PMID: 21095430 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4208665 Tue, 30 Nov 2010 05:41:23 +0100 4208665 http://www.medworm.com/index.php?rid=4208664&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21095431%26dopt%3DAbstract Authors: Jones CB Upper extremity injuries are more prevalent in obese people than in nonobese people after low-energy falls. Because splinting and casting are inefficient methods of stabilization in the setting of obesity, internal fixation provides stability for mobilization and realignment. Morbid obesity adversely affects positioning, surgical exposures, and complications associated with operative fixation. Avoiding short cuts and complications, morbidly obese patients should be able to return to normal functioning. PMID: 21095431 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4208664 Tue, 30 Nov 2010 05:41:14 +0100 4208664 http://www.medworm.com/index.php?rid=4208663&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21095432%26dopt%3DAbstract Authors: Streubel PN, Gardner MJ, Ricci WM Given the ongoing epidemic of obesity, femoral fracture management in the population affected by this condition is likely to become more frequent. Fracture treatment in obese patients poses a special challenge given greater difficulty in establishing an accurate diagnosis and confirming associated injuries. Adequate intraoperative positioning and obtaining accurate reduction and stable fixation may require special considerations. Obese patients have a high predisposition for complications such as compartment syndrome, nerve injuries, and pressure ulcers, and are at increased risk for medical complications given the high prevalence of comorbidities. A thorough understanding of the risks associated with obesity and the diagnostic and therapeutic... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4208663 Tue, 30 Nov 2010 05:41:06 +0100 4208663 http://www.medworm.com/index.php?rid=4208662&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21095433%26dopt%3DAbstract This article reviews the challenges of obesity as they relate to the 7 steps of lower extremity periarticular fracture care. Specifically, helpful modifications to these 7 steps are provided for the treatment of tibial plateau fractures and tibial plafond fractures. As there is little published evidence with respect to the treatment of these injuries in the obese population, the suggestions that are provided are based on the extrapolation from published evidence of fracture care in other areas in patients with obesity, logic, and personal experience with fracture care in patients with obesity. PMID: 21095433 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4208662 Tue, 30 Nov 2010 05:41:01 +0100 4208662 http://www.medworm.com/index.php?rid=4208661&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21095434%26dopt%3DAbstract Authors: Chaudhry S, Egol KA Ankle fractures are a common orthopedic injury. Certain ankle injuries have been associated with patient demographics such as obesity and smoking. Obese patients are more prone to severe ankle injuries. Naturally, these injuries affect the lower extremity mobility significantly, which itself is a risk factor for obesity. Although obese patients have increased complications across the board, there are specific techniques that can be used to assure the best possible outcome. The perioperative, surgical, and postoperative considerations as well as the outcomes are discussed in this article. PMID: 21095434 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4208661 Tue, 30 Nov 2010 05:40:56 +0100 4208661 http://www.medworm.com/index.php?rid=4208660&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21095435%26dopt%3DAbstract Authors: Bates P, Gary J, Singh G, Reinert C, Starr A A body mass index (BMI) greater than 30 is becoming increasingly common in the United States. Surgery for pelvic and acetabular fractures in this population is particularly problematic because conventional treatment often requires large surgical exposures. The surgery for both these fractures is technically difficult because of the volume of soft tissue and proneness to complications. Wound problems and infections are particularly common after open surgery in obese patients, and these increase linearly with the BMI. In this article, we present a small consecutive series over 14 months on obese patients who underwent percutaneous treatment of their pelvic or acetabular fractures. PMID: 21095435 [PubMed - in process] (Source: The ... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4208660 Tue, 30 Nov 2010 05:40:52 +0100 4208660 http://www.medworm.com/index.php?rid=4208659&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21095436%26dopt%3DAbstract This article summarizes the current literature on open treatment of pelvic and acetabular fractures in the obese patient, reviews the physiologic adaptations of obesity as they relate to pelvic surgery, highlights risk factors for complications, and provides recommendations to reduce the incidence of complications. PMID: 21095436 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4208659 Tue, 30 Nov 2010 05:40:47 +0100 4208659 http://www.medworm.com/index.php?rid=4208658&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21095437%26dopt%3DAbstract This article focuses on spine injuries in obese patients. Predisposition to spinal injury, effective evaluation and early management, principles of treatment planning, operative technical pearls, and postoperative management are discussed. PMID: 21095437 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4208658 Tue, 30 Nov 2010 05:40:40 +0100 4208658 http://www.medworm.com/index.php?rid=4208657&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21095438%26dopt%3DAbstract This article describes some of the orthopaedic conditions commonly encountered in overweight/obese children and adolescents, classically infantile and adolescent tibia vara and slipped capital femoral epiphysis. Also discussed are genu valgum, which has been associated with obesity, and other difficulties encountered in providing orthopaedic care to obese children. PMID: 21095438 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4208657 Tue, 30 Nov 2010 05:40:34 +0100 4208657 http://www.medworm.com/index.php?rid=4208656&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21095439%26dopt%3DAbstract Authors: Hamlin BR The purpose of this article is to present the challenges of dealing with the morbidly obese patient suffering from degenerative knee arthrosis. Surgery should only be undertaken when conservative management has failed and comorbidities optimized. Owing to risks related to comorbidities, diligence is necessary before proceeding with surgery to lessen the chance of complications-especially infection. Evaluation, conservative treatments, preoperative optimization, and surgical options are discussed. PMID: 21095439 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4208656 Tue, 30 Nov 2010 05:40:25 +0100 4208656 http://www.medworm.com/index.php?rid=4208655&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21095440%26dopt%3DAbstract This article outlines preoperative and postoperative care and describes current techniques and tools used by surgeons in obese patients to facilitate soft tissue dissection, exposure, implant placement, and closure. PMID: 21095440 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4208655 Tue, 30 Nov 2010 05:40:14 +0100 4208655 http://www.medworm.com/index.php?rid=4208654&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21095441%26dopt%3DAbstract Authors: Russell GV, Pierce CW, Nunley L The obesity epidemic continues to grow. As the number of obese people increases, it is logical to expect an increasing number of obese patients and increasing costs to care for these patients. Orthopedic surgeons will see many of these patients who need treatment for injuries and chronic conditions. Care of obese patients requires more work and time in providing nonoperative and operative care. No system has been proposed to handle reimbursement disparities, particularly for providers. The model for health care will change and, along with it, should be all parties coming together to address inequalities and inequities in care for obese and morbidly obese patients. PMID: 21095441 [PubMed - in process] (Source: The Orthopedic Clinics of North ... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4208654 Tue, 30 Nov 2010 05:40:08 +0100 4208654 http://www.medworm.com/index.php?rid=4073947&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20868880%26dopt%3DAbstract Authors: Chang FM, Rhodes JT, Flynn KM, Carollo JJ Individuals with cerebral palsy (CP) cannot take a normal activity like walking for granted. CP is the most common pediatric neurologic disorder, with an incidence of 3.6 per 1000 live births. The current trend in the treatment of individuals with CP is to perform a thorough evaluation including a complete patient history from birth to present, a comprehensive physical examination, appropriate radiographs, consultation with other medical specialists, and analysis of gait. PMID: 20868880 [PubMed - indexed for MEDLINE] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4073947 Thu, 30 Sep 2010 23:00:00 +0100 4073947 http://www.medworm.com/index.php?rid=4073946&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20868881%26dopt%3DAbstract This article reviews hypertonia and provides information on discriminating between spasticity, dystonia, and rigidity. Medication and neurosurgical options for the management of hypertonia are presented and compared. PMID: 20868881 [PubMed - indexed for MEDLINE] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4073946 Thu, 30 Sep 2010 23:00:00 +0100 4073946 http://www.medworm.com/index.php?rid=4023247&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20868876%26dopt%3DAbstract Authors: Chambers H PMID: 20868876 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4023247 Thu, 30 Sep 2010 23:00:00 +0100 4023247 http://www.medworm.com/index.php?rid=4023246&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20868877%26dopt%3DAbstract This article provides an overview of CP. The author discusses definitions of CP, its epidemiology, pathologies, and range of possible clinical descriptions, and briefly touches on management and prevention. PMID: 20868877 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4023246 Thu, 30 Sep 2010 23:00:00 +0100 4023246 http://www.medworm.com/index.php?rid=4023245&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20868878%26dopt%3DAbstract Authors: Rethlefsen SA, Ryan DD, Kay RM Because of increasing interest in conducting large-scale, multicenter investigations into the epidemiology of cerebral palsy and its prevention and treatment, efforts have been made to establish a standard definition and classification systems for cerebral palsy. In recent years there has also been increased focus on measurement of functional status of patients and new classifications for gross and fine motor function have been developed. The purpose of this article is to update the orthopaedic community on the current classification systems for patients with cerebral palsy. This information will be of value to surgeons in determining patients' suitability for certain treatments and will also assist them in reviewing current literature in cerebra... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4023245 Thu, 30 Sep 2010 23:00:00 +0100 4023245 http://www.medworm.com/index.php?rid=4023244&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20868879%26dopt%3DAbstract This article describes the balanced combination of medical history, detailed physical examination, functional assessment, imaging, observational gait analysis, computerized gait analysis, and assessment of patient and family goals that are necessary to prepare treatment plans and accurately assess outcomes of treatment of children with cerebral palsy. PMID: 20868879 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4023244 Thu, 30 Sep 2010 23:00:00 +0100 4023244 http://www.medworm.com/index.php?rid=4023243&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20868882%26dopt%3DAbstract This article covers the surgical interventions used for the reconstruction of the upper limb in patients with CP. The optimal surgical approach for each deformity type is described. In addition, the various evaluation techniques of the upper extremity, the general principles of an operative treatment plan, and the appropriate postoperative care of these patients is presented. PMID: 20868882 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4023243 Thu, 30 Sep 2010 23:00:00 +0100 4023243 http://www.medworm.com/index.php?rid=4023242&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20868883%26dopt%3DAbstract This article discusses the incidence, causes, natural history, and treatment of patients with scoliosis. PMID: 20868883 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4023242 Thu, 30 Sep 2010 23:00:00 +0100 4023242 http://www.medworm.com/index.php?rid=4023241&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20868884%26dopt%3DAbstract Authors: Valencia FG Hip abnormalities affect most children with cerebral palsy. Dedicated surveillance programs have been shown to be effective means of identifying hips at risk and preventing pathologic dislocation. Patients who are ambulatory and correlate with Gross Motor Function Classification Score I and II experience deformities that affect mobility and gait, but rarely dislocations. Marginal and nonambulatory patients have an increasing risk of dislocation. Once subluxation has been identified, early surgical intervention is indicated. Long-term postoperative follow-up is needed to monitor for recurrence. Individuals who recur or who do not respond to initial soft tissue releases benefit from bony surgery. Comprehensive reconstruction of the hip has become the predominant trea... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4023241 Thu, 30 Sep 2010 23:00:00 +0100 4023241 http://www.medworm.com/index.php?rid=4023240&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20868885%26dopt%3DAbstract This article discusses the sagittal gait patterns in children with spastic diplegia, with an emphasis on the knee, as well as the concept of the "dose" of surgery that is required to correct different gait pathologies. The authors list the various interventions in the order of their increasing dose. The concept of dose is useful in the consideration of the management of knee dysfunction. PMID: 20868885 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4023240 Thu, 30 Sep 2010 23:00:00 +0100 4023240 http://www.medworm.com/index.php?rid=4023239&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20868886%26dopt%3DAbstract Authors: Davids JR Clinical decision making for the management of foot deformities in children with cerebral palsy is based on the collection and integration of data from 5 sources: the clinical history, physical examination, plain radiographs, observational gait analysis, and quantitative gait analysis (which includes kinematic/kinetic analyses, dynamic electromyography, and dynamic pedobarography). The 3 most common foot segmental malalignments in children with CP are equinus, equinoplanovalgus, and equinocavovarus. The 2 most common associated deformities are ankle valgus and hallux valgus. Foot and ankle deformities caused by dynamic overactivity and imbalance of muscles are best treated with pharmacologic or neurosurgical interventions designed to manage muscle tone and spasticity... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4023239 Thu, 30 Sep 2010 23:00:00 +0100 4023239 http://www.medworm.com/index.php?rid=4023238&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20868887%26dopt%3DAbstract Authors: Murphy KP Advances in medical and surgical care over the past 20 years have resulted in children who formerly would have died at birth or infancy now surviving well into adulthood, many with permanent physical disabilities, including those caused by cerebral palsy. Inadequate medical and surgical diagnoses and intervention are prevalent in the adult cerebral palsy population. Decreased physical activity and participation in physical therapy and fitness programs, along with loss of strength, contractures, and pain are common factors in the loss of functional weight bearing, self-care, and daily performance over time. Increased awareness of these problems is needed by adult health care providers who provide care to these individuals and also by pediatric providers who may be abl... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4023238 Thu, 30 Sep 2010 23:00:00 +0100 4023238 http://www.medworm.com/index.php?rid=3604616&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20497805%26dopt%3DAbstract Authors: Levine WN PMID: 20497805 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3604616 Fri, 28 May 2010 10:45:41 +0100 3604616 http://www.medworm.com/index.php?rid=3604615&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20497806%26dopt%3DAbstract This article describes clinical evaluation of the glenohumeral joint using pertinent components of the patient history, physical examination, and selective imaging to arrive at the diagnosis of glenohumeral instability in the symptomatic patient. PMID: 20497806 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3604615 Fri, 28 May 2010 10:45:39 +0100 3604615 http://www.medworm.com/index.php?rid=3604614&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20497807%26dopt%3DAbstract Authors: Yin B, Vella J, Levine WN The capsule, labrum, glenohumeral ligaments, and rotator cuff represent the static and dynamic stabilizers of the glenohumeral joint. Various injuries can occur to one or more of these structures during traumatic shoulder dislocation, predisposing the patient to recurrent instability. Improved understanding of shoulder anatomy and biomechanics, and advancements in arthroscopic technique led to the recognition of various pathologic lesions that may contribute to instability. The ability to identify and address these lesions during arthroscopy will allow the surgeon to more fully tailor operative treatments for each individual patient suffering from shoulder instability. Furthermore, the ability to differentiate pathologic lesions from normal anatomic v... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3604614 Fri, 28 May 2010 10:45:36 +0100 3604614 http://www.medworm.com/index.php?rid=3604613&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20497808%26dopt%3DAbstract Authors: Greiwe RM, Ahmad CS Repetitive throwing or other overhead activity places great stress on the shoulder. As a result, the shoulder is a common site of injury in athletes. Addressing throwing-related injuries requires an understanding of throwing biomechanics and pathology. Nonoperative treatment is directed at restoring strength, flexibility, and neuromuscular control to the entire kinetic chain. Surgery is indicated when nonoperative treatment fails, and is directed at correcting labral, capsular, and rotator cuff pathology. PMID: 20497808 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3604613 Fri, 28 May 2010 10:45:33 +0100 3604613 http://www.medworm.com/index.php?rid=3604612&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20497809%26dopt%3DAbstract This article focuses specifically on the pearls and pitfalls that are important to recognize in the preoperative workup, intraoperative evaluation, and arthroscopic surgery to optimize surgical outcomes for anterior instability. PMID: 20497809 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3604612 Fri, 28 May 2010 10:45:30 +0100 3604612 http://www.medworm.com/index.php?rid=3604611&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20497810%26dopt%3DAbstract This article describes the anatomic-based arthroscopic approach to treatment of RPS, which allows for enhanced identification and repair of intra-articular pathology including posterior capsular laxity, complete or incomplete detachment of the posterior capsulolabral complex, and inferior capsular tears. While postoperative results are generally good to excellent after stabilization for RPS, there is room for improvement. PMID: 20497810 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3604611 Fri, 28 May 2010 10:45:27 +0100 3604611 http://www.medworm.com/index.php?rid=3604610&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20497811%26dopt%3DAbstract This article focuses on the arthroscopic management of MDI. PMID: 20497811 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3604610 Fri, 28 May 2010 10:45:24 +0100 3604610 http://www.medworm.com/index.php?rid=3604609&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20497812%26dopt%3DAbstract This article reviews the potential pitfalls in anterior shoulder stabilization and discusses appropriate methods of addressing them in revision surgery. PMID: 20497812 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3604609 Fri, 28 May 2010 10:45:21 +0100 3604609 http://www.medworm.com/index.php?rid=3604608&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20497813%26dopt%3DAbstract Authors: Boileau P, Mercier N, Old J The all-arthroscopic technique that the authors propose combines a Bristow-Latarjet procedure with a Bankart repair. This combined procedure provides a triple blocking of the shoulder (the so-called 2B3 procedure): (1) the labral repair recreates the anterior bumper and protects the humeral head from direct contact with the coracoid bone graft (Bumper effect); (2) the transferred coracoid bone block compensates for anterior glenoid bone loss (Bony effect); and (3) the transferred conjoined tendon creates a dynamic sling that reinforces the weak anteroinferior capsule by lowering the inferior part of the subscapularis when the arm is abducted and externally rotated (Belt or sling effect). The procedure combines the theoretic advantages of the Bristow... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3604608 Fri, 28 May 2010 10:45:18 +0100 3604608 http://www.medworm.com/index.php?rid=3604607&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20497814%26dopt%3DAbstract This article describes how and why the arthroscopic Latarjet procedure is a valuable tool in the treatment of complex shoulder instability and how the procedure can be introduced into practice. This technique has shown excellent results at short- to mid-term follow-up, with minimal complications. As such, this procedure is recommended to surgeons with good anatomic knowledge, advanced arthroscopic skills, and familiarity with the instrumentation. PMID: 20497814 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3604607 Fri, 28 May 2010 10:45:15 +0100 3604607 http://www.medworm.com/index.php?rid=3604606&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20497815%26dopt%3DAbstract Authors: de Beer JF, Roberts C Recurrent anterior shoulder instability is commonly associated with glenoid bone defects. When the defect is significant, bony reconstruction is typically necessary. The congruent arc modification of the Latarjet procedure uses the concavity of the undersurface of the coracoid to optimally reconstruct the glenoid. Outcomes are maximized and complications minimized. PMID: 20497815 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3604606 Fri, 28 May 2010 10:45:12 +0100 3604606 http://www.medworm.com/index.php?rid=3604605&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20497816%26dopt%3DAbstract Authors: Armitage MS, Faber KJ, Drosdowech DS, Litchfield RB, Athwal GS The Hill-Sachs lesion is a well-known entity that threatens recurrent instability, but the treatment options are multiple and the surgical indications remain undefined. The evidence for each operative technique is limited to retrospective reviews and small case series without controls. The decision of which technique to use resides with the surgeon. Older, osteopenic patients, especially those with underlying arthritis and large defects, should be managed with complete humeral resurfacing. Humeralplasty is best used in younger patients with good quality bone in an acute setting with small- to moderate-sized bone defects. Partial resurfacing and remplissage are best used with small to moderate lesions, and both requ... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3604605 Fri, 28 May 2010 10:45:09 +0100 3604605 http://www.medworm.com/index.php?rid=3604604&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20497817%26dopt%3DAbstract Authors: Boselli KJ, Cody EA, Bigliani LU As our understanding of the pathoanatomy of glenohumeral instability has improved, surgical techniques for the treatment of anterior instability have progressed. Many stabilization procedures are now successfully performed arthroscopically; open capsular shift, however, continues to play an important role in the management of instability in certain patients, providing an accurate and selective means of capsular plication. When performed with proper surgical technique, shoulder range of motion can be preserved with low recurrence rates and high subjective satisfaction, making the open capsular shift a durable and effective option in the modern management of shoulder instability. PMID: 20497817 [PubMed - in process] (Source: The Orthopedic Cl... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3604604 Fri, 28 May 2010 10:45:06 +0100 3604604 http://www.medworm.com/index.php?rid=3487772&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20399351%26dopt%3DAbstract Authors: Khan SN, Lee MA, Gupta MC PMID: 20399351 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3487772 Wed, 31 Mar 2010 23:00:00 +0100 3487772 http://www.medworm.com/index.php?rid=3487771&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20399352%26dopt%3DAbstract Authors: Panesar SS, Philippon MJ, Bhandari M Evidence-based medicine integrates clinical expertise, patients' values and preferences, and the best available evidence from the medical literature. Evidence-based orthopedics is a model to assist surgeons to improve the process of asking questions, obtaining relevant information efficiently, and making informed decisions with patients. With an increasing appreciation for higher levels of evidence, orthopedic surgeons should move away from lower forms of evidence. The adoption of randomized trials and high-quality prospective studies to guide patient care requires 2 prerequisites: (1) greater appreciation for the conduct of randomized trials in orthopedics and (2) improved education and training in evidence-based methodologies in surgery. ... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3487771 Wed, 31 Mar 2010 23:00:00 +0100 3487771 http://www.medworm.com/index.php?rid=3487770&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20399353%26dopt%3DAbstract Authors: Suk M, Hanson B, Helfet DL The promise of evidence-based medicine is to integrate the highest levels of clinical data with patient outcomes. After framing the question and identifying appropriate studies, evaluating their relevance to clinical practice is highly dependent on the instruments and measures selected to demonstrate outcomes. Currently, there are hundreds of outcomes measures available in the orthopedic literature evaluating these treatments, and it is not uncommon for different measures to produce conflicting results. Consequently, the ability to evaluate an outcomes measure is critical in determining the value of a specific treatment intervention. Similarly, selecting the appropriate outcomes measure for research or clinical purposes is an important decision that ... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3487770 Wed, 31 Mar 2010 23:00:00 +0100 3487770 http://www.medworm.com/index.php?rid=3487769&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20399354%26dopt%3DAbstract This article discusses the barriers to implementation of surgical RCTs. PMID: 20399354 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3487769 Wed, 31 Mar 2010 23:00:00 +0100 3487769 http://www.medworm.com/index.php?rid=3487768&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20399355%26dopt%3DAbstract Authors: Lowe JA, Crist BD, Bhandari M, Ferguson TA For decades, the basic tenets of managing displaced femoral neck fractures have not changed, but the optimal treatment choice continues to be highly debated. The contemporary controversies associated with the treatment principles of displaced femoral neck fractures are distinct between young and old patients and are considered individually in this article about the current evidence. Although fixation constructs all seem to have similar complication rates, there is increasing evidence suggesting that total hip replacement improves patient functional outcomes for healthy, independent, elderly patients compared with hemiarthroplasty and should be considered as the treatment of choice for these patients. PMID: 20399355 [PubMed - in pr... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3487768 Wed, 31 Mar 2010 23:00:00 +0100 3487768 http://www.medworm.com/index.php?rid=3487767&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20399356%26dopt%3DAbstract This article compares the outcomes following spinal fusion and disk replacement for degenerative conditions of the lumbar and cervical spine. The short-term outcomes of lumbar and cervical total disk replacement are equivalent to that following spinal fusion. Long-term follow-up studies of total disk replacement are necessary to confirm its potential benefit in reducing or preventing adjacent level degeneration. Also discussed is the philosophy of the surgical management of degenerative conditions of the lumbar and cervical spine. PMID: 20399356 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3487767 Wed, 31 Mar 2010 23:00:00 +0100 3487767 http://www.medworm.com/index.php?rid=3487766&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20399357%26dopt%3DAbstract Authors: Djurasovic M, Glassman SD, Carreon LY, Dimar JR Lumbar spinal stenosis is a common cause of impaired quality of life and diminished functional capacity in the elderly. Due to the advance of noninvasive imaging modalities, spinal stenosis is becoming more frequently identified, and has become the most frequent cause for spinal surgery in patients older than 65 years. Despite the ubiquitous nature of this condition, considerable controversy exists regarding the preferred treatment. Level I evidence that compares the effectiveness of surgical and nonsurgical treatment is lacking. The Spine Patient Outcomes Research Trial, a study that evaluates the common surgical treatments for the lumbar spine, has addressed this deficiency and is discussed in this article. PMID: 20399357 [... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3487766 Wed, 31 Mar 2010 23:00:00 +0100 3487766 http://www.medworm.com/index.php?rid=3487765&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20399358%26dopt%3DAbstract This article explores some of the controversies about CSM and reviews pertinent articles, specifically prospective and randomized clinical trials when possible, to obtain the cleanest and least biased data. The 4 current controversial topics that surround CSM are: (1) natural history of mild CSM; (2) surgical approach: anterior versus posterior; (3) laminoplasty or laminectomy; and (4) cervical arthroplasty for CSM. PMID: 20399358 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3487765 Wed, 31 Mar 2010 23:00:00 +0100 3487765 http://www.medworm.com/index.php?rid=3487764&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20399359%26dopt%3DAbstract This article provides a synopsis of the literature on human subjects. There is a need for high-quality evidence for interventions for spinal pathology. An evidence-based approach to the management of spinal disorders will require ongoing assessment of clinical outcomes and comparison of effectiveness between alternatives. PMID: 20399359 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3487764 Wed, 31 Mar 2010 23:00:00 +0100 3487764 http://www.medworm.com/index.php?rid=3487763&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20399360%26dopt%3DAbstract Authors: Jegede KA, Ndu A, Grauer JN Lumbar disc herniations are common clinical entities that may cause lumbar-related symptoms. The spectrum of treatment options is geared toward a patient's clinical presentation and ranges from nothing to surgical intervention. Many lumbar disc herniations cause no significant symptoms. In studies of asymptomatic individuals who have never experienced lumbar-related symptoms, 30% have been reported to have major abnormality on magnetic resonance imaging. The mainstay of treatment of patients with symptomatic disc herniations is accepted to be nonoperative (as long as there are no acute or progressive neurologic deficits); this includes medications, physical therapy, and potentially lumbar injection. For patients with symptomatic disc herniations who... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3487763 Wed, 31 Mar 2010 23:00:00 +0100 3487763 http://www.medworm.com/index.php?rid=3487762&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20399361%26dopt%3DAbstract Authors: McKee MD Clavicle fractures are common, and they comprise close to 3% of all fractures seen in fracture clinics. Midshaft fractures account for approximately 80% of all clavicle fractures and are the focus of this article. In carefully selected cases primary plate fixation of displaced midshaft clavicle fractures improves outcome, results in earlier return to function, and reduces the nonunion and symptomatic malunion rate significantly compared with nonoperative treatment. PMID: 20399361 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3487762 Wed, 31 Mar 2010 23:00:00 +0100 3487762 http://www.medworm.com/index.php?rid=3487761&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20399362%26dopt%3DAbstract Authors: Higgins TF, Klatt JB, Beals TC Lower Extremity Assessment Project (LEAP) study set out to answer many of the questions surrounding the decision of whether to amputate or salvage limbs in the setting of severe lower extremity trauma. A National Institutes of Health-funded, multicenter, prospective observational study, the LEAP study represented a milestone in orthopedic trauma research, and perhaps in orthopedics. The LEAP study attempted to define the characteristics of the individuals who sustained these injuries, the characteristics of their environment, the variables of the physical aspects of their injury, the secondary medical and mental conditions that arose from their injury and treatment, their ultimate functional status, and their general health. In the realm of evide... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3487761 Wed, 31 Mar 2010 23:00:00 +0100 3487761 http://www.medworm.com/index.php?rid=3487760&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20399363%26dopt%3DAbstract This article is a review and critique of the methodology used in the SPRINT trial. Numerous aspects of the trial's design served to greatly reduce the potential bias, producing sound and reliable results. Overall, the SPRINT trial should provide recommendations for change in clinical practice and also set a benchmark for the conduct of randomized controlled trials in orthopedic surgery. PMID: 20399363 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3487760 Wed, 31 Mar 2010 23:00:00 +0100 3487760 http://www.medworm.com/index.php?rid=3487759&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20399364%26dopt%3DAbstract Authors: Reinhardt KR, Hetsroni I, Marx RG Tear of the anterior cruciate ligament (ACL) is the most common ligamentous injury of the knee. Reconstructing this ligament is often required to restore functional stability of the knee. Many graft options are available for ACL reconstruction, including different autograft and allograft tissues. Autografts include bone-patellar tendon-bone composites (PT), combined semitendinosus and gracilis hamstring tendons (HT), and quadriceps tendon. Allograft options include the same types of tendons harvested from donors, in addition to Achilles and tibialis tendons. Tissue-engineered anterior cruciate grafts are not yet available for clinical use, but may become a feasible alternative in the future. The purpose of this systematic review is to assess w... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3487759 Wed, 31 Mar 2010 23:00:00 +0100 3487759 http://www.medworm.com/index.php?rid=3487758&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20399365%26dopt%3DAbstract Authors: Amanatullah DF, Cheung Y, Di Cesare PE Hip resurfacing arthroplasty has reemerged as a valid reconstruction option for the osteoarthritic hip. Patient selection is critical for excellent surgical outcomes, especially when compared with total hip arthroplasty. However, concerns regarding surgical technique and postsurgical complications persist. The authors review the evidence for surgical technique, outcomes, and complications related to modern metal-on-metal hip resurfacing arthroplasty. PMID: 20399365 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3487758 Wed, 31 Mar 2010 23:00:00 +0100 3487758 http://www.medworm.com/index.php?rid=3487757&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20399366%26dopt%3DAbstract Authors: Sheth NP, Lieberman JR, Della Valle CJ Deep venous thrombosis (DVT) is the end result of a complex interaction of events including the activation of the clotting cascade in conjunction with platelet aggregation. Patients undergoing major lower extremity orthopedic surgery, especially total joint arthroplasty (TJA), are at high risk for developing a postoperative DVT or a subsequent pulmonary embolus. Venous thromboembolic (VTE) prophylaxis, most commonly pharmacologic prophylaxis, has become the standard of care for patients undergoing elective TJA. However, the controversy between the efficacy of VTE prophylaxis and the increased risk for bleeding in the postoperative period continues to exist. This review addresses the controversy underlying VTE prophylaxis by outlining 2 gu... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3487757 Wed, 31 Mar 2010 23:00:00 +0100 3487757 http://www.medworm.com/index.php?rid=3146302&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19931046%26dopt%3DAbstract Authors: Pape HC, Weber TG PMID: 19931046 [PubMed - indexed for MEDLINE] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3146302 Fri, 01 Jan 2010 00:00:00 +0100 3146302 http://www.medworm.com/index.php?rid=3030636&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19931046%26dopt%3DAbstract Authors: Pape HC, Weber TG PMID: 19931046 [PubMed - as supplied by publisher] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3030636 Thu, 26 Nov 2009 23:54:52 +0100 3030636 http://www.medworm.com/index.php?rid=3030635&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19931047%26dopt%3DAbstract This article discusses bone defects caused by high-energy injuries, bone loss, infected nonunions, and nonunions. PMID: 19931047 [PubMed - as supplied by publisher] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3030635 Thu, 26 Nov 2009 23:54:50 +0100 3030635 http://www.medworm.com/index.php?rid=3030634&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19931048%26dopt%3DAbstract Authors: Cannada LK The healing of fractures and nonunions has significant science background to it; however, the application of the products in the surgeon's hands should be considered an art in the science of bone healing. The surgeon must choose adequate fixation for stability and to promote healing by not making the construct too stiff. If a bone graft substitute is necessary, the surgeon must choose the type of bone graft substitute depending on patient factors and surgeon factors involving the treatment of the fracture. PMID: 19931048 [PubMed - as supplied by publisher] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3030634 Thu, 26 Nov 2009 23:54:47 +0100 3030634 http://www.medworm.com/index.php?rid=3030633&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19931049%26dopt%3DAbstract This article describes the use of solid and cancellous bone graft in the treatment of acute bone loss and nonunion. PMID: 19931049 [PubMed - as supplied by publisher] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3030633 Thu, 26 Nov 2009 23:54:43 +0100 3030633 http://www.medworm.com/index.php?rid=3030632&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19931050%26dopt%3DAbstract Authors: Masquelet AC, Begue T Clinical, experimental, and fundamental studies have shown the interest of a foreign body-induced membrane to promote the consolidation of a conventional cancellous bone autograft for reconstruction of long bone defects. The main properties of the membrane are to prevent the resorption of the graft and to secrete growth factors. The induced membrane appears as a biological chamber, which allows the conception of numerous experimental models of bone reconstruction. This concept could probably be extended to other tissue repair. PMID: 19931050 [PubMed - as supplied by publisher] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3030632 Thu, 26 Nov 2009 23:54:40 +0100 3030632 http://www.medworm.com/index.php?rid=3030631&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19931051%26dopt%3DAbstract Authors: Meinig RP The reconstruction of large bone defects remains a clinically challenging condition. Although many treatment approaches exist, they all have limitations. Recently, bioresorbable polylactide membranes have become commercially available. These membranes, when applied to bone defects, enhance bone healing by direct osteoconduction, exclusion of nonosseous tissues, and enhancing the osteogenic environment for autologous grafts. When combined with appropriate internal fixation and autologous bone graft, bioresorbable polylactide membranes allow for single-step reconstruction of large bone defects. PMID: 19931051 [PubMed - as supplied by publisher] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3030631 Thu, 26 Nov 2009 23:54:37 +0100 3030631 http://www.medworm.com/index.php?rid=3030630&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19931052%26dopt%3DAbstract Authors: Viateau V, Bensidhoum M, Guillemin G, Petite H, Hannouche D, Anagnostou F, Pélissier P Animal experiments using the induced membrane procedure for bone tissue engineering purposes have provided evidence that the membrane has structural characteristics and biologic properties that may be used for bone tissue engineering purposes. Clinically relevant animal models have demonstrated that standardized particulate bone constructs can be used to repair large bone defects using the procedure and that the osteogenic ability of these constructs partially approaches that of bone autografts. PMID: 19931052 [PubMed - as supplied by publisher] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3030630 Thu, 26 Nov 2009 23:54:34 +0100 3030630 http://www.medworm.com/index.php?rid=3030629&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19931053%26dopt%3DAbstract Authors: Hak DJ, Pittman JL Bone harvested by intramedullary reaming offers a minimally invasive alternative to harvesting bone from the iliac crest, which has long been considered the gold standard for autogenous bone grafting. The biologic potential of intramedullary reaming material has been studied both in vitro and in vivo. The material provides osteogenic, osteoinductive, and osteoconductive properties that are comparable to the material harvested from the iliac crest. In addition to the ability to obtain a large volume of bone, the graft harvested by the Reamer-Irrigator-Aspirator has been shown to be rich in growth factors, including BMP-2, TGF-beta1, IGF-I, FGFa, and PDGFbb. PMID: 19931053 [PubMed - as supplied by publisher] (Source: The Orthopedic Clinics of North America... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3030629 Thu, 26 Nov 2009 23:54:31 +0100 3030629 http://www.medworm.com/index.php?rid=3030628&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19931054%26dopt%3DAbstract Authors: McCall TA, Brokaw DS, Jelen BA, Scheid DK, Scharfenberger AV, Maar DC, Green JM, Shipps MR, Stone MB, Musapatika D, Weber TG Treatment of large segmental defects using conventional autogenous iliac crest bone graft can be limited by volume of cancellous bone and donor site morbidity. The reamer-irrigator-aspirator (RIA) technique allows access to a large volume of cancellous bone graft containing growth factors with potency equal to or greater than autograft material from the iliac crest. The purpose of this study was to evaluate the effectiveness of RIA-harvested autogenous bone graft for treating large segmental defects of long bones. PMID: 19931054 [PubMed - as supplied by publisher] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3030628 Thu, 26 Nov 2009 23:54:28 +0100 3030628 http://www.medworm.com/index.php?rid=3030627&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19931055%26dopt%3DAbstract This article focuses on comparing patient morbidity with harvesting bone graft for the treatment of nonunions from three different sites. Anterior iliac crest graft is the most commonly used site; however, the posterior iliac crest and intramedullary canal provide greater quantities of bone. The anterior and posterior iliac crests also have some donor site complications such as nerve injury and persistent pain. The intramedullary canal, when compared with anterior and posterior iliac crest, offers the largest quantity of bone graft with the least amount of patient donor site morbidity. The intramedullary canal also appears to be a bone graft source that can be reharvested, unlike the anterior and posterior iliac crest donor sites. PMID: 19931055 [PubMed - as supplied by publisher] (Sou... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3030627 Thu, 26 Nov 2009 23:54:25 +0100 3030627 http://www.medworm.com/index.php?rid=3030626&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19931056%26dopt%3DAbstract Authors: Giannoudis PV, Dinopoulos HT Although the unquestionable value of autologous bone grafting and the analogous value of the reaming by-products in nonunion treatment have been mentioned extensively in the literature, there is ongoing vivid discussion for the treatment of those case scenarios where the fracture nonunion is complicated by other local environment adverse circumstances. The graft expansion with growth factors as the bone morphogenetic proteins (BMPs) offers the possibility to reduce the number of operative procedures, complications, length of hospital stay, and time to union. In this article, we consider the potential clinical scenarios for graft expansion with BMPs. PMID: 19931056 [PubMed - as supplied by publisher] (Source: The Orthopedic Clinics of North Amer... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3030626 Thu, 26 Nov 2009 23:54:22 +0100 3030626 http://www.medworm.com/index.php?rid=3030625&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19931057%26dopt%3DAbstract We report on our novel technique of using a second filter containing beta-tricalcium phosphate (TCP) as a graft extender while using the RIA system. We also quantify growth factor concentrations in the collections from the TCP filter. A second filter attached in series with the standard RIA filtration system yields TCP with substantial concentrations of bioactive proteins that are equal to those seen in the bone graft that is harvested in the first filter. PMID: 19931057 [PubMed - as supplied by publisher] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3030625 Thu, 26 Nov 2009 23:54:17 +0100 3030625 http://www.medworm.com/index.php?rid=3030624&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19931058%26dopt%3DAbstract Authors: Finkemeier CG, Neiman R, Hallare D The Reamer Irrigator Aspirator (RIA) has three main indications in our community trauma practice. The most common indication for RIA is harvesting of autololgous bone graft from the femur for nonstructural bone graft. The second most common indication is for irrigation and debridement of intramedullary osteomyelitis. The final indication for RIA is for acute nailing of femoral shaft fractures in patients with multiple long bone fractures with or without pulmonary injury. If one pays careful attention to the details of the technique, RIA is a safe and effective method of harvesting autologous bone graft with minimal morbidity. Autologous bone graft harvested with RIA is our graft of choice for nearly all of our bone grafting cases. PMID: 1... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3030624 Thu, 26 Nov 2009 23:54:14 +0100 3030624 http://www.medworm.com/index.php?rid=3030623&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19931059%26dopt%3DAbstract This article presents a technique of deformity correction, bone graft techniques that reconstitute residual defects, and definitive fixation using load-sharing devices that provide immediate stability for bone healing and early rehabilitation. Preoperative planning and the potential advantages and disadvantages of newer fixed-angled plates versus established implants are discussed. With proper planning, surgical execution with proved techniques, augmented by the addition of newer graft harvesting techniques, anatomic restoration, and bone reconstitution with healing, has invariably been the result. PMID: 19931059 [PubMed - as supplied by publisher] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3030623 Thu, 26 Nov 2009 23:54:11 +0100 3030623 http://www.medworm.com/index.php?rid=3030622&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19931060%26dopt%3DAbstract Authors: Tarkin IS, Siska PA, Zelle BA A thoughtful treatment algorithm is required to optimally treat distal tibia nonunion. A healthy respect for the tenuous soft tissue envelope, compromised vascularity, and challenging mechanical environment is advisable. Achieving osseous union and improved functionality requires an individualized plan of care based on the personality of the nonunion and host. Attention must be focused on providing mechanical stability at the site of nonunion and providing biologic supplementation. PMID: 19931060 [PubMed - as supplied by publisher] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3030622 Thu, 26 Nov 2009 23:54:05 +0100 3030622 http://www.medworm.com/index.php?rid=2828715&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19773048%26dopt%3DAbstract Authors: Cellocco P, Rossi C, El Boustany S, Di Tanna GL, Costanzo G We prospectively compared the safety and effectiveness of mini-incision (group A) and a limited open technique (group B) for carpal tunnel release (CTR) in 185 consecutive patients operated between November 1999 and May 2001, with a 5-year minimum follow-up. Patients in Group A had a minimally invasive approach (<2 cm incision), performed using the KnifeLight (Stryker, Kalamazoo, Michigan) instrument. Patients in Group B had a limited longitudinal incision (3-4 cm). Patient status was evaluated with an Italian modified version of the Boston Carpal Tunnel questionnaire, administered preoperatively and at 19, 30, and 60 postoperative months. Mini-incision CTR showed advantages over standard technique in early recover... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2828715 Thu, 24 Sep 2009 23:44:43 +0100 2828715 http://www.medworm.com/index.php?rid=2828714&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19773049%26dopt%3DAbstract Authors: Pizzoli AL, Brivio LR, Caudana R, Vittorini E Percutaneous vertebroplasty (PVP) is a minimally invasive, image-guided procedure consisting of an injection of acrylic cement into a vertebral body to reinforce the compressed segment and achieve pain relief. The use of PVP is a minimally invasive option in the treatment of osteoporotic or metastatic vertebral collapses. Our personal experience, using a CT-guided technique, confirms the efficacy and safety of PVP with a lower risk for complications compared with conventional fluoroscopic approaches because of a precise placement of the instruments in the vertebral body and an early detection of small cement leakages. PMID: 19773049 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2828714 Thu, 24 Sep 2009 23:44:40 +0100 2828714 http://www.medworm.com/index.php?rid=2828713&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19773050%26dopt%3DAbstract Authors: Longo UG, Papapietro N, Maffulli N, Denaro V Thoracoscopy has been used worldwide for many years by thoracic surgeons. Despite a long learning curve and technical demands of the procedure, thoracoscopy has several advantages, including better cosmesis, adequate exposure to all levels of the thoracic spine from T2 to L 1, better illumination and magnification at the site of surgery, less damage to the tissue adjacent to the surgical field, less morbidity when compared with standard thoracotomy in terms of respiratory problems, pain, blood loss, muscle and chest wall damages, consequent shorter recovery time, less postoperative pulmonary function impairment, and shorter hospitalization. Good results at short- and medium-term follow-up need to be confirmed at long-term follow-up.... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2828713 Thu, 24 Sep 2009 23:44:37 +0100 2828713 http://www.medworm.com/index.php?rid=2828712&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19773051%26dopt%3DAbstract This article provides an overview of the state of the art in vertebroplasty and kyphoplasty, discussing the indications, techniques, results, and pitfalls. PMID: 19773051 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2828712 Thu, 24 Sep 2009 23:44:34 +0100 2828712 http://www.medworm.com/index.php?rid=2828711&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19773052%26dopt%3DAbstract This article describes the technique of a minimally invasive approach to the hip from the anterolateral direction step by step and includes preoperative settings and pitfalls. PMID: 19773052 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2828711 Thu, 24 Sep 2009 23:44:31 +0100 2828711 http://www.medworm.com/index.php?rid=2828710&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19773053%26dopt%3DAbstract Authors: Khanna A, Gougoulias N, Longo UG, Maffulli N The concept of minimally invasive total knee arthroplasty surgery evolved to reduce quadriceps muscle strength loss and improve clinical outcome following total knee replacement. We performed a systematic review of the published literature on Minimally Invasive Total Knee Arthroplasty (MITKA) and analyzed the reported surgical outcomes. Twenty-eight studies published from January 2003 to June 2008 that met the inclusion criteria were evaluated using the modified Coleman Methodology Score (CMS). At a mean CMS of 60, most studies reporting on outcome of MITKA are of moderate scientific quality. Patients undergoing MITKA tend to have decreased postoperative pain, rapid recovery of quadriceps function, reduced blood loss, improved range... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2828710 Thu, 24 Sep 2009 23:44:27 +0100 2828710 http://www.medworm.com/index.php?rid=2828709&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19773054%26dopt%3DAbstract This article presents recent advances in the field of minimally invasive AT surgery for tendinopathy, acute ruptures, and chronic tears. All of the techniques described in this article are inexpensive and do not require highly specialized equipment and training. Future randomized controlled trials are required to address the issue of the comparison between open versus minimally invasive AT surgery. PMID: 19773054 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2828709 Thu, 24 Sep 2009 23:44:25 +0100 2828709 http://www.medworm.com/index.php?rid=2828708&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19773055%26dopt%3DAbstract Authors: Ronga M, Shanmugam C, Longo UG, Oliva F, Maffulli N The management of distal tibia fractures can be challenging because of the scarcity of soft tissue, their subcutaneous nature, and poor vascularity. Classic open reduction and internal plate fixation require extensive soft tissue dissection and periosteal stripping, with high rates of complications. Minimally invasive plating techniques reduce iatrogenic soft tissue injury and damage to bone vascularity and preserve the osteogenic fracture hematoma. Locking plates (LPs) have the biomechanical properties of internal and external fixators, with superior holding power because of fixed angular stability through the head of locking screws, independent of friction fit. In this review, the rationale for the use of LPs and a descript... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2828708 Thu, 24 Sep 2009 23:44:22 +0100 2828708 http://www.medworm.com/index.php?rid=2828707&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19773056%26dopt%3DAbstract Authors: Bauer T, de Lavigne C, Biau D, De Prado M, Isham S, Laffenétre O Distal first metatarsal osteotomies have been indicated for the correction of mild-to-moderate hallux valgus deformity. The aim of this study was to assess the clinical and radiographic results of the distal Reverdin-Isham first metatarsal osteotomy with use of a percutaneous procedure after a minimum 1-year followup. One hundred eighty-nine feet in 168 consecutive subjects were included in the present prospective multicenter study. A radiographic and clinical assessment using the American Orthopaedic Foot and Ankle Society's (AOFAS) hallux-metatarsophalangeal-interphalangeal scale was performed for all the subjects with a minimum 1-year follow-up. One hundred fifty six subjects (87%) were satisfied or very ... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2828707 Thu, 24 Sep 2009 23:44:17 +0100 2828707 http://www.medworm.com/index.php?rid=2828706&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19773057%26dopt%3DAbstract Authors: Maffulli N, Longo UG, Oliva F, Denaro V, Coppola C Minimally invasive distal metatarsal osteotomies are becoming broadly accepted for correction of hallux valgus. We compared the duration of surgery, the length of hospital stay, the American Orthopaedic Foot and Ankle Society (AOFAS) score, and the Foot and Ankle Outcome Score (FAOS) in 36 patients who underwent a minimal incision subcapital osteotomy of the first metatarsal with 36 matched patients who had hallux valgus corrected by a scarf technique. The minimum follow-up was 2.1 years (mean, 2.5 years; range, 2.1-3.2 years). Patients having the osteotomy had similar AOFAS and FAOS scores with less operating time and earlier discharge. Less operative time may benefit the patients, and earlier discharge has financial implicat... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2828706 Thu, 24 Sep 2009 23:44:15 +0100 2828706 http://www.medworm.com/index.php?rid=2828705&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19773058%26dopt%3DAbstract This article describes our surgical MIS for hallux valgus correction, including the postoperative management, and reviews the literature on MIS for hallux valgus correction. The reports on such techniques are few, and mainly case series are reported. More adequately planned and executed randomized prospective clinical trials are needed. Historical attempts, indications, preferred surgical techniques, and complications are discussed. PMID: 19773058 [PubMed - in process] (Source: The Orthopedic Clinics of North America) The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2828705 Thu, 24 Sep 2009 23:44:12 +0100 2828705 http://www.medworm.com/index.php?rid=2828704&cid=s_33242_31_f&fid=33242&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19773059%26dopt%3DAbstract Authors: Whipple TL Tendinopathy arises from a failed tendon healing process. Current non-invasive therapeutic alternatives are anti-inflammatory in nature, and outcomes are unpredictable. The benefit of invasive alternatives resides in the induction of the healing response. A new technology that uses non-invasive monopolar capacitive coupled radiofrequency has demonstrated the ability to raise temperatures in tendons and ligaments above 50 degrees C, the threshold for collagen modulation, tissue shrinkage and recruitment of macrophages, fibroblasts, and heat shock protein factors, without damaging the overlying structures, resulting in activation of the wound healing response. Monopolar capacitive-coupled radiofrequency offers a new non-invasive choice for tendinopathies and sprained ... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2828704 Thu, 24 Sep 2009 23:44:09 +0100 2828704