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. Tue, 02 Mar 2010 15:53:01 +0100 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 http://www.medworm.com/index.php?rid=2828703&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%3D19773060%26dopt%3DAbstract Authors: Biasca N, Schneider TO, Bungartz M Modern computerized knee navigation systems aid surgeons both in the conventional and in the minimally invasive approach to optimize mechanical and rotational alignments of the components in all three planes to avoid any malrotation and/or any errors in coronal, sagittal, and axial alignments. The advantages of minimally invasive total knee arthroplasty can be achieved without loss of accuracy. There is increasing evidence of a positive correlation between accurate mechanical alignment after total knee arthroplasty and functional as well as quality-of-life patient outcomes. PMID: 19773060 [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=2828703 Thu, 24 Sep 2009 23:44:05 +0100 2828703 http://www.medworm.com/index.php?rid=2672394&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%3D19576397%26dopt%3DAbstract Authors: Beaulé PE PMID: 19576397 [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=2672394 Tue, 30 Jun 2009 23:00:00 +0100 2672394 http://www.medworm.com/index.php?rid=2577251&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%3D19576397%26dopt%3DAbstract Authors: Beaulé PE PMID: 19576397 [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=2577251 Tue, 30 Jun 2009 23:00:00 +0100 2577251 http://www.medworm.com/index.php?rid=2577250&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%3D19576398%26dopt%3DAbstract Authors: Rachbauer F, Kain MS, Leunig M The anterior approach is a safe, reliable, and feasible technique for total hip arthroplasty, permitting optimal soft tissue preservation. Since Hueter first described this interval, many surgeons have approached the hip anteriorly to perform a myriad of surgical procedures. The anterior approach allows optimal muscle preservation, and it is a truly internervous approach to the hip. An understanding of the evolution of the anterior approach to the hip will help the orthopedic community understand these advantages and why so many have used this approach in the treatment of hip pathology and for the implantation total hip arthroplasty. PMID: 19576398 [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=2577250 Tue, 30 Jun 2009 23:00:00 +0100 2577250 http://www.medworm.com/index.php?rid=2577249&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%3D19576399%26dopt%3DAbstract This article describes the surgical technique for total hip arthroplasty using the single-incision direct anterior approach. The authors believe the direct anterior approach has significant advantages, including minimal soft tissue trauma, resulting in faster postoperative mobilization and rehabilitation. The small incision scar also results in better cosmesis. PMID: 19576399 [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=2577249 Tue, 30 Jun 2009 23:00:00 +0100 2577249 http://www.medworm.com/index.php?rid=2577248&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%3D19576400%26dopt%3DAbstract Authors: The authors conducted a retrospective, multicenter cohort study of 1,152 patients across nine clinical sites across the United States, evaluating complications and function associated with the anterior approach to total hip arthroplasty using an orthopedic table. Eligible patients included those with primary diagnosis of hip arthritis. Outcomes included hospital stay, use of assistive devices, complications, and function. In the cohort of 1,152 patients treated with the anterior approach to total hip arthroplasty, the authors found (i) an acceptable complication profile with a very low dislocation rate, (ii) an early return to function, and (iii) a decline in complications in surgeons with greater than 100 case experiences. PMID: 19576400 [PubMed - as supplied by publish... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2577248 Tue, 30 Jun 2009 23:00:00 +0100 2577248 http://www.medworm.com/index.php?rid=2577247&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%3D19576401%26dopt%3DAbstract This article provides a detailed description of the surgical approach, including the use of a standard operating room table and fluoroscopy. Cadaver dissections and one-on-one mentoring are recommended when implementing this approach in one's practice. PMID: 19576401 [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=2577247 Tue, 30 Jun 2009 23:00:00 +0100 2577247 http://www.medworm.com/index.php?rid=2577246&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%3D19576402%26dopt%3DAbstract Authors: Mast NH, Muñoz M, Matta J Simultaneous bilateral anterior approach total hip arthroplasty has been a successful procedure with high patient demand and good short-term clinical results. Complication rates are acceptable and compare favorably with previously published series. The anterior approach takes advantage of supine positioning, allowing improved intraoperative monitoring and anesthesia care. Short-term rehabilitation goals are met early with this technique. Despite these advantages, providing this simultaneous approach imposes a large financial burden on the hospital and surgeon. PMID: 19576402 [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=2577246 Tue, 30 Jun 2009 23:00:00 +0100 2577246 http://www.medworm.com/index.php?rid=2577245&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%3D19576403%26dopt%3DAbstract This article evaluates the safety and the learning curve with the less invasive Hueter hip resurfacing using an anterior approach on an orthopedic traction table. The first 50 hip resurfacings using this approach are compared with the previous 50 procedures performed through a surgical dislocation approach. The authors conclude that it is a reasonable alternative to more extensile surgical approaches for a high-volume resurfacing arthroplasty surgeon. Further long-term studies and comparisons to other approaches will determine if the anterior approach provides advantages in terms of patient function and time to recovery. PMID: 19576403 [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=2577245 Tue, 30 Jun 2009 23:00:00 +0100 2577245 http://www.medworm.com/index.php?rid=2577244&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%3D19576404%26dopt%3DAbstract This study reports on differences in the use of minimally invasive surgery for total hip arthroplasty related to the direction of cup insertion against the operating table, intraoperative hip range of motion, stability, and a choice of cup liners for both a mini-incision posterior approach (MPA) and a mini-incision anterior approach (MAA) using Stryker Navigation's CT-Hip system. The MPA group consisted of 39 consecutive patients and the MAA group consisted of 33 consecutive patients. Clinically, there was no significant difference in the average Japanese Orthopedic Association hip score or the Oxford hip score preoperatively and at 6 months and 2 years follow-up. The intraoperative joint stability measurements showed no large difference between the two groups when malpositioning of the cu... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2577244 Tue, 30 Jun 2009 23:00:00 +0100 2577244 http://www.medworm.com/index.php?rid=2577243&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%3D19576405%26dopt%3DAbstract Authors: Barton C, Kim PR With the direct anterior approach gaining in popularity, it is important to appreciate the complications that are specific to it. The authors outline these potential complications and offer advice on the ways and the techniques to avoid them. This information is especially useful to the surgeon considering using this approach for the first time or to the surgeon who may already have encountered some of these complications as a result of using this approach. PMID: 19576405 [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=2577243 Tue, 30 Jun 2009 23:00:00 +0100 2577243 http://www.medworm.com/index.php?rid=2577242&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%3D19576406%26dopt%3DAbstract Authors: Tang R, Evans H, Chaput A, Kim C Multimodal analgesia incorporates the use of analgesic adjuncts with different mechanisms of action to enhance postoperative pain management. Acetaminophen, anti-inflammatories, and gabapentinoids provide effective analgesia while reducing opioid requirements and opioid-related side effects. Intrathecal morphine and periarticular local anesthetic infiltration further enhance dynamic analgesia and improve postoperative mobilization. Epidural analgesia, peripheral nerve blocks, tramadol, ketamine, and/or clonidine can be added for improved benefit in opioid-tolerant individuals. PMID: 19576406 [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=2577242 Tue, 30 Jun 2009 23:00:00 +0100 2577242 http://www.medworm.com/index.php?rid=2577241&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%3D19576407%26dopt%3DAbstract This article discusses the indications and diagnostic criteria and the surgical technique and early clinical results for the combined arthroscopic/Hueter approach. PMID: 19576407 [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=2577241 Tue, 30 Jun 2009 23:00:00 +0100 2577241 http://www.medworm.com/index.php?rid=2577240&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%3D19576408%26dopt%3DAbstract This article presents critical issues related to the interpretation of biomechanical findings of the hip joint for patients having undergone hip arthroplasty. The use of a gait, or biomechanical, analysis provides objective evidence of the efficiency of the treatments or the effectiveness of hip replacement approaches. Based on our biomechanical analysis, patients who have undergone total hip arthroplasty use a stair ascent and descent strategy allowing them to significantly reduce loading at the prosthetic hip joint. Since hip joint reaction forces are highly dependent on muscle activation, the THA group have adopted a neuromuscular control strategy that is enabling them to reduce loading on the prosthetic hip joint. It could also be a joint loading pattern that stems from a muscular defi... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2577240 Tue, 30 Jun 2009 23:00:00 +0100 2577240 http://www.medworm.com/index.php?rid=2577239&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%3D19576409%26dopt%3DAbstract The objective of this preliminary study was to examine possible differences in gait characteristics between subjects operated by way of a direct anterior approach and a posterior approach for primary total-hip arthroplasty, and age-matched healthy controls. Fifty-one subjects walked over an instrumented mat at two different speeds (self-selected comfortable and faster than normal) and spatiotemporal gait parameters were calculated using a validated methodology. Despite excellent clinical and radiographic scores, and irrespective of surgical approach, patients demonstrated an impaired walking performance (lower velocity and shorter step lengths) during fast walking, but not at the self-selected comfortable speed compared with healthy controls. Subjects operated with the posterior approach r... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2577239 Tue, 30 Jun 2009 23:00:00 +0100 2577239 http://www.medworm.com/index.php?rid=2577238&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%3D19576410%26dopt%3DAbstract Authors: Lane A, Crosby ET Blood conservation techniques are well established and have significant benefits. We review the current literature on these techniques and their applicability to hip reconstruction surgery and offer a suitable strategy to minimize allogeneic red cell transfusion. PMID: 19576410 [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=2577238 Tue, 30 Jun 2009 23:00:00 +0100 2577238 http://www.medworm.com/index.php?rid=2577237&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%3D19576411%26dopt%3DAbstract This article reviews the current evidence-based recommendations for anticoagulant prophylaxis after total-hip arthroplasty and provides insight into the current areas of active research and controversy. PMID: 19576411 [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=2577237 Tue, 30 Jun 2009 23:00:00 +0100 2577237 http://www.medworm.com/index.php?rid=2539173&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%3D19358903%26dopt%3DAbstract Authors: Mont MA, Jones LC PMID: 19358903 [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=2539173 Tue, 31 Mar 2009 23:00:00 +0100 2539173 http://www.medworm.com/index.php?rid=2539172&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%3D19358904%26dopt%3DAbstract Authors: Jones LC, Hungerford MW, Khanuja HS, Hungerford DS With the advent of cell-based therapies, biologics, and pharmaceuticals for the potential treatment of osteonecrosis, it is important to conduct evaluations using scientifically accepted outcomes measures. For the treatment of osteonecrosis, most studies have focused on pain relief, surgery, or the need for surgery, disease progression (advancing stage), and change in lesion size. Quantification of imaging techniques continue to gain in sophistication but have not yet been validated for use in clinical trials. Despite recent interest in using biomarkers or genetic markers in the diagnosis and analysis of disease progression, more research is needed to determine the sensitivity and specificity of these techniques with respect t... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2539172 Tue, 31 Mar 2009 23:00:00 +0100 2539172 http://www.medworm.com/index.php?rid=2539171&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%3D19358905%26dopt%3DAbstract This article reviews the current knowledge of these distinct conditions by describing their etiology, pathology, and pathogenesis, as well as their clinical and radiographic presentations. The various treatment options available for each condition are reviewed, with a discussion of their rationale and indications, and a summary of results with various techniques. A thorough understanding of these conditions and their distinguishing features is critical to selecting the best treatment option for an individual patient. PMID: 19358905 [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=2539171 Tue, 31 Mar 2009 23:00:00 +0100 2539171 http://www.medworm.com/index.php?rid=2539170&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%3D19358906%26dopt%3DAbstract Authors: Gangji V, Hauzeur JP This review article describes bone remodeling in the context of osteonecrosis as a bone disease, the use of stem cells in bone and vascular diseases, and cellular therapy in osteonecrosis. PMID: 19358906 [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=2539170 Tue, 31 Mar 2009 23:00:00 +0100 2539170 http://www.medworm.com/index.php?rid=2539169&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%3D19358907%26dopt%3DAbstract Authors: Goytia RN, Salama A, Khanuja HS They are commonly used to treat osteoporosis and other diseases that involve osteoclast-mediated bone resorption, including Paget's disease and multiple myeloma. Their use in treating osteonecrosis of the femoral head has been studied and theoretically holds promise. There are complications associated with these medications, however, including the development of osteonecrosis in the jaw. PMID: 19358907 [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=2539169 Tue, 31 Mar 2009 23:00:00 +0100 2539169 http://www.medworm.com/index.php?rid=2539168&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%3D19358908%26dopt%3DAbstract Authors: Ajmal M, Matas AJ, Kuskowski M, Cheng EY The relationship between corticosteroids and osteonecrosis is well known. Limited data suggest that statins modulate cholesterol metabolism and may protect against osteonecrosis. The authors analyzed their prospective renal transplant database to determine if statin usage reduces the incidence of corticosteroid-related osteonecrosis and identified 2,881 renal transplantation patients who met the entry criteria. Among 338 patients on statins, 15 (4.4%) developed osteonecrosis, versus 180 of 2,543 (7%) patients who were not on statins. Osteonecrosis-free survival was similar in patients with and without statin exposure. PMID: 19358908 [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=2539168 Tue, 31 Mar 2009 23:00:00 +0100 2539168 http://www.medworm.com/index.php?rid=2539167&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%3D19358909%26dopt%3DAbstract Authors: Aigner N, Meizer R, Meraner D, Becker S, Meizer E, Landsiedl F Bone marrow edema syndrome of the femoral head in pregnant women is a rare disease resulting in disabling coxalgia, beginning in the last 3 months of pregnancy and persisting for several months after parturition. The parenteral administration of the vasoactive drug iloprost constitutes a new approach to the treatment of painful bone marrow edema syndrome of the hip of pregnant women. Six postpartal women (8 hips) with bone marrow edema syndrome of the femoral head were treated with iloprost followed by 3 weeks of partial weight-bearing. Relief from pain, restoration of functional capacity, and normalization of the MRI signal pattern were rapidly achieved, thus avoiding the need for surgical intervention. As the sub... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2539167 Tue, 31 Mar 2009 23:00:00 +0100 2539167 http://www.medworm.com/index.php?rid=2539166&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%3D19358910%26dopt%3DAbstract This article discusses the use of novel noninvasive imaging techniques as a means of assessing bone perfusion and quantifying differences seen in osteoarthritis and avascular necrosis. Review of our human data suggests that the MRI contrast dye is retained for longer periods of time, suggesting decreased perfusion out of regions of osteoarthritis and avascular necrosis. Use of such a noninvasive measure of assessing bone perfusion could be useful in the diagnosis, prevention, and treatment of not only osteoarthritis and avascular necrosis but also other entities that affect the musculoskeletal system. PMID: 19358910 [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=2539166 Tue, 31 Mar 2009 23:00:00 +0100 2539166 http://www.medworm.com/index.php?rid=2539165&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%3D19358911%26dopt%3DAbstract This article evaluates the follow-up results of subchondral fatigue fractures of the femoral head in which femoral head collapse occurred. The study shows that collapsed subchondral fatigue fractures of the femoral head have a benign clinical course quite unlike that of collapsed osteonecrosis of the femoral head. PMID: 19358911 [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=2539165 Tue, 31 Mar 2009 23:00:00 +0100 2539165 http://www.medworm.com/index.php?rid=2539164&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%3D19358912%26dopt%3DAbstract In this study, the authors evaluated the effectiveness of high-degree posterior rotation in terms of regaining the spherical contour of severely collapsed necrotic femoral head that was moved medially. They also investigated whether or not subchondral fracture disappeared on the medial femoral head on postoperative anteroposterior radiographs as a result of remodeling after this procedure. PMID: 19358912 [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=2539164 Tue, 31 Mar 2009 23:00:00 +0100 2539164 http://www.medworm.com/index.php?rid=2539163&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%3D19358913%26dopt%3DAbstract Authors: Amstutz HC, Le Duff MJ The purpose of the study discussed in this article is to review the authors' long-term experience with this procedure, compare their clinical results to those of other centers, particularly regarding the difficulty of predicting pain relief, and determine the role of hemi-resurfacing in the future. PMID: 19358913 [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=2539163 Tue, 31 Mar 2009 23:00:00 +0100 2539163 http://www.medworm.com/index.php?rid=2539162&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%3D19358914%26dopt%3DAbstract This study examined the outcome of the femoral stem of four generations of an uncemented, proximally porous-coated, chrome-cobalt total hip prosthesis. There were 158 cases in 141 osteonecrosis patients (74 men, 67 women) who had a mean age of 46 years (range, 17-83 years). The mean follow-up was 103 months (range, 20-235 months). The femoral components of 144 cases were not revised and had a mean Harris hip score of 84 (+/-15) at final follow-up. Of the 14 revisions (8.9%), the primary reasons for revision were loosening or significant osteolysis. There were one infection and one chronic dislocation. Proximally porous-coated, anatomic, press-fit stems provide excellent long-term results in patients with osteonecrosis of the femoral head. PMID: 19358914 [PubMed - indexed for MEDLINE] (... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2539162 Tue, 31 Mar 2009 23:00:00 +0100 2539162 http://www.medworm.com/index.php?rid=2539161&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%3D19358915%26dopt%3DAbstract This article presents results for total hip arthroplasty after failed transtrochanteric rotational osteotomy according to Sugioka and after failed bone impaction grafting, both initially performed for osteonecrosis of the femoral head. After a minimal follow-up of 2 years, 33 hips were studied. In total hip arthroplasty after failed osteotomy, when compared with total hip arthroplasty after failed bone impaction grafting, clinical and radiologic outcome was less favorable, more complications were observed, and there was a higher revision rate for a technically more demanding procedure. PMID: 19358915 [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=2539161 Tue, 31 Mar 2009 23:00:00 +0100 2539161 http://www.medworm.com/index.php?rid=2539160&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%3D19358916%26dopt%3DAbstract Authors: Marker DR, Mont MA, Seyler TM, LaPorte DM, Frassica FJ The Orthopaedic In-Training Examination (OITE) is used to evaluate the knowledge of residents and focuses on relevant information supported by current scientific literature. The purpose of this study was to assess the relevance of current literature as a study tool for the exam, especially for osteonecrosis-related material. A systematic review was conducted of the OITE and relevant journals to compare the proportion and characterization of questions and published studies related to osteonecrosis and other frequently tested subject areas over a 5-year period (2002 to 2006). This review suggests that the OITE and literature are generally similar in content. However, there may be some differences, especially in subspecialty ... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2539160 Tue, 31 Mar 2009 23:00:00 +0100 2539160 http://www.medworm.com/index.php?rid=2213197&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%3D19064050%26dopt%3DAbstract Authors: Donthineni R, Ofluoglu O PMID: 19064050 [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=2213197 Thu, 01 Jan 2009 05:00:00 +0100 2213197 http://www.medworm.com/index.php?rid=2023552&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%3D19064050%26dopt%3DAbstract Authors: Donthineni R, Ofluoglu O PMID: 19064050 [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=2023552 Thu, 11 Dec 2008 03:31:40 +0100 2023552 http://www.medworm.com/index.php?rid=2023551&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%3D19064051%26dopt%3DAbstract Authors: Donthineni R Persistent axial pain with or without neurologic changes should prompt workup for a possible tumor of the spine. Metastatic disease is more predominant than primary tumors, but still needs adequate evaluation before any management. The various steps of evaluation, diagnosis, and staging are reviewed. PMID: 19064051 [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=2023551 Thu, 11 Dec 2008 03:31:37 +0100 2023551 http://www.medworm.com/index.php?rid=2023550&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%3D19064052%26dopt%3DAbstract This article is a guide to diagnosing and treating such rare tumors. PMID: 19064052 [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=2023550 Thu, 11 Dec 2008 03:31:31 +0100 2023550 http://www.medworm.com/index.php?rid=2023549&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%3D19064053%26dopt%3DAbstract This article reviews the changes in surgical philosophy in the management of malignant spinal tumors during the past two decades. PMID: 19064053 [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=2023549 Thu, 11 Dec 2008 03:31:26 +0100 2023549 http://www.medworm.com/index.php?rid=2023548&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%3D19064054%26dopt%3DAbstract This article discusses the selection of treatment for metastatic spine tumors and, in particular, the indications for surgical treatment. PMID: 19064054 [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=2023548 Thu, 11 Dec 2008 03:31:23 +0100 2023548 http://www.medworm.com/index.php?rid=2023547&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%3D19064055%26dopt%3DAbstract Authors: Kawahara N, Tomita K, Murakami H, Demura S The authors' group has developed a new surgical technique of spondylectomy (vertebrectomy) called "total en bloc spondylectomy" (TES). This technique is different from spondylectomy in that it involves en bloc removal of the lesion, that is, removal of the whole vertebra, body and lamina, as one compartment. The surgical technique of TES has been remarkably improved based on adequate knowledge and consideration of the surgical anatomy, physiology, and biomechanics of the spine and spinal cord. Review of the developmental process of this operation leads to recognition of the tips, pitfalls, and solutions. PMID: 19064055 [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=2023547 Thu, 11 Dec 2008 03:31:19 +0100 2023547 http://www.medworm.com/index.php?rid=2023546&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%3D19064056%26dopt%3DAbstract Authors: Melcher RP, Harms J We initially review the general biomechanical principles that should be considered in surgical reconstruction of spinal tumors. This will be further clarified by more detailed descriptions for individual spinal regions in the subsequent part of the article. In the case of patients with spinal metastases, especially in patients with a median survival time less than a few months, a thorough review of the risks and benefits regarding surgical intervention must be discussed with the patient. However, once the decision for surgery has been made, a biomechanically sound reconstruction should be performed to help restore or maintain the patient's mobility. PMID: 19064056 [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=2023546 Thu, 11 Dec 2008 03:31:16 +0100 2023546 http://www.medworm.com/index.php?rid=2023545&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%3D19064057%26dopt%3DAbstract Authors: Mazel C, Balabaud L, Bennis S, Hansen S Since the first pioneering work in the area of tumors of the spine, medical professionals have sought to determine the proper role of spine surgery in the management of spinal tumors. Experience has proven that spine surgery is effective in the treatment of spinal cord compression for decreasing pain and improving quality of life with low rates of surgical complications. We use several staging systems to assess the patient's prognosis, to determine the best type of tumoral resection in preoperative surgical planning, and to provide guidance as to the best therapeutic option for the patient. In the surgical treatment of spine tumors, one of two opposing strategies must be chosen: (1) palliative surgery with cord decompression and spine st... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2023545 Thu, 11 Dec 2008 03:31:12 +0100 2023545 http://www.medworm.com/index.php?rid=2023544&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%3D19064058%26dopt%3DAbstract Authors: Alamin T, Mayle R More than one-third of patients with cancer have vertebral metastases found at autopsy. Primary and metastatic tumors to the spinal column can lead to pain, instability, and neurologic deficit. Symptomatic lesions are most prevalent in the thoracic spine (70%), followed by the lumbar spine (20%) and cervical spine (10%). Lesions in larger vertebral bodies tend to be asymptomatic given the increased ratio between the diameter of the spinal canal and the traversing nerve roots. PMID: 19064058 [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=2023544 Thu, 11 Dec 2008 03:31:09 +0100 2023544 http://www.medworm.com/index.php?rid=2023543&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%3D19064059%26dopt%3DAbstract Authors: Varga PP, Bors I, Lazary A The evaluation and complex treatments of sacral tumors require a multidisciplinary approach. Because of the complex anatomy conditions and biomechanics of the lumbo-pelvic junction, surgical treatment of sacral neoplasms is one of the most challenging fields in spine. Here, diagnostic process and surgical and nonsurgical treatment options for sacral tumors are summarized based on the literature and on the authors' own experiences. PMID: 19064059 [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=2023543 Thu, 11 Dec 2008 03:31:06 +0100 2023543 http://www.medworm.com/index.php?rid=2023542&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%3D19064060%26dopt%3DAbstract Authors: Bandiera S, Boriani S, Donthineni R, Amendola L, Cappuccio M, Gasbarrini A Morbidity of surgical procedures for spine tumors is expected to be worse than for other conditions. This is particularly true for en bloc resections, a technically demanding procedure. En bloc resections can help improve the prognosis of aggressive benign and malignant tumors in the spine, but the related morbidity is high and sometimes fatal. Reoperations have higher risks because of dissection through scar/fibrosis from previous surgeries and possibly from radiation. Careful planning for treatment is mandatory, and if the surgeon is unsure, referral to a specialty center is necessary. PMID: 19064060 [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=2023542 Thu, 11 Dec 2008 03:31:02 +0100 2023542 http://www.medworm.com/index.php?rid=2023541&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%3D19064061%26dopt%3DAbstract Authors: Swift PS Radiotherapeutic management of vertebral metastases varies based on the extent of disease within the spine and systemically, the histology of the tumor, and the life expectancy of the patient. The goals of pain reduction, structural stability of the axial skeleton, and maintenance of local control for the remainder of the patient's life guide the decision to proceed with a short simple course of standard therapy or a more complex approach with stereotactic regimens. The complex and rigorous processes involved in stereotactic radiotherapy for the spine require close cooperation among the radiation oncologist, neurosurgeon, orthopedic surgeon, and medical oncologist, but the clinical results show that the result is an enhanced quality of life for the patient. PMID: ... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2023541 Thu, 11 Dec 2008 03:30:58 +0100 2023541 http://www.medworm.com/index.php?rid=2023540&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%3D19064062%26dopt%3DAbstract Authors: Sciubba DM, Nguyen T, Gokaslan ZL As survival time increases for many cancers, it is likely that the incidence and prevalence of spinal metastases will increase also. Given that most patients first present with solitary lesions in the spine, proper initial diagnosis and management are of paramount importance in minimizing pain, improving neurologic function, and potentially lengthening survival. Although pain control and standard radiation are still used, spinal stereotactic radiosurgery, vertebroplasty and kyphoplasty, and spinal cord decompression and fusion are now consistently used in aggressive management and offer exciting preliminary results. PMID: 19064062 [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=2023540 Thu, 11 Dec 2008 03:30:54 +0100 2023540 http://www.medworm.com/index.php?rid=2023539&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%3D19064063%26dopt%3DAbstract Authors: Ofluoglu O In most patients who have spinal metastases, treatment is mainly palliative. The conventional surgical methods carry higher risks of complications and postoperative morbidity. Minimally invasive spinal interventions seem to be reasonable alternatives to treat spinal metastatic disease. These procedures can result in less soft tissue trauma, lower blood loss, shorter hospitalization time and are better tolerated by the patients. In this review, the techniques and results of minimally invasive management in spinal metastasis, including percutaneous image-guided interventions (vertebroplasty, kyphoplasty, and radiofrequency ablation) and minimally invasive surgical techniques (endoscopic and minimal access operations), are presented. PMID: 19064063 [PubMed - in pro... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2023539 Thu, 11 Dec 2008 03:30:47 +0100 2023539 http://www.medworm.com/index.php?rid=2023538&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%3D19064064%26dopt%3DAbstract This article introduces the theme of this volume. PMID: 19064064 [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=2023538 Thu, 11 Dec 2008 03:30:27 +0100 2023538 http://www.medworm.com/index.php?rid=1928549&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%3D18803969%26dopt%3DAbstract Authors: Athwal GS PMID: 18803969 [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=1928549 Wed, 01 Oct 2008 04:00:00 +0100 1928549 http://www.medworm.com/index.php?rid=1821346&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%3D18803969%26dopt%3DAbstract Authors: Athwal GS PMID: 18803969 [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=1821346 Thu, 25 Sep 2008 07:06:51 +0100 1821346 http://www.medworm.com/index.php?rid=1821345&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%3D18803970%26dopt%3DAbstract Authors: Robinson BC, Athwal GS, Sanchez-Sotelo J, Rispoli DM The decision to operate and the selection of the appropriate surgical modality for proximal humerus fractures are largely based on the fracture pattern. Understanding the particular fracture pattern in each case is complicated. Most well-accepted classification systems were developed based on radiographs complemented by intraoperative findings. Three-dimensional reconstructions based on CT currently available in most institutions allow a much better understanding of complex fractures. Modern thinking about fracture classification probably should be revisited in the light of improved imaging techniques. PMID: 18803970 [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=1821345 Thu, 25 Sep 2008 07:06:47 +0100 1821345 http://www.medworm.com/index.php?rid=1821344&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%3D18803971%26dopt%3DAbstract Authors: Magovern B, Ramsey ML Closed reduction and percutaneous fixation is a viable treatment option for displaced two-part, three-part, and valgus-impacted four-part proximal humerus fractures. Despite biomechanical studies demonstrating inferior stability compared with plate and intramedullary nail constructs, percutaneous fixation offers a minimally invasive approach with potential clinical advantages. Decreased scarring, improved cosmesis, and lower rates of avascular necrosis have been reported. Potential complications include pin migration, infection, avascular necrosis, neurovascular injury, and malunion. Clinical outcomes have been comparable with conventional techniques, with studies reporting approximately 70% good to excellent results. PMID: 18803971 [PubMed - in proce... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1821344 Thu, 25 Sep 2008 07:06:44 +0100 1821344 http://www.medworm.com/index.php?rid=1821343&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%3D18803972%26dopt%3DAbstract Authors: Young AA, Hughes JS Controversy surrounds the optimal technique for fixation of displaced fractures, although locked intramedullary nailing is emerging as a preferred technique in managing displaced proximal humerus fractures in appropriately selected patients. This technique provides stable fracture fixation allowing early postoperative mobilization critical in ensuring a pain-free shoulder with a functional range of motion. Additional advantages include the ability to insert by way of a minimally invasive approach with limited soft tissue dissection, achieve accurate anatomic reduction, provide a secure construct even in the situation of osteopenic bone or comminution, and manage fractures of the proximal humerus extending into the shaft. PMID: 18803972 [PubMed - in proc... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1821343 Thu, 25 Sep 2008 07:06:40 +0100 1821343 http://www.medworm.com/index.php?rid=1821342&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%3D18803973%26dopt%3DAbstract Authors: Drosdowech DS, Faber KJ, Athwal GS Open reduction of proximal humeral fractures has the advantage of providing direct control over each fracture fragment and permitting anatomic reduction and fixation with advanced devices. Modern fixed-angle locking plates designed specifically for proximal humerus fractures have allowed the expansion of surgical indications permitting surgeons to address more complicated fractures. Advanced preoperative imaging and fluoroscopy allow a better understanding of fracture patterns and permit the surgeon to use this knowledge intraoperatively. Research is required to further validate fracture classification systems, to develop surgical guidelines for decision making, and to compare the outcomes of the various treatments options for proximal humeru... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1821342 Thu, 25 Sep 2008 07:06:37 +0100 1821342 http://www.medworm.com/index.php?rid=1821341&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%3D18803974%26dopt%3DAbstract Authors: Krishnan SG, Bennion PW, Reineck JR, Burkhead WZ Proximal humerus fractures are the most common fractures of the shoulder girdle, and initial management of these injuries often determines final outcome. When arthroplasty is used to manage proximal humeral fractures, surgery remains technically demanding, and outcomes have been unpredictable. Recent advances in both technique and prosthetic implants have led to more successful and reproducible results. Key technical points include restoration of the Gothic arch, anatomic tuberosity reconstruction, and minimal soft tissue dissection. PMID: 18803974 [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=1821341 Thu, 25 Sep 2008 07:06:33 +0100 1821341 http://www.medworm.com/index.php?rid=1821340&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%3D18803975%26dopt%3DAbstract Authors: Martin TG, Iannotti JP Reverse shoulder arthroplasty (RSA) has a successful clinical record when used for treatment of arthropathy accompanied by rotator cuff insufficiency. Efforts to use the same technology for other conditions involving insufficient cuff function are related to proximal humeral fracture described in this review for which RSA has shown promise are treatment of failed hemiarthroplasty for treatment of proximal humeral fractures and treatment of complex fracture sequelae. Specific conclusions as yet are difficult to reach. Future studies are needed to determine if supplemental soft tissue procedures or modification of implant design will serve to improve functional outcome in this difficult-to-treat subset of patients. PMID: 18803975 [PubMed - in process] ... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1821340 Thu, 25 Sep 2008 07:06:30 +0100 1821340 http://www.medworm.com/index.php?rid=1821339&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%3D18803976%26dopt%3DAbstract This article outlines a diagnostic work-up and treatment approach for the various types of scapular fractures. The approach helps guide decision making on operative versus nonoperative treatment based on what is known regarding prognosis and outcomes of management. Operative technique and fixation strategies are discussed for the common fracture patterns along with guidelines for postsurgical shoulder rehabilitation. PMID: 18803976 [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=1821339 Thu, 25 Sep 2008 07:06:26 +0100 1821339 http://www.medworm.com/index.php?rid=1821338&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%3D18803977%26dopt%3DAbstract Authors: Cheung EV, Sperling JW Surgical treatment of proximal humeral nonunions and malunions are technically challenging. Osteosynthesis with bone grafting for the treatment of nonunions is indicated in young, active patients with adequate bone stock in the proximal fragment and preservation of the glenohumeral articular surfaces. Corrective osteotomy may be a reasonable option for proximal humeral malunions in young patients without evidence of degenerative joint disease. Arthroplasty for proximal humerus nonunions and malunions has a guarded outcome because of limitations in shoulder motion, but pain relief is more consistently improved upon. PMID: 18803977 [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=1821338 Thu, 25 Sep 2008 07:06:23 +0100 1821338 http://www.medworm.com/index.php?rid=1821337&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%3D18803978%26dopt%3DAbstract This article provides an easily reproducible yet comprehensive approach to the diagnosis, identification, and treatment of neurovascular injuries following shoulder trauma. PMID: 18803978 [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=1821337 Thu, 25 Sep 2008 07:06:19 +0100 1821337 http://www.medworm.com/index.php?rid=1821336&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%3D18803979%26dopt%3DAbstract This article is based on the currently available clinical evidence on the evolving management of acute clavicle fractures. PMID: 18803979 [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=1821336 Thu, 25 Sep 2008 07:06:16 +0100 1821336 http://www.medworm.com/index.php?rid=1821335&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%3D18803980%26dopt%3DAbstract This article reviews the anatomy, pathophysiology, clinical evaluation, and treatment of anterior shoulder instability. PMID: 18803980 [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=1821335 Thu, 25 Sep 2008 07:06:11 +0100 1821335 http://www.medworm.com/index.php?rid=1821334&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%3D18803981%26dopt%3DAbstract This article provides a detailed discussion of the classification, pathoanatomy, diagnosis, and treatment of traumatic posterior glenohumeral dislocation. PMID: 18803981 [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=1821334 Thu, 25 Sep 2008 07:06:08 +0100 1821334 http://www.medworm.com/index.php?rid=1821333&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%3D18803982%26dopt%3DAbstract Authors: Macdonald PB, Lapointe P Acromioclavicular (AC) joint injuries are a frequent diagnosis following an acute shoulder injury. The literature on AC joint dislocation is extensive, reflecting the intense debate surrounding the topic. The choice of treatment is influenced by factors including the type of injury, the patient's occupation, the patient's past medical history, the acuity of the injury, and patient expectations. Sternoclavicular (SC) joint dislocation is an uncommon injury. The treatment of acute anterior SC joint dislocations is controversial. It is difficult to study with a well-designed prospective study because of the low frequency of this injury. Posterior dislocations are much less common than anterior dislocations. Posterior dislocations, however, are more seriou... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1821333 Thu, 25 Sep 2008 07:06:03 +0100 1821333 http://www.medworm.com/index.php?rid=1781015&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%3D18602556%26dopt%3DAbstract Authors: Leadbetter WB PMID: 18602556 [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=1781015 Tue, 01 Jul 2008 04:00:00 +0100 1781015 http://www.medworm.com/index.php?rid=1601176&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%3D18602556%26dopt%3DAbstract Authors: Leadbetter WB PMID: 18602556 [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=1601176 Tue, 01 Jul 2008 04:00:00 +0100 1601176 http://www.medworm.com/index.php?rid=1601175&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%3D18602557%26dopt%3DAbstract Authors: Grelsamer RP, Dejour D, Gould J Faced with a patient suffering from patellofemoral arthritis, the surgeon must determine the pathophysiology of the condition, because different causes demand different treatments. Possible causes include malalignment, patellofemoral dysplasia, patellofemoral instability, patellofemoral trauma, obesity, osteoarthritis, inflammatory arthritis, and a genetic predisposition. Arthritis secondary to malalignment, dysplasia, instability, or trauma is less likely than arthritis secondary to the other causes to progress to femorotibial arthritis. PMID: 18602557 [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=1601175 Tue, 01 Jul 2008 04:00:00 +0100 1601175 http://www.medworm.com/index.php?rid=1601174&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%3D18602558%26dopt%3DAbstract Authors: Bhave A, Baker E In this article we discuss causes of patellofemoral dysfunction, the treatment algorithm of nonsurgical therapy modalities, and what constitutes a quality rehabilitation protocol for a patient with patellofemoral dysfunction. PMID: 18602558 [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=1601174 Tue, 01 Jul 2008 04:00:00 +0100 1601174 http://www.medworm.com/index.php?rid=1601173&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%3D18602559%26dopt%3DAbstract Authors: Teitge RA The literature regarding suggested treatments for patellofemoral problems is often conflicting and confusing. In this discussion I present the approach I take in evaluating and considering surgery for patients with any of a wide variety of anterior knee pain problems. It has been useful to concentrate on the biomechanics-the mechanical consequence to each tissue affected by any surgical change. In the proposed paradigm, it is assumed that pain is the result of an abnormal load-related either to tension or compression-being applied to each tissue in question. The challenge is to understand how and why that abnormal load was generated. It is essential to make an independent assessment of the condition of the lower limb skeleton, the patellofemoral ligaments, and the tr... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1601173 Tue, 01 Jul 2008 04:00:00 +0100 1601173 http://www.medworm.com/index.php?rid=1601172&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%3D18602560%26dopt%3DAbstract This article describes an approach to the treatment of recurrent patellar instability that considers the unique features and expectations of the patient rather than using a generic algorithm. PMID: 18602560 [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=1601172 Tue, 01 Jul 2008 04:00:00 +0100 1601172 http://www.medworm.com/index.php?rid=1601171&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%3D18602561%26dopt%3DAbstract Authors: Farr J Patellofemoral articular cartilage lesions are challenging to treat. While treatment with tibial tuberosity anteromedialization (AMZ) is effective for isolated distal lateral patellar lesions, other patellar or trochlear lesions have suboptimal outcomes with AMZ. Historically, when autologous cultured chondroctye implantation (ACI) was used at the patellofemoral compartment without optimizing the contact areas, the results were poor. In recent years, the combination of AMZ and ACI has yielded overall outcomes superior to either technique used in isolation for large patellar and trochlear chondral lesions. PMID: 18602561 [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=1601171 Tue, 01 Jul 2008 04:00:00 +0100 1601171 http://www.medworm.com/index.php?rid=1601170&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%3D18602562%26dopt%3DAbstract Authors: Davidson PA, Rivenburgh D Prosthetic patellofemoral inlay resurfacing is a novel treatment concept for degenerative and focal arthrosis of the patellofemoral joint. The theoretic basis of this type of arthroplasty entails recreating ambient anatomy based upon intraoperative topographic mapping. The implant is intrinsically stable by virtue of the inset position relative to the surrounding joint surface. Articular resurfacing, rather than traditional replacement arthroplasty, represents an extension of the concepts of biologic joint restoration. Early results have shown great efficacy. This surgery may be appropriate for a wide variety of indications, including younger patients and those with focal patellofemoral disease concurrent with morphologic or alignment abnormalities. ... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1601170 Tue, 01 Jul 2008 04:00:00 +0100 1601170 http://www.medworm.com/index.php?rid=1601169&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%3D18602563%26dopt%3DAbstract Authors: Lonner JH The results of patellofemoral arthroplasty have been improved over the three decades that the procedure has been used for the treatment of patellofemoral arthritis. Specifically, there has been a reduction in the incidence of patellofemoral-related problems, such as patellar maltracking and catching, after patellofemoral arthroplasty. While these problems were often attributed to errors in surgical technique or component malposition, it is likely that many were related to flawed trochlear component designs. Contemporary patellofemoral arthroplasties have a reduced incidence of the problems related to patellar maltracking that typically plagued earlier generation designs. Further study will likely prove contemporary patellofemoral arthroplasty to be an effective treat... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1601169 Tue, 01 Jul 2008 04:00:00 +0100 1601169 http://www.medworm.com/index.php?rid=1601168&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%3D18602564%26dopt%3DAbstract This article reviews the design rationale, excellent clinical history, and straightforward surgical technique of a unique approach to patellofemoral arthroplasty that incorporates a customized trochlear prosthesis designed to fit the individual patient's patellofemoral groove. Clinical results using this customized approach demonstrate that it is a safe and effective treatment option for patients who have isolated patellofemoral arthritis. PMID: 18602564 [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=1601168 Tue, 01 Jul 2008 04:00:00 +0100 1601168 http://www.medworm.com/index.php?rid=1601167&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%3D18602565%26dopt%3DAbstract Authors: Leadbetter WB Patellofemoral degenerative disease encompasses a spectrum of articular wear from severe chondrosis to advanced arthrosis. The rationale and timing for many operative approaches currently advocated for the relief of symptomatic patellofemoral degeneration can be the subject of intense surgical debate in any one patient. Unfortunately, the limited efficacy of many commonly advocated operative procedures has left a legacy of patellofemoral disability in many younger individuals. While total knee arthroplasty has an established role in the treatment of advanced patellofemoral arthritis in the older patient (age >60 years), the performance of what some have called "a knee joint amputation" in younger patients (age <45 years) remains controversial and less accep... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1601167 Tue, 01 Jul 2008 04:00:00 +0100 1601167 http://www.medworm.com/index.php?rid=1601166&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%3D18602566%26dopt%3DAbstract Authors: Delanois RE, McGrath MS, Ulrich SD, Marker DR, Seyler TM, Bonutti PM, Mont MA Many procedures have been used to treat advanced isolated patellofemoral arthritis, with varying results. Patellofemoral arthroplasty (PFA) is a bone-conserving procedure that has shown short-term success but has relatively high revision rates. Total knee arthroplasty (TKA) has been recommended for treatment of this disease in patients who are older than 60 years of age. Recent literature indicates that PFA is most successful in patients who have isolated patellofemoral arthritis secondary to trochlear dysplasia or patellar fracture and in patients who are younger than 60 years; TKA is recommended for older patients who have primary or idiopathic isolated patellofemoral arthritis. PMID: 18602566 ... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1601166 Tue, 01 Jul 2008 04:00:00 +0100 1601166 http://www.medworm.com/index.php?rid=1553749&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%3D18374804%26dopt%3DAbstract Authors: Steinmann SP PMID: 18374804 [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=1553749 Tue, 01 Apr 2008 04:00:00 +0100 1553749 http://www.medworm.com/index.php?rid=1341526&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%3D18374804%26dopt%3DAbstract Authors: Steinmann SP PMID: 18374804 [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=1341526 Tue, 01 Apr 2008 04:00:00 +0100 1341526 http://www.medworm.com/index.php?rid=1341525&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%3D18374805%26dopt%3DAbstract Authors: Bryce CD, Armstrong AD The elbow is a complex, highly constrained joint that provides critical range of motion to the upper extremity needed for performing the normal activities of daily living. The elbow is protected by a fortress of individual static and dynamic constraints that function together to provide stability. Knowing the identity and specific functions of each stabilizing structure facilitates appropriate diagnosis and treatment of the acutely injured elbow. PMID: 18374805 [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=1341525 Tue, 01 Apr 2008 04:00:00 +0100 1341525 http://www.medworm.com/index.php?rid=1341524&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%3D18374806%26dopt%3DAbstract Authors: Kuhn MA, Ross G The elbow is the second most commonly dislocated major joint in the adult age group and the most commonly dislocated major joint in the pediatric population. The mechanism of injury and resultant ligamentous disruption pattern have been investigated and noted. Classification of elbow dislocation is well described, and allows for appropriate treatment and rehabilitation. For stable reductions, an aggressive early ROM protocol emphasizing active motion has been helpful for maximizing final range of motion and minimizing extension loss. Associated injuries with elbow dislocation are common and can result in significant morbidity if not diagnosed and treated. PMID: 18374806 [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=1341524 Tue, 01 Apr 2008 04:00:00 +0100 1341524 http://www.medworm.com/index.php?rid=1341523&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%3D18374807%26dopt%3DAbstract Authors: Shrader MW Elbow fractures in children are extremely common, making up approximately 15% of all fractures in pediatric patients. The unique radiographic anatomy of the pediatric elbow, along with the potential for neurovascular compromise, often provokes anxiety in orthopedic surgeons. A thorough understanding of the anatomy and treatment principles makes the care for these children more straightforward, however. The distal humerus makes up approximately 85% of all elbow fractures in children. The most common fractures of the distal humerus in children are supracondylar humerus fractures, lateral condyle fractures, medial epicondyle fractures, and transphyseal humerus fractures. Each of these fractures is discussed in detail, outlining their radiographic features, principles o... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1341523 Tue, 01 Apr 2008 04:00:00 +0100 1341523 http://www.medworm.com/index.php?rid=1341522&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%3D18374808%26dopt%3DAbstract Authors: Rosenblatt Y, Athwal GS, Faber KJ Radial head fractures are the most common type of elbow fractures. Although a consensus has emerged that favors the nonsurgical treatment of undisplaced fractures, controversy surrounds the treatment of displaced radial head fractures. Further research is necessary to provide a better scientific rationale for making treatment recommendations. Options for the treatment of displaced fractures include nonoperative management, fragment excision, whole head excision, open reduction and internal fixation, and radial head arthroplasty. The purpose of this article is to review the mechanisms that result in radial head fracture, to describe important physical findings that assist in identifying injuries associated with radial head fractures, and to def... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1341522 Tue, 01 Apr 2008 04:00:00 +0100 1341522 http://www.medworm.com/index.php?rid=1341521&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%3D18374809%26dopt%3DAbstract Authors: Pollock JW, Faber KJ, Athwal GS Intra-articular fractures of the distal humerus are among the most challenging fractures to manage. Nonoperative treatment, although appropriate for some patients, often leads to loss of motion and unsatisfactory functional outcomes. Over the last 2 decades, enhanced operative techniques and implant designs have improved the reduction and stability of distal humerus fractures leading to better outcomes. Careful preoperative planning, adequate exposure, and stable fixation facilitating early mobilization are essential to achieve successful outcomes with internal fixation. PMID: 18374809 [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=1341521 Tue, 01 Apr 2008 04:00:00 +0100 1341521 http://www.medworm.com/index.php?rid=1341520&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%3D18374810%26dopt%3DAbstract This article focuses on the evaluation and management of distal humerus fractures with prosthetic replacement. PMID: 18374810 [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=1341520 Tue, 01 Apr 2008 04:00:00 +0100 1341520 http://www.medworm.com/index.php?rid=1341519&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%3D18374811%26dopt%3DAbstract Authors: Grace SP, Field LD Chronic medial elbow instability can be a debilitating problem for the throwing athlete. It affects non-throwers much less commonly regarding activities of daily living. Instability can occur as a result of repetitive microtrauma over a long period of time or as a result of a single traumatic event. If left untreated, the resulting sequelae can lead to chronic pain, ulnar neuritis, and inability to compete/work. PMID: 18374811 [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=1341519 Tue, 01 Apr 2008 04:00:00 +0100 1341519 http://www.medworm.com/index.php?rid=1341518&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%3D18374812%26dopt%3DAbstract Authors: Cheung EV Posterolateral rotatory instability of the elbow is the most common pattern of chronic lateral elbow instability. The primary lesion in posterolateral rotatory instability is injury or attenuation of the lateral ulnar collateral ligament. Posterolateral rotatory instability is diagnosed on the basis of careful history taking and specific physical examination techniques. Reconstruction of the lateral ulnar collateral ligament with repair of the surrounding soft tissue structures is recommended in patients who have symptoms of recurrent lateral instability. Open and arthroscopic reconstruction techniques have resulted in improvement of elbow function and satisfactory results in most patients, although mild limitation in terminal extension of the elbow is a common findi... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1341518 Tue, 01 Apr 2008 04:00:00 +0100 1341518 http://www.medworm.com/index.php?rid=1341517&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%3D18374813%26dopt%3DAbstract Authors: Veillette CJ, Steinmann SP Approximately 10% of fractures about the adult elbow consist of fractures of the olecranon process of the ulna and range from simple nondisplaced fractures to complex fracture-dislocations of the elbow. Several treatment options for internal fixation have been described, including tension-band wiring, plate fixation, intramedullary screw fixation, and triceps advancement after fragment excision. The method of internal fixation is chosen based primarily on fracture type. Because olecranon fractures are all intra-articular injuries, they require anatomic or essentially normal surface reduction and trochlear notch contour for predictable outcomes. In addition, fixation must be stable enough to permit early mobilization to avoid significant elbow stiffne... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1341517 Tue, 01 Apr 2008 04:00:00 +0100 1341517 http://www.medworm.com/index.php?rid=1341516&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%3D18374814%26dopt%3DAbstract This article focuses on the proper evaluation and treatment of distal biceps tendon ruptures with special attention focused on recently developed techniques. A review of the recent clinical literature will accompany an overview of pertinent biomechanical studies and an explanation of the risks and benefits of the most popular surgical techniques for distal biceps repair. PMID: 18374814 [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=1341516 Tue, 01 Apr 2008 04:00:00 +0100 1341516 http://www.medworm.com/index.php?rid=1341515&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%3D18374815%26dopt%3DAbstract This article provides an overview of treatment options for elbow coverage, with specific emphasis on the use of these four specific flaps. PMID: 18374815 [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=1341515 Tue, 01 Apr 2008 04:00:00 +0100 1341515 http://www.medworm.com/index.php?rid=1077415&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%3D18061761%26dopt%3DAbstract Authors: Bert JM PMID: 18061761 [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=1077415 Sat, 08 Dec 2007 00:35:28 +0100 1077415 http://www.medworm.com/index.php?rid=1077414&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%3D18061762%26dopt%3DAbstract This article reviews the possibilities of multiple types of ancillary service lines available for the orthopedic group practice. PMID: 18061762 [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=1077414 Sat, 08 Dec 2007 00:35:26 +0100 1077414 http://www.medworm.com/index.php?rid=1077413&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%3D18061763%26dopt%3DAbstract This article discusses the elements that are essential for a valid feasibility study. PMID: 18061763 [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=1077413 Sat, 08 Dec 2007 00:35:24 +0100 1077413 http://www.medworm.com/index.php?rid=1077412&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%3D18061764%26dopt%3DAbstract This article discusses the advantages and disadvantages of a hospital physician-group joint venture. PMID: 18061764 [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=1077412 Sat, 08 Dec 2007 00:35:22 +0100 1077412 http://www.medworm.com/index.php?rid=1077411&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%3D18061765%26dopt%3DAbstract This article discusses the complex and time-consuming demands of developing the OASC, and having it operate efficiently. It points out how experts can assist in developing and managing a highly efficient center, freeing the orthopedist to concentrate on performing surgery in an environment that is clinically, financially, and personally rewarding. PMID: 18061765 [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=1077411 Sat, 08 Dec 2007 00:35:19 +0100 1077411 http://www.medworm.com/index.php?rid=1077410&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%3D18061766%26dopt%3DAbstract This article discusses some of the key elements that are essential in creating an overall effective business plan for the group medical practice. PMID: 18061766 [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=1077410 Sat, 08 Dec 2007 00:35:17 +0100 1077410 http://www.medworm.com/index.php?rid=1077409&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%3D18061767%26dopt%3DAbstract This article focuses on the idea of gain-sharing, defined as engagement between the hospitals and physician to create effective joint processes, common outcome measures, joint accountability, and a sharing of results. Gain-sharing is a logical approach to addressing fragmented care, cost containment, and improved clinical outcomes. In particular, this article focuses on contracts under which a hospital or institutional provider retains an independent clinic or physicians to tackle specific issues of service line performance. PMID: 18061767 [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=1077409 Sat, 08 Dec 2007 00:35:15 +0100 1077409 http://www.medworm.com/index.php?rid=1077408&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%3D18061768%26dopt%3DAbstract This article elucidates this general trend in orthopedic imaging and examines practical aspects of the physician/practice-owned imaging center. PMID: 18061768 [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=1077408 Sat, 08 Dec 2007 00:35:13 +0100 1077408 http://www.medworm.com/index.php?rid=1077407&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%3D18061769%26dopt%3DAbstract This article discusses the issues that are important to address in creating a physician-owned physical therapy department. PMID: 18061769 [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=1077407 Sat, 08 Dec 2007 00:35:11 +0100 1077407 http://www.medworm.com/index.php?rid=1077406&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%3D18061770%26dopt%3DAbstract This article provides a process to evaluate the likelihood of establishing a financially viable occupational medicine program (OMP), and discusses opportunities in which the occupational medicine clinic can partner with employers to help them to reduce the occurrence of work-related injuries and provide a safer work environment. Not all germane topics are discussed-employers must address safety and ergonomic issues within the workplace as well as those that a successful OMP is designed to address. However, the OMP should be a readily available resource for any of these issues. Common occupational challenges and opportunities also are examined. PMID: 18061770 [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=1077406 Sat, 08 Dec 2007 00:35:10 +0100 1077406 http://www.medworm.com/index.php?rid=1077405&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%3D18061771%26dopt%3DAbstract This article describes how to construct and follow such a plan. PMID: 18061771 [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=1077405 Sat, 08 Dec 2007 00:35:07 +0100 1077405 http://www.medworm.com/index.php?rid=1077404&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%3D18061772%26dopt%3DAbstract This article discusses the factors that contribute to the success of an independent medical examination company. It considers opportunity costs, the regulatory environment, the assessment of the competition and the customer base, and marketing principles. It also details the management expertise and the staff skill sets required for a successful venture. PMID: 18061772 [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=1077404 Sat, 08 Dec 2007 00:35:05 +0100 1077404 http://www.medworm.com/index.php?rid=1077403&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%3D18061773%26dopt%3DAbstract This article focuses on how state and federal laws shape the ability of an orthopedic physician to offer ancillary services, whether as an individual, through a group practice, or as part of a joint venture. It focuses on how the Stark law, the Medicare anti-kickback statute, state anti-kickback, fee-splitting provisions, certificate of need laws, and various Medicare billing and supervision requirements impact the provision of ancillary services. It also briefly discusses how physicians should prepare for and respond to government investigations. PMID: 18061773 [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=1077403 Sat, 08 Dec 2007 00:35:03 +0100 1077403 http://www.medworm.com/index.php?rid=1077402&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%3D18061774%26dopt%3DAbstract Authors: Cimasi R The health care delivery system in the United States has witnessed more dramatic changes during the last decade than it had since the passage of Medicare. The managed care revolution and changes in reimbursement for Medicare services have forced providers to look for more efficient ways to provide services as well as for additional sources of revenue- and margin-producing business. The move toward specialized inpatient and outpatient facilities, often owned by physicians, is a natural reaction to these significant changes. These developments have resulted a "turf war" between physicians and hospitals over who should control these revenues. PMID: 18061774 [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=1077402 Sat, 08 Dec 2007 00:35:01 +0100 1077402 http://www.medworm.com/index.php?rid=1077401&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%3D18061775%26dopt%3DAbstract This article explores the current reasons why orthopedic surgeons might consider the adoption of an electronic medical record system in their practices today. The costs and benefits as well as the barriers to implementation are discussed. PMID: 18061775 [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=1077401 Sat, 08 Dec 2007 00:34:59 +0100 1077401 http://www.medworm.com/index.php?rid=1077400&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%3D18061776%26dopt%3DAbstract This article describes the elements necessary for successful restructuring. PMID: 18061776 [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=1077400 Sat, 08 Dec 2007 00:34:57 +0100 1077400 http://www.medworm.com/index.php?rid=965453&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%3D17945125%26dopt%3DAbstract Authors: Stans AA PMID: 17945125 [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=965453 Mon, 01 Oct 2007 04:00:00 +0100 965453 http://www.medworm.com/index.php?rid=965452&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%3D17945126%26dopt%3DAbstract Authors: Shaughnessy WJ Orthotic treatment with a brace remains the treatment of choice for adolescent idiopathic scoliosis in the immature patient with documented progression or a curve magnitude of 25 degrees to 40 degrees . Studies of natural history and bracing consistently show high rates of curve progression and surgery with observation and significantly less so with brace treatment. Brace treatment is difficult in overweight patients and challenging in males. Many of the variations in brace study results may be attributable to differing rates of compliance with brace wear, a parameter that is becoming easier to measure. PMID: 17945126 [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=965452 Mon, 01 Oct 2007 04:00:00 +0100 965452 http://www.medworm.com/index.php?rid=965451&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%3D17945127%26dopt%3DAbstract Authors: D'Astous JL, Sanders JO There is little consensus among spinal deformity surgeons as to the best way to treat infantile or early-onset scoliosis. Bracing may or may not be effective, and subcutaneous rods have a high complication rate. Current techniques of casting as championed by Min Mehta and Jean Dubousset are presented as is the use of halo-gravity traction for the more severe cases. We firmly believe that "outdated" techniques, such as casting and traction, still play an important role in the treatment of this challenging problem. PMID: 17945127 [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=965451 Mon, 01 Oct 2007 04:00:00 +0100 965451 http://www.medworm.com/index.php?rid=965450&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%3D17945128%26dopt%3DAbstract Authors: Sarwark J, Sarwahi V The outcome of spinal fusion in neuromuscular scoliosis demonstrates a consistently high satisfaction rate among parents and caretakers. It is somewhat more difficult to determine the functional benefits in individual patients, especially in those with the most severe involvement. Even in those children, a predicted 70% survival rate at 11 years has been documented following surgery. Scoliosis is common in children with neuromuscular diseases, especially cerebral palsy. Most of these children need stabilization to enhance their quality of life by improving sitting ability. Studies continue to show a high family satisfaction and caregiver satisfaction following spine reconstructive surgery for neuromuscular scoliosis and other spine deformities. PMID: 1... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=965450 Mon, 01 Oct 2007 04:00:00 +0100 965450 http://www.medworm.com/index.php?rid=965449&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%3D17945129%26dopt%3DAbstract This article reviews the general surgical principles that need to be followed to treat these patients safely. The numerous surgical procedures available for treating these patients also are reviewed. PMID: 17945129 [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=965449 Mon, 01 Oct 2007 04:00:00 +0100 965449 http://www.medworm.com/index.php?rid=965448&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%3D17945130%26dopt%3DAbstract The objectives of this article are twofold. The first is to discuss the surgical experience in patients who have Lenke 1C (King type II) curves, including the experience with newer instrumentation. These patients present a significant challenge to the deformity surgeon because they have structural thoracic deformities and significant, but nonstructural, lumbar curves. Over the years, selective instrumentation and fusion of the thoracic curve have been the primary approach to preserve motion of the lumbar segments, and thus, improve the long-term outlook. This strategy has been undertaken with the expectation that the uninstrumented lumbar curve will allow for a well-balanced spinal column postoperatively. The second objective of this article is to present basic strategies that may be helpf... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=965448 Mon, 01 Oct 2007 04:00:00 +0100 965448 http://www.medworm.com/index.php?rid=965447&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%3D17945131%26dopt%3DAbstract Authors: Rose PS, Lenke LG Patients presenting with adolescent idiopathic scoliosis may be classified into one of 42 curve types using the system of Lenke and associates. This classification system provides a template to guide the selection of surgical approaches and fusion levels for patients undergoing surgical treatment of adolescent idiopathic scoliosis. PMID: 17945131 [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=965447 Mon, 01 Oct 2007 04:00:00 +0100 965447 http://www.medworm.com/index.php?rid=965446&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%3D17945132%26dopt%3DAbstract Authors: Upasani VV, Newton PO Surgical management of idiopathic scoliosis is based on the natural history of this spinal disorder and on the likelihood of developing a worsening deformity. Anterior surgical treatments continue to evolve and provide advantages over posterior procedures in specific instances. Open and thoracoscopic anterior approaches allow direct access to the anterior stabilizing structures of the spine, enable mobilization of a rigid deformity, and provide a large surface area for arthrodesis. Thoracoscopic procedures provide a more cosmetically appealing alternative to a large midline posterior or anterolateral thoracotomy scar. Although the indications and contraindications for anterior versus posterior surgical intervention (for thoracic and thoracolumbar curve pa... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=965446 Mon, 01 Oct 2007 04:00:00 +0100 965446 http://www.medworm.com/index.php?rid=965445&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%3D17945133%26dopt%3DAbstract Authors: Guille JT, D'Andrea LP, Betz RR The recent investigations of convex anterior vertebral body stapling have offered promising early results with use of improved implants and techniques. The use of a shape memory alloy staple tailored to the size of the vertebral body, the application of several staples per level, the instrumentation of the Cobb levels of all curves, and the employment of minimally invasive thoracoscopic approaches all offer substantial improvements over previous fusionless techniques. Patient selection may also play a role in the current success of these fusionless treatments, with perhaps the ideal candidates for this intervention possessing smaller and more flexible curves. Long-term results of the effects on the instrumented motion segments and adjacent spine... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=965445 Mon, 01 Oct 2007 04:00:00 +0100 965445 http://www.medworm.com/index.php?rid=965444&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%3D17945134%26dopt%3DAbstract This article provides an overview of current methods and outcomes for spinal instrumentation in the growing spine. PMID: 17945134 [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=965444 Mon, 01 Oct 2007 04:00:00 +0100 965444 http://www.medworm.com/index.php?rid=965443&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%3D17945135%26dopt%3DAbstract Authors: Crawford AH, Herrera-Soto J Neurofibromatosis type 1 (NF-1) is a multisystemic disease. It may manifest as abnormalities of the nervous tissue, bones, soft tissue, and skin. The manifestations of NF-1 vary from person to person and range from subclinical to severe. Individuals who carry the gene eventually exhibit some clinical feature of the disease. The penetrance for NF-1 nears 100% during adulthood. Skeletal abnormalities are common in NF-1, with most patients presenting with some type of bony dysplasia. The orthopedic complications usually appear early. They include spinal deformities, such as scoliosis or kyphosis, congenital tibial dysplasia with bowing and pseudarthrosis of the tibia, forearm, other bones, as well as overgrowth phenomenon of an extremity, and soft tiss... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=965443 Mon, 01 Oct 2007 04:00:00 +0100 965443 http://www.medworm.com/index.php?rid=965442&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%3D17945136%26dopt%3DAbstract Authors: Demetracopoulos CA, Sponseller PD Marfan syndrome is a connective tissue disease that affects the skeletal system among other organ systems. Kyphoscoliosis, spondylolisthesis, and atlantoaxial subluxation are common spinal deformities in Marfan syndrome, and distinctive vertebral morphology within such patients presents significant treatment challenges. Although most scoliosis curves in patients who have Marfan syndrome are minor, those that require treatment progress rapidly; brace treatment has proven ineffective for most patients. Surgical correction is associated with complications, such as failure of fixation and additional deformity; however good results are possible when consideration is given to the unique challenges presented by patients who have Marfan syndrome. ... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=965442 Mon, 01 Oct 2007 04:00:00 +0100 965442 http://www.medworm.com/index.php?rid=739303&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%3D17629979%26dopt%3DAbstract Authors: Samartzis D, Shen FH, Anderson DG PMID: 17629979 [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=739303 Sun, 01 Jul 2007 04:00:00 +0100 739303 http://www.medworm.com/index.php?rid=739302&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%3D17629980%26dopt%3DAbstract This article provides a succinct historical perspective of the development of spine surgery from the more traditional, open procedures to the use of more "minimal access" or minimally invasive spine surgery procedures. PMID: 17629980 [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=739302 Sun, 01 Jul 2007 04:00:00 +0100 739302 http://www.medworm.com/index.php?rid=739301&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%3D17629981%26dopt%3DAbstract Authors: Lee SH, Lee JH, Choi WC, Jung B, Mehta R The percutaneous endoscopic discectomy (PECD) with working channel endoscope (WSH) endoscopy set could be a safe and effective minimally invasive surgical option for non-contained cervical disc herniation in selected patients. Judicious use of the end-firing Ho: Yttrium-Aluminium-Garnet (YAG) laser for both decompressive and thermoannuloplasty effect during the percutaneous endoscopic cervical annuloplasty (PECA) is mandatory in order to prevent possible injury to spinal cord or root. Although the percutaneous cervical stabilization (PCS) using the cervical B-Twin may not completely replace the cervical arthrodesis, this minimally invasive procedure can preserve anterior structures and thereby retain segmental stability and prevent the ... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=739301 Sun, 01 Jul 2007 04:00:00 +0100 739301 http://www.medworm.com/index.php?rid=739300&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%3D17629982%26dopt%3DAbstract Authors: Gala VC, O'toole JE, Voyadzis JM, Fessler RG Cervical microendoscopic foraminotomy/discectomy and cervical microendoscopic decompression of stenosis are highly effective, minimally invasive approaches to cervical radiculopathy due to foraminal osteophytes or lateral disc herniation and cervical spondylotic myelopathy, respectively. The operative technique utilized in each of these procedures is described in detail, together with the advantages of the minimally invasive technique over traditional open approaches. Complication avoidance and management is also discussed. PMID: 17629982 [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=739300 Sun, 01 Jul 2007 04:00:00 +0100 739300 http://www.medworm.com/index.php?rid=739299&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%3D17629983%26dopt%3DAbstract This article discusses a novel minimally invasive procedure for the surgical treatment of thoracic disc herniations referred to as a minimally invasive thoracic microdiscectomy. It uses a series of muscle dilators, a tubular retractor, and microscopic visualization by way of a posterolateral approach in an effort to minimize many of the complications that are associated with the more traditional approaches. PMID: 17629983 [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=739299 Sun, 01 Jul 2007 04:00:00 +0100 739299 http://www.medworm.com/index.php?rid=739298&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%3D17629984%26dopt%3DAbstract Authors: Yeung AT, Yeung CA Traditionally, minimally invasive techniques for surgical discectomy have been defined as smaller incisions, tubular retractors, microscopically assisted tissue dissection, and conservative removal of only extruded or sequestered nucleus pulposus with preservation of the annulus. The first truly minimally invasive technique was chymopapain dissolution of the nucleus pulposus. Other percutaneous techniques followed; however, none were as efficacious as the gold standard of microlumbar discectomy until endoscopically visualized methods evolved to allow visualized mechanical discectomy through the foramen. In experienced hands, such a technique is as effective as microlumbar discectomy and results in less surgical morbidity for herniations that are appropriate ... The Orthopedic Clinics of North America journals http://www.medworm.com/rss/comments.php?id=739298 Sun, 01 Jul 2007 04:00:00 +0100 739298 http://www.medworm.com/index.php?rid=739297&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%3D17629985%26dopt%3DAbstract This article provides a general review of the history, indications, brief overview, and description of the more common minimally invasive spine surgery techniques used for achieving a lumbar interbody fusion. PMID: 17629985 [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=739297 Sun, 01 Jul 2007 04:00:00 +0100 739297