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Surgical advances in periacetabular osteotomy for treatment of hip dysplasia in adults.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19919373 [PubMed - as supplied by publisher] (Source: Acta Orthopaedica)
Source: Acta Orthopaedica - November 19, 2009 Category: Orthopaedics Authors: Troelsen A Tags: Acta Orthop Source Type: journals

The Scandinavian Sarcoma Group.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19919379 [PubMed - as supplied by publisher] (Source: Acta Orthopaedica)
Source: Acta Orthopaedica - November 19, 2009 Category: Orthopaedics Authors: Alvegård T, Hall KS, Bauer H, Rydholm A Tags: Acta Orthop Source Type: journals

On the diagnosis and treatment of femoral neck fractures.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19919380 [PubMed - as supplied by publisher] (Source: Acta Orthopaedica)
Source: Acta Orthopaedica - November 19, 2009 Category: Orthopaedics Authors: Frihagen F Tags: Acta Orthop Source Type: journals

Evolution of the hip and pelvis.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19919389 [PubMed - as supplied by publisher] (Source: Acta Orthopaedica)
Source: Acta Orthopaedica - November 19, 2009 Category: Orthopaedics Authors: Hogervorst T, Bouma HW, de Vos J Tags: Acta Orthop Source Type: journals

18 years of results with cemented primary hip prostheses in the Norwegian Arthroplasty Register.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background and purpose Few studies have compared the long-term survival of cemented primary total hip arthroplasties (THAs), and several prostheses have been used without adequate knowledge of their endurance. We studied long-term outcome based on data in the Norwegian Arthroplasty Register. Patients and methods The 10 most used prosthesis brands in 62,305 primary Palacos or Simplex cemented THAs reported to the Register from 1987 through 2007 were included. Survival analyses with revision as endpoint (for any cause or for aseptic loosening) were performed using Kaplan-Meier and multiple Cox regression with time-depend...
Source: Acta Orthopaedica - October 30, 2009 Category: Orthopaedics Authors: Espehaug B, Furnes O, Engesæter LB, Havelin LI Tags: Acta Orthop Source Type: journals

Shoulder rhythm in patients with impingement and in controls.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background and purpose Impingement syndrome is probably the most common cause of shoulder pain. Abnormal abduction and proximal humeral translation are associated with this condition. We evaluated whether the relative distribution between glenohumeral and scapular-trunk motions (the scapulohumeral rhythm) and the speed of motion of the arm differed between patients with impingement and a control group without shoulder symptoms. Patients and methods 30 patients with shoulder impingement (Neer stage 2) and 11 controls were studied during active abduction and 21 patients and 9 controls were studied during passive abductio...
Source: Acta Orthopaedica - August 1, 2009 Category: Orthopaedics Authors: Hallström E, Kärrholm J Tags: Acta Orthop Source Type: journals

Open reduction and internal fixation compared to closed reduction and external fixation in distal radial fractures.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background and purpose In unstable distal radial fractures that are impossible to reduce or to maintain in reduced position, the treatment of choice is operation. The type of operation and the choice of implant, however, is a matter of discussion. Our aim was to investigate whether open reduction and internal fixation would produce a better result than traditional external fixation. Methods 50 patients with an unstable or comminute distal radius fracture were randomized to either closed reduction and bridging external fixation, or open reduction and internal fixation using the TriMed system. The primary outcome paramet...
Source: Acta Orthopaedica - August 1, 2009 Category: Orthopaedics Authors: Abramo A, Kopylov P, Geijer M, Tägil M Tags: Acta Orthop Source Type: journals

The osteogenic response of undifferentiated human mesenchymal stem cells (hMSCs) to mechanical strain is inversely related to body mass index of the donor.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background While the importance of physical factors in the maintenance and regeneration of bone tissue has been recognized for many years and the mechano-sensitivity of bone cells is well established, there is increasing evidence that body fat constitutes an independent risk factor for complications in bone fracture healing and aseptic loosening of implants. Although mechanical causes have been widely suggested, we hypothesized that the osteogenic mechano-response of human mesenchymal stem cells (hMSCs) may be altered in obese patients. Methods We determined the phenotypic and genotypic response of undifferentiated hMS...
Source: Acta Orthopaedica - August 1, 2009 Category: Orthopaedics Authors: Friedl G, Windhager R, Schmidt H, Aigner R Tags: Acta Orthop Source Type: journals

Growth rate after limb deformity correction by the Ilizarov method with or without knee joint distraction.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background and purpose Growth inhibition and stimulation have both been reported after juvenile limb lengthening. Distraction of a joint usually suspends and unloads the growth plate and may stimulate growth. We investigated the influence of knee joint distraction on the speed of growth after limb lengthening. Methods In a retrospective study, growth patterns were analyzed in 30 children mean 61 (24-109) months after limb lengthening with the Ilizarov method, each child having more than 2 years of remaining growth. In 14 patients with knee joint instability, the knee was bridged over during lengthening for joint stabil...
Source: Acta Orthopaedica - June 1, 2009 Category: Orthopaedics Authors: Oostenbroek HJ, Brand R, van Roermund PM Tags: Acta Orthop Source Type: journals

Surgery for scapula process fractures.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background Generally, scapula process fractures (coracoid and acromion) have been treated nonoperatively with favorable outcome, with the exception of widely displaced fractures. Very little has been published, however, regarding the operative management of such fractures and the literature that is available involves very few patients. Our hypothesis was that operative treatment of displaced acromion and coracoid fractures is a safe and effective treatment that yields favorable surgical results. Methods We reviewed 26 consecutive patients (27 fractures) treated between 1998 and 2007. Operative indications for these pro...
Source: Acta Orthopaedica - June 1, 2009 Category: Orthopaedics Authors: Anavian J, Wijdicks CA, Schroder LK, Vang S, Cole PA Tags: Acta Orthop Source Type: journals

History of the treatment of scapula fractures.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The history of treatment of scapula fractures is closely connected with the history of the French surgery. Paré (Les oeuvres d Ambroise Paré, conseiller, et premier chirurgien du Roy, Gabriel Buon, Paris, p VCV, 1579), Petit (Traité des maladies des os. Tome second, Charles-Etienne Hochereau, Paris, pp 122-138, 1723), Du Verney (Traité des maladies des os. Tome I, de Burre, Paris, pp 220-231, 1751) and Desault (OEuvres chirurgicales, ou tableau de la doctrine et de la pratique dans le traitement des maladies externes par Xav. Bichat, Desault, Méquignon, Devilliers, Deroi, Paris, pp 98-106, 1798...
Source: Acta Orthopaedica - May 13, 2009 Category: Orthopaedics Authors: Bartoníček J, Cronier P Tags: Arch Orthop Trauma Surg Source Type: journals

Pulsating fluid flow modulates gene expression of proteins involved in Wnt signaling pathways in osteocytes.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Strain-derived flow of interstitial fluid activates signal transduction pathways in osteocytes that regulate bone mechanical adaptation. Wnts are involved in this process, but whether mechanical loading modulates Wnt signaling in osteocytes is unclear. We assessed whether mechanical stimulation by pulsating fluid flow (PFF) leads to functional Wnt production, and whether nitric oxide (NO) is important for activation of the canonical Wnt signaling pathway in MLO-Y4 osteocytes. MC3T3-E1 osteoblasts were studied as a positive control for the MLO-Y4 osteocyte response to mechanical loading. MLO-Y4 osteocytes and MC3T3-E1 o...
Source: Acta Orthopaedica - April 7, 2009 Category: Orthopaedics Authors: Santos A, Bakker AD, Zandieh-Doulabi B, Semeins CM, Klein-Nulend J Tags: J Orthop Res Source Type: journals

Black holes in bone - irresistible attractors of foreign materials?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Black holes in bone - irresistible attractors of foreign materials? Acta Orthop. 2009 Feb;80(1):2-3 Authors: Aspenberg P PMID: 19297784 [PubMed - indexed for MEDLINE] (Source: Acta Orthopaedica)
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Aspenberg P Tags: Acta Orthop Source Type: journals

Outcome after tantalum rod implantation for treatment of femoral head osteonecrosis: 26 hips followed for an average of 3 years.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Outcome after tantalum rod implantation for treatment of femoral head osteonecrosis: 26 hips followed for an average of 3 years. Acta Orthop. 2009 Feb;80(1):20-5 Authors: Varitimidis SE, Dimitroulias AP, Karachalios TS, Dailiana ZH, Malizos KN BACKGROUND AND PURPOSE: Tantalum rod implantation has recently been proposed for treatment of early stages of femoral head osteonecrosis.The purpose of our study was to report the early results of its use in pre- and post-collapse stages of the disease. METHODS: We studied prospectively 27 patients who underwent tantalum rod implantation for treatment of nontraumatic femo...
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Varitimidis SE, Dimitroulias AP, Karachalios TS, Dailiana ZH, Malizos KN Tags: Acta Orthop Source Type: journals

Pneumatic wound compression after hip fracture surgery did not reduce postoperative blood transfusion: A randomized controlled trial involving 292 fractures.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
BACKGROUND AND PURPOSE: Patients with fracture of the proximal femur often undergo blood transfusion. A pneumatic compression bandage has been shown to reduce transfusion after primary hip arthroplasty for osteoarthritis. In this randomized trial, we evaluated the efficacy of this bandage following surgery for hip fracture. PATIENTS AND METHODS: 288 patients, 50 years or older with 292 fractured hips treated with hemiarthroplasty or internal fixation (except pinning), were randomized to an experimental group with pneumatic wound compression applied after surgery (n = 138) and a control group with the same dressing but ...
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Apelqvist A, Waldén M, Larsson GU, Atroshi I Tags: Acta Orthop Source Type: journals

Periprosthetic infection: where do we stand with regard to Gram stain?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We examined the role of this diagnostic test in a large cohort of patients from a single institution. MATERIALS AND METHODS: A positive gram stain was defined as the visualization of bacterial cells or "many neutrophils" (> 5 per high-power field) in the smear. The sensitivity, specificity, and predictive values of each individual diagnostic arm of Gram stain were determined. Combinations were performed in series, which required both tests to be positive to confirm infection, and also in parallel, which necessitated both tests to be negative to rule out infection. RESULTS: The presence of organisms and "many" neutrophil...
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Ghanem E, Ketonis C, Restrepo C, Joshi A, Barrack R, Parvizi J Tags: Acta Orthop Source Type: journals

Once-weekly oral medication with alendronate does not prevent migration of knee prostheses: A double-blind randomized RSA study.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSION: With uncemented fixation of knee implants, no benefit of once-weekly treatment with alendronate, starting postoperatively, could be seen during a 2-year follow-up period. PMID: 19297788 [PubMed - indexed for MEDLINE] (Source: Acta Orthopaedica)
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Hansson U, Toksvig-Larsen S, Ryd L, Aspenberg P Tags: Acta Orthop Source Type: journals

Injuries as a result of treatment of tibial fractures in children: Claims for compensation submitted to the Patient Insurance Center in Finland.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
BACKGROUND AND PURPOSE: Tibial fractures comprise 10% of all fractures in children. To our knowledge there have been no previous reports of treatment injuries in these fractures. We analyzed compensation claims concerning treatment of these fractures in Finland. We used this information to determine preventable causes of treatment injuries. MATERIAL AND METHODS: In Finland, the Patient Insurance Center (PIC) provides financial compensation for patients who have sustained an injury in connection with medical treatment or operation. We retrospectively analyzed all claims for compensation arising from treatment of tibial ...
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Palmu S, Paukku R, Mäyränpää MK, Peltonen J, Nietosvaara Y Tags: Acta Orthop Source Type: journals

Introduction of total knee arthroplasty in Lithuania: Results from the first 10 years.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
BACKGROUND AND PURPOSE: We have previously reported that the first 10 years of hip arthroplasty in Lithuania resulted in a higher cumulative revision rate than that observed in Sweden. We thus compared the corresponding results after introduaction of total knee replacement in Lithuania. METHODS: The 10-year revision rate for the first 595 primary ScanKnee arthroplasties inserted in Klaipeda, Lithuania, was compared to that for the first 1,280 ScanKnee primary arthroplasties inserted in Sweden. As in the hip replacement study, only patients with osteoarthritis (OA) were included. Primary knee arthroplasties without pate...
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Tarasevicius S, Stucinskas J, Robertsson O, Wingstrand H Tags: Acta Orthop Source Type: journals

Risk factors for revision after shoulder arthroplasty: 1,825 shoulder arthroplasties from the Norwegian Arthroplasty Register.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We describe the results of shoulder replacement in the Norwegian population (of 4.7 million) during a 12-year period. Trends in the use of shoulder arthroplasty during the study period were also investigated. PATIENTS AND METHODS: 1,531 hemiprostheses (HPs), 69 total shoulder replacements (Neer type TSR), and 225 reversed total shoulder replacement (reversed TSR) operations were reported to the Norwegian Arthroplasty Register between 1994 and 2005. Kaplan-Meier failure curves were drawn up for particular subgroups of patients, and revision rates were calculated using Cox regression analysis. RESULTS: The 5- and 10-year fai...
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Fevang BT, Lie SA, Havelin LI, Skredderstuen A, Furnes O Tags: Acta Orthop Source Type: journals

Does fixed-angle plate osteosynthesis solve the problems of a fractured proximal humerus? A prospective series of 87 patients.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
BACKGROUND AND PURPOSE: There is considerable controversy about the treatment of complex, displaced proximal humeral fractures. Various types of head-preserving osteosynthesis have been suggested. This prospective case series was designed to evaluate the perioperative and early postoperative complications associated with fixed-angle implants and to record outcome after bone healing. PATIENTS AND METHODS: Fractures of the proximal humerus were stabilized surgically in 87 patients (mean age 64 (16-93) years) by application of a fixed-angle plate (65 PHILOS, 22 T-LCP). There were 34 2-segment fractures, 42 3-segment fract...
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Helwig P, Bahrs C, Epple B, Oehm J, Eingartner C, Weise K Tags: Acta Orthop Source Type: journals

Newly discovered mutations in the GALNT3 gene causing autosomal recessive hyperostosis-hyperphosphatemia syndrome.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Newly discovered mutations in the GALNT3 gene causing autosomal recessive hyperostosis-hyperphosphatemia syndrome. Acta Orthop. 2009 Feb;80(1):131-4 Authors: Gok F, Chefetz I, Indelman M, Kocaoglu M, Sprecher E BACKGROUND AND PURPOSE: Periosteal new bone formation and cortical hyperostosis often suggest an initial diagnosis of bone malignancy or osteomyelitis. In the present study, we investigated the cause of persistent bone hyperostosis in the offspring of two consanguineous parents. METHODS: Clinical assessment, imaging, and direct sequencing were used to elucidate the etiology of the condition seen in the p...
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Gok F, Chefetz I, Indelman M, Kocaoglu M, Sprecher E Tags: Acta Orthop Source Type: journals

The effects of nail rigidity on fracture healing in rats with osteoporosis.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
BACKGROUND AND PURPOSE: Stress shielding from rigid internal fixation may lead to refracture after removal of the osteosynthesis material. We investigated the effect of a low-rigidity (Ti-24Nb-4Zr-7.9Sn) intramedullary nail regarding stress shielding and bone healing of osteoporotic fractures in the rat. METHODS: 40 female Sprague-Dawley rats, aged 3 months, were divided into the following groups: sham-operation (SHAM) (n = 10), ovariectomized (OVX) (n = 10) and OVX-fracture (n = 20). 10 SHAM rats and 10 OVX rats were killed after 12 weeks to provide biomechanical data. Ovariectomy was performed 12 weeks before fractur...
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Sha M, Guo Z, Fu J, Li J, Yuan CF, Shi L, Li SJ Tags: Acta Orthop Source Type: journals

New format, open access, and online pre-publication.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19301447 [PubMed - indexed for MEDLINE] (Source: Acta Orthopaedica)
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Rydholm A, Svensson O Tags: Acta Orthop Source Type: journals

Large femoral bone loss after hip revision using the uncemented proximally porous-coated Bi-Metric prosthesis: 22 hips followed for a mean of 6 years.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
BACKGROUND AND PURPOSE: Periprosthetic bone loss after uncemented femoral hip revision is a matter of concern. We have used a proximally porous- and hydroxyapatite-coated prosthesis (Bi-Metric) in revision since 1989 and now we report the bone changes. This prosthesis is intended to distribute the forces more evenly and to avoid proximal femoral unloading. METHODS: 22 patients were unilaterally reoperated because of aseptic loosening. Only patients with a healthy contralateral hip were included. Mean age at revision was 69 (55-80) years. Bone defects were graded by Gustilo-Pasternak and Endo-Klinik classifications. Cli...
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Adolphson PY, Salemyr MO, Sköldenberg OG, Bodén HS Tags: Acta Orthop Source Type: journals

Proximal femoral resection arthroplasty for patients with cerebral palsy and dislocated hips: 20 patients followed for 1-6 years.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
BACKGROUND AND PURPOSE: Chronic hip dislocation in non-ambulatory individuals with cerebral palsy (CP) can lead to severe problems, of which pain is often the most severe. We studied the outcome of proximal femoral resection, especially regarding pain, sitting balance, perineal care, and patient satisfaction. PATIENTS AND METHODS: During the period 1998-2005, we operated 20 non-ambulatory patients with spastic quadriplegic CP (8 females and 12 males). 13 patients had unilateral dislocation and 7 had bilateral. The mean age at operation was 15 (3-27) years. The indications for operation were chronic hip dislocation plus...
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Knaus A, Terjesen T Tags: Acta Orthop Source Type: journals

Celecoxib does not appear to affect prosthesis fixation in total knee replacement: A randomized study using radiostereometry in 50 patients.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
BACKGROUND AND PURPOSE: After joint replacement, a repair process starts at the interface between bone and cement. If this process is disturbed, the prosthesis may never become rigidly fixed to the bone, leading to migration-and with time, loosening. Cox-2 inhibitors are widely used as postoperative analgesics, and have adverse effects on bone healing. This could tamper prosthesis fixation. We investigated whether celecoxib, a selective Cox-2 inhibitor, increases prosthesis migration in total knee replacement (TKR). METHODS: 50 patients were randomized to either placebo or celecoxib treatment, 200 mg twice daily, for 3...
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Meunier A, Aspenberg P, Good L Tags: Acta Orthop Source Type: journals

Knee arthroplasty: are patients' expectations fulfilled? A prospective study of pain and function in 102 patients with 5-year follow-up.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study shows that patients have high preoperative expectations concerning reduction of pain. To a considerable extent, these expectations are fulfilled after one year. Expectations concerning demanding physical activities are not fulfilled to the same degree; however, most patients reported general satisfaction with the outcome indicating that satisfaction is not equivalent to fulfilled expectations. Preoperative counseling should include realistic information on outcomes concerning physical function and pain relief. PMID: 19234886 [PubMed - in process] (Source: Acta Orthopaedica)
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Nilsdotter AK, Toksvig-Larsen S, Roos EM Tags: Acta Orthop Source Type: journals

Conversion of patellofemoral arthroplasty to total knee arthroplasty: A matched case-control study of 13 patients.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
BACKGROUND AND PURPOSE: The long-term outcome of patellofemoral arthroplasty is related to progression of femorotibial osteoarthritis with need for conversion to total knee arthroplasty. We investigated whether prior patellofemoral arthroplasty compromises the results of total knee arthroplasty. METHODS: 13 patients who had had 14 Richards type II patellofemoral arthroplasties converted to total knee arthroplasty because of femorotibial osteoarthritis, were individually matched to a control group of 13 patients with 14 primary total knee arthroplasties. The mean follow-up times for the patients and the control group we...
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: van Jonbergen HP, Werkman DM, van Kampen A Tags: Acta Orthop Source Type: journals

External fixation of fractures of the distal radius: a randomized comparison of the Hoffman compact II non-bridging fixator and the Dynawrist fixator in 75 patients followed for 1 year.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
BACKGROUND AND PURPOSE: External fixators allowing movement during fracture healing are commonly used for treatment of unstable distal radius fractures. The dynamic Dynawrist fixator with the distal pins in metacarpal bone may avoid fixation problems in comminuted fractures and may reduce the risk of nerve injury. We compared anatomical and functional outcome for the well-established Hoffmann compact II non-bridging fixator and for the Dynawrist fixator. PATIENTS AND METHODS: 75 patients with unstable distal radius fractures were randomized to treatment with either the Hoffman compact II fixator (the H-group) or the Dy...
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Krukhaug Y, Ugland S, Lie SA, Hove LM Tags: Acta Orthop Source Type: journals

From evidence to action: Understanding clinical practice guidelines.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Good guidelines will help us to take evidence into practice. In a survey among Dutch orthopedic surgeons, development and use of evidence-based guidelines was perceived as one of the best ways of moving from opinion-based to evidence-based orthopedic practice. The increasing number of guidelines means that knowing how to make a critical appraisal of guidelines is now a key part of every surgeon's life. This is particularly true because guidelines use varying systems to judge the quality of evidence and the strength of recommendations. In this manuscript we discuss what a guideline is, where we can find guidelines, how...
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Poolman RW, Verheyen CC, Kerkhoffs GM, Bhandari M, Schünemann HJ, Tags: Acta Orthop Source Type: journals

Bisphosphonates and implants: an overview.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19234893 [PubMed - in process] (Source: Acta Orthopaedica)
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Aspenberg P Tags: Acta Orthop Source Type: journals

Bone defects following curettage do not necessarily need augmentation.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study demonstrates the natural healing ability of bone without any adjuvant filling. It could be used as a baseline for future studies using any sort of filling with autograft, allograft, or bone substitute. PMID: 19234881 [PubMed - in process] (Source: Acta Orthopaedica)
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Hirn M, de Silva U, Sidharthan S, Grimer RJ, Abudu A, Tillman RM, Carter SR Tags: Acta Orthop Source Type: journals

Curettage of benign bone tumors without grafts gives sufficient bone strength.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report the outcome in patients with benign bone tumors that were treated with curettage but no filling. Patients and methods We retrospectively studied 78 patients (mean age at the time of operation was 27 (6-73) years, 44 men) who had had a benign bone tumor curetted with no filling of the defect. The commonest tumor types were giant cell tumor of bone (27), fibrous dysplasia (13), enchondroma (9), and simple bone cyst (7). The mean size of the lesions was 35 (2-196) cm(3). Normal activities, including full weight bearing for lower extremity lesions, were allowed after 3 months or less. The patients were followed for a...
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Yanagawa T, Watanabe H, Shinozaki T, Takagishi K Tags: Acta Orthop Source Type: journals

Large femoral bone loss after hip revision using the uncemented proximally porous-coated Bi-Metric prosthesis.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background and purpose Periprosthetic bone loss after uncemented femoral hip revision is a matter of concern. We have used a proximally porous- and hydroxyapatite-coated prosthesis (Bi-Metric) in revision since 1989 and now we report the bone changes. This prosthesis is intended to distribute the forces more evenly and to avoid proximal femoral unloading. Methods 22 patients were unilaterally reoperated because of aseptic loosening. Only patients with a healthy contralateral hip were included. Mean age at revision was 69 (55-80) years. Bone defects were graded by Gustilo-Pasternak and Endo-Klinik classifications. Clini...
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Adolphson PY, Salemyr MO, Skoldenberg OG, Boden HS Tags: Acta Orthop Source Type: journals

Proximal femoral resection arthroplasty for patients with cerebral palsy and dislocated hips.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background and purpose Chronic hip dislocation in non-ambulatory individuals with cerebral palsy (CP) can lead to severe problems, of which pain is often the most severe. We studied the outcome of proximal femoral resection, especially regarding pain, sitting balance, perineal care, and patient satisfaction. Patients and methods During the period 1998-2005, we operated 20 non-ambulatory patients with spastic quadriplegic CP (8 females and 12 males). 13 patients had unilateral dislocation and 7 had bilateral. The mean age at operation was 15 (3-27) years. The indications for operation were chronic hip dislocation plus s...
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Knaus A, Terjesen T Tags: Acta Orthop Source Type: journals

Celecoxib does not appear to affect prosthesis fixation in total knee replacement.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background and purpose After joint replacement, a repair process starts at the interface between bone and cement. If this process is disturbed, the prosthesis may never become rigidly fixed to the bone, leading to migration-and with time, loosening. Cox-2 inhibitors are widely used as postoperative analgesics, and have adverse effects on bone healing. This could tamper prosthesis fixation. We investigated whether celecoxib, a selective Cox-2 inhibitor, increases prosthesis migration in total knee replacement (TKR). Methods 50 patients were randomized to either placebo or celecoxib treatment, 200 mg twice daily, for 3 w...
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Meunier A, Aspenberg P, Good L Tags: Acta Orthop Source Type: journals

Knee arthroplasty: are patients' expectations fulfilled?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study shows that patients have high preoperative expectations concerning reduction of pain. To a considerable extent, these expectations are fulfilled after one year. Expectations concerning demanding physical activities are not fulfilled to the same degree; however, most patients reported general satisfaction with the outcome indicating that satisfaction is not equivalent to fulfilled expectations. Preoperative counseling should include realistic information on outcomes concerning physical function and pain relief. PMID: 19234886 [PubMed - in process] (Source: Acta Orthopaedica)
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Nilsdotter AK, Toksvig-Larsen S, Roos EM Tags: Acta Orthop Source Type: journals

Conversion of patellofemoral arthroplasty to total knee arthroplasty.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background and purpose The long-term outcome of patellofemoral arthroplasty is related to progression of femorotibial osteoarthritis with need for conversion to total knee arthroplasty. We investigated whether prior patellofemoral arthroplasty compromises the results of total knee arthroplasty. Methods 13 patients who had had 14 Richards type II patellofemoral arthroplasties converted to total knee arthroplasty because of femorotibial osteoarthritis, were individually matched to a control group of 13 patients with 14 primary total knee arthroplasties. The mean follow-up times for the patients and the control group were...
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: van Jonbergen HP, Werkman DM, Kampen A Tags: Acta Orthop Source Type: journals

Outcome of prosthesis exchange for infected knee arthroplasty: the effect of treatment approach.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background and purpose Two-stage revision remains the gold standard in the treatment of infected knee arthroplasty. Lately, good long-term results of direct exchange arthroplasty have been reported. The purpose of this literature review is to compare the clinical outcome achieved with one-stage revision and two-stage revision with different types of spacers. Methods A thorough systematic review of literature was undertaken to idenepsy reports on the treatment alternatives. Papers written in English or including an English abstract, published from 1980 through 2005, and reporting either the success rate in eradication o...
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Jamsen E, Stogiannidis I, Malmivaara A, Pajamaki J, Puolakka T, Konttinen YT Tags: Acta Orthop Source Type: journals

Development of a new model for rotator cuff pathology: the rabbit subscapularis muscle.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background and purpose The New Zealand white rabbit subscapularis tendon passes under a bony arch to insert on the lesser tubercle of the humerus in a manner analogous to the supraspinatus tendon in humans. We assessed whether this unique anatomy may provide a new animal model of the shoulder to improve our understanding of rotator cuff pathology. Methods The dimensions of the rotator cuff insertions (subscapularis, supraspinatus, and infraspinatus) were measured on 10 fresh frozen cadaveric New Zealand white rabbit shoulders. Mechanical testing was performed on 8 fresh frozen subscapularis insertions (4 matched pairs)...
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Grumet RC, Hadley S, Diltz MV, Lee TQ, Gupta R Tags: Acta Orthop Source Type: journals

External fixation of fractures of the distal radius.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background and purpose External fixators allowing movement during fracture healing are commonly used for treatment of unstable distal radius fractures. The dynamic Dynawrist fixator with the distal pins in metacarpal bone may avoid fixation problems in comminuted fractures and may reduce the risk of nerve injury. We compared anatomical and functional outcome for the well-established Hoffmann compact II non-bridging fixator and for the Dynawrist fixator. Patients and methods 75 patients with unstable distal radius fractures were randomized to treatment with either the Hoffman compact II fixator (the H-group) or the Dyna...
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Krukhaug Y, Ugland S, Lie SA, Hove LM Tags: Acta Orthop Source Type: journals

Dutch orthopedic thromboprophylaxis: a 5-year follow-up survey.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background and purpose Previous surveys in the Netherlands have revealed that guidelines regarding orthopedic thromboprophylaxis were not followed and that a wide variation in protocols exists. This survey was performed to assess the current use of thromboprophylactic modalities and to compare it with the results of a previous survey. Methods All departments of orthopedic surgery in the Netherlands were sent a follow-up survey on venous thromboprophylaxis, and the data obtained were compared to the results of a survey performed 5 years earlier. Results All departments used pharmacological thromboprophylaxis following a...
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Ettema HB, Mulder MC, Nurmohamed MT, Buller HR, Verheyen CC Tags: Acta Orthop Source Type: journals

From evidence to action.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
ABSTRACT Good guidelines will help us to take evidence into practice. In a survey among Dutch orthopedic surgeons, development and use of evidence-based guidelines was perceived as one of the best ways of moving from opinion-based to evidence-based orthopedic practice. The increasing number of guidelines means that knowing how to make a critical appraisal of guidelines is now a key part of every surgeon's life. This is particularly true because guidelines use varying systems to judge the quality of evidence and the strength of recommendations. In this manuscript we discuss what a guideline is, where we can find guideli...
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Poolman RW, Verheyen CC, Kerkhoffs GM, Bhandari M, Schunemann HJ Tags: Acta Orthop Source Type: journals

Bisphosphonates and implants.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19234893 [PubMed - in process] (Source: Acta Orthopaedica)
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Aspenberg P Tags: Acta Orthop Source Type: journals

Notes on the use and interpretation of radiostereometric analysis.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
ABSTRACT With increasing numbers of research groups carrying out radiostereometric analysis (RSA), it is important to reach a consensus on how the main aspects of the technique should be carried out and how the results should be presented in an appropriate and consistent way. In this collection of guidelines, we identify a number of methodological and reporting issues including: measurement error and precision, migration and migration direction data, and the use of RSA as a screening technique. Alternatives are proposed, and a statistical analysis is presented, from which a sample size of 50 is recommended for screenin...
Source: Acta Orthopaedica - February 1, 2009 Category: Orthopaedics Authors: Derbyshire B, Prescott RJ, Porter ML Tags: Acta Orthop Source Type: journals

C-reactive protein levels for early detection of postoperative infection after fracture surgery in 787 patients.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19097302 [PubMed - in process] (Source: Acta Orthopaedica)
Source: Acta Orthopaedica - December 1, 2008 Category: Orthopaedics Authors: Jenny JY Tags: Acta Orthop Source Type: journals

Hip resurfacing: expectations and limitations.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19085487 [PubMed - in process] (Source: Acta Orthopaedica)
Source: Acta Orthopaedica - December 1, 2008 Category: Orthopaedics Authors: Spierings PT Tags: Acta Orthop Source Type: journals

58-year follow-up of a vitallium mold hip arthroplasty: a case report and literature review.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19085488 [PubMed - in process] (Source: Acta Orthopaedica)
Source: Acta Orthopaedica - December 1, 2008 Category: Orthopaedics Authors: Northover JR, Maqsood M Tags: Acta Orthop Source Type: journals

Metal-on-metal hip resurfacing arthroplasty: a review of periprosthetic biological reactions.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Metal-on-metal hip resurfacing arthroplasty has undergone a recent resurgence as an alternative treatment option for young and active patients with significant osteoarthritis. The claimed advantages of metal-on-metal hip resurfacing arthroplasty include lower wear rate, preservation of bone stock for subsequent revision procedures, restoration of anatomic hip mechanics, and enhanced stability due to the larger diameter of articulation. A disadvantage, however, is that the metal-on-metal resurfacing releases large amounts of very small wear particles and metal ions. The long-term biological consequences of the exposure ...
Source: Acta Orthopaedica - December 1, 2008 Category: Orthopaedics Authors: Mabilleau G, Kwon YM, Pandit H, Murray DW, Sabokbar A Tags: Acta Orthop Source Type: journals