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IndexEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - November 19, 2009 Category: Orthopaedics Source Type: journals

Soft Tissue and Biomechanical Challenges Encountered with the Management of Distal Tibia NonunionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - November 19, 2009 Category: Orthopaedics Authors: Ivan S. Tarkin, Peter A. Siska, Boris A. Zelle Source Type: journals

Managing Bone Deficiency and Nonunions of the Proximal FemurEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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. (Source: Orthopedic Clin...
Source: Orthopedic Clinics of North America - November 19, 2009 Category: Orthopaedics Authors: John J. Perry, Brent Winter, Jeffrey W. Mast Source Type: journals

RIA: One Community's ExperienceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 morbidi...
Source: Orthopedic Clinics of North America - November 19, 2009 Category: Orthopaedics Authors: Christopher G. Finkemeier, Rafael Neiman, Domingo Hallare Source Type: journals

Quantitative Analysis of Growth Factors from a Second Filter Using the Reamer-Irrigator-Aspirator System: Description of a Novel TechniqueEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - November 19, 2009 Category: Orthopaedics Authors: James P. Stannard, Ashoke K. Sathy, Fariba Moeinpour, Rena L. Stewart, David A. Volgas Source Type: journals

Autologous Bone Graft: When Shall We Add Growth Factors?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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...
Source: Orthopedic Clinics of North America - November 19, 2009 Category: Orthopaedics Authors: Peter V. Giannoudis, Haralampos T. Dinopoulos Source Type: journals

Autograft and Nonunions: Morbidity with Intramedullary Bone Graft versus Iliac Crest Bone GraftEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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...
Source: Orthopedic Clinics of North America - November 19, 2009 Category: Orthopaedics Authors: Janet D. Conway Source Type: journals

Treatment of Large Segmental Bone Defects with Reamer-Irrigator-Aspirator Bone Graft: Technique and Case SeriesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - November 19, 2009 Category: Orthopaedics Authors: Todd A. McCall, David S. Brokaw, Bradley A. Jelen, D. Kevin Scheid, Angela V. Scharfenberger, Dean C. Maar, James M. Green, Melanie R. Shipps, Marcus B. Stone, Dana Musapatika, Timothy G. Weber Source Type: journals

Biological Rationale for the Intramedullary Canal as a Source of Autograft MaterialEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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, T...
Source: Orthopedic Clinics of North America - November 19, 2009 Category: Orthopaedics Authors: David J. Hak, Jason L. Pittman Source Type: journals

Use of the Induced Membrane Technique for Bone Tissue Engineering Purposes: Animal StudiesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - November 19, 2009 Category: Orthopaedics Authors: Véronique Viateau, Morad Bensidhoum, Geneviève Guillemin, Hervé Petite, Didier Hannouche, Fani Anagnostou, Philippe Pélissier Source Type: journals

Clinical Use of Resorbable Polymeric Membranes in the Treatment of Bone DefectsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - November 19, 2009 Category: Orthopaedics Authors: Richard P. Meinig Source Type: journals

The Concept of Induced Membrane for Reconstruction of Long Bone DefectsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - November 19, 2009 Category: Orthopaedics Authors: Alain C. Masquelet, Thierry Begue Source Type: journals

Use of Solid and Cancellous Autologous Bone Graft for Fractures and NonunionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article describes the use of solid and cancellous bone graft in the treatment of acute bone loss and nonunion. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - November 19, 2009 Category: Orthopaedics Authors: James T. Marino, Bruce H. Ziran Source Type: journals

Viable Bone and Circulatory Factors Required for Survival of Bone GraftsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - November 19, 2009 Category: Orthopaedics Authors: Lisa K. Cannada Source Type: journals

Bone Defects Caused by High-energy Injuries, Bone Loss, Infected Nonunions, and NonunionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article discusses bone defects caused by high-energy injuries, bone loss, infected nonunions, and nonunions. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - November 19, 2009 Category: Orthopaedics Authors: Andrea Wiese, Hans C. Pape Source Type: journals

PrefaceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The management of traumatic bone defect continues to be a tremendous challenge to orthopedic trauma surgeons. Although many products that stimulate the growth of bone and replace defects have become available within the past decades, autologous bone continues to have ideal biologic properties. Although some of the well-described techniques to grow bone, such as distraction osteogenesis, have incurrent risks of infections, newer methods have become available to treat bone defects in the presence of an infection. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - November 19, 2009 Category: Orthopaedics Authors: Hans C. Pape, Timothy G. Weber Source Type: journals

Forthcoming issuesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - November 19, 2009 Category: Orthopaedics Source Type: journals

ContentsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - November 19, 2009 Category: Orthopaedics Source Type: journals

IndexEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - September 18, 2009 Category: Orthopaedics Source Type: journals

Minimally Invasive Computer-Navigated Total Knee ArthroplastyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - September 18, 2009 Category: Orthopaedics Authors: Nicola Biasca, Thomas-Oliver Schneider, Matthias Bungartz Source Type: journals

From Mini-Invasive to Non-Invasive Treatment Using Monopolar Radiofrequency: The Next Orthopaedic FrontierEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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°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 o...
Source: Orthopedic Clinics of North America - September 18, 2009 Category: Orthopaedics Authors: Terry L. Whipple Source Type: journals

Minimally Invasive Hallux Valgus CorrectionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - September 18, 2009 Category: Orthopaedics Authors: Francesco Oliva, Umile Giuseppe Longo, Nicola Maffulli Source Type: journals

Bosch Osteotomy and Scarf Osteotomy for Hallux Valgus CorrectionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 e...
Source: Orthopedic Clinics of North America - September 18, 2009 Category: Orthopaedics Authors: Nicola Maffulli, Umile Giuseppe Longo, Francesco Oliva, Vincenzo Denaro, Cristiano Coppola Source Type: journals

Percutaneous Hallux Valgus Surgery: A Prospective Multicenter Study of 189 CasesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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...
Source: Orthopedic Clinics of North America - September 18, 2009 Category: Orthopaedics Authors: Thomas Bauer, Christophe de Lavigne, David Biau, Mariano De Prado, Stephen Isham, Olivier Laffenétre Source Type: journals

Minimally Invasive Osteosynthesis of Distal Tibial Fractures Using Locking PlatesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 loc...
Source: Orthopedic Clinics of North America - September 18, 2009 Category: Orthopaedics Authors: Mario Ronga, Chezhiyan Shanmugam, Umile Giuseppe Longo, Francesco Oliva, Nicola Maffulli Source Type: journals

Minimally Invasive Surgery of the Achilles TendonEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - September 18, 2009 Category: Orthopaedics Authors: Nicola Maffulli, Umile Giuseppe Longo, Francesco Oliva, Mario Ronga, Vincenzo Denaro Source Type: journals

Minimally Invasive Total Knee Arthroplasty: A Systematic ReviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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...
Source: Orthopedic Clinics of North America - September 18, 2009 Category: Orthopaedics Authors: Anil Khanna, Nikolaos Gougoulias, Umile Giuseppe Longo, Nicola Maffulli Source Type: journals

The Anterolateral Minimally Invasive Approach for Total Hip Arthroplasty: Technique, Pitfalls, and Way OutEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - September 18, 2009 Category: Orthopaedics Authors: Erhan Basad, Bernd Ishaque, Henning Stürz, Jörg Jerosch Source Type: journals

Vertebroplasty and Kyphoplasty: Reasons for Concern?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article provides an overview of the state of the art in vertebroplasty and kyphoplasty, discussing the indications, techniques, results, and pitfalls. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - September 18, 2009 Category: Orthopaedics Authors: Luca Denaro, Umile Giuseppe Longo, Vincenzo Denaro Source Type: journals

Thoracoscopy for Minimally Invasive Thoracic Spine SurgeryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 shorte...
Source: Orthopedic Clinics of North America - September 18, 2009 Category: Orthopaedics Authors: Umile Giuseppe Longo, Nicola Papapietro, Nicola Maffulli, Vincenzo Denaro Source Type: journals

Percutaneous CT-Guided Vertebroplasty in the Management of Osteoporotic Fractures and Dorsolumbar MetastasesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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. (Sou...
Source: Orthopedic Clinics of North America - September 18, 2009 Category: Orthopaedics Authors: Andrea L. Pizzoli, Lodovico Renzi Brivio, Roberto Caudana, Enrico Vittorini Source Type: journals

Minimally Invasive Carpal Tunnel ReleaseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 ( (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - September 18, 2009 Category: Orthopaedics Authors: Paolo Cellocco, Costantino Rossi, Stefano El Boustany, Gian Luca Di Tanna, Giuseppe Costanzo Source Type: journals

DedicationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I would like to dedicate this issue to Gayle Denise Maffulli, my wife, who has always been more than extremely supportive, and to Giuseppe Darius Peter Maffulli, my son, who inspires me each and every single day, though he does not sleep! (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - September 18, 2009 Category: Orthopaedics Authors: Nicola Maffulli Source Type: journals

PrefaceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Minimally invasive trauma and orthopedic surgery is increasingly taking hold. It is technically demanding. Although some would consider that arthroscopy is the ultimate minimally invasive procedure, over the course of the last few years many techniques and philosophies of treatment have been introduced and have since evolved. Now such techniques are used to manage fractures, nonunions, malunions, bone infections, arthritis, and deformities. These techniques have the theoretic advantage of decreasing recovery and rehabilitation times, because surgical exposure and deep tissue dissection are smaller and gentler to the soft t...
Source: Orthopedic Clinics of North America - September 18, 2009 Category: Orthopaedics Authors: Nicola Maffulli Source Type: journals

Forthcoming issuesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - September 18, 2009 Category: Orthopaedics Source Type: journals

ContentsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - September 18, 2009 Category: Orthopaedics Source Type: journals

IndexEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - June 30, 2009 Category: Orthopaedics Source Type: journals

Overview of Current Venous Thromboembolism Protocols in Hip ReconstructionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - June 30, 2009 Category: Orthopaedics Authors: Alejandro Lazo-Langner, Marc A. Rodger Source Type: journals

Blood Management for Hip Reconstruction SurgeryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - June 30, 2009 Category: Orthopaedics Authors: Alan Lane, Edward T. Crosby Source Type: journals

Spatiotemporal Parameters of Gait After Total Hip Replacement: Anterior versus Posterior ApproachEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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...
Source: Orthopedic Clinics of North America - June 30, 2009 Category: Orthopaedics Authors: Nicola A. Maffiuletti, Franco M. Impellizzeri, Katharina Widler, Mario Bizzini, Michael S.H. Kain, Urs Munzinger, Michael Leunig Source Type: journals

Gait and Motion Analysis of the Lower Extremity After Total Hip Arthroplasty: What the Orthopedic Surgeon Should KnowEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 ne...
Source: Orthopedic Clinics of North America - June 30, 2009 Category: Orthopaedics Authors: Mario Lamontagne, Mélanie L. Beaulieu, Daniel Varin, Paul E. Beaulé Source Type: journals

Anterior Hueter Approach in the Treatment of Femoro–Acetabular Impingement: Rationale and TechniqueEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article discusses the indications and diagnostic criteria and the surgical technique and early clinical results for the combined arthroscopic/Hueter approach. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - June 30, 2009 Category: Orthopaedics Authors: Cefin Barton, Kamaljeet Banga, Paul E. Beaulé Source Type: journals

Multimodal Analgesia for Hip ArthroplastyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - June 30, 2009 Category: Orthopaedics Authors: Raymond Tang, Holly Evans, Alan Chaput, Christopher Kim Source Type: journals

Complications of the Direct Anterior Approach for Total Hip ArthroplastyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - June 30, 2009 Category: Orthopaedics Authors: Cefin Barton, Paul R. Kim Source Type: journals

Comparison of Mini-Incision Total Hip Arthroplasty Through an Anterior Approach and a Posterior Approach Using NavigationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 preoperativ...
Source: Orthopedic Clinics of North America - June 30, 2009 Category: Orthopaedics Authors: Nobuhiko Sugano, Masaki Takao, Takashi Sakai, Takashi Nishii, Hidenobu Miki, Nobuo Nakamura Source Type: journals

Hueter Anterior Approach for Hip Resurfacing: Assessment of the Learning CurveEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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. (...
Source: Orthopedic Clinics of North America - June 30, 2009 Category: Orthopaedics Authors: Benoit Benoit, Wade Gofton, Paul E. Beaulé Source Type: journals

Simultaneous Bilateral Supine Anterior Approach Total Hip Arthroplasty: Evaluation of Early Complications and Short-Term RehabilitationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - June 30, 2009 Category: Orthopaedics Authors: Nicholas H. Mast, Michelle Muñoz, Joel Matta Source Type: journals

Anterior-Supine Minimally Invasive Total Hip Arthroplasty: Defining the Learning CurveEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - June 30, 2009 Category: Orthopaedics Authors: Brian E. Seng, Keith R. Berend, Andrew F. Ajluni, Adolph V. Lombardi Source Type: journals

Outcomes Following the Single-Incision Anterior Approach to Total Hip Arthroplasty: A Multicenter Observational StudyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 retur...
Source: Orthopedic Clinics of North America - June 30, 2009 Category: Orthopaedics Authors: The Anterior Total Hip Arthroplasty Collaborative (ATHAC) Investigators Source Type: journals

Direct Anterior Approach for Total Hip ArthroplastyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - June 30, 2009 Category: Orthopaedics Authors: Benjamin Bender, Michael Nogler, William J. Hozack Source Type: journals