Abstract:
:Clinical failures of all-polyethylene tibial components in total knee arthroplasty generally have been failures of design, not materials. The current study was designed to compare a modern congruent all-polyethylene tibial component with a metal-backed tibial component with the same articular design and geometry. All patients older than 60 years of age requiring total knee arthroplasty were randomized prospectively to receive either a cemented posterior cruciate ligament-retaining all-polyethylene component or a metal-backed tibial component with identical articular surfaces. All patients received identical cemented femoral and all-polyethylene patellar implants. The mean age of the patients was 69 years, and the mean American Society of Anesthesiology score was 3. The diagnosis was osteoarthritis in 92% of this population. Three hundred twenty-four total knee arthroplasties in 296 patients were performed; 213 joints (111 all-polyethylene tibias and 102 metal-backed tibias) with a minimum of 3 years followup (mean, 49 months) are reported. The preoperative Knee Society knee score in the group of patients who received an all-polyethylene tibial component was 38 points, improving to 84 points at latest followup, whereas in the group of patients who received a metal-backed tibial component, the score improved from 35 to 85 points. Functional scores increased from preoperative values of 56 to 74 points in the patients who received all-polyethylene tibial components, and 57 to 72 points in the patients who received metal-backed tibial components. Range of motion measured at latest followup averaged 106 degrees in patients who received an all-polyethylene tibial component and 107 degrees in the patients who received a metal-backed component, and postoperative tibiofemoral alignment averaged 6 degrees valgus for both groups. There were 13 reoperations for instability, patellofemoral problems, or deep infection, but none for aseptic loosening or wear in either group. These differences were not statistically significant, nor were any measures of patient satisfaction or clinical outcome between the two groups in this period. Total knee arthroplasty with a well-designed, contemporary congruent all-polyethylene tibial component functions equivalently to its metal-backed tibial counterpart at 3- to 5-year followup in this patient population, and is less costly ($675).
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Gioe TJ,Bowman KRdoi
10.1097/00003086-200011000-00015subject
Has Abstractpub_date
2000-11-01 00:00:00pages
108-15issue
380eissn
0009-921Xissn
1528-1132pub_type
临床试验,杂志文章,随机对照试验abstract:BACKGROUND:Compressive osseointegration is a promising modality for limb salvage in distal femoral oncologic tumors. However, few studies have explored short-term survival rates in a large patient cohort of distal femur compressive endoprostheses or highlighted the risk factors for spindle failures. QUESTIONS/PURPOSES...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-016-4839-7
更新日期:2016-07-01 00:00:00
abstract::Gout commonly occurs as an acute arthritis. In a 64-year-old man, gout was associated with a proliferative hemosiderin-laden synovitis. The association of recurrent atraumatic hemarthrosis seems not to have been reported in the literature on gout. ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1992-04-01 00:00:00
abstract:BACKGROUND:Although some clinical reports suggest patient-specific instrumentation in TKA may improve alignment, reduce surgical time, and lower hospital costs, it is unknown whether it improves pain- and function-related outcomes and gait. QUESTIONS/PURPOSES:We hypothesized that TKA performed with patient-specific in...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11999-014-3544-7
更新日期:2014-08-01 00:00:00
abstract::Osteonecrosis of the talus secondary to adrenal corticosteroids is rare. The pathophysiology of the disorder is controversial. This is a report of bilateral talar necrosis secondary to steroid medications in a 23-year-old male. Conservative methods of management of the condition are not altogether satisfactory. Bilate...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract::External fixation is the treatment of choice for fractures of the leg involving severe damage to the soft tissue. Each of the various patterns of application has advantages and disadvantages. Based on various biomechanical studies and clinical experience, the authors use a right-angle arrangement for the screws. If th...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-09-01 00:00:00
abstract:BACKGROUND:MRI is the gold standard for evaluating the relationship of disc material to soft tissue and neural structures. However, terminologies used to describe lumbar disc herniation and nerve root compression have always been a source of confusion. A clear understanding of lumbar disc terminology among clinicians, ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1007/s11999-014-3674-y
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:The literature suggests lateral unicompartmental knee arthroplasties are associated with low revision rates. However, there are fewer reports describing techniques for lateral unicompartmental arthroplasty and whether technique influences ROM and function compared to reports for medial unicompartmental arthr...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-2005-9
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Osteosarcoma is a rare complication of Paget's disease with a very poor prognosis. Treatment is controversial: the older age of the patients affected by Paget's disease may limit the use of chemotherapy and axial involvement may limit the practicality of surgery. QUESTIONS/PURPOSES:The purposes of this stud...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1473-7
更新日期:2010-11-01 00:00:00
abstract::Recently developed inflatable nails avoid reaming and interlocking screws in tibial fractures and reflect a new principle for stabilization of long bone fractures. We asked if the bending stiffness, rotational rigidity, or play (looseness of rotation) differed between an inflatable versus large-diameter reamed interlo...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-008-0169-8
更新日期:2008-05-01 00:00:00
abstract::In 1994, a pro bono hand clinic was started on the Navajo Nation in northeastern Arizona. The Navajo Nation, larger than the state of West Virginia, holds the greatest concentration of Native Americans in the United States. There has been no specialty hand care on the reservation, home to a population approximately 16...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200203000-00006
更新日期:2002-03-01 00:00:00
abstract::Chondrocytes are the single cellular component of hyaline cartilage. Under physiologic conditions, they show steady-state equilibrium between anabolic and catabolic activities that maintains the structural and functional integrity of the cartilage extracellular matrix. Implicit in the loss of cartilage matrix that is ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/01.blo.0000144854.66565.8f
更新日期:2004-10-01 00:00:00
abstract::Sixty patients with congenital upper-limb deficiency were evaluated for scoliosis in 1972. Twenty-one patients had scoliosis of 5 degrees or more and 15 had scoliosis of 10 degrees or more. Fifteen of these patients had long-term follow-up periods. Thirteen patients had idiopathic scoliosis. Idiopathic scoliosis assoc...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND:High tibial osteotomy (HTO) has long been accepted as an effective treatment for unicompartmental osteoarthritis of the knee in young, active adults. For varus knees, the two most commonly performed valgus-producing HTOs are the lateral closing wedge and the medial opening wedge. Regardless of technique, som...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-013-3040-5
更新日期:2014-01-01 00:00:00
abstract::Two untreated completely dislocated hips were examined pathologically in a 74-year-old male dissecting room cadaver. The femoral heads bilaterally were 9 cm above the acetabular fossae. They lay adjacent to each ilium with no secondary acetabulum formation. A thickened and markedly elongated fibrous capsule appeared t...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1976-09-01 00:00:00
abstract::This study explored the possibility that altered sensitivities of the dorsal root and dorsal root ganglion to neuroactive substances released in inflamed tissue may be involved in radicular pain. The chemical sensitivities of the dorsal root and ganglion of rats were examined by monitoring nerve membrane potential. En...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199912000-00036
更新日期:1999-12-01 00:00:00
abstract::While the entity of nonsecretory myeloma is rare, its diagnosis may be delayed or remain undetected if too much reliance is placed on the presence of a serum or urinary M component, which traditionally has been considered an important, if not essential, feature of plasma cell myelomatosis. Nonsecretory myeloma is char...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1982-11-01 00:00:00
abstract::A technique of computed tomography with intravenous contrast has proven useful in the differentiation between osteoid osteoma and other similar appearing lucent lesions of bone in 6 cases. The clinical evaluation of benign appearing radiolucent lesions of long bones has been greatly improved by the use of modern imagi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199606000-00030
更新日期:1996-06-01 00:00:00
abstract::Seventy-five adults who sustained 76 tibial plateau fractures were treated according to a prospective protocol using instability in extension as the principal indication for operative fixation. Patients showing instability underwent closed manipulative reduction under fluoroscopic guidance. If significant joint depres...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199706000-00007
更新日期:1997-06-01 00:00:00
abstract::Regional cortical blood flow was measured in 23 adult mongrel dogs using the hydrogen washout technique. Cortical blood flow in the rib was found to be 4.7 +/- 0.8 ml/min/100 ml (n=21). The concept of a dual blood supply to cortical bone is supported since eliminating the medullary supply did not affect the measurable...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1982-05-01 00:00:00
abstract::Temporal and distance gait factors, foot-switch contact patterns, ankle/subtalar joint motion, and center of foot pressure distribution have been used to evaluate normal and abnormal foot mechanics. A normal control group and selected patients with well defined pathologic conditions were studied to examine the effecti...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-07-01 00:00:00
abstract::Thirty-five patients with a benign lesion of the femoral neck or trochanter were treated and seen in followup at the authors' institution from 1988 to 1991. Sixteen men and 19 women between the ages of 18 and 54 years (average, 27 years) were seen at an average followup of 3 years 6 months (range, 2-5 years). Eight pa...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199607000-00034
更新日期:1996-07-01 00:00:00
abstract:BACKGROUND:An entrustable professional activity describes a professional task that postgraduate residents must master during their training. The use of simulation to assess performance of entrustable professional activities requires further investigation. QUESTIONS/PURPOSES:(1) Is simulation-based assessment of reside...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-015-4553-x
更新日期:2016-04-01 00:00:00
abstract::A new mouse osteopetrotic mutation, osteosclerosis, has been examined with respect to rickets. These osteopetrotic mice were hypocalcemic and hypophosphatemic, and had greatly thickened epiphyseal plates with abnormalities in matrix vesicles when compared with normal littermates. Such biochemic and morphologic manifes...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1985-12-01 00:00:00
abstract::Intraoperative proximal femur fractures are a significant concern during noncemented total hip arthroplasty. The current study was performed to investigate the hypothesis that broaching the femur and inserting the stem without using mallet applied impact loads will reduce the risk of intraoperative fracture. Rosette s...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200001000-00025
更新日期:2000-01-01 00:00:00
abstract::To study the revascularization pattern of nontraumatic osteonecrosis, superselective angiography of the femoral medical circumflex artery was done twice on 13 hips for which no treatment had been given. Angiographic evaluation of the hips with early-stage osteonecrosis not visible on radiographs showed the absence of ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199604000-00019
更新日期:1996-04-01 00:00:00
abstract:BACKGROUND:Revision THA to treat recurrent instability can itself be complicated by recurrent instability, and when this occurs, this problem is difficult to treat. Some patients' THAs will continue to dislocate despite use of a constrained liner. One option in this difficult-to-treat group is conversion to a dual-mobi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999.0000000000000026
更新日期:2018-02-01 00:00:00
abstract::Humerus fractures comprise 5% to 8% of all fractures. Nonunions are uncommon, but when they occur, they present a challenge to the orthopaedic surgeon and often are debilitating to patients. There are risk factors that may predispose patients to nonunion. Many methods of treating these nonunions have been described wi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/00003086-200402000-00008
更新日期:2004-02-01 00:00:00
abstract::The major problem in osteoarthritis research today is our inability to promote effective cartilage regeneration in the presence of adult chondromalacia. Yet such regeneration is consistently present in acromegalics. The present study of experimentally damaged rabbit knee cartilage measures numbers of cells, mitoses, t...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1975-01-01 00:00:00
abstract::Therapeutic radiation delivered to bone and the adjacent local tissues before allograft limb-salvage surgery has been associated with poor graft incorporation and higher numbers of clinical complications. Our objective was to determine the effect of preoperative radiation therapy on specific histologic, molecular and ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000165732.64757.bb
更新日期:2005-06-01 00:00:00
abstract::Computer-assisted navigation systems for hip resurfacing arthroplasty are designed to minimize the chance of implant malposition. However, there is little evidence computer navigation is useful in the presence of anatomical deformity. We therefore determined the accuracy of an image-free resurfacing hip arthroplasty n...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-009-0850-6
更新日期:2009-09-01 00:00:00