Abstract:
:A prospective study of the sensitivity, specificity, and predictive values for frozen sections against cultures obtained at the time of revision total joint replacement was done. One hundred twenty-one revision total joint replacements were done in 92 men and 29 women. A positive frozen section with more than 10 polymorphonuclear leukocytes per high power field was compared with the intraoperative cultures. Twenty-one patients who had revision surgery had greater than 10 polymorphonuclear leukocytes per high power field. Of these, 14 patients had positive cultures. The remaining 100 patients had less than 10 polymorphonuclear leukocytes per high power field, but seven had positive cultures. Statistical analysis of frozen sections for all total joint arthroplasties revealed a 67% sensitivity, 93% specificity, 67% positive predictive value, and 93% negative predictive value. Analysis of frozen sections for total hip arthroplasties revealed a 45% sensitivity, 92% specificity, 55% positive predictive value, and 88% negative predictive value. Analysis for total knee arthroplasties revealed 100% sensitivity, 96% specificity, 82% positive predictive value, and 100% negative predictive value. Comparisons of sensitivity, positive predictive value, and negative predictive value between total knee arthroplasty and total hip arthroplasty were significant. The results indicate that the use of intraoperative frozen section analysis with greater than 10 polymorphonuclear leukocytes per high power field as an indication of infection lacks the positive predictive value and sensitivity for accurate determination of prosthetic infection at the time of revision total hip arthroplasty. Frozen sections have an acceptable sensitivity and positive predictive value in total knee arthroplasty. The results of the current study show the limitation of using frozen sections as a diagnostic test for infection in revision total hip arthroplasty.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Banit DM,Kaufer H,Hartford JMdoi
10.1097/00003086-200208000-00026subject
Has Abstractpub_date
2002-08-01 00:00:00pages
230-8issue
401eissn
0009-921Xissn
1528-1132pub_type
杂志文章abstract::There has been a substantial change in the population demographics of patients who potentially will require total joint replacements. We studied data regarding temporal trends in physical condition, life expectancy, education, and other population demographics of individuals most likely to receive total joint replacem...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000188066.01833.4f
更新日期:2006-02-01 00:00:00
abstract::Twenty-eight joints with heterotopic ossification in 16 head-injured adults were forcefully manipulated 39 times under general anesthesia. The etiology of the heterotopic bone was trauma in seven joints and idiopathic (neurogenic) in 21. Indications for manipulation were inability to participate in therapy due to a lo...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1982-09-01 00:00:00
abstract::Ten years ago, a protocol using Depo-Medrol injections was developed for the treatment of unicameral bone cysts. This concept, designed by tumor surgeons and based on theory, has been cautiously approached. However, reproducible results have gradually increased clinical acceptance. Understanding the healing process ha...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND:The standard approach to lateral tibial plateau fractures involves elevation of the iliotibial band (IT) and anterior tibialis origin in continuity from Gerdy's tubercle and metaphyseal flare. We describe an alternative approach to increase lateral plateau joint exposure and maintain iliotibial band insertio...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-013-2962-2
更新日期:2013-09-01 00:00:00
abstract::Dual energy xray absorptiometry was investigated as a method for evaluation of the strength of closed tibial fractures. In 40 goats, a closed midshaft fracture was created in the left tibia. The fractures were stabilized with an external fixator. After 2 weeks (n = 21) and after 4 weeks (n = 19), both tibias were expl...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200011000-00035
更新日期:2000-11-01 00:00:00
abstract::Rupture of the Achilles tendon is being reported more frequently. Results published in the literature in the past 25 years were reviewed to determine the overall outcome comparing surgical with nonsurgical treatment and to identify areas needing further study. The rerupture rate for surgically treated patients was 12/...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-06-01 00:00:00
abstract::Bone tumors occurring in periarticular locations may cause a substantial risk of subchondral fracture and collapse. Poly-methylmethacrylate has been used for reconstruction in these instances because of its immediate structural stability. Allogeneic graft allows for biologic incorporation and remodeling, but it takes ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/blo.0b013e31804e8470
更新日期:2007-08-01 00:00:00
abstract::The treatment of 19 congenitally dislocated knees in 11 patients is reviewed. The knees were subdivided into genu recurvatum, subluxation and dislocation. Nine knees were treated conservatively and ten surgically. A good result was obtained with conservative treatment if started before the age of three months; after t...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-03-01 00:00:00
abstract::A stylized wedge-shaped defect was created in the medial plateau of autopsy specimens of the tibia to evaluate methods for fixation in total knee arthroplasty. A series of tibial components was inserted by five different methods. With each method loading of up to 1780 N axially and a varus load of 1340 N at 28 Newton-...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1984-04-01 00:00:00
abstract:BACKGROUND:Hybrid revision knee component fixation, in which cement is placed in the metaphysis combined with a cementless diaphyseal engaging stem, provides ease of insertion, possibly improved component alignment, and easier removal if required, compared with fully cemented prostheses. The literature suggests the tec...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1569-0
更新日期:2011-03-01 00:00:00
abstract::Movement between screw threads and bone inhibits bone formation, revascularization and remodeling of dead bone. Movement causes the screw to become enveloped by fibrous tissue in response to necrosis and resorption of adjacent dead cortical bone. This results in a radiologically discernible radiolucent "halo" about th...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-197509000-00032
更新日期:1975-09-01 00:00:00
abstract::Stress deprivation alters the morphologic, biochemical, and biomechanical characteristics of various components of synovial joints. Prominent among the protean changes that result are proliferation of fibrofatty connective tissue within the joint space, adhesions between synovial folds, adherence of fibrofatty connect...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-06-01 00:00:00
abstract:UNLABELLED:This study was performed to determine whether patients who sustain an intertrochanteric fracture have better outcomes when stabilized using a sliding hip screw or an intramedullary nail. A 20% sample of Part A and B entitled Medicare beneficiaries 65 years or older was used to generate a cohort of patients w...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,多中心研究
doi:10.1007/s11999-008-0285-5
更新日期:2008-11-01 00:00:00
abstract::The presence of a "pseudocapsule," composed of an inner compression zone and outer reactive zone, is a frequent finding in the periphery of osteosarcoma. Morphologic and immunohistochemical methods were used to determine the type of inflammatory cell most closely related to the formation of this pseudocapsule. Six and...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1994-03-01 00:00:00
abstract::Creating a tissue engineered meniscus requires that specific biologic considerations such as cell type, matrix scaffold, bioreactor design (in vitro, in vivo, or both), and environmental conditions (media, cytokines, physical stimuli) be addressed. Meniscal cells, fibroblasts, and mesenchymal stem cells have been prop...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1999-10-01 00:00:00
abstract::On January 17, 1995, the Hanshin-Awaji earthquake directly hit a metropolis and destroyed approximately 120,000 houses. Many people were buried under the debris of the Japanese style wooden houses or were injured by falling furniture. Twenty-five patients (35 extremities) with earthquake associated peripheral nerve pa...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1999-05-01 00:00:00
abstract::A prospective study ascertained the effect of lateral retinacular release and/or excision of the infrapatellar fat pad on patellar vascularity after total knee arthroplasty. Fifty patients (70 knees) had postoperative technetium bone scans, which revealed a higher incidence of vascular compromise of the patella after ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1990-11-01 00:00:00
abstract:BACKGROUND:Stiffness after a TKA can cause patient dissatisfaction and diminished function, therefore it is important to characterize predictors of ROM after TKA. Studies of AP translation in conscious individuals disagree whether AP translation affects maximum knee flexion angle after implantation of a highly congruen...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-013-3274-2
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:Several recently published population-based studies have highlighted the association between insurance status and survival in patients with various cancers such as breast, head and neck, testicular, and lymphoma [22, 24, 38, 41]. Generally, these studies demonstrate that uninsured patients or those with Medi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/CORR.0000000000000889
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Treatment of giant cell tumor of bone (GCT) often is complicated by local recurrence. Intralesional curettage is the standard of care for primary GCTs. However, there is controversy whether intralesional curettage should be preferred over wide resection in recurrent GCTs. QUESTIONS/PURPOSES:We investigated ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1560-9
更新日期:2011-04-01 00:00:00
abstract::Giant sacral schwannomas (GSS) are extremely rare. Complete resection of benign but neurologically devastating tumors has been recommended. A 48-year-old man with GSS had a tumor so large that a total sacrectomy was necessary. A special method of lumbar iliac fixation was devised. Two years and nine months after surge...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-09-01 00:00:00
abstract::One option for dealing with considerable femoral bone deficiency at revision surgery is the use of extensively porous coated cobalt-chrome cylindrical stems. This technique has been shown to be a reliable, technically straightforward method that can be applied to all but the most severe femoral structural defects. Ver...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000150274.21573.f4
更新日期:2004-12-01 00:00:00
abstract::Fractures of the proximal femur are, more than ever, an important challenge in the field of traumatology. The Gamma nail, a combination of advantages of the sliding screw with the intramedullary nail, represents an efficient technique in the management of these fractures. A series of 224 fractures of the proximal femu...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1998-05-01 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::This paper gives a general introduction to the terminology, concepts, and classifications of external fixators. A clear distinction is made between characteristics typical of the three types of external fixators, simple, clamp, and ring, and those typical of the four standard frames that can be built with each of the ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1989-04-01 00:00:00
abstract::In the majority of skeletal metastases, new bone develops simultaneously with bone destruction. The roentgenogram indicates the net effect of these two processes. Where the bone formation predominates, the lesion appears sclerotic. Where bone destruction predominates, it appears lytic. Mixed lesions may also occur. Th...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1982-09-01 00:00:00
abstract::The involvement of peripheral nerves in burn injury is not common, but when nerves are involved, prompt therapeutic intervention is necessary to avoid increased morbidity. Aside from the direct effects of the trauma, the burn team must anticipate dangerously excessive edema from circumferential burns, and avoid second...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1982-03-01 00:00:00
abstract::The growth plate of the tibial tuberosity does not develop until several months after birth and is structurally different than most growth plates that are loaded primarily in compression. Histologically, it is particularly different from the juxtaposed proximal tibial growth plate. The physis of the tibial tuberosity ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1976-05-01 00:00:00
abstract::In this study, the effect of clarithromycin on the destruction of bacterial biofilm in Pseudomonas aeruginosa osteomyelitis was investigated. Foreign body-related osteomyelitis caused by ceftazidime-sensitive Pseudomonas aeruginosa was produced in the tibias of 26 rats. After osteomyelitis was verified on Day 14, 10 r...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:2005-01-01 00:00:00
abstract::Postirradiation and Paget's osteosarcomas are high-grade malignancies. The five-year survival was only 10% in recent experience at the author's institution. Progressive pain is an important clinical feature in both conditions. Careful roentgenographic studies demonstrate cortical destruction and a soft-tissue mass in ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1991-09-01 00:00:00