Abstract:
:The acute and repetitive impact and torsional joint loading that occurs during participation in sports can damage articular surfaces causing pain, joint dysfunction, and effusions. In some instances, this articular surface damage leads to progressive joint degeneration. Three classes of chondral and osteochondral injuries can be identified based on the type of tissue damage and the repair response: (1) damage to the joint surface that does not cause visible mechanical disruption of the articular surface, but does cause chondral damage and may cause subchondral bone injury; (2) mechanical disruption of the articular surface limited to articular cartilage; and (3) mechanical disruption of articular cartilage and subchondral bone. In most instances, joints can repair damage that does not disrupt the articular surface if they are protected from additional injury. Mechanical disruption of articular cartilage stimulates chondrocyte synthetic activity, but it rarely results in repair of the injury. Disruption of subchondral bone stimulates chondral and bony repair, but it rarely restores an articular surface that duplicates the biologic and mechanical properties of normal articular cartilage. In selected patients, surgeons have used operative treatments including penetrating subchondral bone, soft tissue grafts, and cell transplants and osteochondral autografts and allografts to restore articular surfaces after chondral injuries. Experimental studies indicate that use of artificial matrices and growth factors also may promote formation of a new joint surface. However, an operative treatment of an articular surface injury that will benefit patients must not just provide a new joint surface, it must produce better long-term joint function than would be expected if the injury was left untreated or treated by irrigation and debridement alone. Therefore, before selecting a treatment for a patient with an articular cartilage injury, the surgeon should define the type of injury and understand its likely natural history.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Buckwalter JAdoi
10.1097/00003086-200209000-00004subject
Has Abstractpub_date
2002-09-01 00:00:00pages
21-37issue
402eissn
0009-921Xissn
1528-1132pub_type
杂志文章,评审abstract::The prerequisites for normal gait are: (1) stability in the stance phase of gait, (2) clearance of the foot in the swing phase, (3) proper foot preposition in swing, and (4) an adequate step length. In the stance phase, the knee provides shock absorption and energy conservation; in the swing phase, it allows foot clea...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1990-04-01 00:00:00
abstract:BACKGROUND:High hip center reconstructions, used in revision and complex primary THAs, rely on pelvic bone stock at least 35 mm above the anatomic teardrop. However, the technique does not restore normal hip biomechanics and controversy exists regarding acetabular implant survival. Previous reports document a wide rang...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-012-2574-2
更新日期:2012-12-01 00:00:00
abstract::Observable objects in biology and medicine extend across a range of scale, from individual molecules and cells; through the varieties of tissue and interstitial interfaces; and to complete organs, organ systems, and body parts. These objects include functional attributes of these systems such as biophysical, biomechan...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:2006-01-01 00:00:00
abstract::A large, well-encapsulated intraneural lipoma occurred within the sciatic nerve of a 34-year-old woman. In a review of the literature, significant differences were noted between the well-encapsulated and the diffusely infiltrative lipofibromatous hamartoma types of intraneural lipomas. The average age at the time of a...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-08-01 00:00:00
abstract::Interposition grafting material is used frequently to treat osteoarthritis of the base of the thumb or tendinous and ligamentous injuries of the hand. The observation of duplicated tendons in the first dorsal compartment of the hand prompted us to explore the possibility of using the accessory abductor pollicis longus...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-009-1059-4
更新日期:2010-05-01 00:00:00
abstract::Fifty-two chronic osteomyelitis patients treated with gentamicin-polymethylmethacrylate (Septopal) antibiotic bead chains were observed retrospectively to explore the relationship between the duration of bead implantation and clinical results. Group A contained 35 asymptomatic patients who had elective bead removal ba...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-10-01 00:00:00
abstract:BACKGROUND:Postoperative varus alignment has been associated with lower IKS scores and increased failure rates. Appropriate positioning of TKA components therefore is a key concern of surgeons. However, obtaining neutral alignment can be challenging in patients with substantial preoperative varus deformity and it is un...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-1988-6
更新日期:2011-12-01 00:00:00
abstract::We describe an alternative method for lengthening a short femoral stump after wide amputation of a malignant bone tumor of the distal femur in two patients. The method consists of two procedures during the operation. The first procedure is amputation of the affected cylindrical segment of the involved limb. The second...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000141899.77580.3b
更新日期:2004-09-01 00:00:00
abstract::Although celecoxib may provide perioperative pain relief, the effect of the short-term use of celecoxib on bone ingrowth into porous-coated devices has not been previously studied in humans. Bone ingrowth into titanium and tantalum plugs was measured in nine patients who underwent staged bilateral total knee arthropla...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000238838.18799.61
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:Heterotopic ossification (HO) is a common extrinsic cause of elbow stiffness after trauma. However, factors associated with the development of HO are incompletely understood. QUESTIONS/PURPOSES:We retrospectively identified (1) patient-related demographic factors, (2) injury-related factors, and (3) treatme...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-013-3304-0
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Patient satisfaction surveys play an increasingly important role in United States healthcare policy and serve as a marker of provided physician services. In attempts to improve the patient's clinical experience, focus is often placed on components of the healthcare system such as provider interaction and oth...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/CORR.0000000000000927
更新日期:2019-12-01 00:00:00
abstract::Isogeneic and allogeneic chondrocytes cultured in collagen gel were transplanted into osteochondral defects in knee joints of inbred strains of rats. At 12 weeks, all eight isografted defects had healed successfully, compared with only four of eight allografted defects (p < 0.05). At 26 and 52 weeks, all defects excep...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1994-05-01 00:00:00
abstract::One hundred eighty five consecutive patients underwent anterior decompression, stabilization, and/or fusion procedures of the thoracolumbar spine. At 1 year or more followup, the incidence of complications was analyzed. There were no iatrogenic spinal neurologic deficits and no deep wound infections. The most common c...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1994-09-01 00:00:00
abstract::The purpose of this study was to determine whether a brace designed to unload varus degenerative knees actually alters medial compartment loads by decreasing the adduction moment. Eleven patients who had arthrosis confined to the medial compartment were fitted with a valgus brace and tested before and after brace wear...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1997-11-01 00:00:00
abstract::Rheumatoid arthritis (RA) affects the articular surfaces and the ligamentous supporting structures of synovial-lined joints. In approximately one-fourth of the patients with RA, the sacroiliac joints demonstrate radiographic changes of subchondral bony erosions and articular destruction, as well as ankylosis. Subluxat...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-08-01 00:00:00
abstract::The effects of fluoride (20 mumol/L) and bovine bone extract (17 micrograms/ml) were determined on cultures of human bone cells, embryonic chick bone cells, and human skin fibroblasts. The incorporation of [3H]thymidine into DNA was measured 16 hours after the addition of factors. After three to five days treatment, T...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1988-08-01 00:00:00
abstract:BACKGROUND:Health literacy is the ability to obtain, process, and understand health information needed to make appropriate health decisions. The proper comprehension by patients regarding a given disease, its treatment, and the physician's instructions plays an important role in shared decision-making. Studies have dis...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,收录出版
doi:10.1007/s11999.0000000000000075
更新日期:2018-04-01 00:00:00
abstract::Thirty-two rabbits were used experimentally to study the effect of cortisone in bone, lungs, kidneys, and liver. Cortisone does induce abnormal increases in the serum cholesterol, fatty metamorphosis of the liver and the fatty emboli of the subchondral vessels of the femoral heads. Clofibrate therapy appeared to modif...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract::Placement of a Steinmann pin in the calcaneus is indicated in various orthopaedic conditions. Planning the point of entry and the direction of transcalcaneal pin insertion is crucial for avoidance of neurovascular injury, tendon injury, and subtalar joint violation. Fifteen cadaveric feet were studied in which transfi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199611000-00033
更新日期:1996-11-01 00:00:00
abstract::No agreement exists on how coordinate flexion and extension movements of the interphalangeal joints of the long fingers of the hand are performed. A cinematic study in 18 healthy volunteers was done to assess the objective sequence of beginning and ending of movement in the eight free movements of the hand in which th...
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:BACKGROUND:The American Academy of Orthopaedic Surgeons (AAOS) is a globally recognized leader in musculoskeletal and orthopaedic education. Clinical guidelines are one important focus of the AAOS' educational efforts. Although their recommendations sometimes generate controversy, a critical appraisal of the overall qu...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-014-3530-0
更新日期:2014-06-01 00:00:00
abstract::Hemophilic pseudotumor is a rare, but well-known, complication of hemophilia. We describe a 50-year-old man with mild hemophilia A, but with no previous need for Factor VIII supplementation, who presented with a pathologic fracture of the right femoral neck and shaft caused by a large hemophilic pseudotumor. Initial n...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000137545.37824.b0
更新日期:2005-01-01 00:00:00
abstract::Despite widespread acceptance of total knee replacement surgery's clinical effectiveness, variation persists in long-term functional outcome. Our aim was to quantify the relative contributions of physical and emotional coexisting conditions to the variation in improvement in 12-month post-total knee replacement physic...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000185447.43622.93
更新日期:2005-11-01 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::The extraosseous blood supply to the femoral head was studied by microdissection of latex-injected vessels in 19 neonatal hips. The fetuses were of black African descent. Although the general pattern was similar to that described by previous investigators, in seven of the specimens the largest contribution to the bloo...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-04-01 00:00:00
abstract::A histologic study of vertebral end plates was performed on young rats' tails subjected to intensive passive motion. Seven six-week-old rats had two-hour motion cycles daily, for two months. Histologic changes of proximal caudal vertebrae in the experimental group were compared with those of a control group of seven r...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1992-06-01 00:00:00
abstract::A study of the injury fatality rate in an adult population was done in the Moscow region. Investigators determined that side by side with the severity of injury, the direct causes of death were erroneous diagnosis, ungrounded delay of surgical interventions, and lack of and insufficient use of necessary medical care. ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1995-11-01 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:BACKGROUND:Locking plate fixation of proximal humeral fractures improves biomechanical stability. It has expanded the indications of traditional open reduction internal fixation and become increasingly common for treating unstable, displaced proximal humeral fractures. Despite improved stability it is unclear whether t...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-1935-6
更新日期:2011-12-01 00:00:00
abstract::In this study, the authors investigated enhancing the results of autoclaved autograft bone by combining it with a vascularized bone graft and supplementing it with autogenous bone marrow for replacement of a 2-cm tibial defect in the rabbit model. The study was divided into 4 groups. Group I consisted of autoclaved au...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1995-11-01 00:00:00