Abstract：
:In this literature review, 30 reports provided outcome data on 37 direct exchange arthroplasties, 530 open debridements, and 23 arthroscopic debridements. The average followup was approximately 4 years, but the range was broad (range, 0.02-14 years). Infection was controlled in 33 of the 37 infected total knee arthroplasties (89.2%) treated by direct exchange arthroplasty, in only 173 of the 530 infected total knee arthroplasties (32.6%) treated by open debridement and retention of the prosthetic components, and in 12 of the 23 infected total knee arthroplasties (52.2%) treated by arthroscopic debridement. There was wide variability in associated antibiotic therapy. Factors associated with successful direct exchange included infections by gram-positive organisms, absence of sinus formation, use of antibiotic-impregnated bone cement for the new prosthesis, and 12 weeks of antibiotic therapy. Direct exchange arthroplasty failed in four of 37 knees; two were in patients with rheumatoid arthritis who were taking corticosteroids. Factors associated with successful debridements included those done within 4 months of the index procedure, or in patients with less than 4 weeks of symptoms, antibiotic sensitive gram-positive organisms, well-fixed components with no radiologic evidence of osteitis, and in young healthy patients. Factors associated with the failed debridements included postoperative drainage for more than 2 weeks, sinus tracts present at the time of the debridement, a hinged prosthesis, and an immunocompromised host. Direct exchange can be successful with a sensitive organism in a healthy host with prolonged antibiotic therapy. Debridement can be successful in early infections in a healthy host.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Silva M,Tharani R,Schmalzried TPdoi
10.1097/00003086-200211000-00022subject
Has Abstractpub_date
2002-11-01 00:00:00pages
125-31issue
404eissn
0009-921Xissn
1528-1132pub_type
杂志文章abstract：:The skeletal dysplasias are a large and heterogeneous group of disorders. Currently, there are more than 100 recognized forms of skeletal dysplasia, which makes arriving at a specific diagnosis difficult. This process is additionally complicated by the rarity of the individual conditions. The establishment of a precis...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200208000-00006
更新日期：2002-08-01 00:00:00
abstract：:Do X-rays adequately reflect the strength of callus post fracture? Eleven rabbit tibiae were manually fractured and allowed to heal in plaster. At varying times post fracture, the rabbits were sacrificed and the tibiae were removed. AP and lateral X-rays of each tibia were obtained and shown to 27 orthopedists and rad...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1979-07-01 00:00:00
abstract：BACKGROUND:Osteochondral allografting is an option for successful treatment of large articular cartilage defects. Use of osteochondral allografting is limited by graft availability, often because of loss of chondrocyte viability during storage. QUESTIONS/PURPOSES:The purpose of this study was to compare osteochondral ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-014-3773-9
更新日期：2014-11-01 00:00:00
abstract：BACKGROUND:Ankle arthrodesis may be achieved using the Ilizarov method. Comorbidities, such as diabetes, Charcot neuroarthropathy, osteomyelitis, leg length discrepancy, and smoking, can make an ankle fusion complex and may be associated with lower rates of healing. QUESTIONS/PURPOSES:We asked if (1) smoking and other...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2470-9
更新日期：2012-10-01 00:00:00
abstract：:In situ hybridization and ultrastructural immunohistochemistry were used to study the synthesis and distribution of 2 bone matrix proteins, bone sialoprotein and osteopontin, in the proximal tibial epiphysis in 21-, 32-, and 84-day-old rats. Bone sialoprotein messenger ribonucleic acid expression was restricted to cel...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199609000-00033
更新日期：1996-09-01 00:00:00
abstract：:A prospective comparative study was conducted involving 62 patients to determine the effects and limits of accelerated rehabilitation on clinical outcome. The study focused on whether aggressive rehabilitation after anterior cruciate ligament reconstruction with the doubled semitendinosus and gracilis tendon autograft...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200204000-00043
更新日期：2002-04-01 00:00:00
abstract：:In 15 documented cases, subluxation or dislocation of the hip was discovered months or years after previous multiple normal physical examinations. The examiners were unique in that six were professors specializing in childrens' orthopedics, four were board-certified orthopedists, and five were pediatricians. An increa...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-02-01 00:00:00
abstract：:Osteoarthropathy in congenital sensory neuropathy with anhidrosis (CSNA) is not only a rare complication but also difficult to treat. Two patients with CSNA, a three-year-old boy and a 24-year-old woman, were treated as follows. The boy was affected in his left knee and left heel and required reduction of recurrent bi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1990-09-01 00:00:00
abstract：:The Hackethal technique of using stacked medullary pins for fixation of humeral shaft fractures is usually associated with relatively little blood loss; in addition, exposure of the fracture site and possible associated muscular trauma are avoided, and the risk of contusion of the radial nerve that may occur in fixati...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-10-01 00:00:00
abstract：:A computer-assisted model has been developed to improve the results of surgical techniques for reconstruction of hip dysplasia. This method assesses the coverage and congruency of the femoral head by evaluating multiple factors that may influence surgical planning. It achieves a more reliable image because the measure...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-07-01 00:00:00
abstract：:Degenerative changes in the spine, specifically disc degeneration and facet arthrosis, and osteoporosis are conditions that primarily affect the elderly and may significantly impact the quality of life. The relationship between osteoporosis and degenerative changes in the hip joint has been studied, but their correlat...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199603000-00017
更新日期：1996-03-01 00:00:00
abstract：:During the past ten years, approximately 3000 cases of knee arthroscopy have been performed in a CO2 medium. The setup for the use of CO2 is quite simple and is explained here on a step-by-step basis. Advantages are a better visual field and no motion of tissue in the arthroscopic field. The disadvantages are minimal....
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1990-03-01 00:00:00
abstract：:Sixteen porous polysulfone-coated canine femoral stems were inserted into 14 dogs. Coatings were approximately 40% porous, with an average pore size of 125 or 250 microns. Bone was formed within at least about 30% of the surface pores of the implants. The tissue ingrowths filling the pores included marrow and fibrous ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-06-01 00:00:00
abstract：:Avulsion of the navicular tuberosity in association with fracture at the calcanecuboid joint is a characteristic pattern of injury resulting from an acute valgus and dorsiflexion stress. Only 22 cases of this unusual injury pattern have been reported, and confusion exists regarding treatment. Recommendations for manag...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1993-07-01 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：:Despite a standardized operative technique and appropriate patient selection for physeal bar resection, a bar size less than 50% of the physis, and a prospective growth period greater than 2 years, failure may result. Limited growth because of poor function of the remaining physis and secondary tethers (incomplete res...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200212000-00031
更新日期：2002-12-01 00:00:00
abstract：:The literature on the biomechanics of the intervertebral disk is reviewed with emphasis on biomechanical--biochemical--morphological correlative studies. The deficiency of definitive correlative studies is apparent and an appeal is made to interested investigators to fill in the voids in this extremely important area ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-197711000-00015
更新日期：1977-11-01 00:00:00
abstract：:Plugs of cartilage and subchondral bone from patellae were subjected to cyclic compression consisting of rapid ramp loading for 0.3 seconds followed by a 2.7 second pause. At 1000 psi cyclic load, surface abrasion of the cartilage was noted at 250 cycles of compression. Primary fissures, which penetrated to the calcif...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-04-01 00:00:00
abstract：:Juvenile rheumatoid arthritis (JRA) involves a wide range of joint tissues. Tissue changes include proliferation of synovial cells, alterations in synovial fluid, and degradation of articular cartilage. Synovial cell proliferation results in increased numbers of fibroblasts and lymphocytes. Changes in the synovial flu...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1990-10-01 00:00:00
abstract：:Axillary nerve injury remains the most common peripheral nerve injury to affect the shoulder. It most often is seen after glenohumeral joint dislocation, proximal humerus fracture, or a direct blow to the deltoid muscle. Compression neuropathy has been reported to occur in the quadrilateral space syndrome, although th...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1999-11-01 00:00:00
abstract：:Osteonecrosis (ON) is commonly caused by high doses of glucocorticoids or ethanol intake. We previously reported suppression of BMP-2 by dexamethasone was more pronounced and enhancement by lovastatin was less pronounced in bone marrow stromal cells (BMSCs) from patients with ON than from patients without ON. We there...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-009-0803-0
更新日期：2009-08-01 00:00:00
abstract：:Intracapsular fractures of the hip have been classified by different authors with a basis on various concepts. Pauwels classified these fractures according to the angle of inclination; Linton used trabecular disposition among the fractural fragments, and Garden described four types according to the order of displaceme...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-200206000-00004
更新日期：2002-06-01 00:00:00
abstract：BACKGROUND:Combat-wounded service members are surviving battle injuries more than ever. Given different combat roles held by men and women, female service members should survive wounds at an unprecedented rate. QUESTIONS/PURPOSES:We determined whether the casualty rates for females differ from their male counterparts ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-1840-z
更新日期：2011-07-01 00:00:00
abstract：:Eighty-three total knee arthroplasties done at a single university hospital were reviewed specifically to examine the presence of lysis. Components that were radiographically loose were excluded. The incidence of lysis varied significantly with the method of component fixation. The highest incidence of lysis (30%) was...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1995-12-01 00:00:00
abstract：:Fifteen patients with fracture of the axis arch ("Hangman's Fracture" of the cervical spine) reviewed with regard to the clinical features, mechanism of injury and management, present a relatively high rate of cord involvement (11 patients) and injuries around the jaw (5 patients). All of the injuries occurred in civi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-197501000-00024
更新日期：1975-01-01 00:00:00
abstract：:The osseous tunnel technique of anterior cruciate ligament (ACL) reconstruction was compared to the over-the-top (OTT) technique in vivo. A prosthesis replaced the ACL in 35 dogs by one of three methods: double osseous tunnels, OTT, or a combined method utilizing the unique Y shape of the prosthesis by placing one for...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-06-01 00:00:00
abstract：BACKGROUND:Osteoid osteoma has a nidus surrounded by sclerotic bone with a size usually less than 20 mm. Its diagnosis is made on typical presentation of nocturnal pain and imaging findings. Excision of the niduses, which are often small and difficult to precisely identify, sometimes may result in resection of surround...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-010-1265-0
更新日期：2010-07-01 00:00:00
abstract：:Medial meniscal anomalies are rare. The anterior horn insertion into the anterior cruciate ligament is the most common. In the course of an arthroscopy for torn lateral meniscus, an anomalous band in continuity with the posterior horn of the medial meniscus was observed to insert into the anterior cruciate ligament. A...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1998-03-01 00:00:00
abstract：:Patients who received a single corticosteroid injection for treatment of third webspace plantar interdigital neuroma were studied retrospectively. Forty-three patients (51 feet) were available for followup study (followup mean, 4 years; range, 2 to 6 years). Mean age of patients was 53 years. Pain initially was reliev...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199605000-00022
更新日期：1996-05-01 00:00:00
abstract：:Arterial occlusion after total knee arthroplasty is an uncommon complication. In the literature only a few cases have been reported, and non consensus exists on the optimal management for this condition. The authors report two patients with popliteal artery thrombosis in the early postoperative period. Both patients w...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199909000-00020
更新日期：1999-09-01 00:00:00
