Abstract：
:The forces and torques that occur during walking gait, particularly during toe-off, promote articulation in the posteromedial quadrant of tibial inserts. Retrieved components of failed knee arthroplasties show ultrahigh molecular weight polyethylene damage patterns in this region. Component-designed constraint, compromised polymer, and surgical factors account for these observations. The current authors compare the contact stresses that developed on four implant designs during toe-off for optimally aligned and externally torqued components using the finite element method. Under 16 N-m of torque, the four designs studied varied regarding their centers of rotation and magnitude of external rotation, which are related directly to their specific articulating surface geometry. Designs with conforming condylar geometry had greater rotational constraint and therefore, less external rotation. These conforming designs offer the benefits of lower stresses and tend to limit contact near the edge of the plateau. However, because of their increased rotational constraint, torque is transmitted more readily to the implant-bone interface, increasing the potential for implant loosening. The data presented serve as an indicator of the potential for polyethylene tibial component surface damage and define the role that implant geometry plays in resisting external rotation.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Morra EA,Postak PD,Plaxton NA,Greenwald ASdoi
10.1097/01.blo.0000063597.67412.e9subject
Has Abstractpub_date
2003-05-01 00:00:00pages
90-100issue
410eissn
0009-921Xissn
1528-1132pub_type
杂志文章abstract：:The indication for otherwise established lateral plate fixation in fractures of the calcaneus becomes relative when severe comminution (Sander's Type III and IV) of the bone involves concomitant massive soft-tissue swelling. The calcaneus is shortened, Böhler's angle flattened, and lateral bulging and varus deformity ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-05-01 00:00:00
abstract：:The etiology of the foot deformity in patients with Charcot-Marie-Tooth disease has not previously been discussed in relation to the extrinsic muscle function around the foot and ankle. Eight adult patients with a strong familial history were evaluated, and their foot findings were remarkably similar. All demonstrated...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-09-01 00:00:00
abstract：BACKGROUND:Reconstruction of the extensor mechanism after resection of the proximal tibia is challenging, and several methods are available. A medial gastrocnemius flap commonly is used, although it may be associated with an extensor lag. This problem also is encountered, although perhaps to a lesser extent, with other...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-013-2851-8
更新日期：2013-07-01 00:00:00
abstract：:The present study evaluated cortical porosity and thickness of intact rat femora 12 weeks after intramedullary reaming and nailing. The right femora were reamed and received either flexible polyacetal nails or rigid stainless steel nails. A third group was reamed but not nailed. The left femora were used as controls. ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1989-09-01 00:00:00
abstract：:Stress fracture of the patella can occur with significant frequency following patellar replacement with the duopatellar knee prosthesis. In the first 372 knees with patellar resurfacing, the incidence was 0.7% in rheumatoid arthritis (2 fractures in 286 knees) and 3.5% in osteoarthritis (3 fractures in 86 knees). The ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1982-10-01 00:00:00
abstract：:Deep flexion affects both femorotibial contact pattern and the patellofemoral articulation. The purpose of this study was to compare the patellofemoral motion of nonimplanted and implanted knees and to analyze femorotibial kinematics after total knee replacement designed for deep flexion. Three-dimensional patellofemo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000148948.79128.76
更新日期：2004-11-01 00:00:00
abstract：:Despite their increasing clinical use, mobile-bearing total knee replacements have not been well characterized biomechanically. An experimental and finite element analysis was done to assess the mobility and contact mechanics of a widely used rotating platform total knee replacement. Parameters that varied were axial ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200111000-00004
更新日期：2001-11-01 00:00:00
abstract：:Fourteen boys (56%) and 11 girls (44%) 4 to 17 years of age (mean, 12.2 years) who had osteosarcoma and open epiphyseal plates were studied. A possible correlation between transepiphyseal spread of osteosarcoma and radiologic and histopathologic findings was investigated. Epiphyseal plate invasion was detected radiolo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200004000-00006
更新日期：2000-04-01 00:00:00
abstract：:Dissociation of the polyethylene liner from its metal shell has been reported as a rare occurrence. During a 4-year period, six hips in five patients who had the Harris-Galante II porous acetabular component implanted as part of a primary or revision total hip arthroplasty presented with acute onset of pain and diffic...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200105000-00021
更新日期：2001-05-01 00:00:00
abstract：:A massive solitary tophus containing calcium pyrophosphate dihydrate (CPPD) crystals was resected from the distal clavicle and proximal acromion of a 62-year-old man who presented with a painful shoulder mass. The diagnosis was confirmed histologically and by X-ray diffraction. CPPD crystal deposition was found within...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-02-01 00:00:00
abstract：:Metasul metal-on-metal articulations have been used for 15 years in approximately 300,000 total hip replacements. We have used Metasul articulations in three clinical studies and have shown clinical success as measured by Harris hip scores and patient self-assessment; we also have had the usual mechanical complication...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/01.blo.0000150343.66755.79
更新日期：2004-12-01 00:00:00
abstract：BACKGROUND:Wound closure accounts for a relatively constant portion of the time required to complete a surgical case. Both longer closure times and wound infections contribute to higher medical costs and patient morbidity. QUESTIONS/PURPOSES:We therefore determined whether (1) biologic and treatment factors greater in...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2524-z
更新日期：2013-03-01 00:00:00
abstract：BACKGROUND:So-called "hazardous attitudes" (macho, impulsive, antiauthority, resignation, invulnerable, and confident) were identified by the Federal Aviation Administration and the Canadian Air Transport Administration as contributing to road traffic incidents among college-aged drivers and felt to be useful for the p...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-014-3966-2
更新日期：2015-05-01 00:00:00
abstract：:A 19-year-old man with a fracture of the distal humerus avulsed the anterior interosseous nerve. Avulsion of this nerve may be more common than previously believed. As shown by a cadaver study, the mechanism of injury is related to traction on the median nerve. Complete clinical assessment requires an accurate neurolo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-12-01 00:00:00
abstract：:To evaluate magnetic resonance imaging (MRI) of meniscal, ligamentous, and bony abnormalities in patients without clinical symptoms, scans were performed on 74 asymptomatic volunteers without histories or symptoms of knee injury. Before review by three radiologists in an independent and blinded fashion, the scans were...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-09-01 00:00:00
abstract：:Gunshot injuries to the hand and upper extremity have been studied during military conflicts and in urban settings. Treatment concepts include identification of injured structures, aggressive surgical wound care, and reconstruction of important functional structures. There are various types of missile injuries. For si...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-200303000-00016
更新日期：2003-03-01 00:00:00
abstract：:Several extracellular matrices are formed by healing fractures, and the collagens within these matrices have been identified in rabbit and rat fracture models. Type III collagen is the major collagen of the fibrous matrix that forms along the periosteal surface. Type I collagen is secreted in large amounts as trabecul...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1990-06-01 00:00:00
abstract：:Traditional imaging methods used in the detection and evaluation of metastatic bone disease lack either sensitivity (plain radiography) or specificity (bone scintigraphy). Magnetic resonance imaging now has been shown to be the most sensitive imaging technique available for the detection of bone metastases. On T1-weig...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1995-03-01 00:00:00
abstract：:Lauge-Hansen's system of classification of ankle fractures has been of pioneering importance and when correctly employed has improved the results of conservative treatment. Weber's classification scheme introduced by AO is simpler and more suited for surgical than nonoperative therapy. Both systems have deficiencies. ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1985-10-01 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：BACKGROUND:When considering arthroscopic surgery for treatment of hip pain, it is important to understand the influence of joint degeneration on the likelihood of success. Previous research has shown poorer outcomes among patients with osteoarthritis but new arthroscopic techniques including femoroacetabular impingemen...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2594-y
更新日期：2013-02-01 00:00:00
abstract：:Biodegradable local antibiotic delivery systems have gained interest for prophylaxis and treatment of musculoskeletal infections. We studied the biodegradable materials Osteo- Set, DBX and Collagraft for local delivery of vancomycin and gentamicin in vitro. We determined the antimicrobial activity of vancomycin and ge...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000229319.45416.81
更新日期：2006-10-01 00:00:00
abstract：:Patellar tendinosis is characterized by longstanding localized and activity-related pain, swelling and tenderness on palpation, and characteristic features on magnetic resonance imaging and ultrasonography and during surgical excision. Histologic examination of tendinosis tissues shows disrupted collagen matrix, incre...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200207000-00022
更新日期：2002-07-01 00:00:00
abstract：:Vast advances in technology have taken place in the field of radiology led by the introduction of magnetic resonance imaging. The added advantages of exquisite soft tissue contrast and multiplanar imaging capabilities have revolutionized the understanding of complex anatomic relationships and diagnoses. The current au...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-200102000-00018
更新日期：2001-02-01 00:00:00
abstract：BACKGROUND:Extensive posteromedial release to correct severe varus deformity during TKA may result in mediolateral or flexion instability and may require a constrained implant. We describe a technique combining computer navigation and medial condylar osteotomy in severe varus deformity to achieve a primary goal of liga...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2773-x
更新日期：2013-05-01 00:00:00
abstract：:The purpose of the current investigation was to present a standard method by which an orthopaedic practice can analyze its practice expenses. To accomplish this, a five-step process was developed to analyze practice expenses using a modified version of activity-based costing. In this method, general ledger expenses we...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200003000-00033
更新日期：2000-03-01 00:00:00
abstract：UNLABELLED:Because of improvements in surgical technique, anesthesia, and rehabilitation, mortality after hip arthroplasty may be on the decline. The purpose of this study was to determine the 90-day mortality rate after uncemented total hip arthroplasty (THA) performed under regional anesthesia. We retrospectively rev...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0528-5
更新日期：2009-01-01 00:00:00
abstract：:After reviewing a series of 220 patients operated upon between 1975 and 1985 for traumatic brachial plexus injuries, the authors present the results of 103 myelographies, 48 computed tomographies (CT scans) combined with standard myelography, and 25 series of images obtained by magnetic resonance imaging (MRI). To eva...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-12-01 00:00:00
abstract：:An osteosarcoma of the talus occurred in a 21-year-old man. The tumor had been mistaken for a fibrosarcoma, but its osteogenic nature was demonstrated by multiple sectioning of the entire talus. Nineteen months after amputation the patient died from pulmonary metastases. Osteosarcoma in the talus seems not to have bee...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1980-07-01 00:00:00
abstract：:Saos-2 cultured human osteosarcoma cells contain an extractable bone inducing agent that can induce heterotopic bone in the muscle of Nu/Nu mice. A semipurified GuHCl extract of Saos-2 cells also can promote healing and complete bony union in otherwise non-healing surgically induced defects of rat femur. Northern blot...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1995-04-01 00:00:00
