Abstract:
:The ideal local antibiotic delivery system has not been created. Antibiotic-laden bone cement has become the gold standard in the treatment of infected orthopaedic implants and there are confirmatory laboratory and clinical data that support the use of these materials. Heat-stable antibiotics elute from antibiotic-laden bone cement and do not have a notable influence on the compressive strengths of bone cement if the antibiotics are used in appropriate amounts. If the proper antibiotic is chosen, placed in the appropriately porous materials in sufficient amounts, and implanted in bone, antibiotic levels in the surrounding bone are many times greater than can be achieved by safe systemic antibiotic doses. Although the materials that have been manufactured commercially have been used for over 30 years in Europe, until recently, they have not been available in the United States. Currently, there are five antibiotic-laden bone cement composites that have been approved by the FDA and that are available for clinical use. Studies are being done to search for biodegradable implants preferable to antibiotic-laden bone cement; however, these studies and the materials are still in early stages and development. Currently, there are no FDA-approved biodegradable materials available for use to treat infected orthopaedic implants. As new materials become available and their elution characteristics are recorded, it is important for surgeons to understand how the data were collected so they can have a clear understanding of the elution characteristics of the material used and how the material acts in different environments. Even with extensive historic, clinical, and research data that prove the effectiveness of antibiotic-laden cement, the ideal drug delivery system is neither agreed on nor available.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Nelson CLdoi
10.1097/01.blo.0000143741.92384.18subject
Has Abstractpub_date
2004-10-01 00:00:00pages
72-8issue
427eissn
0009-921Xissn
1528-1132pub_type
杂志文章,评审abstract:BACKGROUND:Femoroacetabular impingement has been proposed as a cause of early osteoarthritis, but it is not known how this develops over time or whether the shape of the proximal femur influences this risk. QUESTIONS/PURPOSES:(1) Which areas of the acetabulum are worn more frequently by individuals with a cam deformit...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-012-2720-x
更新日期:2013-02-01 00:00:00
abstract::Various guidelines have been proposed regarding which portions of a surgical gown may be considered sterile. Unfortunately, the validity of these recommendations has not been definitively established. We therefore evaluated gown sterility after major spinal surgery to assess the legitimacy of these guidelines. We used...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-008-0341-1
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Previous studies have shown that perioperative blood transfusion increases cancer recurrence and decreases patient survival after resection of primary malignancies. The question arises whether this association also exists in patients with already disseminated disease undergoing surgery for metastatic long-bo...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-015-4167-3
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Platelet-rich concentrates are used as a source of growth factors to improve the healing process. The diverse preparation protocols and the gaps in knowledge of their biological properties complicate the interpretation of clinical results. QUESTIONS/PURPOSES:In this study we aimed to (1) analyze the concent...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-015-4192-2
更新日期:2015-05-01 00:00:00
abstract::Hip arthroscopy has obvious advantages over arthrotomy in the pediatric population. Hip arthroscopy, used as a diagnostic or therapeutic tool, is significantly less invasive than arthrotomy and allows for quicker recovery and return to activities. In addition, arthroscopy avoids dislocation of the femoral head and the...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/01.blo.0000043044.84315.90
更新日期:2003-01-01 00:00:00
abstract::In a search for factors predisposing to the occurrence of spontaneous fractures in the renal organ transplant patient, a comparison has been made of 38 recipients sustaining spontaneous fractures and 106 without this complication. The comparison was made with regard to the clinical findings, the immunosuppressive ther...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1982-01-01 00:00:00
abstract::In adults, when flexor tendons cannot be repaired until weeks or months after injury or when tendons have ruptured and part of the tendon is nonviable, it is often inadvisable to suture the tendon ends together. When a primary repair has failed, when there has been a delay in tendon reconstruction to allow skin covera...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1989-05-01 00:00:00
abstract::Analysis of bilateral EMG and operative findings reveal that there is a definite correlation between bilateral positive EMG in particular and multiradicular EMG's and the findings of stenosis or spondylosis of the lumbar canal. Electromyography is helpful in identifying the atypical patient or the patient with unilate...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1976-03-01 00:00:00
abstract:BACKGROUND:Preoperative depressive symptoms have been shown in some but not all studies to be associated with poor self-reported pain and function outcomes. In addition, depressive symptoms after surgery have been shown to improve relative to preoperative levels. QUESTIONS/PURPOSES:We hypothesized that (1) preoperativ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,多中心研究
doi:10.1007/s11999-015-4203-3
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:T1ρ MRI has been shown feasible to detect the biochemical status of hip cartilage, but various region-of-interest strategies have been used, compromising the reproducibility and comparability between different institutions and studies. QUESTIONS/PURPOSES:The purposes of this study were (1) to determine repr...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-016-5011-0
更新日期:2017-04-01 00:00:00
abstract::The aim of this study was to describe the course of untreated or conservatively treated arthrosis of the knee joint. Of 265 patients presenting with knee pain who had weightbearing radiographs taken between 1970 and 1973, 132 (33 men and 99 women) responded to and participated in a clinical followup 20 years later usi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199707000-00019
更新日期:1997-07-01 00:00:00
abstract::Wound problems can often be prevented with careful planning. When transverse incisions are used for knee surgery many years prior to any anticipated knee arthroplasty, no major problems are typically encountered with a conventional, anterior longitudinal incision. We recommend lateral incisions (eg, after a previous l...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/01.blo.0000238821.71271.cc
更新日期:2006-11-01 00:00:00
abstract::Subjective evaluations often are used after knee arthroplasty to quantify function; however, these scores may be influenced by pain and/or function of the nonoperated limb. Multiple influences increase variability of these scores, which in turn may result in a greater change in score required to be considered clinical...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-009-0811-0
更新日期:2009-09-01 00:00:00
abstract::The standard of care for femoral fractures is an intramedullary nail, placed in an antegrade approach. This has produced high rates of healing and low complication rates. The use of retrograde nailing for femoral shaft fractures is a relatively new technique, previously described as an extraarticular approach. Forty-o...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199611000-00013
更新日期:1996-11-01 00:00:00
abstract::Forty patients were studied retrospectively to evaluate the effect of epidural steroid injections on low back pain and sciatica characteristic of spinal stenosis or a herniated lumbar disc. All but one of these patients had radicular symptoms. The average age was 55 years, and the average follow-up time was eight mont...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1988-03-01 00:00:00
abstract:UNLABELLED:Acetabular retroversion (AR) alters load distribution across the hip and is more prevalent in pathologic conditions involving the hip. We hypothesized the abnormal orientation and mechanical changes may predispose certain individuals to stress injuries of the femoral neck. We retrospectively reviewed the ant...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-009-0969-5
更新日期:2010-03-01 00:00:00
abstract::For reappraisal of total hip arthroplasty (THA) in the treatment of nontraumatic osteonecrosis (ON) of the femoral head, 29 hips in 23 patients with ON were surveyed in a comparison with 63 osteoarthritic (OA) hips treated in the same manner during the same period; the hips were selected according to the same criteria...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1989-07-01 00:00:00
abstract:BACKGROUND:High tibial osteotomy (HTO) and unicompartmental arthroplasty (UKA) are reconstructive surgeries advocated for younger patients. In case of failure or progression of osteoarthritis, they can both be converted to a total knee arthroplasty (TKA). QUESTIONS/PURPOSES:We used registry data to answer if the risks...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-014-3712-9
更新日期:2015-01-01 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::From 1977 to 1982, 13 patients were diagnosed with avascular necrosis of the femoral head. The diagnoses were made with a combination of clinical exams, radiographs, tomograms, and Tc99 bone scans. One hip was classified as Ficat Stage I, 9 as Stage II, and 5 as Stage III. There were 11 male and 2 female patients with...
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::Few studies quantitate the cost of a quality well being as produced by arthroplasty surgery. The objective was to use the Quality of Well Being Index to calculate the cost per quality of well year in knee arthroplasty surgery. The difference in Quality of Well Being Index scores before and after the intervention was c...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1997-12-01 00:00:00
abstract::Three patients with osteonecrosis of the femoral head in whom the extent of necrosis increased by repeated episodes of osteonecrosis are described. In all cases the evidence of two attacks of osteonecrosis was detected clearly on magnetic resonance images. The significance of the recurrent attacks of osteonecrosis is ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000037441.23683.ee
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:The failure rate of tendon-bone healing after repair of rotator cuff tears remains high. A variety of biologic- and cell-based therapies aimed at improving rotator cuff healing have been investigated, and stem cell-based techniques have become increasingly more common. However, most studies have focused on t...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-015-4218-9
更新日期:2015-05-01 00:00:00
abstract::Bipartite patellae, though not unusual as an incidental roentgenographic finding, are rarely painful. This is a report of bilateral medial bipartite patella in a 20-year-old woman, which seems not to have been previously described in the literature. The symptoms were significantly relieved by an excision of the access...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1978-07-01 00:00:00
abstract:BACKGROUND:Modern metal-on-metal hip resurfacing arthroplasty designs have been used for over a decade. Risk factors for short-term failure include small component size, large femoral head defects, low body mass index, older age, high level of sporting activity, and component design, and it is established there is a su...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-012-2347-y
更新日期:2012-11-01 00:00:00
abstract:UNLABELLED:Long-term results of periacetabular osteotomy for advanced-stage osteoarthritis secondary to developmental dysplasia of the hip are reportedly unsatisfactory compared with results for early-stage osteoarthritis. Other preoperative information that can be used to determine indications for periacetabular osteo...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-008-0443-9
更新日期:2009-04-01 00:00:00
abstract::The absolute treatment of extensively involved cases of Legg-Calvé-Perthes disease (LCPD) remains unsolved. The basic principle of adequate containment of the capital femoral epiphysis in its acetabulum while minimizing the disability time is widely accepted, but the definition of adequate containment and methods of a...
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::Comparable groups of patients with osteoarthritic knees who had either a St. Georg sledge unicompartmental arthroplasty or an upper tibial osteotomy were reviewed in 1985, five to ten years after operation. The results of unicompartmental arthroplasty were better, but it was uncertain whether the superior results woul...
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::Mini-incision total knee arthroplasty can be accomplished through versions of exposures used in standard total knee arthroplasty. Modifications of the medial parapatellar, subvastus, and midvastus approaches are presented, and potential advantages and disadvantages of each approach are reviewed. When making the transi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/01.blo.0000148574.79874.d0
更新日期:2004-11-01 00:00:00
abstract::Proximal realignment was performed in 75 knees due to patellar pain or instability. With a follow-up period of from two to ten years, the result was excellent or good in 68 knees (91%) and fair or poor in seven knees (9%). Postoperative Merchant views were obtained in 57 knees. In the 52 knees rated good and excellent...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-06-01 00:00:00