Abstract:
:Osteolysis is defined as the process of progressive destruction of periprosthetic bony tissue, characterized on serial radiographs as progressive radiolucent lines and/or cavitation at the implant-bone or cement-bone interface. Without proper treatment, osteolysis may progress to aseptic loosening and catastrophic failure of the implant. Osteolysis is a multifactorial process stemming from host, prosthesis, and surgical factors. Billions of submicron wear particles are generated at material interfaces that cause osteolysis. Wear particles are dispersed along the effective joint space, into bone, and throughout the adjacent soft tissues. Initially, patients may have no clinical symptoms despite radiographic evidence of osteolysis and can remain completely asymptomatic, even in the presence of substantial bone loss. Symptoms usually do not occur until the bone loss has reached the point of causing implant loosening, implant failure (fracture), or periprosthetic fracture. Radiographic images and standard examination provide limited information and almost always underestimate the amount of bone loss. Three-dimensional computed tomography is more sensitive and can monitor the volume of the lesion, however the trade-offs are its high cost and radiation exposure. The timing for treatment of periprosthetic osteolysis is controversial and the medical decision-making is debatable. Medical treatment seems to be attractive but there is no proven or approved drug therapy to prevent or inhibit periprosthetic osteolysis. We reviewed the medical and surgical options that are available for treatment of periprosthetic osteolysis.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Saleh KJ,Thongtrangan I,Schwarz EMsubject
Has Abstractpub_date
2004-10-01 00:00:00pages
138-47issue
427eissn
0009-921Xissn
1528-1132pub_type
杂志文章,评审abstract::One hundred fifteen patients with nonunions or delayed fracture healing were treated with high-energy shock waves. After shock wave treatment, immobilization of the fracture also was done. The followup was at least 3 months and as long as 4 years. In 87 patients (75.7%), one treatment with shock waves resulted in bony...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200106000-00012
更新日期:2001-06-01 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:BACKGROUND:Developmental hip disorders (DHDs), eg, developmental dysplasia of the hip, slipped capitis femoris epiphysis, and femoroacetabular impingement, can be considered morphology variants of the normal hip. The femoroacetabular morphology of DHD is believed to induce osteoarthritis (OA) through local cumulative m...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1007/s11999-012-2511-4
更新日期:2012-12-01 00:00:00
abstract::Ectopic bone formation (EBF) is a well-known complication of total hip arthroplasty (THA). The etiology and pathogenesis are still obscure. An analysis of 119 consecutive patients with 129 primary THAs was performed to identify factors predisposing to ectopic bone formation, its frequency, and its effect on the result...
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:BACKGROUND:Fixation of unstable ankle fractures, including fixation of posterior malleolus fracture fragments with the attached, intact posteroinferior tibiofibular ligament (PITFL), reportedly provides more stable fixation than transsyndesmotic screws. QUESTIONS/PURPOSES:To confirm this observation we compared the Fo...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-009-1111-4
更新日期:2010-04-01 00:00:00
abstract::All patients treated by total hip arthroplasty (THA) from 1971 to 1980 were analyzed to assess cause and rate of revision. Multiparameter radiographic analysis of failed femoral components ( FFC ) and matched control THAs was performed to determine predictability of failure, based on initial postarthroplasty and subse...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1984-06-01 00:00:00
abstract:BACKGROUND:Although not all elderly patients with femoral neck fractures are candidates for THA, active, mentally competent, independent patients achieve the most durable functional scores with THA compared with hemiarthroplasty. However, a relatively high frequency of early or late dislocation could reduce the potenti...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-1987-7
更新日期:2011-11-01 00:00:00
abstract::We questioned whether our current preoperative demand matching accurately predicted patient activity after TKA. From a prospective database we reviewed 511 patients who had unilateral, primary TKA from 1994 to 1999 and who were preoperatively assessed for five patient characteristics: age, weight, expected postoperati...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000229361.12244.2d
更新日期:2006-11-01 00:00:00
abstract::The treatment of hip disorders in adolescents and young adults has evolved rapidly during the past decade because of enhanced understanding of prearthritic and early arthritic hip disease combined with improved diagnostic skills, better patient selection criteria, and refinements in alternative surgical procedures. De...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/01.blo.0000193511.91643.2a
更新日期:2005-12-01 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::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: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::Spinal traction is a time-honored method for the treatment of disc protrusion, degenerative disc disease, and joint dysfunction. Effective treatment is not as easy or as simple to administer as it may appear. Many variations of technique exist, some of questionable value. It must be emphasized that spinal traction is ...
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::Division of the posterior cruciate ligament in amputation specimens enables one to classify injuries as: (a) isolated posterior cruciate ligament injuries with or without damage of the posterior capsule; or (b) injuries of the posterior cruciate ligament plus lateral and/or medial structures which may be associated wi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1980-03-01 00:00:00
abstract::External fixators commonly used in orthopaedic trauma and reconstruction may pose a potential safety hazard to patients exposed to magnetic resonance imaging. This interaction with the scanner depends on fixator composition, magnetism, and geometry. Image artifact produced by devices during scanning may diminish the d...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1995-08-01 00:00:00
abstract::Roentgenographic analysis showed that centrifugation significantly reduced the gross and regional porosity of the cement compared with hand-mixed controls in a simulated total hip arthroplasty model. Static failure test of the prosthetic system demonstrated that the centrifuged cement had significantly greater strengt...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1992-12-01 00:00:00
abstract::Insufficient posterior tibial tendons in 28 specimens from patients with clinical Stage II or III disease were examined to clarify the etiology of adult-acquired flatfoot deformity. Hematoxylin and eosin and Masson trichrome-stained sections of formalin-fixed tissue were viewed in plain and polarized light. We perform...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000218759.42805.43
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:Overwhelming evidence supports the concept that wear particles are the primary initiator of aseptic loosening of orthopaedic implants. It is likely, however, that other factors modulate the biologic response to wear particles. This review focuses on three potential other factors: genetic susceptibility, Toll...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1007/s11999-014-3786-4
更新日期:2014-12-01 00:00:00
abstract::Two hundred and twenty-one consecutive arthroscopic examinations of the knee are reviewed to establish diagnostic accuracy based on subsequent arthrotomy and the clinical course in the absence of arthrotomy. One hundred and nine knees showed an arthroscopic accuracy of 89.9 per cent at subsequent arthrotomy. Ninety-fi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1976-11-01 00:00:00
abstract::The formation of heterotopic bone within soft connective tissue is a common feature of at least three distinct genetic disorders of osteogenesis in humans: fibrodysplasia ossificans progressiva; progressive osseous heteroplasia; and Albright hereditary osteodystrophy. The pathobiologic characteristics of osteogenic in...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/00003086-200005000-00028
更新日期:2000-05-01 00:00:00
abstract::Medicolegal aspects of orthopaedic foot and ankle surgery, including issues of standard of care, complications, and discrepancies between patient and physician expectations, generally are similar to those encountered in other orthopaedic subspecialties. However, there are some unique aspects involving foot and ankle s...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/00003086-200504000-00012
更新日期:2005-04-01 00:00:00
abstract::Femoral head collapse occurred in a 20-year-old ballet dancer with anorexia nervosa. The patient developed anorexia nervosa at the age of 11 years and had short stature. The condition never resolved, and she developed pain and stiffness in the right hip at the age of 18 years, with documentation of femoral head collap...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1990-02-01 00:00:00
abstract::Although the primary goal of total knee arthroplasty is to relieve pain, the attainment of high flexion has emerged as an important secondary goal. Clinical pathways are evolving and focus on rapid recovery. The entire perioperative process for the patient and family, including office and hospital procedures, has been...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000238824.56024.7a
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:Total joint arthroplasty (TJA) has been identified as a procedure with substantial variations in inpatient and postacute care payments. Most studies in this area have focused primarily on the Medicare population and rarely have characterized the younger commercially insured populations. Understanding the inp...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-017-5444-0
更新日期:2017-11-01 00:00:00
abstract::During the period from March 1983 to April 1987, autotransfusion was used in 64 patients treated with cementless revision total hip arthroplasties. An average of 3.9 units of intraoperative blood was salvaged, using a semicontinuous system; 6.5 units were salvaged in patients requiring segmental grafting of the acetab...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1989-08-01 00:00:00
abstract::A long-term review of 272 resections of the metatarsal heads and bases of the phalanges in 128 patients with severe rheumatoid feet is presented. The longest follow-up is 11 years and the average follow-up was 4.7 years. Recurrent deformity and callus formation was usually due to a long metatarsal shaft. The operation...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-197505000-00036
更新日期:1975-05-01 00:00:00
abstract::The failure of meniscal regeneration via a fibrous semilunar mold can be correlated with an increased incidence of degenerative joint disease. Experiments on rabbits revealed a statistically significant relationship between the failure of meniscal regeneration and the development of degenerative joint disease, charact...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1977-05-01 00:00:00
abstract::Seventy-seven patients treated by chymopapain and laminectomy were compared before, and 6 and 14 weeks after, treatment. A standardized, multidimensional scale of low back pain providing scores on 7 independent dimensions of sensory and affective discomfort and one measure of intensity were used. Fourteen weeks after ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1980-01-01 00:00:00
abstract::Mineralization processes in the body are controlled by physicochemical and cellular regulation of hydroxyapatite (HA) nucleators and inhibitors. The chemical mechanism of action of HA inhibitors has been studied in vitro using solution pH-stat techniques or Types I and II collagen gel diffusion systems. Three biologic...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1989-10-01 00:00:00
abstract:BACKGROUND:To prevent symptomatic heterotopic ossification (HO) and guide primary prophylaxis in patients with combat wounds, physicians require risk stratification methods that can be used early in the postinjury period. There are no validated models to help guide clinicians in the treatment for this common and potent...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-015-4302-1
更新日期:2015-09-01 00:00:00