Abstract：
:Prompt diagnosis of proximal lower extremity deep vein thrombosis in outpatients is critical because of the risk of pulmonary embolism. Our purpose was to determine the accuracy of orthopaedists' clinical decisions regarding the diagnosis of proximal deep vein thrombosis in outpatients. A nationally representative random sample of 2300 orthopaedists received a survey of six clinical vignettes. They were asked to estimate the probability of proximal lower extremity deep vein thrombosis using defined criteria and to specify their planned diagnostic tests. A clinical decision rule and evidence-based diagnostic test recommendations from the general literature served as the gold standard for comparison. Six-hundred seventy-six (29%) surgeons completed the survey. The orthopaedists' planned diagnostic tests differed from the gold standard, but these differences varied depending on the probability of deep vein thrombosis. For the moderate and high risk vignettes, the diagnostic test recommendations agreed with the gold standard approximately 70% of the time. With the exception of gender, no differences were found between respondents and nonrespondents. Orthopaedists' approach to the diagnosis of deep vein thrombosis in outpatients potentially could be improved by applying a clinical decision rule and current evidence on diagnostic test usage.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Riddle DL,Hillner BE,Wells PS,Johnson REdoi
10.1097/01.blo.0000152599.53574.a5subject
Has Abstractpub_date
2005-03-01 00:00:00pages
258-66issue
432eissn
0009-921Xissn
1528-1132pii
00003086-200503000-00034pub_type
杂志文章abstract：:In situ hybridization was employed to study cellular phenotypes in the ossification groove of Ranvier in young rabbits. The expression of Type II collagen mRNA was seen in chondrocytes in all layers of the growth plate. Messenger RNA for the cartilage-specific Type II collagen was also detected in cells of the inner l...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-12-01 00:00:00
abstract：:This article presents a prospective clinical and radiologic review of 55 total hip replacements in 50 patients in which the cementless Harris-Galante porous-coated acetabular component was used. All patients were 50 years of age or younger. The cups were inserted by 15 different surgeons. The minimum followup was 5 ye...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200007000-00021
更新日期：2000-07-01 00:00:00
abstract：:A method of surface replacement of the knee joint using an uncemented titanium-on-high-density-polyethylene prosthesis has been investigated in 61 patients. The results show that pain is relieved in the vast majority of cases. Overall, the joint range is marginally improved. Preoperative deformities can be considerabl...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1980-05-01 00:00:00
abstract：:Cartilage function after resurfacing with cell-based transplantation procedures or during the early stages of arthritic disease may be bolstered by the addition of growth factor genes to the transplanted tissue. Insulinlike growth factor-I maintains chondrocyte metabolism in normal cartilage homeostasis and has been s...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200010001-00026
更新日期：2000-10-01 00:00:00
abstract：:The annual wear rate in polyethylene articulations should be 0.1 mm or less to avoid future osteolysis. Highly cross-linked polyethylene shows an 80 to 90% wear reduction in hip simulator testing, but the clinical documentation of this new polyethylene is still inadequate. We evaluated the highly cross-linked polyethy...
journal_title：Clinical orthopaedics and related research
pub_type： 临床试验,杂志文章,随机对照试验,评审
doi：
更新日期：2004-12-01 00:00:00
abstract：BACKGROUND:Metal-on-metal articulations can release substantial amounts of particles containing cobalt and chromium into the surrounding milieu, causing concern for cellular toxicity and adverse local soft tissue reactions. The diameter of the femoral head has been one of the variables that inversely affects wear of me...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-010-1630-z
更新日期：2011-06-01 00:00:00
abstract：:In 15 normal adults an advanced biomechanical analysis of walking patterns at slow, natural, and fast cadences showed that the ankle had two mechanical power phases: a negative work phase during weight acceptance, followed by a dominant burst of positive work at push-off. The knee had four power phases: a negative wor...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-05-01 00:00:00
abstract：:The Fabella Syndrome is recognized by a sharp pain, local tenderness, and intensification of pain in the area of the fabella by full extension of the knee. After diagnostic tests with local anesthesia and ineffective conservative treatment, surgical extirpation may produce lasting relief of symptoms. ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1977-07-01 00:00:00
abstract：:Adhesive capsulitis occurs as a pathologic entity in the shoulder, hip, and ankle joints. Thickening and contracture of the wrist joint capsule were demonstrated on arthrograms performed on ten patients ranging in age from 20 to 82 years. The patients had pain and limited range of motion in the wrist. The findings inc...
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:CT pulmonary angiography (CTPA) has become widely adopted to detect pulmonary embolism (PE) after total joint arthroplasty (TJA). CTPA is a sensitive tool, which has the ability to detect emboli that may be clinically insignificant. This may lead to iatrogenic harm from overtreatment. QUESTIONS/PURPOSES:The...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-013-3041-4
更新日期：2013-09-01 00:00:00
abstract：:Following peripheral nerve repair, tension on the suture line is regarded as an important factor in producing scar tissue. In some cases, one or more microsurgical epiperineurium-fascial stitches (EPFS) along the proximal and distal stumps of a transected nerve permit their firm approximation, shifting tensile forces ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1987-03-01 00:00:00
abstract：:Marlex mesh is a synthetic material which has been used clinically to replace ligamentous structures. It serves as a scaffold for infiltration of the fibroblasts eventually becoming mature fibrocytes. In dogs, almost totally mature fibrocytes appear within the framework of the Marlex mesh prosthesis by the end of 3 mo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-11-01 00:00:00
abstract：BACKGROUND:Outcomes for minimally invasive scoliosis correction surgery have been reported for mild adult scoliosis. Larger curves historically have been treated with open surgical procedures including facet resections or posterior column osteotomies, which have been associated with high-volume blood loss. Further, min...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-014-3565-2
更新日期：2014-06-01 00:00:00
abstract：:Abduction contracture of the hip (frog-leg deformity) is caused by contracture of the gluteus maximus muscle. A simple operation consisting of complete detachment of involved fibrous portions of the gluteus maximus from the greater trochanter to the ischial tuberosity is sufficient to release the contracture and enabl...
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：:Orthopaedic residency has undergone continual evolution since the early 1900s. Training has evolved from a preceptorship to a highly evolved and structured educational system which largely standardizes training throughout the United States. Approval and accreditation of training programs, as well as content, is now ov...
journal_title：Clinical orthopaedics and related research
pub_type： 历史文章,杂志文章
doi：10.1097/01.blo.0000224022.11282.71
更新日期：2006-08-01 00:00:00
abstract：:Bone tumors occurring in periarticular locations may cause a substantial risk of subchondral fracture and collapse. Poly-methylmethacrylate has been used for reconstruction in these instances because of its immediate structural stability. Allogeneic graft allows for biologic incorporation and remodeling, but it takes ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/blo.0b013e31804e8470
更新日期：2007-08-01 00:00:00
abstract：:Major vascular, nonthromboembolic complications of total hip arthroplasty are rare: only 23 have been reported over the last 20 years. This is a report of two additional cases. In an 84-year-old woman, the external iliac artery was lacerated following removal of the acetabular component. Two such injuries have been re...
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:Low-cost indigenous megaprostheses used in the developing world are prone to mechanical failure but the frequency and causes are not well established. QUESTIONS/PURPOSES:We retrospectively analyzed the causes of failure, particularly design, and suggest changes to reduce the breakage. We also report our exp...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-010-1409-2
更新日期：2010-11-01 00:00:00
abstract：:Femoral head vitality was evaluated by tetracycline labeling and 99mTc-MDP scintimetry in 317 femoral neck fractures before and after internal fixation with two hook-pins. The preoperative vitality was about the same as that observed by others using comparable methods. The postoperative vitality was reduced in five of...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-12-01 00:00:00
abstract：:This current study describes how human genetic approaches are used to identify and understand the roles of genes and their protein products, during skeletal development, growth, and homeostasis. Searches for the genes responsible for brachydactyly, symphalangism, spondyloepiphyseal dysplasia, and camptodactyly-arthrop...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-200010001-00006
更新日期：2000-10-01 00:00:00
abstract：:Fracture-healing problems today occur predominantly in the weight-bearing tibia and femur. This review of 83 lower-limb nonunions out of a series of 100 fracture-healing problems identified avoidable causes in 30%. These included rigid fixation, which produced fracture gap, fibulectomy, which destabilized the tibia, a...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1985-04-01 00:00:00
abstract：:Postoperative prophylaxis with antiinflammatory medications, primarily indomethacin, is extremely effective in preventing the severest degrees of heterotopic ossification (HO) after a total hip arthroplasty (THA) and the recurrence of excised HO developed after a previous hip surgery. Prophylaxis with indomethacin sho...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1991-02-01 00:00:00
abstract：:Reconstruction of the proximal humerus after resection for tumor and modification of the clavicular transposition procedure is described in which the blood supply of the clavicle is preserved and the clavicle is used to bridge the defect. An 11-year-old boy presented with shoulder pain, and the diagnosis was osteosarc...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200104000-00026
更新日期：2001-04-01 00:00:00
abstract：:The authors report the results of a consecutive series of 37 total condylar prostheses inserted between 1975 and 1977 in 31 osteoarthritic and six rheumatoid arthritic knees. Prostheses were inserted in 33 usually low-activity patients with an average age of 65 years. There was a five-year minimum follow-up period for...
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：:In this series of 62 free flap transfers, 48 (80%) have been successful. There have been a significant number of vascular complications, 39% of which the majority were arterial thrombosis. Fifty per cent of those which thrombosed were salvaged on exploration and revision of the vessels. The frequency of complications ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-06-01 00:00:00
abstract：:Fusion indications in adult degenerative disk disease of the lumbosacral spine include isolated disk resorption, primary and secondary instability, recurrent disk herniation, and pseudarthrosis. Common to these indications are variable proportions of biomechanical insufficiency of the motion segment, instability, defo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1994-03-01 00:00:00
abstract：:The study compared the effects of laser and monopolar radiofrequency energy on thermal and architectural properties of joint capsular tissue in an in vitro ovine model. Sheep glenohumeral joint capsular specimens were treated with laser (5, 10, 15 W) or radiofrequency energy (55 degrees, 65 degrees, 75 degrees C) (n =...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200006000-00034
更新日期：2000-06-01 00:00:00
abstract：:In an experimental ischemic compartment syndrome in dogs, phosphorus (31P) nuclear magnetic resonance (NMR) spectroscopy was used to determine the tissue pressure threshold at which resting skeletal muscle begins to use anaerobic energy sources due to insufficient cellular oxygen delivery. The interactive effects of s...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1988-01-01 00:00:00
abstract：BACKGROUND:Kidney dysfunction (KD) after hip fracture surgery is a major complication. However, the incidence and risk factors of KD in this population are unclear. QUESTIONS/PURPOSES:We therefore (1) determined the incidence of KD in a large cohort of fracture patients, (2) identified preoperative risk factors predis...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-013-3098-0
更新日期：2013-12-01 00:00:00
abstract：:The clinical use of electric and electromagnetic fields for fracture healing applications began in the early 1970s. Since then, several technologies have been developed and shown to promote healing in difficult to heal fractures. The development of these devices has been aided in recent years by basic research and sev...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-199810001-00021
更新日期：1998-10-01 00:00:00
