Abstract:
:Therapeutic radiation delivered to bone and the adjacent local tissues before allograft limb-salvage surgery has been associated with poor graft incorporation and higher numbers of clinical complications. Our objective was to determine the effect of preoperative radiation therapy on specific histologic, molecular and structural parameters of large-segment, bone allograft incorporation in a canine model. Skeletally mature dogs received a total of 0, 25, or 50 Gy of radiation to the foreleg (radius and ulna) delivered in 2-Gy fractions during a 5-week period before reconstruction of a 3.5-cm defect in the radius. The dogs were sacrificed at postoperative day 150. Nondestructive four-point bending was done on the harvested allograft-host bone immediately after euthanasia and specimens were compared using biomechanical, histomorphometric, immunohistochemical, and in situ reverse transcription polymerase chain reaction techniques. Preoperative irradiation significantly impaired allograft incorporation as determined by radiographic healing scores, histomorphometry, and frequency of nonunions. Biochemical differences included diminished bone morphogenetic protein-2 and bone morphogenetic protein-4 protein levels and messenger ribonucleic acid expression. Vascular endothelial growth factor expression was not altered. These data suggest that bone morphogenetic protein-2 and bone morphogenetic protein-4 signaling at the allograft-host junction is altered after preoperative fractionated radiation and provides a plausible albeit partial mechanistic explanation for radiation-mediated delays in allograft incorporation.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Ehrhart NP,Eurell JA,Constable PD,Gaddy D,Nicholas RWdoi
10.1097/01.blo.0000165732.64757.bbsubject
Has Abstractpub_date
2005-06-01 00:00:00pages
43-51issue
435eissn
0009-921Xissn
1528-1132pii
00003086-200506000-00009pub_type
杂志文章abstract::Nutrient diffusion across the vertebral endplate can occur by convection (bulk flow) or diffusion. Previous studies, using animal models, suggested diffusion as the primary mechanism of small-solute transport but did not adequately determine the contribution of bulk flow to total nutrient transport. This study was des...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-09-01 00:00:00
abstract::A prospective study of 570 patients with fracture of the upper end of the femur was carried out between 1967 and 1971 in Jerusalem. Of three distinct ethnic groupings, Western or Ashkenazi females and Eastern or Sephardi males produced the highest incidence of fractured neck of the femur proportional to their makeup i...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract:BACKGROUND:For unicompartmental knee arthroplasty (UKA), abnormal loading on the tibiofemoral joint could exacerbate knee osteoarthritis or implant wear. Joint moments are an indirect measure of such loading. However, little is known about knee moments of patients with UKA, tempering enthusiasm for its use. QUESTIONS/...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-013-3128-y
更新日期:2014-01-01 00:00:00
abstract::Anteroposterior pelvic roentgenograms of 790 patients admitted for treatment of alcoholism were examined for evidence of osteonecrosis of the femoral head. Laboratory data on these patients, obtained shortly after admission, demonstrated that average serum cholesterol levels were within normal limits and average serum...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1979-09-01 00:00:00
abstract::Studies in the 1980s, including one from central Norway, in most cases showed that the incidence of hip fractures was increasing. In the 1990s, however, studies from Sweden and the United States indicated that the increase may have stopped. We report the current incidence of hip fractures in subjects in central Norway...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200402000-00028
更新日期:2004-02-01 00:00:00
abstract::Long-term results of total hip replacement by low-friction arthroplasty show a consistent and reproducible outcome for relief of pain, increased mobility, and function in most patients followed for five to 15 years after surgery. In a review of 1009 consecutive operations, the rate of reoperation and potential failure...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-12-01 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::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::A heterogeneous group of 17 patients with aseptic necrosis of the femoral head had treatment of 23 hips by bone grafting. Phemister-type tibial grafts were used in 20 and iliac grafts in 3. All hips were evaluated before and after grafting according to roentgenographic stage of disease and the Hospital for Special Sur...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract::Although femoral shaft fractures constitute fewer than 2% of all fractures in children and adolescents, their treatment has produced many pieces of literature and years of controversy. Prevailing opinion has favored nonoperative and operative treatment, and a variety of techniques have been advocated to avoid complica...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/01.blo.0000163463.05141.1c
更新日期:2005-05-01 00:00:00
abstract::Quality of life measures have neglected to include a critical self-assessment component in pediatric sarcoma patients. Our report shows how children rate their own quality of life and how that varies over time after surgery. Using the Pediatric Outcomes Data Collection Instrument, quality of life data was prospectivel...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/BLO.0b013e31804f545d
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:Femoroacetabular impingement (FAI) can occur after slipped capital femoral epiphysis (SCFE) regardless of slip severity and even after in situ pinning. These patients represent a rare and unique demographic that is largely unreported on. It is important to further characterize the clinical presentation of th...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/CORR.0000000000001576
更新日期:2020-11-17 00:00:00
abstract::The spherocentric knee, designed to allow triaxial rotation and provide intrinsic stability, includes desirable design features of metal on high density polyethelene bearing surfaces, metal support for all plastic components, metal-cement-bone interfacing for all fixation surfaces, sufficient strength to eliminate fat...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1979-11-01 00:00:00
abstract::There have been numerous efforts to alter the lipid content of cardiovascular tissues. Although equally important, only limited information is available about musculoskeletal tissues. I characterized joint and bone marrow lipids in patients having joint replacement surgery and explored the effects of fish oils and sta...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/BLO.0b013e31802cfa9e
更新日期:2007-03-01 00:00:00
abstract::Discography as a diagnostic method is not a panacea and has distinct limitations. It should not replace myelography but is a useful adjunct, particularly in those cases in which myelography has not been helpful and in which conservative management has failed to produce improvement. It is particularly helpful in determ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-197503000-00016
更新日期:1975-01-01 00:00:00
abstract::The initial experience with the Freeman-Swanson (ICLH) total knee arthroplasty (1971-1975) led to changes of tibial component size, alignment, instruments, and surgical technique in 1975. Certain patients in this initial series, however, have shown excellent long-term (5 1/2-9 years) results. In patients with overall ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-03-01 00:00:00
abstract::Reconstruction operations for severe acetabular defects using bone grafting and a bipolar hemiarthroplasty retrospectively reviewed in 81 hips between 1983 and 1985. The most common indication was failed total hip arthroplasty. Bone grafts consisted of cancellous bone, bone blocks, and wafer-type grafts used singly or...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1991-07-01 00:00:00
abstract::Two hundred sixteen patients were treated by a simplified unilateral posterior lumbar interbody fusion (U-PLIF) in which the disc was removed and replaced by bone. The disc was approached far laterally by removing two-thirds of the superior facet preserving most of the ligamentum flavum, removing the disc, decorticati...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1985-03-01 00:00:00
abstract::Almost all computer-assisted orthopaedic surgery systems that rely on the anterior pelvic plane definition, such as in computed tomography and magnetic resonance image-based, fluoroscopy-based, and nonimage total hip replacement approaches, are derived from identifying two pairs of pelvic bony landmarks: anterior supe...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000164027.06880.3a
更新日期:2005-08-01 00:00:00
abstract::Primary total hip arthroplasty using an uncemented AML total hip prosthesis (trispiked cup and a 4/5 porous coated stem) was performed in 50 patients (52 hips). The average age of the patients at the time of surgery was 47.6 years (range, 19-68 years), and the diagnosis was osteonecrosis of the femoral head in 18 hips...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199903000-00018
更新日期:1999-03-01 00:00:00
abstract::Rheumatoid arthritis (RA) is initiated by an unknown antigen(s) in the genetically programmed host. HLA-DR4 is associated with RA. The antigen could be exogenous (e.g., Epstein-Barr virus, bacterial cell wall products) or endogenous (e.g., collagen or immunoglobulin). Within the synovium, where the immune response beg...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1984-01-01 00:00:00
abstract::To determine the vascular architecture of nontraumatic avascular necrosis of the femoral head (ANFH), 38 femoral heads procured from 31 ANFH patients were studied by microangiographic and histologic methods. Microangiography showed that the head was consistently stratified into three zones: the normal vascular, the re...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1992-04-01 00:00:00
abstract::Twenty knee dislocations in 19 patients (one bilateral) occurred over a period of 20 years. The age range was 21 to 65 years, with an average age of 40.8 years. There were two popliteal artery and eight peroneal nerve injuries in the group. All patients were managed by early closed reduction at the scene of the accide...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1985-09-01 00:00:00
abstract:BACKGROUND:There is a general perception in practice that a vascular supply should be used when large pieces of bone graft are used, particularly those greater than 6 cm in length for long-bone and large-joint reconstructions. However, the scientific source of this recommendation is not clear. QUESTIONS/PURPOSES:We wi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1007/s11999-016-4769-4
更新日期:2016-05-01 00:00:00
abstract::Pigmented villonodular synovitis (PVNS) is rare in the foot; however, it developed in the subtalar joint extending around the ankle of a 24-year-old man. The diagnosis was made by a combination of clinical findings, most notably the aspiration of the synovial fluid. Magnetic resonance imaging was most useful in showin...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1992-10-01 00:00:00
abstract::Rotator cuff repair is one of the most common surgical procedures done in the shoulder. Traditionally, repair has required an open incision with release of a portion of the deltoid from the acromion. In the past decade, an arthroscopically-assisted, mini-open approach has gained popularity. This has been facilitated b...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:2001-09-01 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::Predictors of success of orthopaedic residents on the American Board of Orthopaedic Surgery (ABOS) examination are controversial. We therefore evaluated numerous variables that may suggest or predict candidate performance on the ABOS examination. We reviewed files of 161 residents (all graduates) from one residency pr...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-009-0939-y
更新日期:2009-09-01 00:00:00
abstract::The effect of chymopapain injection was investigated in myelographically confirmed intervertebral disc herniation in 268 patients after ten years. Mean age is 39.4 years, 178 males and 90 females. Sixty-two patients had compensation or litigation and 12 had prior lumbar spine surgery. Discography was performed in 223 ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-05-01 00:00:00
abstract::Glomus tumors are benign vascular tumors composed of round to oval uniform cells associated with vascular structures, usually found in the soft tissue of the nail bend. A 24-year-old woman with a two-year history of progressive right elbow pain and swelling was found to have a histologically characteristic intraosseou...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-07-01 00:00:00