Abstract:
:Fifteen consecutive total hip arthroplasties (THAs) in 14 patients considered at risk for developing significant heterotopic ossification (HO) were treated postoperatively with 7.5 Gy of external beam radiation in three fractions. Eight hips in eight of the patients (Group I) had developed previous Brooker Class III or IV HO after THA and were radiated after having excision of HO in conjunction with a revision THA. Three additional hips in three patients (Group II) were radiated after primary THA, because they developed significant HO on the contralateral hip after a previous THA. The remaining four hips in three patients (Group III) were radiated after primary THA because they had bilateral hypertrophic arthritis. Precision shielding was employed to minimize the volume of tissue in the radiation field and to protect the bone-implant interface around porous-coated components and the trochanteric osteotomy sites. Of the eight hips in which Class III or IV bone was excised during revision THA (Group I), no new bone formed in five hips and in the other three hips, only Class I bone formed. No heterotopic bone formed in the remaining seven hips of Groups II and III. All six trochanteric osteotomies healed. There were no wound healing problems. There were no significant radiolucencies around any of the components and there was no radiographic evidence of implant instability. This regimen using 7.5 Gy over three fractions minimizes the radiobiologic impact, whereas the use of precision shielding minimizes the total volume of tissue treated. This regimen is an effective means of preventing significant HO after THA in high-risk patients while minimizing radiation exposure.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Maloney WJ,Jasty M,Willett C,Mulroy RD Jr,Harris WHsubject
Has Abstractpub_date
1992-07-01 00:00:00pages
230-4issue
280eissn
0009-921Xissn
1528-1132pub_type
杂志文章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::Osteochondral allograft transplantation is a well-accepted treatment for articular cartilage damage. However, chondrocyte viability declines during graft storage, which may compromise graft performance. We first tested the hypothesis that the composition of commonly used storage media affects the viability of articula...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-008-0302-8
更新日期:2008-08-01 00:00:00
abstract::The noncollagenous proteins (NCPs) that predominate the bone matrix have recently been the focus of intense investigation because of their potential influence on cell attachment, Ca2+ and hydroxyapatite binding, and the mineralization of bone tissue. With the advent of molecular biology, all of the major NCPs of bone ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1992-08-01 00:00:00
abstract::Comminuted fractures of the femoral shaft, especially when combined with fractures of the hip, may be difficult to treat. A four-sided titanium alloy locking nail with transfixing screws was designed in 1967 and allows compression of the fracture site. If necessary, the nail may be inserted without intraoperative roen...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-11-01 00:00:00
abstract::Nonconsolidated particles of ultra high molecular weight polyethylene are believed to be defects that adversely can affect the wear performance of total joint prostheses. The present study was done to determine the number, size, and distribution of these particles and to determine if their presence correlated with wea...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1995-10-01 00:00:00
abstract::Avascular necrosis of the femoral head affects 10,000 to 20,000 people every year and often these patients are in their 30s and 40s. The natural history of this disease is important to understand because the rate of femoral head collapse and treatment options are related to multiple factors including the cause of the ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/00003086-200401000-00007
更新日期:2004-01-01 00:00:00
abstract::Eleven patients with a previous patellectomy and primary total knee arthroplasty (TKA) had chart reviews, recent clinical examinations, evaluation of roentgenograms, rating of knee arthroplasty on a standard scale, and quantitation of quadriceps and hamstring torque using an isokinetic dynamometer. Good to excellent r...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-10-01 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:BACKGROUND:Ankle arthrodesis may be achieved using the Ilizarov method. Comorbidities, such as diabetes, Charcot neuroarthropathy, osteomyelitis, leg length discrepancy, and smoking, can make an ankle fusion complex and may be associated with lower rates of healing. QUESTIONS/PURPOSES:We asked if (1) smoking and other...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-012-2470-9
更新日期:2012-10-01 00:00:00
abstract::The orthopedic surgeion should be an integral part of a medical team for evaluation and treatment of young children with cerebral palsy. Surgical procedures in this first three years of life are usually limited to the adductor releases about the hip. Stretching and plastic splints about the ankle and knee followed by ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1980-09-01 00:00:00
abstract::Milwaukee brace treatment for patients with idiopathic scoliosis very rarely accomplishes improvement approaching that of successful surgery. Prpgression of small and medium-sized curves (60 degrees or less) has been routinely halted. Few curves progress with adequate brace treatment. Occasionally, improvement in defo...
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::Lead markers were placed on various osseous structures of the talus and calcaneus in fresh amputation specimens to analyze the radiographic anatomy of the hindfoot. Analysis of the talocalcaneal articulations revealed that only the central one-third of the posterior subtalar joint can be visualized on the lateral proj...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-07-01 00:00:00
abstract::Overweight patients are often considered poor candidates for total knee arthroplasty. For assessment of the validity of this proscription, two-year follow-up data from 109 patients were analyzed. Hospital for Special Surgery Scores were recorded, roentgenograms were inspected for radiolucencies, and isokinetic strengt...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1992-03-01 00:00:00
abstract::Genu recurvatum deformities are unusual before total knee arthroplasty (TKA), occurring in less than 1% of patients. Because of its rarity, concern may exist regarding the recurrence of the deformity and the potential for instability after TKA. Recurvatum may be associated with a severe osseous deformity, including ge...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/01.blo.0000092988.12414.18
更新日期:2003-11-01 00:00:00
abstract::From the time of Hippocrates to the beginning of the nineteenth century, fractures of the distal end of the radius were mistaken for dislocations of the wrist. Clinical observations, anatomic dissections, and experiments on cadavers dispelled this error. It was not, however, until after the discovery of roentgenograms...
journal_title:Clinical orthopaedics and related research
pub_type: 传,历史文章,杂志文章
doi:
更新日期:1984-07-01 00:00:00
abstract:BACKGROUND:As new Patient-Reported Outcomes Measurement Information System (PROMIS) instruments are incorporated into clinical practice, determining how large a change on these instruments represents a clinically relevant difference is important; the metric that describes this is the minimum clinically important differ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/CORR.0000000000000419
更新日期:2018-10-01 00:00:00
abstract::Joint damage occurs when structures protecting the joint fail. Because osteoarthritis consists of end-stage joint damage, I propose that risk factors for disease can be best understood as either impairments of joint protectors, increasing joint vulnerability, or as factors that excessively load the joint, leading to i...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/01.blo.0000144971.12731.a2
更新日期:2004-10-01 00:00:00
abstract::Management of nonunions requires careful and critical assessment of the true biologic status of the fracture. The mere radiographic persistence of a fracture line does not invariably indicate nonunion. Ten percent of fractures considered initially to be ununited in this series healed spontaneously without further trea...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1981-11-01 00:00:00
abstract:UNLABELLED:Fractures of the distal radius are common injuries. Low-energy or high-energy mechanisms may be involved. Unstable distal radius fractures present a challenge to the treating orthopaedic surgeon. External fixation is a valuable instrument for fracture reduction and stabilization. Limited open incisions, earl...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000205898.21233.f5
更新日期:2006-04-01 00:00:00
abstract::The bone mineral content in the shafts of the forearm in 17 women with cervical fracture of the upper end of the femur was low. The cortex of the femoral neck was also lower than normal. Thus women with hip fractures at an early age may have lower than average total skeletal tissue density. This may be due not simply ...
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::Periosteal osteosarcoma is a surface lesion without evidence of medullary involvement. This report extends the Mayo Clinic series of periosteal osteosarcoma cases from 11 to 22 cases. In a review of demographic information from our 22 cases and from 30 additional cases, referred only for pathologic diagnosis, the aver...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-06-01 00:00:00
abstract::A resurgence of classic vitamin D deficiency rickets has been noted in the recent pediatric literature, but no mention of it appears in recent orthopedic journals. Three cases of vitamin D deficiency rickets occurred in children whose ages ranged from 14 to 17 months. Similar to the experience of others, all three occ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-11-01 00:00:00
abstract:BACKGROUND:Pelvic and retroperitoneal trauma is a major cause of morbidity and mortality in multiply injured patients. The Injury Severity Score (ISS) has been criticized for underrepresenting and inaccurately defining mechanical injury. The influence of pelvic injury volume on organ dysfunction and multiple organ fail...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-015-4676-0
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:The incidence of acetabular fractures in osteoporotic patients is increasing. Immediate total hip arthroplasty (THA) has potential advantages, but achieving acetabular component stability is challenging and, at early followup, reported revision rates for loosening are high. QUESTIONS/PURPOSES:This study mea...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-015-4460-1
更新日期:2015-12-01 00:00:00
abstract::Osteoid osteoma seems to have been reported only twice before in a Negro child. The lesion is also unusual in the ulna. Treatment by en bloc resection bone graft of a large surgical defect was successful. ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1976-07-01 00:00:00
abstract::In 20 dogs olecranon osteotomies fixed with tension band wires were studied histologically to reveal the pattern of healing. Different degrees of stability existed in different areas of the osteotomy. Under stable conditions cancellous bone healed by direct formation of woven bone. Instability resulted in an internal ...
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::During a 5 year period 50 patients with chronic low back pain, with or without sciatica due to a proven lumbosacral disk lesion, underwent a spinal fusion using the Boucher method of screw fixation of the facet joints. The L-4 spinous process was excised and fashioned into an H-shape to act as the bone graft between t...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1979-05-01 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::To update the status of chymopapain in the treatment of herniated intervertebral discs, a review of the current literature and data from an unpublished Texas study are presented. Studies in animals and humans have consistently demonstrated that chymopapain can dissolve the nucleus pulposus. Twenty-eight uncontrolled a...
journal_title:Clinical orthopaedics and related research
pub_type: 临床试验,杂志文章,评审
doi:
更新日期:1984-03-01 00:00:00
abstract::Radiation therapy in the treatment of osteosarcoma has been considered with respect of the subclinical metastatic disease in the lung and the primary lesion. Emphasis is given to the necessity of coordinating the management plan of the primary lesion with an adjuvant program. Evaluation of the efficacy of a conservati...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/00003086-197509000-00009
更新日期:1975-09-01 00:00:00