Abstract：
UNLABELLED:Replacement of bone segments after resection of a tumor-containing bone has a long history, and currently metallic implants and allografts have reasonable rates of success in terms of patient survival and restoration of useful function. Total femoral resections for extensive tumors are uncommon but clearly represent a major problem, which in the past has required hip disarticulations. In recent years, resection and replacement using custom metallic implants and more recently modular devices have allowed the patients to be restored to reasonable function. Allografts have not been used commonly for this purpose. During the past 23 years, we have done 15 total femoral replacements for osteosarcoma, chondrosarcoma, metastatic carcinoma, and an osteonecrotic fractured femur in a patient with rheumatoid arthritis and for a patient with severe deformity based on Paget's disease. Ten of these patients had allografts implanted with total hip replacement and total knee replacement implants and five patients had metallic implants. Eight of the patients died from disease, but the remaining seven have done reasonably well in terms of function and absence of complications such as fracture or infection. None of the patients required an amputation. The procedure is complex and metallic implant and allograft implantation require wide surgery and special systems of reconstruction. LEVEL OF EVIDENCE:Therapeutic study, Level IV-1 (case series). See the Guidelines for Authors for a complete description of levels of evidence.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Mankin HJ,Hornicek FJ,Harris Mdoi
10.1097/00003086-200509000-00012subject
Has Abstractpub_date
2005-09-01 00:00:00pages
60-4eissn
0009-921Xissn
1528-1132pii
00003086-200509000-00012journal_volume
438pub_type
杂志文章abstract：BACKGROUND:Surgeons perform THA to address a variety of conditions in younger patients, including osteoarthritis (OA), osteonecrosis, inflammatory arthritis, and congenital deformities. Younger patients aged 50 years or younger have been characterized as active in the literature, but a direct relationship between age a...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-014-3952-8
更新日期：2015-03-01 00:00:00
abstract：BACKGROUND:Massive soft tissue loss involving the pelvis and extremities from trauma, infections, and tumors remains a challenging and debilitating problem. Although vacuum-assisted closure (VAC) technology is effective in the management of soft tissue loss, the adjunct of a silver dressing in the setting of massive wo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-013-3123-3
更新日期：2014-03-01 00:00:00
abstract：:An in vitro study was performed using a singular unibody design CoCr tibial baseplate with fins to test the hypothesis that the addition of cement surrounding the tibial stem decreases micromotion of the tibial tray in cemented total knee arthroplasty. Five configurations were tested. Significant micromotion occurred ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199811000-00012
更新日期：1998-11-01 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：:A retrospective study of gunshot wounds of the extremities present 148 patients who had sufficient clinical and radiological follow-up data to assess the results. The routine treatment for this injury consisted mainly of cleansing the wound, introduction of systemic antibiotics in the emergency room followed by hospit...
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：:Transfer of a graft taken from the iliac crest apophysis of 48 immature dogs was studied as a means of repairing an epiphysiodesis constituting more than 50% of the growth plate area. Four groups of dogs were studied. In Group I the graft was pedicled on the superficial circumflex iliac vessels and reimplanted in situ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-11-01 00:00:00
abstract：:We evaluated the healing rate, complications, and functional outcomes in 32 adult patients with very short metaphyseal fragments in fractures of the distal tibia treated with a polyaxial locking system. The average distance from the distal extent of the fracture to the tibial plafond was 11 mm. All fractures healed an...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0459-1
更新日期：2009-03-01 00:00:00
abstract：BACKGROUND:Three-dimensional imaging (CT and MRI) is the gold standard for detecting femoral head-neck junction malformations in femoroacetabular impingement, yet plain radiographs are used for initial diagnostic evaluation. It is unclear, however, whether the plain radiographs accurately reflect the findings on three-...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2510-5
更新日期：2012-12-01 00:00:00
abstract：:Five patients treated with gentamicin-polymethylmethacrylate (PMMA) beads were monitored during the treatment of nine to 14 days. Kinetic data of the gentamicin delivery were gathered constantly by multiple samples of blood and urine. The treatment with 48-360 beads caused a gentamicin serum concentration of 0.03-0.4 ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-04-01 00:00:00
abstract：:Four cases of cervical osteoid osteoma occurred predominantly in the adolescent age group with either pain, pain with scoliosis, or radicular pain usually without neurological signs. The initial X-rays did not demonstrate the lesions but a high index of suspicion led to additional roentgenographic as well as tomograph...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1977-10-01 00:00:00
abstract：:The primary indication for arthroplasty of the hip is the elimination of pain and the restoration of function. This paper addresses the progression of developments leading to the present satisfactory attainment of this goal. Having achieved this goal, patients and surgeons have come to expect far more than the necessi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1985-11-01 00:00:00
abstract：BACKGROUND:The navigation system was introduced to orthopaedic surgery in the 1990s. More recently, CT-based navigation systems have been used more commonly in spine and joint replacement surgery because of their precision. QUESTIONS/PURPOSES:The aim of our study was to evaluate the accuracy and efficacy of navigation...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-2094-5
更新日期：2012-01-01 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：: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：:The role of local heat or cold therapy used in conjunction with exercise in the rehabilitation of total knee arthroplasty patients was investigated. Thirty-six osteoarthritic patients were analyzed. Parameters evaluated were range of motion, swelling about the knee, and pain. All patients received the total condylar k...
journal_title：Clinical orthopaedics and related research
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1983-09-01 00:00:00
abstract：:This CORR Insights is a commentary on the article ''Ultrasound as a first line test in the diagnosis of carpal tunnel syndrome: a cost effectiveness analysis" by John R Fowler and colleagues available at DOI 10.1007/s11999-012-2662-3 . ...
journal_title：Clinical orthopaedics and related research
pub_type： 评论,杂志文章
doi：10.1007/s11999-012-2663-2
更新日期：2013-03-01 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：:Three total knee designs were evaluated to test the hypothesis that femoral component design affects the clinical and mechanical functions of the unresurfaced patella after total knee arthroplasty. Patients with the Ortholoc II, Advantim, and Profix femoral components were followed up for as many as 14 years and revis...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000063605.67412.4d
更新日期：2003-05-01 00:00:00
abstract：:Intraoperative femoral fracture is a well-recognized technical complication of cementless total hip arthroplasty. This study was designed to establish an in vitro model for initiation and propagation of fractures of the proximal femur in cementless THA and to assess the effect of fracture fixation in the form of cercl...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1991-11-01 00:00:00
abstract：:A light and electron microscopy investigation was performed on a Leeds-Keio ligament removed because of rupture 18 months after implantation to repair an anterior cruciate ligament. The investigation showed fibrous connective tissue on the plane of the main stress force. There was elastin and adequate vascularization ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1991-06-01 00:00:00
abstract：:Stress fracture of the hip is a rare complication of total knee arthroplasty (TKA). Only eight cases seem to have been reported in the literature. A ninth case is reported in the present study. A 76-year-old obese woman was treated by right TKA for osteoarthrosis with cementing of the tibial component because of insuf...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-08-01 00:00:00
abstract：BACKGROUND:The National Inpatient Sample (NIS) database is accessible, inexpensive, and increasingly used in orthopaedic research, but it has complex design features that require nuanced methodological considerations for appropriate use and interpretation. A recent study showed poor adherence to recommended research pr...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/CORR.0000000000001355
更新日期：2020-12-01 00:00:00
abstract：:Growth or radiologic modification of an osteochondroma after the epiphyseal plate closes suggests the diagnosis of malignant transformation to a chondrosarcoma. However, extensive growth of an osteochondroma in a skeletally mature patient whose tumor proved benign has been reported. We report a similar case in an adul...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000203474.96549.80
更新日期：2006-06-01 00:00:00
abstract：:Twenty-one patients older than 60 years of age with septic arthritis were reviewed over a ten-year period. The knee was the joint most commonly involved. Concurrent medical illnesses were noted in the majority of patients, with diabetes mellitus present in 24%. Seventy-one percent of patients had roentgenographic evid...
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：:Forty-six patients with 48 operatively fixed unstable posterior pelvic ring disruptions were observed for an average of 44 months. Two thirds of the patients returned to their original jobs and 16% changed jobs because of an associated injury. Sixty-three percent of the patients had no pain or pain only on strenuous a...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199608000-00022
更新日期：1996-08-01 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：:When inserting screws into a vertebral pedicle, the surgeon usually exposes the back part of the vertebra and uses his or her anatomic knowledge to align the drill in the proper direction. A slight error in direction may result in an important error in the position of the tip of the screw. This is done with no direct ...
journal_title：Clinical orthopaedics and related research
pub_type： 临床试验,杂志文章
doi：10.1097/00003086-199704000-00011
更新日期：1997-04-01 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：:Three cases of an isolated femoral component failure of a hip surface replacement were treated by use of a press-fit bipolar prosthesis to articulate with the retained acetabular cup. At two to three years post-surgery (average, 31 months), these three conversions had good clinical function and maintained an acceptabl...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-07-01 00:00:00
abstract：:Tibial articular cartilage and the knee meniscus from cast-immobilized rabbits whose quadriceps were electrically stimulated for 17 days were compared with those from cast-immobilized rabbits without muscle stimulation. Cartilage from non-stimulated rabbits showed evidence of deep fibrillation and loss of Safranin O m...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-10-01 00:00:00
