Abstract：
UNLABELLED:Flexion instability after cruciate-retaining total knee arthroplasty has been well documented. We identified an analogous patient group with symptomatic flexion instability without dislocation after primary posterior stabilized total knee arthroplasty. We sought to determine the typical symptoms and exam findings that lead to the diagnosis, to assess the reliability of revision total knee arthroplasty as a treatment, and to assess the technical difficulties encountered during revision total knee arthroplasty. Between 1995 and 2001, 10 patients had revision of a well-fixed posterior stabilized total knee arthroplasty for isolated symptomatic flexion instability. The typical constellation of symptoms and physical findings included a sense of instability without giving way, recurrent knee effusions, multiple areas of soft tissue tenderness about the knee, and substantial anterior tibial translation at 90 degrees of flexion. The revision operation focused on balancing the flexion and extension gaps while taking care to fill the enlarged flexion gap. Revision total knee arthroplasty was reliable in alleviating pain (mean Knee Society Pain scores improved from 68 points preoperatively to 89 points postoperatively), improving stability (nine of 10 patients had < 5 mm anterior tibial translation postoperatively) and improving patient satisfaction (nine of 10 patients were satisfied). We had no particular technical difficulties with the revision total knee arthroplasty procedures and had reliably achieved well-balanced flexion and extension gaps. 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
Schwab JH,Haidukewych GJ,Hanssen AD,Jacofsky DJ,Pagnano MWdoi
10.1097/00003086-200511000-00018subject
Has Abstractpub_date
2005-11-01 00:00:00pages
96-100eissn
0009-921Xissn
1528-1132pii
00003086-200511000-00018journal_volume
440pub_type
杂志文章abstract：BACKGROUND:Numerous cementless femoral stem design variations are in clinical use. Because initial implant instability and micromotion are associated with aseptic loosening of the femoral component, migration analysis provides an early assessment of implant survivorship. QUESTIONS/PURPOSES:We determined the (1) migrat...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-2160-z
更新日期：2012-02-01 00:00:00
abstract：:The increasing number of hip and knee arthroplasties implies a greater likelihood of periprosthetic fractures and need for successful treatment options. We asked whether in situ effective lengthening of the indwelling prosthesis by a custom-made slotted hollow intramedullary nail provided a reasonable alternative to t...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/BLO.0b013e3181468b20
更新日期：2007-10-01 00:00:00
abstract：:This is a report of outcomes after a review of the demographic, diagnostic, therapeutic, and survival data for patients with pelvic primary and secondary tumors treated during the past 28 years. Using a computerized system it has been possible to assess the results for 206 patients with bone and soft tissue sarcomas a...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200408000-00030
更新日期：2004-08-01 00:00:00
abstract：:Eighteen hips in 15 children showed persistent roentgenographic evidence of congenital acetabular residual dysplasia at four- to eight-year follow-up evaluations. The mean follow-up period was 5.8 years. These hips were subsequently evaluated by magnetic resonance (MR) imaging. MR imaging studies revealed thick unossi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1991-04-01 00:00:00
abstract：BACKGROUND:Although use of nonsteroidal antiinflammatory drugs and low-dose irradiation has demonstrated efficacy in preventing heterotopic ossification (HO) after THA and surgical treatment of acetabular fractures, these modalities have not been assessed after traumatic blast amputations where HO is a common complicat...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/CORR.0000000000000594
更新日期：2019-03-01 00:00:00
abstract：:A human osteosarcoma cell line, HuO9, was established from a tumor that was heterotransplanted into athymic nude mice. Antiserum against nude mouse spleen cells was added to the early passage cultures to eliminate the host fibroblastic cells. The cell line retained a high activity of liver/bone/kidney-type alkaline ph...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1990-10-01 00:00:00
abstract：:Supplements of glucosamine hydrochloride, low molecular weight chondroitin sulfate, and manganese ascorbate were tested separately and in combination for their ability to retard progression of cartilage degeneration in a rabbit instability model of osteoarthrosis. Computerized quantitative histologic evaluation of saf...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200012000-00027
更新日期：2000-12-01 00:00:00
abstract：:The diagnosis of forearm compartment syndrome by clinical findings alone has been difficult and inconsistent. This study was designed to assist in the diagnosis and treatment of forearm compartment syndromes. We evaluated several forearm incisions and determined their effectiveness by measuring compartment pressures u...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-07-01 00:00:00
abstract：:This report presents an initial clinical experience with arterial embolization as adjuvent therapy in the surgical treatment of selected benign primary bone tumors in childhood. Embolization was dramatically effective in 4 children with spinal or pelvic vascular tumors. This technique facilitated local surgical resect...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1979-03-01 00:00:00
abstract：:By the use of modern techniques, the nature of the immunological response to bone and cartilage grafts is becoming clear. Fresh bone, whether cancellous or cortical, will elicit a cell-mediated immunological response; removal of the bone marrow has little effect in reducing immunogenicity. Antibodies against cellular ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1976-10-01 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：:Percutaneous pelvic fixation is possible because intraoperative fluoroscopic imaging and other technologies have been refined. Anterior and posterior unstable pelvic ring disruptions are amenable to percutaneous fixation after closed manipulation or open reduction. Stable and safe fixation is achieved only after an ac...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-200006000-00004
更新日期：2000-06-01 00:00:00
abstract：:The literature on the biomechanics of the intervertebral disk is reviewed with emphasis on biomechanical--biochemical--morphological correlative studies. The deficiency of definitive correlative studies is apparent and an appeal is made to interested investigators to fill in the voids in this extremely important area ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-197711000-00015
更新日期：1977-11-01 00:00:00
abstract：:Thirty-two total hip arthroplasties (THAs) were performed on 26 severely incapacitated patients with congenital dislocation of the hip. The arthroplasty technique varied with the problems encountered, but the cup was always placed in the true acetabulum. In 19 cases, femoral head autografts were transplanted. The over...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1989-05-01 00:00:00
abstract：:Between 1976 and 1992, reinfection developed in 34 patients treated for an infected total hip arthroplasty with removal of the prosthesis and implantation of another prosthesis. These patients included 15 men and 19 women with a mean age of 62 years. Infection recurred an average of 2.2 years after reimplantation of t...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199705000-00026
更新日期：1997-05-01 00:00:00
abstract：:This is a report of replantation of a completely severed forefoot which was divided through the distal tarsus by a samurai sword cut. Primary reconstruction of bone, vessels, nerve and skin was carried out 2 hours following amputation. Neither the long extensor nor the long flexor tendons were repaired. Three years fo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1979-03-01 00:00:00
abstract：:The authors reviewed the use of chemotherapy and anterior/posterior spinal fusion without instrumentation to treat children with extensive spinal tuberculosis and kyphosis. Six children underwent anterior and posterior spinal fusion. All of the patients were followed until after maturity, except for 1 child who died o...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199604000-00027
更新日期：1996-04-01 00:00:00
abstract：:Chronic spontaneous dislocation of the sternoclavicular joint occurs more frequently in athletes than nonathletes, causing weakness and sometimes pain during prolonged stress upon the arm. Five such joints were successfully treated in 4 patients by means of a dynamic method of repair--tenodesis of the sternal head of ...
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：:Two hundred seventy-nine patients undergoing primary unilateral total knee replacement and 280 patients undergoing primary bilateral total knee replacements were reviewed retrospectively. Patients' height, weight, hemoglobin level before donation, hemoglobin level before surgery, autologous donation, number and type o...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199812000-00008
更新日期：1998-12-01 00:00:00
abstract：:Osteogenic sarcoma, a highly malignant tumor of bone, is generally treated by amputation. This is a report of 19 cases of excision of the entire femur because of skip areas which are occasionally seen. The femur usually has the lowest cure rate according to site of involvement. In total femur replacement, the whole bo...
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：:Immunohistochemistry and radioimmunoassay were used to study the rejection mechanism of allografted bone tissue in rats through changes in major histocompatibility complex (MHC) antigen expression by osteocytes in the allograft and in alloantibody levels in the serum of the host rats. Some osteocytes in normal rat bon...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-07-01 00:00:00
abstract：:For many years knee arthrodesis has been recommended for patients with severe degenerative disease complicated by obesity, venous insufficiency or old sepsis. Recently, failed total knee arthroplasties are being treated by arthrodesis, but these new indications entail new and difficult circumstances. A biplane fixatio...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1981-10-01 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：:The collagens are products of a superfamily of closely related genes. Currently, there are 13 described collagens encompassing at least 25 separate genes. The collagen molecules can be categorized into four classes. Class I consists of molecules that form the banded collagen fibers that are readily seen by routine ele...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1992-09-01 00:00:00
abstract：:A large, well-encapsulated intraneural lipoma occurred within the sciatic nerve of a 34-year-old woman. In a review of the literature, significant differences were noted between the well-encapsulated and the diffusely infiltrative lipofibromatous hamartoma types of intraneural lipomas. The average age at the time of a...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1987-08-01 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：UNLABELLED:Total knee arthroplasty frequently is required during early adulthood in patients with advanced juvenile rheumatoid arthritis. We queried patients on issues of importance to them, asked whether they were satisfied with surgical outcomes, and ascertained their postoperative status. We retrospectively reviewed...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-007-0010-9
更新日期：2008-01-01 00:00:00
abstract：:Eighty-three total knee arthroplasties done at a single university hospital were reviewed specifically to examine the presence of lysis. Components that were radiographically loose were excluded. The incidence of lysis varied significantly with the method of component fixation. The highest incidence of lysis (30%) was...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1995-12-01 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：:This study aimed to provide anatomic data for the location of the vertebral artery and offer an optimal approach for lateral cervical decompression that minimizes the risk of injury to the vertebral artery. Anatomically, there has been little study documenting the safe zone to prevent vertebral artery injury during th...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1996-01-01 00:00:00
