Abstract：
:Today's surgeon is required to demonstrate a variety of professional competencies in an increasingly complex environment. Recently, the time available to train this surgeon has started to erode due to external pressures on administrators and faculty. This growing crisis has led to questions about how to optimize learning in the surgical environment. Clearly, to adequately train a competent surgeon in all the required aspects, multiple environments will be required. We must, therefore, look carefully at each environment to maximize its educational potential for each of the competencies. At the same time, however, we must ensure these educational environments and opportunities integrate into a coherent and systematic program of training that is flexible and adaptable to the individual needs of the trainees. This paper describes two broad areas that must be at the forefront of the community's thinking as we strive toward this goal: the irreplaceable value of a mentor and maximizing the potential of optimal challenge points in learning.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Gofton W,Regehr Gdoi
10.1097/01.blo.0000224028.93355.8csubject
Has Abstractpub_date
2006-08-01 00:00:00pages
100-7eissn
0009-921Xissn
1528-1132journal_volume
449pub_type
杂志文章,评审abstract：:Ectopic bone formation (EBF) is a well-known complication of total hip arthroplasty (THA). The etiology and pathogenesis are still obscure. An analysis of 119 consecutive patients with 129 primary THAs was performed to identify factors predisposing to ectopic bone formation, its frequency, and its effect on the result...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-03-01 00:00:00
abstract：:Biopsy is an integral part of the overall management of patients with soft-tissue sarcoma. The types of biopsy are fine needle, trocar, open incision or en bloc excision. There are advantages and disadvantages of each. Open biopsy requires strict adherence to a number of surgical principles. Proper execution requires ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1993-04-01 00:00:00
abstract：:Bisphosphonate treatment has been shown to decrease endosteal bone formation and increase periosteal bone apposition in the rat tibial diaphysis. This study tested the hypothesis that the increase in periosteal apposition is a compensatory attempt to maintain skeletal mass appropriate for the mechanical load. Twenty-f...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-05-01 00:00:00
abstract：UNLABELLED:Resurfacing arthroplasty has become an attractive option for young patients who want to maintain a high activity level. One recent study reported modestly increased activity levels for patients with resurfacing compared to standard total hip arthroplasty (THA). We conducted a prospective randomized clinical ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,随机对照试验
doi：10.1007/s11999-009-1029-x
更新日期：2010-02-01 00:00:00
abstract：:Avulsion of the navicular tuberosity in association with fracture at the calcanecuboid joint is a characteristic pattern of injury resulting from an acute valgus and dorsiflexion stress. Only 22 cases of this unusual injury pattern have been reported, and confusion exists regarding treatment. Recommendations for manag...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1993-07-01 00:00:00
abstract：BACKGROUND:Bone cancer pain is very common, and patients with this type of pain may be difficult to treat. Development of an experimental model for studying this condition is critical to advancing an understanding of the mechanisms that cause pain in patients with malignant disease. METHODS:A murine model of bone canc...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/01.blo.0000093059.96273.56
更新日期：2003-10-01 00:00:00
abstract：:Since the inception of adjuvant chemotherapy for osteogenic sarcoma (OS), 25 patients were treated for telangiectatic osteogenic sarcoma (TOS) from 1973 through 1980. This represented 12% of all patients with primary OS of an extremity seen during this time period. Tumors that demonstrated only focal areas of TOS with...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-06-01 00:00:00
abstract：:Two extracts of bovine bone, bone morphogenetic protein (BMP) supplied by the UCLA Bone Research Laboratory, and osteogenic factor extract (OFE) supplied by the industrial group Celtrix Pharmaceuticals, were tested for the ability to transform embryonic skeletal muscle into cartilage. Skeletal muscle was placed into o...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1994-02-01 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：:Whether a preoperative long leg radiograph taken with the patient standing helps the surgeon reproduce a normal mechanical axis after total knee arthroplasty is unknown. The purpose of the current study was to evaluate whether a preoperative long leg radiograph helps to restore normal limb alignment after total knee a...
journal_title：Clinical orthopaedics and related research
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1097/00003086-200211000-00032
更新日期：2002-11-01 00:00:00
abstract：BACKGROUND:Shoulder arthroplasty provides reliable pain relief and restoration of function. However, the effects of fatty infiltration and atrophy in the supraspinatus and infraspinatus muscles on functional outcomes are not well understood. QUESTIONS/PURPOSES:The purposes of this study were to (1) compare preoperativ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-014-3963-5
更新日期：2015-02-01 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：:There has been a resurgence in the treatment of end-stage tibiotalar arthritis with prosthetic replacement. This procedure has highlighted numerous complications including malleolar fracture. We wanted to determine the clinical relevance of malleolar fracture with the two most commonly used implants in the United Stat...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/01.blo.0000131202.58536.89
更新日期：2004-07-01 00:00:00
abstract：:To learn about the changes appearing in hip muscles after an above-knee amputation, 3-dimensional reconstructions of the hip and thigh region of 12 patients with above-knee amputations were made based on transverse magnetic resonance images. In all patients, the amputations were done at least 2 years before the study ...
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：BACKGROUND:Many procedures have been developed to correct hallux valgus deformity using distal soft tissue realignment, metatarsal osteotomy, and periodically, a proximal phalanx osteotomy (Akin). The ideal metatarsal osteotomy allows for varying degrees of correction with reliable improvement in deformity and patient ...
journal_title：Clinical orthopaedics and related research
pub_type： 临床试验,杂志文章
doi：10.1007/s11999-010-1510-6
更新日期：2011-03-01 00:00:00
abstract：:An approach to mild, moderate, and severe fixed valgus deformities of the knee is described. The sequential approach to soft-tissue releases in the fixed valgus knee allows the surgeon to regain a neutral alignment in valgus deformities of up to 90 degrees. An additional benefit of the approach is spontaneous correcti...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1990-11-01 00:00:00
abstract：:A rare case of glomus tumor of the rotator cuff is presented. A 35-year-old man had a 20-year history of left shoulder pain. Through physical examination, muscular atrophy in the supraspinatus and infraspinatus muscles and restriction of shoulder motion was seen. Magnetic resonance imaging showed an abnormal oval shad...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199605000-00031
更新日期：1996-05-01 00:00:00
abstract：:Plugs of cartilage and subchondral bone from patellae were subjected to cyclic compression consisting of rapid ramp loading for 0.3 seconds followed by a 2.7 second pause. At 1000 psi cyclic load, surface abrasion of the cartilage was noted at 250 cycles of compression. Primary fissures, which penetrated to the calcif...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-04-01 00:00:00
abstract：:A review of clinical records and radiographs revealed that five of 10 patients with conjoined twinning (three of six ischiopagus and two of two pyopagus twins) had congenital vertebral anomalies including hemivertebrae (3), multiple thoracic anomalies (1), right hemisacral agenesis (1), and three lumbar vertebra (1). ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200012000-00017
更新日期：2000-12-01 00:00:00
abstract：:Exogenous steroids are known to induce aseptic necrosis in the femoral head of adults. This case report of a 9-year-old girl with corticosteroid induced femoral head necrosis demonstrates effective treatment with an abduction device in a manner similar to that prescribed for the treatment of Legg-Calve-Perthes disease...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1977-06-01 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：:Habilitation of the upper extremity limb-deficient child is enhanced when the treatment program is based on normal growth and development guidelines. Specific developmental tasks have been identified as key indicators of a child's readiness to benefit from prosthetic fitting, activation of major components, use traini...
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：:Using a titanium alloy femoral prosthesis (STH Zimmer) and an ultra high molecular weight polyethylene acetabular cup with a posterior surgical approach to the hip joint, 237 consecutive total hip arthroplasties in 215 patients were performed between December 1975 and May 1977. The preliminary results and early postop...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1979-10-01 00:00:00
abstract：:An analysis of the patellofemoral joint based on experimental determinations of pressure distributions on the patellar cartilage and vectorial calculations is presented. The extension torque of all quadriceps muscles is similar. The force transmitted to the patella by the retinacula is small in all knee positions. Bec...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1990-09-01 00:00:00
abstract：UNLABELLED:The success of metal-on-metal hip resurfacing in the medium term in young and active patients is becoming evident. The procedure now can be done using a minimal approach developed by the senior author using a single posterior incision. This mini-incision resurfacing arthroplasty of the hip has made resurfaci...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000192034.37049.83
更新日期：2005-12-01 00:00:00
abstract：:As degenerative changes progress in the aging population, more patients will present with degenerative spondylolisthesis. The clinical picture is usually of a woman older than 50 years of age with a degenerative lumbar spondylolisthesis at L5 with symptoms of neurogenic claudication or radiculopathy. Imaging studies w...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：2001-03-01 00:00:00
abstract：:The history of the artificial wrist joint is brief and begins as recently as 1971. The prosthesis is designed as a ball-and-socket joint. The metallic trunnion component is cemented into the radius and the metallic cup component into the carpal and metacarpal II and III bones. There is a central articulating polyethyl...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1980-06-01 00:00:00
abstract：:Supracondylar osteotomy is an alternative to other procedures for realignment of the rheumatoid hindfoot. Of 64 hindfoot operations performed since 1964, 12 were supracondylar osteotomies. The specific indication for this procedure was an ankylosed rheumatoid foot with equinovarus deformity and limited range of tarsal...
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：:Modification of the implant surface with the Arg-Gly-Asp tripeptide (RGD) putatively facilitates osteoblast attachment for improved implant fixation in the laboratory. We compared the histomorphometric and mechanical performance of titanium implants coated with RGD using a novel interface of self-assembled monolayers ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0117-7
更新日期：2008-04-01 00:00:00
abstract：:Total knee arthroplasty (TKA) has evolved during the past 30 years to a well-defined technical surgery with excellent results for as many as 20 years of followup. The concepts of exposure, ligament balancing, and joint alignment have been established clearly by Insall and others. In the early 1990s, Repicci introduced...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000093030.56370.d9
更新日期：2003-11-01 00:00:00
