Abstract：
UNLABELLED:Impaction grafting is controversial in the presence of segmental and cavitary acetabular defects and requires the use of supplemental devices to close segmental defects. This approach, however, would allow treating combined deficiencies that could not be managed with impacted cancellous bone alone. We raised the following two questions: (1) What is the survival rate in patients with combined deficiencies reconstructed with metal mesh, impaction grafting and a cemented cup and (2) can metal mesh prevent cup migration? We evaluated 23 cavitary uncontained acetabular defects in revision hip arthroplasty. Preoperative diagnoses were aseptic loosening (19 hips) and second-stage reimplantations after resection for infection (four hips). The preoperative Merle D'Aubigné-Postel score averaged 7.4 points. Two patients had reoperations for mechanical failure at 6 and 24 months. The survival rate with further revision as an end point was 90.8% at an average of 36 months (range, 24-56 months; 95% confidence interval, 68.1-97.6). Metal mesh did not prevent cup migration: migration occurred in all patients, averaging 5.1 mm (range, 2-25 mm). Another three patients with severe combined defects had asymptomatic mesh rupture with 3- to 15-mm migration. Postoperative functional score averaged 16.2 points. Metal mesh, impaction grafting, and a cemented cup should be considered for reconstruction of medium uncontained acetabular defects, but not for severe combined deficiencies. LEVEL OF EVIDENCE:Level IV, therapeutic study. 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
Buttaro MA,Comba F,Pusso R,Piccaluga Fdoi
10.1007/s11999-008-0442-xsubject
Has Abstractpub_date
2008-10-01 00:00:00pages
2482-90issue
10eissn
0009-921Xissn
1528-1132journal_volume
466pub_type
临床试验,杂志文章abstract：BACKGROUND:Locking titanium plates revolutionized the treatment of osteoporotic and metaphyseal fractures of long bones. However as with any innovation, with time new complications are identified. One of the problems with titanium locking plates is removal of screws, often attributable to cold welding of screw heads in...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-010-1508-0
更新日期：2011-02-01 00:00:00
abstract：:By the time a patient's shoulder problem has reached the stage in which an arthrodesis is being considered, the patient usually is willing to accept the restraints of an arthrodesed shoulder. If there is a chance of relieving chronic pain and restoring some reasonable degree of function in the upper extremity, arthrod...
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：:Predicting pathologic fractures of long bones caused by metastatic disease continues to be a challenging clinical problem. We assessed the ability of noninvasive imaging and computational techniques to predict the strength of bones with osteolytic lesions. A murine model of induced tumor osteolysis to the distal femur...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0241-4
更新日期：2008-06-01 00:00:00
abstract：:Fourteen boys (56%) and 11 girls (44%) 4 to 17 years of age (mean, 12.2 years) who had osteosarcoma and open epiphyseal plates were studied. A possible correlation between transepiphyseal spread of osteosarcoma and radiologic and histopathologic findings was investigated. Epiphyseal plate invasion was detected radiolo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200004000-00006
更新日期：2000-04-01 00:00:00
abstract：:The purpose of this study was to determine trends and differences between various medical specialties with regard to the treatment of postmenopausal osteoporosis. The method used was a cross-sectional survey, and the authors' sample was composed of 116 physicians. There was an overall lack of consensus on choice of tr...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1985-01-01 00:00:00
abstract：BACKGROUND:Locking plate fixation of proximal humeral fractures improves biomechanical stability. It has expanded the indications of traditional open reduction internal fixation and become increasingly common for treating unstable, displaced proximal humeral fractures. Despite improved stability it is unclear whether t...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-1935-6
更新日期：2011-12-01 00:00:00
abstract：:Four cases of pathologic periacetabular insufficiency/fracture in patients with extensive neoplastic metastatic involvement of the hemipelvis were treated by pelvic reconstruction with hemipelvis pin reinforcement with total hip arthroplasty (THA). Reconstruction was reserved for patients with limited other bony or vi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-09-01 00:00:00
abstract：:In 1958 a group of Swiss general and orthopaedic surgeons established the AO (Arbeitsgemeinschaft für Osteosynthesefragen) or the Association of the Study of Internal Fixation (ASIF) to strive to transform the contemporary treatment of fractures in Switzerland. This association was revolutionary in development of inst...
journal_title：Clinical orthopaedics and related research
pub_type： 传,历史文章,杂志文章
doi：
更新日期：1998-02-01 00:00:00
abstract：:Evidence suggests neovascularization is involved in the etiology of spontaneous Achilles tendon rupture. Therefore we investigated expression of the receptors of one of the most important angiogenic factors, the vascular endothelial growth factor in normal and pathologic human Achilles tendons by immunohistochemical a...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200403000-00040
更新日期：2004-03-01 00:00:00
abstract：UNLABELLED:Fractures of the femur after a knee or hip arthroplasty historically have been plagued with high complication rates. The Less Invasive Stabilization System (LISS) has theoretical advantages of improved biomechanics and limited insult to the bone's vascular supply. We theorized that the LISS would have a lowe...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000223987.59702.17
更新日期：2006-09-01 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：:Thirty-five patients with a benign lesion of the femoral neck or trochanter were treated and seen in followup at the authors' institution from 1988 to 1991. Sixteen men and 19 women between the ages of 18 and 54 years (average, 27 years) were seen at an average followup of 3 years 6 months (range, 2-5 years). Eight pa...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199607000-00034
更新日期：1996-07-01 00:00:00
abstract：:The elution of antibiotics from antibiotic-impregnated polymethylmethacrylate (PMMA) beads was measured in mongrel dogs. The antibiotics, used in mixture with Simplex cement, included cefazolin (Ancef; 4.5 g/40 g cement powder), ciprofloxacin (Cipro; 6 g/40 g powder), clindamycin (Cleocin; 6 g/40 g powder), ticarcilli...
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：:Occupational radiation exposure was measured using three film badges and one ring thermoluminescent dosimeter. The radiation dose in the hospital but outside the operating room was measured as zero for the 12-month period. The measured trunk dose in the operating room was 5 mrem, and the measured dose to the head and ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-01-01 00:00:00
abstract：BACKGROUND:Cost-effectiveness research is an increasingly used tool in evaluating treatments in orthopaedic surgery. Without high-quality primary-source data, the results of a cost-effectiveness study are either unreliable or heavily dependent on sensitivity analyses of the findings from the source studies. However, to...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-015-4369-8
更新日期：2015-10-01 00:00:00
abstract：:The biomechanic and histologic changes following replacement of the medial collateral digit of the knee with carbon fiber filament prostheses of varying diameters were studied in young rabbits. Biomechanic testing showed changes with time in the mode of failure and force to failure of the replacements, but the initial...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-12-01 00:00:00
abstract：:The factors which determine the rate and amount of acetabular growth in congenital dislocation of the hip are ill-understood. A prospective radiological study has been devised in order to assess the influence of the age of congruity, femoral anteversion and neck/shaft angles on acetabular growth. To be included, the c...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1976-09-01 00:00:00
abstract：:The purpose of this study was to evaluate the stability of different types of internal fixation requiring anterior, posterior, or combined surgical approaches for the T-type acetabular fracture. Eight specimens were loaded 25 times in a cyclic manner to 150 N for each type of fixation construct evaluated. The model at...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1995-05-01 00:00:00
abstract：:In order to determine the effects of parathyroid hormone on bone formation, mean wall thickness (MWT) of trabecular bone packets was measured on transilial undecalcified bone biopsies from 26 patients (14 females and 12 males) with primary hyperparathyroidism (HPT). Mean value of MWT in HPT patients (45.2 +/- 5.8 micr...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1982-01-01 00:00:00
abstract：:Static and fatigue tests of the small Orthofix unilateral external fixator frame and its main components were performed. The use of six pins increased torsional rigidity, but this configuration failed at lower bending loads when compared to the four-pin configuration, reflecting the uneven holding strength of the pin ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1990-04-01 00:00:00
abstract：:After reviewing a series of 220 patients operated upon between 1975 and 1985 for traumatic brachial plexus injuries, the authors present the results of 103 myelographies, 48 computed tomographies (CT scans) combined with standard myelography, and 25 series of images obtained by magnetic resonance imaging (MRI). To eva...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-12-01 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：:British surgeons and engineers contributed various types of knee prostheses, including hinged, unconstrained, and semiconstrained prostheses, in the development of total knee arthroplasty. Methods of implant fixation, the place of stems, pegs, the use of special instrumentation, and alignment procedures ensure both in...
journal_title：Clinical orthopaedics and related research
pub_type： 历史文章,杂志文章
doi：
更新日期：1986-09-01 00:00:00
abstract：:Osteonecrosis (aseptic or avascular necrosis of bone) is an entity with many causes that can occur at a variety of sites. It is a known complication of corticosteroid therapy, either alone or combined with other drugs in the treatment of malignancy. Osteonecrosis associated with chemotherapy that does not include cort...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-03-01 00:00:00
abstract：:A 61-year-old man who received a porous-metal-coated knee implant returned eight months later with chronic synovitis, instability, and loosening of his artificial joint. Subsequently, metal beads were detected in the joint space and soft tissues and were also embedded in the articulating surface of the tibial componen...
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：: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：: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：: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：BACKGROUND:The indication for hip arthrotomy accompanied by intraarticular work during periacetabular osteotomy (PAO) has not been precisely defined. To validate a role for routine hip arthrotomy accompanied by intraarticular work, frequent intraarticular pathology must exist, and the adjunct procedures must not be ass...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2602-2
更新日期：2013-02-01 00:00:00
abstract：:Kinematic and kinetic parameters of gait have a significant dependency on subject age and walking velocity. Hip flexion-extension, stride length, hip resultant force, hip resultant moment, and hip contact force all increase with increasing velocity. All of these parameters except hip resultant force are significantly ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-05-01 00:00:00
