Abstract：
UNLABELLED:Total knee replacement effectively relieves arthritis pain but improvement in physical function varies. A clearer understanding of the patient attributes associated with differing levels of functional gain after TKR is critical to surgical decision making. We reviewed 8050 primary, unilateral TKR patients enrolled in a prospective registry between 2000 and 2005 who had complete data. We evaluated associations between 12-month function (SF12/PCS) and preoperative gender, age, BMI, emotional health (MCS), knee diagnosis, quadriceps strength, and physical function (PCS). More than 98% of patients reported pain relief (KS pain score). At 12 months, mean PCS gain was 13.6 points, but the distribution was bimodal. The mean gain in PCS in the 63% of patients with greater improvement was 21 (SD = 7), and 4.1 (SD = 7) in the remaining 37%. Increased likelihood of poor functional gain was associated with older age, body mass index (BMI) over 40, lower MCS, and poor quadriceps strength. While two-thirds of patients reported functional gain well above national average at 12 months post-TKR, 37% reported limited functional improvement. Further understanding of the patient attributes associated with limited improvement will guide the design of innovative strategies to improve functional outcomes. LEVEL OF EVIDENCE:Level II, prognostic 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
Franklin PD,Li W,Ayers DCdoi
10.1007/s11999-008-0428-8subject
Has Abstractpub_date
2008-11-01 00:00:00pages
2597-604issue
11eissn
0009-921Xissn
1528-1132journal_volume
466pub_type
杂志文章abstract：:The evaluation of medical students consists, in part, of a transparent academic record of grades, awards, and any publications or special clinical activities. In addition, however, each student is evaluated through more opaque processes within a medical school that speak to the behavior, character, and developing prof...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/01.blo.0000229271.36076.77
更新日期：2006-08-01 00:00:00
abstract：BACKGROUND:Early adverse tissue reactions around metal-on-metal (MoM) hip replacements, especially pseudotumors, are a major concern. Because the causes and pathomechanisms of these pseudotumors remain largely unknown, clinical monitoring of patients with MoM bearings is challenging. QUESTIONS/PURPOSES:The purpose of ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-015-4466-8
更新日期：2015-12-01 00:00:00
abstract：:Wrist arthrodesis is a reliable procedure that, although it sacrifices motion for stability, provides the patient with relief from pain. This review of 26 wrist arthrodeses performed in 24 patients using the AO technique, with plate and screw fixation and iliac crest bone graft, shows a 100% union rate and high patien...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1997-08-01 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：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：BACKGROUND:Patient-reported outcomes (PROs) are increasingly relevant when evaluating the treatment of orthopaedic injuries. Little is known about how PROs may vary in the setting of polytrauma or secondary to high-energy injury mechanisms, even for common injuries such as distal radius fractures. QUESTIONS/PURPOSES:(...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/CORR.0000000000000757
更新日期：2019-10-01 00:00:00
abstract：:The patella is an important functional component of the knee extension mechanism. It accounts for 13 to 30% of the knee extensors' moment arm. Functional deficits owing to patellectomy include decreased knee extension power, extension lag, instability, chronic effusion, decreased stance phase flexion, alteration of th...
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：:Seventy-seven patients treated by chymopapain and laminectomy were compared before, and 6 and 14 weeks after, treatment. A standardized, multidimensional scale of low back pain providing scores on 7 independent dimensions of sensory and affective discomfort and one measure of intensity were used. Fourteen weeks after ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1980-01-01 00:00:00
abstract：:Osteopetrosis is an inherited skeletal condition characterized by increased bone radiodensity. There are three clinical groups: infantile-malignant autosomal recessive, fatal within the first few years of life (in the absence of effective therapy); intermediate autosomal recessive, appears during the first decade of l...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1993-09-01 00:00:00
abstract：:A prospective comparative study was conducted involving 62 patients to determine the effects and limits of accelerated rehabilitation on clinical outcome. The study focused on whether aggressive rehabilitation after anterior cruciate ligament reconstruction with the doubled semitendinosus and gracilis tendon autograft...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200204000-00043
更新日期：2002-04-01 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：:Molecular diagnostic strategies have been implemented to enhance the treatment of musculoskeletal infections. Once primarily a research tool, molecular-based assays, have become accepted clinical tests for the genomic detection of certain pathogens involved in bone and joint infections. Currently, culture remains the ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/01.blo.0000175126.37343.44
更新日期：2005-08-01 00:00:00
abstract：UNLABELLED:Revision total knee arthroplasty can be considerably more difficult in cases involving severe bone loss, complete absence of collateral ligaments, and persistent periprosthetic supracondylar femoral fractures. Modular segmental endoprosthetic distal femur replacement is a limb salvage option when other surgi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000214433.64774.1b
更新日期：2006-05-01 00:00:00
abstract：BACKGROUND/RATIONALE:A 10-year survivorship of 100% was reported for patients with PFC cruciate-retaining prostheses. Beyond 10 years, we observed additional polyethylene wear likely related to thin liners gamma-irradiated in air and were concerned this wear might predispose to implant construct failure. QUESTIONS/PUR...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-010-1303-y
更新日期：2010-09-01 00:00:00
abstract：BACKGROUND:Rotator cuff repair is a successful treatment in terms of patient satisfaction and pain relief regardless of the repair method. Although arthroscopic repair is commonly thought to be less painful than open or miniopen repair, studies disagree on this point. QUESTIONS/PURPOSES:We wished to compare the result...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-014-3715-6
更新日期：2014-09-01 00:00:00
abstract：:Scoliosis screening has been practiced for nearly 50 years and has provided valuable knowledge about the prevalence and natural history of scoliosis. Early diagnosis allows for nonoperative treatment, like wearing an orthosis that has been shown to be effective by numerous outcome studies. Challenges in scoliosis scre...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/01.blo.0000163242.92733.66
更新日期：2005-05-01 00:00:00
abstract：:The spherocentric knee, designed to allow triaxial rotation and provide intrinsic stability, includes desirable design features of metal on high density polyethelene bearing surfaces, metal support for all plastic components, metal-cement-bone interfacing for all fixation surfaces, sufficient strength to eliminate fat...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1979-11-01 00:00:00
abstract：:Tumoral calcinosis is the deposition of calcium crystals and salts in the periarticular soft tissues. It commonly is seen as a complication of renal dialysis or in patients with a hereditary disposition. Occasionally, it is seen as an isolated condition with no known cause. Tumoral calcinosis usually affects adults an...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：2005-07-01 00:00:00
abstract：:Failure accurately to determine distal femoral screw hole position can sometimes prolong operating time for placing an interlocking Grosse-Kempf rod. The described technique allows the distal femoral screw holes to be localized accurately with minimal radiation exposure. This technique utilizes readily available instr...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-01-01 00:00:00
abstract：:Using a testing apparatus that allows axial loading and displacement in the sagittal, axial, and coronal planes, 6 ankles were tested under experimental conditions intended to model the Lauge-Hansen pronation external rotation injury. All specimens were rotated through a continuous range of sagittal motion with the an...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199607000-00043
更新日期：1996-07-01 00:00:00
abstract：:The mainstay of local control of primary bone malignancies in the skeletally immature has been amputation or, in selected cases, rotationplasty. The development of expandable endoprostheses has permitted an alternative approach for local control in the growing child. Between January 1985 and December 1987, 12 skeletal...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-12-01 00:00:00
abstract：BACKGROUND:Osteoporosis may complicate surgical fixation and healing of proximal humerus fractures and should be assessed preoperatively. Peripheral quantitative CT (pQCT) and the Tingart measurement are helpful methods, but both have limitations in clinical use because of limited availability (pQCT) or fracture lines ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-015-4322-x
更新日期：2015-09-01 00:00:00
abstract：BACKGROUND:The choice of surgical approach for THA remains controversial. Some studies suggest that the direct anterior approach (DAA) leads to less muscle damage than the miniposterior approach (MPA), but there is little high-quality evidence indicating whether this accelerates recovery, or whether this approach-which...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,随机对照试验
doi：10.1007/s11999.0000000000000112
更新日期：2018-02-01 00:00:00
abstract：:Biodegradable local antibiotic delivery systems have gained interest for prophylaxis and treatment of musculoskeletal infections. We studied the biodegradable materials Osteo- Set, DBX and Collagraft for local delivery of vancomycin and gentamicin in vitro. We determined the antimicrobial activity of vancomycin and ge...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000229319.45416.81
更新日期：2006-10-01 00:00:00
abstract：:Multimodal, limb-saving therapy is the treatment of choice in children with osteosarcoma. However, few data are available on long-term functional problems and disabilities in surviving patients. Seventy-eight children treated for Stage II-B osteosarcoma who were treated between 1970 and 1997 were evaluated. Beyond the...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：2004-04-01 00:00:00
abstract：:The impact of preoperative gait analysis on the orthopaedic care of 97 patients (101 gait analyses) at the authors' institution was evaluated. For the 70 patients for whom a specific treatment plan had been outlined before the preoperative gait study, the treatment plan was altered in 62 (89%) after the gait analysis ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200003000-00023
更新日期：2000-03-01 00:00:00
abstract：:Three patients had distraction osteogenesis as a salvage method for infected endoprostheses. At the first operation, the infected prosthesis was removed and stabilization was achieved with an external fixator to preserve limb length. An additional external fixator was applied later for distraction osteogenesis after e...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000128215.33603.4c
更新日期：2004-07-01 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：:Forty-six hands of 23 cadavers (15 female and 8 male) were dissected to observe the patterns of distribution of the median nerve. The findings showed that in 33 hands the median nerve had a normal distribution of its branches. Also identified was the commonly recognized transligamentous variant, where the recurrent br...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1998-07-01 00:00:00
abstract：:The natural history of degenerative lumbar spinal stenosis is documented poorly. Little is known about the efficacy of nonoperative treatments. An aggressive nonoperative treatment consisting of therapeutic exercise, analgesics, and epidural steroid injections is proposed. The clinical evaluation of the patients is re...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200103000-00018
更新日期：2001-03-01 00:00:00
