Abstract:
UNLABELLED:Information regarding national trends in bilateral TKAs is needed for a rational allocation of resources, policy making, and research. Therefore, we analyzed data from the National Hospital Discharge Survey to elucidate temporal changes in the demographics, comorbidity profiles, hospital stay, and in-hospital complications of patients undergoing bilateral TKAs in the United States. We created three 5-year periods: 1990-1994, 1995-1999, 2000-2004. Procedure, healthcare system, and patient-related variables were analyzed for an estimated 153,259 discharges. Use of bilateral TKAs more than doubled for the entire civilian population and almost tripled among the female population, with the steepest increase seen during the last two study periods. A decline of nearly 50% in the use of bilateral TKAs in patients 85 years and older was seen between the second and third study periods. The prevalence of coronary artery disease and pulmonary disease increased from the first to the second study periods but decreased from the second to the third. The changes in the variables studied may reflect a recently acquired reluctance to perform bilateral TKAs in elderly patients with cardiopulmonary comorbidities. Additional studies are necessary to identify other causal relationships and define the impact of these changes on various aspects of the healthcare system. 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
Memtsoudis SG,Besculides MC,Reid S,Gaber-Baylis LK,González Della Valle Adoi
10.1007/s11999-008-0610-zsubject
Has Abstractpub_date
2009-06-01 00:00:00pages
1568-76issue
6eissn
0009-921Xissn
1528-1132journal_volume
467pub_type
杂志文章abstract::The interpretation of loosening on the basis of contrast flow about the cement-bone interface in arthrograms of total knee arthroplasties includes special considerations. The first is that arthrography is misleading in the presence of severe cystic changes. The second is that clinical criteria should be given priority...
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 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::Postoperative prophylaxis with antiinflammatory medications, primarily indomethacin, is extremely effective in preventing the severest degrees of heterotopic ossification (HO) after a total hip arthroplasty (THA) and the recurrence of excised HO developed after a previous hip surgery. Prophylaxis with indomethacin sho...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1991-02-01 00:00:00
abstract::A retrospective review was performed on 20 patients treated at the authors' hospital between 1961 and 1981 with noninfected nonunions following primary open reduction and internal fixation (ORIF) of intertrochanteric femoral fractures. All patients were available for follow-up examination. Each patient was interviewed...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-05-01 00:00:00
abstract:BACKGROUND:Adverse local tissue reactions (ALTR) around metal-on-metal (MOM) hip arthroplasties are increasingly being recognized as a cause of failure. These reactions may be associated with intraoperative tissue damage and complication rates as high as 50% after revision. Although MRI can identify ALTR in MOM hips, i...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-013-2788-y
更新日期:2014-02-01 00:00:00
abstract::Septic arthritis of the hip occurred in a 32-year-old hemophiliac with circulating Factor VIII antibodies. The clinical presentation suggested a soft tissue hematoma, but failure of early resolution with immobilization and Factor VIII replacement led to a correct diagnosis. A non-invasive method of management is essen...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-197711000-00030
更新日期:1977-11-01 00:00:00
abstract::The purpose of the current study was to determine the incidence of distal biceps tendon ruptures within a defined population, to describe the demographics of affected individuals, and to identify potential risk factors. The healthcare system in this study provides care to a known number of members in an area defined b...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:2002-11-01 00:00:00
abstract::Two children with premature partial arrest of the tibial physis, one proximal and the other distal, were treated by resection of the bony bar and by the Langenskiold method of interposition of fat. In one child the arrest was the result of an open fracture and bony loss of the upper tibia. In the other child the arres...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1984-03-01 00:00:00
abstract::As early as 1956, laboratory investigations into the carcinogenicity of modern dental and orthopaedic alloys were undertaken. Such studies were prompted by the observation that workers, particularly in nickel and chromate refining, had increased risks of nasal and lung tumors. For the past 25 years, sporadic case repo...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/00003086-199608001-00023
更新日期:1996-08-01 00:00:00
abstract:BACKGROUND:Metal-on-metal articulations can release substantial amounts of particles containing cobalt and chromium into the surrounding milieu, causing concern for cellular toxicity and adverse local soft tissue reactions. The diameter of the femoral head has been one of the variables that inversely affects wear of me...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1630-z
更新日期:2011-06-01 00:00:00
abstract::Muscle transplantation in deltoid paralysis in poliomyelitis has been practiced only sporadically and considered ineffective. Trapezius transfer to humeral shaft with fascia lata extension was performed to restore abduction power of the shoulder in 24 patients between 4--10 years of age. It is recommended that the mus...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1978-09-01 00:00:00
abstract::Endoprosthetic proximal femur replacement is a well-accepted method for treatment of primary bone tumors; however the functional results of treatment are not well documented. To evaluate functional outcomes, we recorded the Toronto Extremity Salvage Score and Musculoskeletal Tumor Society 1987 and 1993 scores in 29 pa...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000136840.67864.78
更新日期:2004-09-01 00:00:00
abstract::The introduction of new techniques to the magnetic resonance imaging (MRI) armamentarium is beginning to provide an MRI examination that overcomes many of the disadvantages noted in earlier reports. An analysis of the various advantages and disadvantages of MRI, plain film myelography, and computed tomographic myelogr...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1989-02-01 00:00:00
abstract::In a series of 70 consecutive patients with nonpathologic intertrochanteric or subtrochanteric hip fractures, the first 35 were treated by a single semi-flexible condylocephalic nail. The second 35 patients were treated by a sliding compression screw and side-plate. The groups were comparable regarding age and intercu...
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::Forty-nine children with diaphyseal both-bone forearm fractures were treated with either both-bone intramedullary wire fixation (24), single ulnar intramedullary wire fixation (22), or single radial intramedullary wire fixation (3). Six fractures were open and 43 were closed. A limited open approach to one or both bon...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200209000-00024
更新日期:2002-09-01 00:00:00
abstract::The authors studied 10 consecutive patients with closed femoral shaft or supracondylar fractures who were nonambulatory and who were treated by reamed retrograde intramedullary nailing via an intercondylar notch approach. The study consisted of five women and five men with an average age of 60.7 years (range, 40-89 ye...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200004000-00026
更新日期:2000-04-01 00:00:00
abstract::The current study analyzed subjects having a total knee arthroplasty to determine the incidence of condylar lift-off and correlate lift-off with the alignment of the femoral component with respect to the transepicondylar axis. Twenty-five subjects, implanted with a posterior stabilized total knee prosthesis, were aske...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200210000-00022
更新日期:2002-10-01 00:00:00
abstract::Common misconceptions about distal radius fractures result in undertreatment of many fractures, particularly in an active population. Loss of reduction of the fracture may cause a symptomatic malunion. Fourteen patients with an average age of 39 years (range, 21-65 years) underwent reconstructive procedures for radial...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199606000-00021
更新日期:1996-06-01 00:00:00
abstract::Predictors of success of orthopaedic residents on the American Board of Orthopaedic Surgery (ABOS) examination are controversial. We therefore evaluated numerous variables that may suggest or predict candidate performance on the ABOS examination. We reviewed files of 161 residents (all graduates) from one residency pr...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-009-0939-y
更新日期:2009-09-01 00:00:00
abstract::The skeletal system manifestations of thalassemia are characterized by severe osteoporosis, frequent fractures and delayed healing. Permanent deformity and disability can complicate the fractures. Surgical correction of deformity by osteotomy of severely osteoporotic bone and immobilization without internal fixation w...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1978-09-01 00:00:00
abstract::The variability in alignment of the natural patellar groove was determined about various anatomic axes of the femur, using 3 plane radiographs and electronic digitization. After the patellar groove was identified and marked on 15 anatomic specimen femurs, radiographs were taken in the coronal, sagittal, and transverse...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199610000-00009
更新日期:1996-10-01 00:00:00
abstract::Popliteal artery injury during surgery of the knee is rare but can have devastating consequences. The position of knee flexion has been thought to be protective for the popliteal artery, allowing it to fall back from the knee joint. No prior study has provided in vivo cross sectional evidence of the behavior of the po...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1999-10-01 00:00:00
abstract:BACKGROUND:Because the injured joint has an actively inflammatory environment, the survival and repair potential of cartilage grafts may be influenced by inflammatory processes. Understanding the interactions of those processes with the graft may lead to concepts for pharmacologic or surgical solutions allowing improve...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-1826-x
更新日期:2011-10-01 00:00:00
abstract::The goal of subtotal arthrodesis of the wrist is to provide a stable and pain-free joint, with preservation of a limited but useful range of motion. Experience indicates that the available mobility of the joints that are left unfused tends to increase with time and use of the extremity, and that accelerated wear of th...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1984-07-01 00:00:00
abstract::In certain circumstances osteotomy of the greater trochanter in total hip arthroplasty is of benefit. To attack the problem of nonunion following trochanteric osteotomy, the authors apply several different wiring techniques. To quantify the efficacy of these approaches, they have reviewed 804 consecutive total hip art...
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::Syndesmosis sprains have received increasing recognition during recent years because of a heightened awareness of the mechanism, symptoms, and signs of injury. Syndesmosis injuries take longer to recover than lateral ankle sprains, and no consensus exists regarding optimal treatment of these injuries. Therefore, we un...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/BLO.0b013e31802eb471
更新日期:2007-02-01 00:00:00
abstract:BACKGROUND:Periprosthetic joint infection (PJI) is a leading cause of revision arthroplasty. Considerable controversy still exists whether single- or two-stage exchange is the better approach for patients with chronic PJI. Historically, single-stage exchange arthroplasty was thought to have an unacceptably high risk of...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/CORR.0000000000001243
更新日期:2020-08-01 00:00:00
abstract::Osteoblastic and chondroblastic (i.e., osteogenic) cells belong to the stromal cell system, which is associated with bone marrow, and bone and is separate from the hematopoietic stem-cell system. Stromal stem cells are capable of producing reticular, fibroblastic, osteogenic, and adipose stromal lines. Marrow-derived ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1990-03-01 00:00:00
abstract::The Hall model of experimental arthritis of the knee (excision of the lateral femoral condyle) offers a unique way of investigating the earliest changes of degenerative arthritis. Predictable degeneration of the lateral tibial plateau occurs when there is lack of contact with an opposing surface. Previous work by Hall...
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:BACKGROUND:A 10-point Surgical Apgar Score, based on patients' estimated blood loss, lowest heart rate, and lowest mean arterial pressure during surgery, was developed to rate patients' outcomes in general and vascular surgery but has not been tested for patients having orthopaedic surgery. QUESTIONS/PURPOSES:For pati...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1721-x
更新日期:2011-04-01 00:00:00