Abstract：
UNLABELLED:Patellar resurfacing (PR) in total knee arthroplasty (TKA) is controversial. The Outerbridge classification of cartilage defects in the patella is commonly used in the literature. The purpose of this study was to determine if the Outerbridge classification can predict the need for PR as part of total knee arthroplasty. Between 1995 and 2000, we performed a prospective, randomized study of 500 TKAs. We carried out PR depending on the Outerbridge classification of the patella at the time of surgery. Patients with Outerbridge Grades I, II, and III formed Group A, whereas patients with Grade IV formed Group B. Within each group, resurfacing was completed on half of the patients. Group A had 328 patients (164 with PR, 164 without PR). In Group B, there were 172 patients (86 with PR, 86 without PR). An identical prosthetic design was used for both groups. The minimum followup was 5 years (average, 7.8 years) for both Group A and Group B. At the end of followup, we assessed the number of patients in each group that required secondary resurfacing as a result of patellofemoral pain. Patients in Group A required fewer revisions for PF pain. In Group A, only one patient required a secondary PR (0.6% rate), whereas in Group B, 10 patients needed PR (11.6% rate). In Group B, the risk of need of a patellar resurfacing was 21.5 times greater than in Group A. On the basis of these findings, we recommend PR in Outerbridge Grade IV patellae, but not in Grades I, II, and III. LEVEL OF EVIDENCE:Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Rodríguez-Merchán EC,Gómez-Cardero Pdoi
10.1007/s11999-009-1123-0subject
Has Abstractpub_date
2010-05-01 00:00:00pages
1254-7issue
5eissn
0009-921Xissn
1528-1132journal_volume
468pub_type
杂志文章,随机对照试验abstract：UNLABELLED:Allograft ankle arthrodesis using a retrograde intramedullary tibial nail is a new strategy in limb salvage for treatment of distal intraarticular tibial tumors. After tumor resection, the ankle is reconstructed using an intercalary allograft and retrograde intramedullary fixation. We retrospectively reviewe...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000176449.77149.81
更新日期：2005-11-01 00:00:00
abstract：:Gene therapy has much to offer in the treatment of conditions in which it is necessary to increase the formation of bone. Nonunions, segmental defects, and aseptic loosening are examples of conditions where the local expression of genes that inhibit osteolysis and promote osteogenesis might be helpful. Studies in whic...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200010001-00016
更新日期：2000-10-01 00:00:00
abstract：:Fifty-two patients with subtalar joint involvement secondary to os calcis fractures have been treated with a surgical technique designed by George F. Pennal. There were 23 tongue-type fractures and 33 joint depression fractures in this series. All were treated by open reduction and internal fixation, and occasionally ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1985-10-01 00:00:00
abstract：:There are numerous newer techniques that have been developed for the internal fixation of the cervical spine in recent years. Wiring techniques are still appropriate for posterior stabilization of the cervical spine. The halo vest is still widely used for the conservative management of cervical fractures and for posto...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1997-02-01 00:00:00
abstract：:A three-part fracture of the acetabulum occurred in a 74-year-old woman seven years after a McKee-Farrar total hip arthroplasty (THA). The hip was successfully reconstructed using an allogenic femoral head for a bone graft and titanium mesh for reinforcement. Thirty-six months after the operation, the revised THA was ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1981-03-01 00:00:00
abstract：:Fifty patients with signs and symptoms of chronic impingement syndrome and/or rotator cuff tear were evaluated with shoulder arthrograms and ultrasonography. Ninety asymptomatic shoulders of a comparable age had ultrasonography to serve as a control group. All controls had normal ultrasonograms with no hypoechoic or s...
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：:Calcified cartilage transplants induce bone formation. This process may be inhibited if the recipient is immunized by the transplant. To study the relation between the degree of antigen incompatibility between the donor and recipient and bone formation in more detail, chondrocytes isolated from cartilaginous epiphyses...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-01-01 00:00:00
abstract：:A case of isolated dislocation of the pisiform occurred in an 18-year-old man who was treated by primary resection and followed for two years. As observed in previous reports, primary resection was a successful treatment. ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1989-04-01 00:00:00
abstract：:In 63 anatomic specimens of the shoulder, the coracohumeral ligament was found to be a clear, well-developed structure in 59 and absent or vestigial in four. The origin of the coracohumeral ligament was consistently found at the base of the coracoid process. The insertion was more variable, between the rotator interva...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-07-01 00:00:00
abstract：BACKGROUND:Leverage of the femoral head against the acetabular rim may lead to posterior hip dislocation during sports activities in hips with femoroacetabular impingement (FAI) deformity. Abnormal concavity of the femoral head and neck junction has been well described in association with posterior hip dislocation. How...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/CORR.0000000000000514
更新日期：2019-05-01 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 authors report their 15-year experience with primary total hip arthroplasty using collarless, tapered, porous-coated femoral stems (Trilock and Taperloc) in patients with osteoarthritis, rheumatoid arthritis, and in octogenarians. Excellent clinical results were achieved in all groups at latest followup. For the p...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200112000-00014
更新日期：2001-12-01 00:00:00
abstract：:The major problem in osteoarthritis research today is our inability to promote effective cartilage regeneration in the presence of adult chondromalacia. Yet such regeneration is consistently present in acromegalics. The present study of experimentally damaged rabbit knee cartilage measures numbers of cells, mitoses, t...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1975-01-01 00:00:00
abstract：:Osteonecrosis (ON) is commonly caused by high doses of glucocorticoids or ethanol intake. We previously reported suppression of BMP-2 by dexamethasone was more pronounced and enhancement by lovastatin was less pronounced in bone marrow stromal cells (BMSCs) from patients with ON than from patients without ON. We there...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-009-0803-0
更新日期：2009-08-01 00:00:00
abstract：:A simple but efficient way to secure the biceps tendon after it has been detached at its upper end by either trauma, attrition or surgical interference is the use of the keyhole in the upper humerus. A tied or rolled knot of tendon inserted into a keyhole shaped opening in the bicipital groove permits firm attachment ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1975-10-01 00:00:00
abstract：:Decisions made regarding resumption of driving after total hip arthroplasty may be determined by a combination of factors including driving reaction time and when postsurgical precautions need no longer be adhered to. Ninety patients, ranging in age from 34 to 85 years old were recruited after total hip arthroplasty t...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000072468.32680.ff
更新日期：2003-08-01 00:00:00
abstract：:Forty-five patients (49 knees) who had torn complete or incomplete discoid lateral menisci were treated during the period from 1968 to 1980. Both instrumentation and specific techniques considerably evolved in the arthroscopic complete excision the torn discoid meniscus. The current technique involves the initial remo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1982-07-01 00:00:00
abstract：BACKGROUND:The standard approach to lateral tibial plateau fractures involves elevation of the iliotibial band (IT) and anterior tibialis origin in continuity from Gerdy's tubercle and metaphyseal flare. We describe an alternative approach to increase lateral plateau joint exposure and maintain iliotibial band insertio...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-013-2962-2
更新日期：2013-09-01 00:00:00
abstract：:Severe involvement of the wrist in rheumatoid arthritis poses great functional restrictions in eating, maintaining personal hygiene, and in performing general daily activities. Twenty-six Swanson radiocarpal implant arthroplasties were performed in 23 patients. Patients' average age was 57 years, with a preoperative d...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1982-06-01 00:00:00
abstract：:Orthopaedic surgeons can enjoy good patient and physician relationships and be happy in the work setting. Here's how. It is important to know oneself. Explore one's spirituality. Maintain humor, humility, and humanity. Make only original mistakes. Attend to one's mental health. Invest time, thought, and energy in inte...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199904000-00032
更新日期：1999-04-01 00:00:00
abstract：:Increasing knowledge of instability in the shoulder has created a more complex evaluation sequence. The history continues to be important. Many physical examination maneuvers are available to further define the problem. Routine roentgenographic examination has been extended to include views specifically designed to de...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1987-10-01 00:00:00
abstract：:Intramedullary nailing after reaming of the medullary cavity according to Küntscher, provides a rigid fixation and makes early mobilization possible, and is even applicable to infected non-unions. Experience with 150 cases of fresh femoral fractures and more than 80 cases of non-union of the femur, the tibia, the hume...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1976-03-01 00:00:00
abstract：:A previously undescribed accessory flexor digitorum superficialis muscle-tendon unit was discovered on surgical exploration of the wrist in an 18-year-old girl with symptoms of distal ulnar neuropathy and a volar soft-tissue mass. Excision of the muscle-tendon unit resulted in complete resolution of symptoms. The preo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1985-04-01 00:00:00
abstract：:Low fibular fractures that were associated with deltoid ligament disruption and inferior tibiofibular syndesmotic disruption were studied. All of the patients had a Type B Weber fibular fracture associated with a deltoid ligament injury. It was difficult to detect the syndesmosis disruption on the initial assessment o...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000052935.71325.30
更新日期：2003-04-01 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：:Pelvic osteotomy for symptomatic hip dysplasia usually is performed for young and adolescent females. Delivery after pelvic osteotomy is a concern for patients of childbearing age. We asked whether the clinical results differed before and after pregnancy, whether eccentric rotational acetabular osteotomy alters the bo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/BLO.0b013e31803b8d82
更新日期：2007-06-01 00:00:00
abstract：:The current study investigated healing of large full-thickness articular cartilage defects during the first 8 weeks with and without penetration of the subchondral bone using microfracture in an established equine model of cartilage healing. Chondral defects in the weightbearing portion of the medial femoral condyle w...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200302000-00031
更新日期：2003-02-01 00:00:00
abstract：:One hundred and five patients were treated by instrumentation for various spinal conditions by means of the posterior route. There were 90 patients with scoliosis in this series. Of these, 61 cases (67.7%) were corrected by Harrington distraction rod and segmental wire fixation. The various degrees of deformity in the...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1987-02-01 00:00:00
abstract：:Contemporary management of Grade IIIB open tibial fractures has evolved to include intravenous antibiotics, thorough interval surgical debridement, rigid skeletal fixation, early local or free tissue myoplasty, and liberal use of autogenous bone graft beneath a clean, stable wound. External fixation has been the skele...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,meta分析
doi：10.1097/00003086-199611000-00003
更新日期：1996-11-01 00:00:00
abstract：:Both total knee alignment methods, the anatomic and classic, seek to achieve stability in flexion and extension. However, posterior femoral condyle referencing (anatomic alignment) combined with perpendicular tibial resection (classic alignment) results in a 3 degree relative internal rotation of the femoral component...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200201000-00029
更新日期：2002-01-01 00:00:00
