Abstract：
BACKGROUND:Hybrid revision knee component fixation, in which cement is placed in the metaphysis combined with a cementless diaphyseal engaging stem, provides ease of insertion, possibly improved component alignment, and easier removal if required, compared with fully cemented prostheses. The literature suggests the technique has a 2 to 5 year survivorship ranging from 81% to 94%. QUESTIONS/PURPOSES:To confirm the literature we asked whether (1) a modified hybrid fixation technique is durable and reliable at an average 5-year followup, (2) this method of fixation provides clinical improvements as assessed by knee scores, (3) there are radiographic findings unique to this fixation technique, (4) the degree of knee constraint influences clinical performance or radiographic findings, and (5) end-of-stem pain is associated with this fixation method? PATIENTS AND METHODS:We retrospectively reviewed all 83 patients who had 88 both-component revision TKAs using our modified hybrid fixation technique. We assessed the Knee Society scores and evaluated radiographs for radiolucent and radiosclerotic lines. The minimum followup was 24 months (average, 65 months; range, 24-126 months). RESULTS:Kaplan-Meier survivorship free of aseptic loosening was 100% at 5 years and 90% at 10 years. Postoperatively, the mean Knee Society pain and function scores both improved. Partial radiolucent lines were rare; two components were loose. We commonly observed radiosclerotic lines adjacent to stem extensions but these did not affect clinical scores or implant stability at last followup. Neither knee scores nor radiographic findings differed based on knee constraint. End-of-stem pain occurred rarely and was transient. CONCLUSIONS:Modified hybrid fixation of revision knee arthroplasty using a diaphyseal engaging stem and cementation only in the metaphysis is durable at a mean 5 years followup. LEVEL OF EVIDENCE:Level IV, 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
Sah AP,Shukla S,Della Valle CJ,Rosenberg AG,Paprosky WGdoi
10.1007/s11999-010-1569-0subject
Has Abstractpub_date
2011-03-01 00:00:00pages
839-46issue
3eissn
0009-921Xissn
1528-1132journal_volume
469pub_type
杂志文章abstract：UNLABELLED:New prostheses should be evaluated for stability and clinical performance. In a prospective randomized clinical trial, we implanted 22 titanium (Ti) and 20 hydroxyapatite-coated (HA) ProxiLock femoral hip prostheses during total hip arthroplasty in 42 patients. The patients were followed for 24 months with c...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,随机对照试验
doi：10.1097/01.blo.0000224011.12175.83
更新日期：2006-07-01 00:00:00
abstract：:The Hoffmann external fixator has proved to be an effective means of stabilizing complex femoral fractures in patients in whom prolonged traction or internal fixation is not advisable. It provides for the prompt mobilization of multiple-trauma victims and assists in the evaluation of the "floating knee." Pin tract inf...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-11-01 00:00:00
abstract：:People are the major source of bacterial contamination in the hospital environment, and to control environmental bacteria, the shedding potential of people must be controlled. In a conventional operating room, the more complete the surgical attire worn by everyone in the room, the better the control; i.e., body exhaus...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-11-01 00:00:00
abstract：:Two hundred thirty-four primary total knee prostheses were evaluated with a 45 degrees merchant view to examine patellar position and fixation. Despite a standardized technique for obtaining roentgenographs, patellar position varied with leg position. Overall, 54.7% tracked centrally, 31.2% tilted, and 14.5% displaced...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-01-01 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：:Endometriosis is a disorder resulting from the presence of actively growing and functioning endometrial tissue in aberrant sites outside the uterus. Ectopic implantation of the endometrium can be located throughout the pelvic cavity. Depending on the location of the endometriosis, it can mimic common musculoskeletal p...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1999-11-01 00:00:00
abstract：:The efficacy of treatment of overuse patellofemoral pain with an elastic knee sleeve with a silicone patellar ring was compared with a simple elastic sleeve and with no treatment in a prospective study of 395 army recruits. During 14 weeks of basic training, 84 knees were diagnosed as having overuse patellofemoral pai...
journal_title：Clinical orthopaedics and related research
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1993-08-01 00:00:00
abstract：:Scheuermann's juvenile kyphosis may be considered a form of vertebral osteochondrosis. Although the etiology remains unknown, the ultimate effect is a disorderliness of vertebral growth in the growth plate cartilage. The biomechanical effects of increased kyphosis on saggital plane deformity, especially in a growing c...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1981-07-01 00:00:00
abstract：:The combined Coventry-Maquet procedure has been proposed as a means of treating dual-compartment degenerative arthritis of the knee. The procedure was investigated in a prospective study of 14 patients treated by combined high tibial osteotomy and tibial tubercle elevation. Preoperative scores averaged 50 points and s...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-11-01 00:00:00
abstract：:Limb salvage was previously described for patients with osteogenic sarcoma who had resectable lesions. In the very young child the usual methods of reconstruction are not applicable due to the resulting major leg-length inequality. One solution is to resect the lesion in accordance with good cancer surgery guidelines ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-09-01 00:00:00
abstract：:Many patients with acute herniated nucleus pulposus can be expected to resolve their conditions with conservative management. To date, however, no reliable sign has been described in the literature that can predict which patient will respond. This report shows that the ability to achieve normal lumbar extension repres...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-01-01 00:00:00
abstract：:A consecutive series of 125 hybrid total hip arthroplasties were performed in 120 patients by a single surgeon and were observed for an average of 8.6 years (range, 7-11 years). There were 38 men and 82 women with an average age of 71 years (range, 25-87 years) at the time of surgery. The diagnoses included primary an...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1996-12-01 00:00:00
abstract：BACKGROUND:Most contemporary total disc replacements (TDRs) use conventional orthopaedic bearing couples such as ultrahigh-molecular-weight polyethylene (polyethylene) and cobalt-chromium (CoCr). Cervical total disc replacements incorporating polyetheretherketone (PEEK) bearings (specifically PEEK-on-PEEK bearings) hav...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-016-5041-7
更新日期：2016-11-01 00:00:00
abstract：:Pigmented villonodular synovitis, bursitis and tenosynovitis may present a variable picture depended upon the site and whether they are localized or diffuse. In the localized form of the disease occurring in association with tendon sheaths, complete surgical excision should result in a cure. Local recurrences probably...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1976-01-01 00:00:00
abstract：:Median nerve compression may occur acutely, subacutely, or late following fractures of the distal radius. Hematoma and swelling at the mouth of the carpal tunnel are the likely cause in acute cases. A contributing factor generally not recognized initially is a volarly displaced fragment of distal radius compressing th...
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：:Joint damage occurs when structures protecting the joint fail. Because osteoarthritis consists of end-stage joint damage, I propose that risk factors for disease can be best understood as either impairments of joint protectors, increasing joint vulnerability, or as factors that excessively load the joint, leading to i...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/01.blo.0000144971.12731.a2
更新日期：2004-10-01 00:00:00
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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：:The increasing clinical use of human demineralized bone matrix has brought about the desire to understand better the osteoinductivity of these graft materials. The rat heterotopic model has been used successfully to show the sequence of events involved in the endochondral ossification process resulting in osteoinducti...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199812000-00028
更新日期：1998-12-01 00:00:00
abstract：:The lumbar syndrome of Paget's disease is classified according to its severity, clinical findings, biochemical factors, and radiological pattern. Pagetoid spinal stenoses may occur in three stages as a progressive clinical syndrome. Several diagnostic procedures, including computerized tomography, (CT) are analyzed to...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-05-01 00:00:00
abstract：:We describe an alternative method for lengthening a short femoral stump after wide amputation of a malignant bone tumor of the distal femur in two patients. The method consists of two procedures during the operation. The first procedure is amputation of the affected cylindrical segment of the involved limb. The second...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000141899.77580.3b
更新日期：2004-09-01 00:00:00
abstract：:Bilateral simultaneous Achilles tendon ruptures are rare, with only ten cases reported in the English literature. Our case is that of a 44-year-old woman, along with a review of the literature. Affected persons usually are on chronic steroid treatment and in the fifth to seventh decades of life. The patient may have c...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-12-01 00:00:00
abstract：:A study of the injury fatality rate in an adult population was done in the Moscow region. Investigators determined that side by side with the severity of injury, the direct causes of death were erroneous diagnosis, ungrounded delay of surgical interventions, and lack of and insufficient use of necessary medical care. ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1995-11-01 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：: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：:Thirty-two total hip arthroplasties (THAs) were performed on 26 severely incapacitated patients with congenital dislocation of the hip. The arthroplasty technique varied with the problems encountered, but the cup was always placed in the true acetabulum. In 19 cases, femoral head autografts were transplanted. The over...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1989-05-01 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：:Dual energy xray absorptiometry was investigated as a method for evaluation of the strength of closed tibial fractures. In 40 goats, a closed midshaft fracture was created in the left tibia. The fractures were stabilized with an external fixator. After 2 weeks (n = 21) and after 4 weeks (n = 19), both tibias were expl...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200011000-00035
更新日期：2000-11-01 00:00:00
abstract：:Three patients were treated for pathologic fractures of the thoracolumbar spine causing progressive neurologic deficit. An anterior decompression with partial removal of the diseased vertebra was performed with improvement of neurologic function in each patient. Active tumor was not found, but necrotic bone with colla...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-09-01 00:00:00
abstract：BACKGROUND:After resecting tumors confined to one femoral condyle, a unicondylar osteoarticular allograft can be used for reconstruction without sacrificing the uninvolved condyle. However, unicondylar osteoarticular allografts have been associated with a high rate of joint degeneration. We describe a unicondylar osteo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2455-8
更新日期：2012-12-01 00:00:00
abstract：UNLABELLED:We report the results of a minimum 21-year followup of a consecutive series of 103 patients who had 136 Marmor cemented unicompartmental knee replacements done between 1975 and 1982. Patients were evaluated clinically and radiographically. At minimum 21-year followup 14 patients (19 knees) were alive, 87 pat...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000185451.96987.aa
更新日期：2005-11-01 00:00:00
