Abstract：
BACKGROUND:Bone quality should play an important role in decision-making for orthopaedic treatment options, implant selection, and affect ultimate surgical outcomes. The development of decision-making tools, currently typified by clinical guidelines, is highly dependent on the precise definition of the term(s) and the appropriate design of basic and clinical studies. This review was performed to determine the extent to which the issue of bone quality has been subjected to this type of process. QUESTIONS/PURPOSES:We address the following issues: (1) current methods of clinically assessing bone quality; (2) emerging technologies; (3) how bone quality connects with surgical decision-making and the ultimate surgical outcome; and (4) gaps in knowledge that need to be closed to better characterize bone quality for more relevance to clinical decision-making. METHODS:PubMed was used to identify selected papers relevant to our discussion. Additional sources were found using the references cited by identified papers. RESULTS:Bone mineral density remains the most commonly validated clinical reference; however, it has had limited specificity for surgical decision-making. Other structural and geometric measures have not yet received enough study to provide definitive clinical applicability. A major gap remains between the basic research agenda for understanding bone quality and the transfer of these concepts to evidence-based practice. CONCLUSIONS:Basic bone quality needs better definition through the systematic study of emerging technologies that offer a more precise clinical characterization of bone. Collaboration between basic scientists and clinicians needs to improve to facilitate the development of key questions for sound clinical studies.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Johanson NA,Litrenta J,Zampini JM,Kleinbart F,Goldman HMdoi
10.1007/s11999-011-1838-6subject
Has Abstractpub_date
2011-08-01 00:00:00pages
2237-47issue
8eissn
0009-921Xissn
1528-1132journal_volume
469pub_type
杂志文章,评审abstract：:Traditional imaging methods used in the detection and evaluation of metastatic bone disease lack either sensitivity (plain radiography) or specificity (bone scintigraphy). Magnetic resonance imaging now has been shown to be the most sensitive imaging technique available for the detection of bone metastases. On T1-weig...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1995-03-01 00:00:00
abstract：:Thirty intraarticular calcaneal fractures were studied by computed tomography and then treated with a variety of closed methods. A classification of the fractures was devised according to the amount of displacement of the posterior facet. Follow-up evaluation showed that Type I fractures recovered function and healed ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-05-01 00:00:00
abstract：:The choice of pin site in shoulder arthrodesis after brachial plexus injury is important for efficient external fixation. The pins are inserted into the coracoid process from the anterior aspect and the scapular spine from the acromion. This insertion method holds the scapula more rigid and allows the patient to lie s...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1989-10-01 00:00:00
abstract：BACKGROUND:Hip fractures are a major public health concern. For displaced femoral neck fractures, the needs for medical services during hospitalization and extending beyond hospital discharge after total hip arthroplasty (THA) may be different than the needs after THA performed for osteoarthritis (OA), yet these differ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-016-4868-2
更新日期：2017-02-01 00:00:00
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：:The process of digital capture, editing, and archiving video has become an important aspect of documenting arthroscopic surgery. Recording the arthroscopic findings before and after surgery is an essential part of the patient's medical record. The hardware and software has become more reasonable to purchase, but the l...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/01.blo.0000126868.90079.61
更新日期：2004-04-01 00:00:00
abstract：:Fractures of the femur in two women, ages 17 and 27, were treated with Brooker-Wills nails. While the distal deployment device was inserted into the nail in one patient, the tip of the driver/inserter broke into the proximal end of the distal deployment device. This complicated the extraction of the nail and the dista...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-05-01 00:00:00
abstract：:The Hackethal technique of using stacked medullary pins for fixation of humeral shaft fractures is usually associated with relatively little blood loss; in addition, exposure of the fracture site and possible associated muscular trauma are avoided, and the risk of contusion of the radial nerve that may occur in fixati...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-10-01 00:00:00
abstract：:Specialty boards serve the function of defining qualifications and issuing credentials to assure the public of the specialist's preparation and skill. Over the past 72 years, 23 such boards have been approved and now issue 31 different types of general specialty certificates and 57 types of subspecialty credentials. F...
journal_title：Clinical orthopaedics and related research
pub_type： 历史文章,杂志文章
doi：
更新日期：1990-08-01 00:00:00
abstract：:A cellulose acetate membrane was fashioned into a cone to serve as a substratum for an outgrowth of connective tissue from normal neonatal muscle, and a container for diffusion of bone morphogenetic protein (BMP) of an aggregate of BMP and cold water insoluble noncollagenous protein (BMP/iNCP). The BMP/iNCP was prepar...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-06-01 00:00:00
abstract：:Patients with shoulder arthritis present to the orthopedic surgeon due to joint pain and loss of shoulder motion. A differential diagnosis is established, based on the history and physical examination and selected laboratory tests and roentgenograms. Synovial fluid analysis is often very helpful in the diagnosis of sh...
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：BACKGROUND:For patients with failed surgical treatment of an infected TKA, salvage operations such as arthrodesis or above-knee amputation (AKA) may be considered. Clinical and institutional factors associated with AKA and arthrodesis after a failed TKA have not been investigated in a large-scale population, and the ut...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-017-5285-x
更新日期：2017-12-01 00:00:00
abstract：:Spasticity that interferes with upper extremity function is common in adults following stroke, brain injury, or anoxia. During the period of neurologic recovery definitive surgical procedures are avoided. Techniques to temporarily reduce spasticity include the implantation of a MicroPort reservoir and catheter for rep...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1988-08-01 00:00:00
abstract：:Axillary crutch palsy, although well described in the literature, is rarely seen in clinical practice. Little has been written in the contemporary orthopaedic literature. The purpose of this case report is to report on a well-documented axillary crutch palsy with bilateral, predominantly radial, nerve dysfunction that...
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:Sacrectomy may offer curative potential for primary sarcomas of the sacrum. However, it is unclear whether and to what extent sacrectomies achieve local control. QUESTIONS/PURPOSE:We therefore determined the curative potential, walking ability, continence control, and quality of life for children after sacr...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-2199-x
更新日期：2012-05-01 00:00:00
abstract：:The effects of chondroitinase ABC on surgically induced degenerative rabbit intervertebral discs were determined during a 12-week period by magnetic resonance imaging, radiography, and histologic examination. Rabbit intervertebral discs were surgically extruded, inducing disc degeneration 12 weeks before injection of ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1995-09-01 00:00:00
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：:Gunshot injuries to the hand and upper extremity have been studied during military conflicts and in urban settings. Treatment concepts include identification of injured structures, aggressive surgical wound care, and reconstruction of important functional structures. There are various types of missile injuries. For si...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-200303000-00016
更新日期：2003-03-01 00:00:00
abstract：:A composite fixation method for a porous-coated modular segmental bone/joint prosthetic system was developed to improve fixation at revision surgery of the hip and knee after failure of the original implant with resulting massive bone loss. The porous coating is limited only to the segmental shoulder region of the pro...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-03-01 00:00:00
abstract：:There are no data in the literature concerning the outcome of Colles' fracture beyond six years. One hundred consecutive patients with displaced Colles' fractures were reviewed ten years after the injury. Function, radiographic anatomy, osteoarthrosis, and reflex sympathetic dystrophy (algodystrophy) were all objectiv...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-10-01 00:00:00
abstract：:Local antibiotic delivery is an emerging area of study designed to provide alternative methods of treatment to clinicians for compromised wound sites where avascular zones can prevent the delivery of antibiotics to the infected tissue. Antibiotic-loaded bone cement is the gold standard for drug-eluting local delivery ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0228-1
更新日期：2008-06-01 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：: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：:In 37 of 43 cases (86%) the late results of fasciotomy for chronic lateral epicondylitis were excellent or good. The initial result was maintained for an average of 8.0 years. The procedure is simple and morbidity is minimal. Patient selection and technical factors appeared to account for the failures. ...
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：:Degenerative arthritis of the wrist follows very specific patterns from onset to terminal severe bone and joint destruction. About 95% of them occur as periscaphoid area problems: SLAC (scapholunate advanced collapse pattern) wrist (55%), triscaphe arthritis (26%), and a combination of the two (14%). In SLAC wrist, th...
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：BACKGROUND:Alpha defensin was proposed as a new biomarker in synovial fluid for the diagnostic workup of failed joint prostheses. To our knowledge, no comparative study of the performance of the quantitative enzyme-linked immunosorbent assay (ELISA) and qualitative lateral flow alpha defensin test has been reported. Q...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/CORR.0000000000000336
更新日期：2018-08-01 00:00:00
abstract：BACKGROUND:Revision TKA is a serious adverse event with substantial consequences for the patient. As the demand for TKA rises, reducing the risk of revision TKA is becoming increasingly important. Predictive tools based on machine-learning algorithms could reform clinical practice. Few attempts have been made to combin...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/CORR.0000000000001343
更新日期：2020-09-01 00:00:00
abstract：:Degradation of yttria-stabilized zirconia femoral heads in vivo has been linked to increased roughening and even fracture of the femoral head. To determine whether magnesia-stabilized zirconia is better suited to resist degradation, we characterized the monoclinic phase concentration, surface topography, and microhard...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/BLO.0b013e318158b4d3
更新日期：2007-12-01 00:00:00
abstract：:Sixteen porous polysulfone-coated canine femoral stems were inserted into 14 dogs. Coatings were approximately 40% porous, with an average pore size of 125 or 250 microns. Bone was formed within at least about 30% of the surface pores of the implants. The tissue ingrowths filling the pores included marrow and fibrous ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-06-01 00:00:00
abstract：:Alcohol can induce adipogenesis by bone marrow stromal cells and may cause osteonecrosis of the femoral head. Currently, there are no medications available to prevent alcohol-induced osteonecrosis. We hypothesized puerarin, a Chinese herbal medicine with antioxidative and antithrombotic effects, can prevent alcohol-in...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0178-7
更新日期：2008-05-01 00:00:00
