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. For 50 years, the American Board of Medical Specialties has encouraged a system of recertification to demonstrate that the certified specialist has maintained skill and has incorporated the new knowledge associated with advancing medical science. Presently, 17 of the 23 boards are committed to time-limited certificates requiring recertification every seven to ten years, and others are currently planning such a process. New methods of performance assessment are being used for recertification processes. In addition to recertification, the other major change in specialty credentialing is the number of subspecialty certificates sought and authorized. The numbers have increased dramatically during the past 20 years and reflect the advances in science as well as new styles of practice. As a consequence, some specialties are moving toward accreditation without certification to improve training, even if there is no authorized type of certification. Another consequence of subspecialty proliferation is concern about fragmentation of medical care and its effect on the costs of health care.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Langsley DGsubject
Has Abstractpub_date
1990-08-01 00:00:00pages
22-8issue
257eissn
0009-921Xissn
1528-1132pub_type
历史文章,杂志文章abstract:BACKGROUND:Surgical navigation in TKA facilitates better alignment; however, it is unclear whether improved alignment alters clinical evolution and midterm and long-term complication rates. QUESTIONS/PURPOSES:We determined the alignment differences between patients with standard, manual, jig-based TKAs and patients wi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11999-011-2044-2
更新日期:2011-12-01 00:00:00
abstract::In situ hybridization and ultrastructural immunohistochemistry were used to study the synthesis and distribution of 2 bone matrix proteins, bone sialoprotein and osteopontin, in the proximal tibial epiphysis in 21-, 32-, and 84-day-old rats. Bone sialoprotein messenger ribonucleic acid expression was restricted to cel...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199609000-00033
更新日期:1996-09-01 00:00:00
abstract::In the past ten years, three related prostheses (Freeman-Swanson, ICLH, Freeman-Samuelson) have been used at the London Hospital. The new findings reported in this article are the result of cementless fixation of the ICLH prosthesis has not deteriorated with time; the patellofemoral complications and postoperative lim...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-04-01 00:00:00
abstract::In the past decade, two concepts have caused considerable controversy in orthopedic surgery of the knee. Some orthopedic centers contend that osteotomy of the tibia is the procedure of choice for unicompartmental gonarthrosis of the knee and resist the concept of unicompartmental arthroplasty. The other concept is tha...
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::Axillary nerve injury remains the most common peripheral nerve injury to affect the shoulder. It most often is seen after glenohumeral joint dislocation, proximal humerus fracture, or a direct blow to the deltoid muscle. Compression neuropathy has been reported to occur in the quadrilateral space syndrome, although th...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1999-11-01 00:00:00
abstract:BACKGROUND:To avoid ischemic necrosis, compartment syndrome is a surgical emergency treated with decompression once identified. A potentially lethal, oxidant-driven reperfusion injury occurs after decompression. N-acetylcysteine is an antioxidant with the potential to attenuate the reperfusion injury. QUESTIONS/PURPOS...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1287-7
更新日期:2010-08-01 00:00:00
abstract::Osteoarticular defects present a reparative challenge to orthopaedic surgeons. Osteoarticular allografts provided a promising solution. Unfortunately, many of these allografts failed secondary to articular cartilage degeneration. To determine the role of the extracellular matrix in graft failure, the authors have char...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200101000-00004
更新日期:2001-01-01 00:00:00
abstract::Computer-assisted navigation systems for hip resurfacing arthroplasty are designed to minimize the chance of implant malposition. However, there is little evidence computer navigation is useful in the presence of anatomical deformity. We therefore determined the accuracy of an image-free resurfacing hip arthroplasty n...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-009-0850-6
更新日期:2009-09-01 00:00:00
abstract:BACKGROUND:Several recently published population-based studies have highlighted the association between insurance status and survival in patients with various cancers such as breast, head and neck, testicular, and lymphoma [22, 24, 38, 41]. Generally, these studies demonstrate that uninsured patients or those with Medi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/CORR.0000000000000889
更新日期:2020-03-01 00:00:00
abstract::Seventy-five symptomatic dysplastic hip joints (63 patients) were treated with the Bernese periacetabular osteotomy during a period of 44 months. The mean patients' age was 29 years (range, 13-56 years) and the female:male ratio was 3.4:1. Group III dysplasia according to Severin was seen in 50% and Group IV dysplasia...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1999-06-01 00:00:00
abstract::Bone allografts are commonly used in spinal surgery. Structural allografts placed anteriorly in the spine may be used as interbody grafts or as strut grafts spanning multiple segments. Posterior allografts are used to supplement autologous bone for spinal fusions in patients who lack sufficient host bone and to avoid ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/00003086-199603000-00010
更新日期:1996-03-01 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::The magnetic resonance (MR) signal behavior of freshly excised pig femoral heads undergoing ischemic necrosis in vitro was evaluated. Ten femoral heads removed from skeletally immature pigs were stored at 37 degrees in a sealed, sterile container during the observation period. Imaging was initially performed 40 minute...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1989-07-01 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:UNLABELLED:Deep venous thrombosis and pulmonary embolism after shoulder arthroplasty are not well described. We sought to identify the frequency of deep venous thrombosis and pulmonary embolisms in patients after shoulder arthroplasties to compare these rates with the frequency of deep venous thrombosis and pulmonary e...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000194679.87258.6e
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:The ability of injection of corticosteroids into the subacromial space to relieve pain ascribed to rotator cuff tendinosis is debated. The number of patients who have an injection before one gets relief beyond what a placebo provides is uncertain. QUESTIONS/PURPOSES:We asked: (1) Do corticosteroid injection...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s11999-016-5002-1
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Kyphosis in myelomeningocele is a rare and difficult problem. Many strategies have been used with no single procedure universally agreed on. Techniques involving anterior and posterior fixation may provide better fusion. QUESTIONS/PURPOSES:We describe a novel procedure for anteroposterior kyphectomy in pati...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1611-2
更新日期:2011-05-01 00:00:00
abstract::The purpose of this study was to explore the relationship between the integrity of collagen and biomechanical properties of bone. In this study, age (range, 5-26 years old) and gender related changes in cortical bone samples from 33 baboon femurs (15 males and 18 females) were examined. The percentage of denatured col...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200002000-00027
更新日期:2000-02-01 00:00:00
abstract::An osteoid osteoma occurred in the distal femoral epiphysis of an 11-year-old boy. Only eight other cases of this tumor in an open epiphysis have been reported. An image intensifier was used to place the tip of a wire in the center lesion. Removal through a small incision with a bone trephine placed over a guiding Kir...
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::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::The authors retrospectively reviewed 29 hip and 13 knee arthroplasties performed in 17 adolescents and young adults from 1973 through 1979. Most patients had severe multiple joint involvement; 16 had juvenile rheumatoid arthritis. Clinical and roentgenographic evaluations were performed before operation and at routine...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1992-10-01 00:00:00
abstract::Morphologic changes observed in osteoarthritis include cartilage erosion and a variable degree of synovial inflammation. Proinflammatory cytokines such as interleukin-1 beta, locally produced by the inflamed synovium, also likely contribute to these alterations. Despite an extensive armamentarium and numerous surgical...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:2000-10-01 00:00:00
abstract::Cases of longstanding (median, 60 months) tarsal tunnel syndrome were decompressed surgically in 14 female and four male patients. Patients reported intermittent dysesthesia, paresthesia, or anesthesia at the medial plantar aspect of the foot. Symptoms were aggravated by physical activities. Previous trauma was noted ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1997-10-01 00:00:00
abstract::This study determined whether patients with severe knee disease below a hip arthrodesis can be treated successfully with total knee replacement alone or whether such patients require total hip arthroplasty followed by knee replacement. Eighteen patients who had hip arthrodesis for a mean of 33 years underwent total hi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200002000-00017
更新日期:2000-02-01 00:00:00
abstract::A prospective study ascertained the effect of lateral retinacular release and/or excision of the infrapatellar fat pad on patellar vascularity after total knee arthroplasty. Fifty patients (70 knees) had postoperative technetium bone scans, which revealed a higher incidence of vascular compromise of the patella after ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1990-11-01 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::Fifty years ago Albright contributed the following to understanding osteoporosis: (1) He recognized it as a deficiency of formation, not of mineralization of bone matrix; (2) he observed that 40 of 42 patients with osteoporosis before age 65 were women past menopause or young women postoophorectomy; (3) he concluded t...
journal_title:Clinical orthopaedics and related research
pub_type: 传,历史文章,杂志文章
doi:
更新日期:1991-08-01 00:00:00
abstract::Symptomatic (Stage II) impingement of the rotator cuff against the coracoacromial arch has been treated with anterior acromioplasty in 60 shoulders in 56 patients. Patient selection is crucial. Arthrography of the shoulder was routinely included in the preoperative diagnostic tools to rule out a tear of the rotator cu...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00
abstract::Twenty-three patients with open fractures of the humerus who had been treated with immediate external fixation were reviewed retrospectively. Eighteen patients had adequate followup and were included in this study. Four patients (22%) had Gustilo and Anderson Grade I injury; 1 (5%), Grade II; and 13 (72%), Grade III (...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199704000-00021
更新日期:1997-04-01 00:00:00
abstract::Histomorphologic analyses of artificial joint components implanted into bone need special technology for processing and for documentation; published histological work systematically done therefore is rare. The histopathology, three-dimensionally analyzed in a complete sequence of sections is, however, the only precise...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/01.blo.0000150424.59854.7b
更新日期:2005-01-01 00:00:00