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 osteoallograft prosthesis composite reconstruction replacing only one side of the joint to reduce compartment degeneration and avoid contamination of the tibia, but the survival, function, and complications of a unicondylar osteoallograft prosthesis composite are unclear. DESCRIPTION OF TECHNIQUE:We located a bone resection plane intraoperatively as planned before surgery using a computer-assisted navigation system. The tumor then was removed en bloc and the unicondylar defect filled with a size-matched allogeneic unicondyle. The allograft cartilage was removed. Thereafter, the condyle of the femoral component was resurfaced with a unicompartmental knee prosthesis to form a unicondylar osteoallograft prosthesis composite, however the tibia was left undisturbed. Navigation allowed precise apposition between the unicondylar osteoallograft prosthesis composite and host bone to ensure mechanical alignment and congruency of the joint surface before fixation with a plate. METHODS:We retrospectively reviewed 12 patients who underwent unicondylar osteoallograft prosthesis composite reconstructions after unicondylar resection for tumors. One patient died from tumor-related causes without unicondylar osteoallograft prosthesis composite failure after 18 months. We observed the survival rate of unicondylar osteoallograft prosthesis composite reconstruction and related complications. Function and radiographs also were documented according to the Musculoskeletal Tumor Society (MSTS) functional scoring system and the International Society of Limb Salvage radiographic scoring system. The minimum followup was 8 months (median, 37 months; range, 8-65 months). RESULTS:At last followup, 10 of the 12 unicondylar osteoallograft prosthesis composite reconstructions were still in place. Three reconstructions failed owing to two local recurrences (both treated with amputation) and there was one infection (treated with revision and maintenance of the implant at last followup). The average MSTS functional score at last followup was 27 points and the radiographic score 91%. CONCLUSIONS:Our observations suggest unicondylar osteoallograft prosthesis composite reconstruction might be a reliable technique with relatively few major complications and at least short-term maintenance of the tibial cartilage. 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
Fan H,Guo Z,Wang Z,Li J,Li Xdoi
10.1007/s11999-012-2455-8subject
Has Abstractpub_date
2012-12-01 00:00:00pages
3577-86issue
12eissn
0009-921Xissn
1528-1132journal_volume
470pub_type
杂志文章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：:Thirteen insufficiency stress fractures of the femoral neck in 13 elderly patients (average age, 82 years) were studied retrospectively. All occurred in Caucasian women with severe osteoporosis. A vague pain about the hip, of spontaneous onset, was the main symptom on first visit. The diagnosis was delayed in most cas...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-07-01 00:00:00
abstract：:In 15 normal adults an advanced biomechanical analysis of walking patterns at slow, natural, and fast cadences showed that the ankle had two mechanical power phases: a negative work phase during weight acceptance, followed by a dominant burst of positive work at push-off. The knee had four power phases: a negative wor...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-05-01 00:00:00
abstract：:In a series of children's hip fracture seen over a 27-year-period, there were 39 patients (40 fractures) with a mean age of 8.9 years followed for an average 7 years. After an initial period of traction, 50% of the fractures were treated in a spica cast, 40% by internal fixation, and 10% by bed rest. Overall, there we...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1980-06-01 00:00:00
abstract：:Eleven patients had either repair (two) or nerve graft reconstruction (nine) of the common peroneal nerve or its superficial or deep divisions about the knee. The average follow-up period was 29.1 months. A good or excellent result was achieved in six (54.5%) patients. The results appeared best when direct nerve repai...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1991-06-01 00:00:00
abstract：:Published reports of series of total knee replacements vary between 20% and 75% in the percentage of patients eventually having bilateral replacements. There are no data in the literature on the predicted course of the contralateral knee for patients presenting for total knee replacement. This study reviewed the histo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1995-12-01 00:00:00
abstract：:Growth prediction data and graphs have not been available previously for the fibula. In this report, this information is wholly derived from a longitudinal radiographic study of growth in children. Teleradiographs of the tibia and fibula in 244 children (123 boys and 121 girls) were made at 6-month intervals from age ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1997-01-01 00:00:00
abstract：:Most studies on shoulder arthroplasty include a diverse group of patients presenting to a tertiary care center. Little information is available regarding outcomes in a community setting. We reviewed 98 residents (110 shoulders) of Olmsted County, Minnesota who had shoulder arthroplasties from 1976 to 2000. There were ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000238870.99980.64
更新日期：2007-02-01 00:00:00
abstract：:Two unrelated patients with Kniest dysplasia had the same substitution of a CG dinucleotide in exon 12 of the COL2A1 gene that resulted in alternative splicing and interruption of the triple helix of a1(II) chains of Type II collagen. In early childhood, they shared the typical clinical and radiographic features of Kn...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1997-08-01 00:00:00
abstract：:Radial polydactyly, a common congenital problem, most often occurs as thumb duplication. It appears in pentadactylous, polydactylous, and hypoplastic hands and is simulated by complex syndactyly. Classically, there are three categories for radial polydactyly: severe hypoplasia, partial duplication, and total duplicati...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1985-05-01 00:00:00
abstract：:To address the issue of nonunion with trochanteric osteotomy, surgeons have experimented with various modes of fixation, wire and cable being the two most popular. From a group of 643 primary cemented total hip arthroplasties performed by a single surgeon via the trans-trochanteric approach, minimum four-year roentgen...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-12-01 00:00:00
abstract：:The benchmark fluoroscopic technique of iliosacral screw insertion is disadvantaged by its reliance on ionizing radiation and presentation of dynamic information in only one plane. Multiplane targeting requires interpolation, which may be associated with inherent errors. Computer-assisted surgery enables surgeons to m...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：2007-10-01 00:00:00
abstract：:Isometric elbow strength was measured with torque cell dynamometers in a group of 104 normal subjects. Their mean age was 43 years (range, 21-79 years). Test functions included elbow flexion and extension, forearm pronation and supination, and grip. In general, the men were twice as strong as the women, and the domina...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1987-09-01 00:00:00
abstract：BACKGROUND:There is growing interest in value-based health care in the United States. Statistical analysis of large databases can inform us of the factors associated with and the probability of adverse events and unplanned readmissions that diminish quality and add expense. For example, increased operating time and hig...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-016-5147-y
更新日期：2017-12-01 00:00:00
abstract：BACKGROUND:Arthroplasty for shoulder fractures is a technically challenging and unpredictable procedure and its use is controversial. QUESTIONS/PURPOSES:We therefore asked (1) to what degree function would be restored, (2) whether tuberosity healing would reliably occur, and (3) whether stem design would influence fun...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-1919-6
更新日期：2011-12-01 00:00:00
abstract：:The best treatment for intramuscular hemangiomas is unclear in part because the outcome is variable, with recurrence rates ranging from 18% to 61%. This variance is due to deficiencies in previous reports such as an inadequate population size, lack of life table analyses, lack of uniform pathologic criteria, and loose...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/BLO.0b013e318063c61b
更新日期：2007-06-01 00:00:00
abstract：:Because there is no consensus regarding the factors predicting femoral head collapse in asymptomatic osteonecrosis of the hip, we studied the risk factors for collapse. Between 1990 and 2000, we used MRI to confirm asymptomatic osteonecrosis of the femoral head in 81 patients (81 hips) whose other hip had nontraumatic...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0191-x
更新日期：2008-05-01 00:00:00
abstract：:Patellar fracture after knee arthroplasty was found in 11 patients (12 knees) during a 15-year period. Causes of this fracture include trauma, technical factors, and biophysical factors. The incidence of this infrequent complication was significantly increased after patella resurfacing and revision arthroplasty. Minim...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-05-01 00:00:00
abstract：:Subjective evaluations often are used after knee arthroplasty to quantify function; however, these scores may be influenced by pain and/or function of the nonoperated limb. Multiple influences increase variability of these scores, which in turn may result in a greater change in score required to be considered clinical...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-009-0811-0
更新日期：2009-09-01 00:00:00
abstract：:In experiments involving disuse osteoporosis induced by plaster cast immobilization, 2 commonly used commercial feeds (Wayne Lab Blox and Purina Laboratory Chow) gave different results. Preliminary evidence suggests that this dichotomy of results is due to an interaction between metabolic changes caused by physiologic...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1979-01-01 00:00:00
abstract：:There have been numerous efforts to alter the lipid content of cardiovascular tissues. Although equally important, only limited information is available about musculoskeletal tissues. I characterized joint and bone marrow lipids in patients having joint replacement surgery and explored the effects of fish oils and sta...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/BLO.0b013e31802cfa9e
更新日期：2007-03-01 00:00:00
abstract：:In order to clearly understand the synovial metabolic pathway of 5-HT, which is interesting as an inflammatory mediator and a pain producing substance, in patients with RA and with OA, determinations were made of 5-HIAA levels and of the activities of MAO-A and MAO-B, in the synovial fluid and the blood. With respect ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1979-03-01 00:00:00
abstract：:Between 1974 and 1984 the Zickel supracondylar nail system was used to fix 82 femora. Sixty-nine femora had supracondylar fractures and 13 supracondylar osteotomies. A high rate of union (98%) was achieved in the fracture group, which included a variety of fracture types, but five supracondylar osteotomies failed to u...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-11-01 00:00:00
abstract：:Hemophilic pseudotumor is a rare, but well-known, complication of hemophilia. We describe a 50-year-old man with mild hemophilia A, but with no previous need for Factor VIII supplementation, who presented with a pathologic fracture of the right femoral neck and shaft caused by a large hemophilic pseudotumor. Initial n...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000137545.37824.b0
更新日期：2005-01-01 00:00:00
abstract：:An 11-year-old boy sustained complete brachial artery disruption following closed posterior elbow dislocation. This is the first documentation in the English-language literature of this type of arterial transection following closed elbow dislocation in a child. It is also the first report of surgical repair of the bra...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-04-01 00:00:00
abstract：:The etiology of aseptic loosening of prosthetic joint replacement components is unclear. Implant materials have been considered biologically inert, but recently studies indicate that inflammatory reactions directed against the implanted materials may contribute to aseptic loosening. Data suggesting a progression from ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199605000-00008
更新日期：1996-05-01 00:00:00
abstract：:Three typical cases demonstrate the achievement of precision in the reconstruction of ununited fractures of the tibia by preliminary planning with the aid of tracings on roentgenograms, templates, and goniometer measurements. ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-09-01 00:00:00
abstract：UNLABELLED:We sought to determine whether open reduction and internal fixation in combination with free vascularized bone grafting and elbow contracture release is an effective treatment for patients with recalcitrant distal humeral nonunions with segmental bone loss. In addition, we wondered whether this treatment str...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：2005-06-01 00:00:00
abstract：:Various guidelines have been proposed regarding which portions of a surgical gown may be considered sterile. Unfortunately, the validity of these recommendations has not been definitively established. We therefore evaluated gown sterility after major spinal surgery to assess the legitimacy of these guidelines. We used...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0341-1
更新日期：2009-03-01 00:00:00
abstract：:Pathologic fractures of the proximal femur secondary to benign bone tumors often are difficult to treat because of specific anatomic features of this region and the aggressiveness of the tumors. Between 1986 and 1996, 11 patients presented with a pathologic fracture of the proximal femur secondary to a benign bone tum...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200112000-00032
更新日期：2001-12-01 00:00:00
