Abstract：
BACKGROUND:Biopsies of musculoskeletal tumors lead to alterations in treatment in almost 20% of cases. Control charts are useful to ensure that a process is operating at a predetermined level of performance, although their use has not been demonstrated in assessing the adequacy of musculoskeletal biopsies. QUESTIONS/PURPOSES:We therefore (1) assessed the incidence of and the reasons for inadequate musculoskeletal biopsies when following guidelines for performing the procedure; and (2) implemented a process control chart, the CUSUM test, to monitor the proportion of inadequate biopsies. METHODS:We prospectively studied 116 incisional biopsies. The biopsy was performed according to 10 rules to (1) minimize contamination in the tissues surrounding the tumor; and (2) improve accuracy. A frozen section was systematically performed to confirm that a representative specimen was obtained. Procedures were considered inadequate if: (1) another biopsy was necessary; (2) the biopsy tract was not appropriately placed; and (3) the treatment provided based on the diagnosis from the biopsy was not appropriate. RESULTS:Five (4.3%) of the 116 incisional biopsy procedures were considered failures. Three patients required a second repeat open biopsy and two were considered to receive inappropriate treatment. No alarm was raised by the control chart and the performance was deemed adequate over the monitoring period. CONCLUSIONS:The proportion of inadequate musculoskeletal open biopsies performed at a referral center was low. Using a statistical process control method to monitor the failures provided a continuous measure of the performance.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Biau DJ,Weiss KR,Bhumbra RS,Davidson D,Brown C,Wunder JS,Ferguson PCdoi
10.1007/s11999-012-2544-8subject
Has Abstractpub_date
2013-03-01 00:00:00pages
905-14issue
3eissn
0009-921Xissn
1528-1132journal_volume
471pub_type
杂志文章abstract：:A spectrum of medical problems, including self-limited acute mountain sickness, high-altitude retinopathy, and the potentially fatal high-altitude pulmonary and cerebral edemas, may afflict residents and sojourners at higher elevations. However, appropriate prevention and prompt recognition will minimize the impact of...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1987-03-01 00:00:00
abstract：BACKGROUND:Low-cost indigenous megaprostheses used in the developing world are prone to mechanical failure but the frequency and causes are not well established. QUESTIONS/PURPOSES:We retrospectively analyzed the causes of failure, particularly design, and suggest changes to reduce the breakage. We also report our exp...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-010-1409-2
更新日期：2010-11-01 00:00:00
abstract：BACKGROUND:Research addressing the burden of musculoskeletal disease in low- and middle-income countries does not reflect the magnitude of the epidemic in these countries as only 9% of the world's biomedical resources are devoted to addressing problems that affect the health of 90% of the world's population. Little is ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-015-4254-5
更新日期：2015-06-01 00:00:00
abstract：:Reconstruction of massive proximal tibial defects caused by failed cemented total knee arthroplasty (TKA) was evaluated using cancellous allograft and a rigidly fixed tibial component. Twenty patients with massive tibial defects requiring revision TKA were operated on using this technique from December 1984 to Decembe...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1989-11-01 00:00:00
abstract：:The trauma pandemic disproportionately kills and maims citizens of low-income countries although the immediate cause of the trauma is often an industrial export of a high-income country, such as a motor vehicle. Addressing the trauma pandemic in low-income countries requires access to relevant research information reg...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1007/s11999-008-0397-y
更新日期：2008-10-01 00:00:00
abstract：:There are 3 common types of spondylolisthesis: dysplastic; isthmic; degenerative. This classification, presented anew in an article published in this volume, evolved from a discussion by the members of the International Society for the Study of the Lumbar spine. The surgical treatment is designed to correct a combinat...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1976-06-01 00:00:00
abstract：:Nutrient diffusion across the vertebral endplate can occur by convection (bulk flow) or diffusion. Previous studies, using animal models, suggested diffusion as the primary mechanism of small-solute transport but did not adequately determine the contribution of bulk flow to total nutrient transport. This study was des...
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：:Femoral impaction allografting has been done with and without variations of the original description. The purpose of this study was to review Harris hip scores, radiographs, and complications in patients in whom we used the original technique without significant modifications. Preoperative and postoperative hip scores...
journal_title：Clinical orthopaedics and related research
pub_type： 临床试验,杂志文章
doi：10.1097/01.blo.0000150320.73465.82
更新日期：2005-03-01 00:00:00
abstract：:The mode of action of the periosteum in the growth of the long bones was investigated by comparing the activity of the growth plate after hemicircumferential and longitudinal periosteal incisions. Twenty-eight rabbits were divided into three groups. A longitudinal periosteum incision was made on the medial upper tibia...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-11-01 00:00:00
abstract：BACKGROUND:Osteoid osteomas consist of a nidus surrounded by reactive sclerotic bone. The diagnosis typically is based on imaging and clinical presentation involving nocturnal pain. Removal of the lesion is essential and currently is performed mainly with image-guided, minimally invasive techniques. We describe a case ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2772-y
更新日期：2013-05-01 00:00:00
abstract：:Forty-nine knees with osteochondritis dissecans were evaluated and in many cases, treated by arthroscopic means. The lesions were classified as to location and degree of separation. Arthroscopic treatment involved drilling, pinning, reduction of fragments, removal and replacement of fragments, and bone grafting. Of th...
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：:A series of 260 noncemented total hip arthroplasties with a titanium alloy stem and fixation by the Zweymüller press-fit and an Endler polyethylene threaded cup was reviewed in detail. The minimum follow-up period was 48 months and the maximum 72 months, with an average of 60 months. A scale from zero to five points w...
journal_title：Clinical orthopaedics and related research
pub_type： 临床试验,杂志文章,多中心研究
doi：
更新日期：1992-10-01 00:00:00
abstract：BACKGROUND:Successful brace treatment entails good control of scoliosis with avoidance of surgery. However, achieving curve regression may be an even better radiological result than prevention of curve progression for patients with adolescent idiopathic scoliosis. Vertebral remodeling may occur with well-fitted braces....
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/CORR.0000000000000989
更新日期：2020-02-01 00:00:00
abstract：:Rigid body mechanics with computer data acquisition and analysis techniques were used to determine the three-dimensional motions of any point on the tibial component of a total knee arthroplasty. Three stem configurations were compared: (1) no stem; (2) short stem (40 mm); and (3) long stem (75 mm). In addition, three...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1997-12-01 00:00:00
abstract：:Two hundred sixteen patients were treated by a simplified unilateral posterior lumbar interbody fusion (U-PLIF) in which the disc was removed and replaced by bone. The disc was approached far laterally by removing two-thirds of the superior facet preserving most of the ligamentum flavum, removing the disc, decorticati...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1985-03-01 00:00:00
abstract：:Bone morphogenic proteins (BMPs) may have neurotrophic functions but there is limited evidence of these functions in the peripheral nervous system. We therefore investigated the expression of BMPs and BMP receptors (BMPRs) in normal and injured peripheral nerves. In 10 of 15 Sprague-Dawley rats, a 3-mm segment of scia...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-009-1009-1
更新日期：2009-12-01 00:00:00
abstract：:In 1958 a group of Swiss general and orthopaedic surgeons established the AO (Arbeitsgemeinschaft für Osteosynthesefragen) or the Association of the Study of Internal Fixation (ASIF) to strive to transform the contemporary treatment of fractures in Switzerland. This association was revolutionary in development of inst...
journal_title：Clinical orthopaedics and related research
pub_type： 传,历史文章,杂志文章
doi：
更新日期：1998-02-01 00:00:00
abstract：:From 1977 to 1982, 13 patients were diagnosed with avascular necrosis of the femoral head. The diagnoses were made with a combination of clinical exams, radiographs, tomograms, and Tc99 bone scans. One hip was classified as Ficat Stage I, 9 as Stage II, and 5 as Stage III. There were 11 male and 2 female patients with...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1994-09-01 00:00:00
abstract：UNLABELLED:As the number of unicompartmental knee arthroplasties performed continues to rise, so too will the number of failures. In order to justify its continued use, conversion to total knee arthroplasty must be evaluated. From 1993-2004, 22 consecutive knees from 18 patients with a failed unicondylar knee arthropla...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000214431.19033.fa
更新日期：2006-05-01 00:00:00
abstract：:Of 1100 femoral neck fractures observed through an eight-year period, 27 occurred in rheumatoid conditions. The complications and functional results were compared with unselected femoral neck fracture data of nonrheumatoid patients. At two-year follow-up examinations, five of 27 surviving rheumatoid patients had had u...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-03-01 00:00:00
abstract：BACKGROUND:Although pulsed electromagnetic fields (PEMFs) are used to treat delayed unions and nonunions, their mechanisms of action are not completely clear. However, PEMFs are known to affect the expression of certain genes. QUESTIONS/PURPOSES:We asked (1) whether PEMFs affect gene expression in human osteoblastlike...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-010-1341-5
更新日期：2010-08-01 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：:Titanium implants are an alternative to stainless steel implants for internal fixation after fracture. The advantages of titanium include decreased implant stiffness, increased bio-compatibility, and diminished stress shielding. However, titanium has been implicated in tendon irritation and adhesions when used in the ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000205894.98361.29
更新日期：2006-04-01 00:00:00
abstract：:This is a report of experience with 48 carpal disruptions including anterior dislocations of the lunate, transnavicular perilunate and perilunate dislocations and subluxation of the navicular. The correct radiographic diagnosis is absolutely essential for effective treatment. Many of these injuries may be treated by c...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1976-07-01 00:00:00
abstract：BACKGROUND:Combat-wounded service members are surviving battle injuries more than ever. Given different combat roles held by men and women, female service members should survive wounds at an unprecedented rate. QUESTIONS/PURPOSES:We determined whether the casualty rates for females differ from their male counterparts ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-1840-z
更新日期：2011-07-01 00:00:00
abstract：:Highly cross-linked polyethylene (PE) has been introduced as an alternative bearing material in total hip arthroplasty (THA) because of high wear resistance in laboratory tests but the clinical experience of this material is limited. We evaluated a highly cross-linked PE (warm irradiated adiabatic melting, absorbed do...
journal_title：Clinical orthopaedics and related research
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1097/01.blo.0000096802.78689.45
更新日期：2003-12-01 00:00:00
abstract：BACKGROUND:Vitamin D plays an essential role in bone health and muscle function. Some studies have shown a widespread rate of vitamin D deficiency in the general population, but few have reported on the vitamin D status of orthopaedic patients. QUESTIONS/PURPOSES:We investigated (1) the extent of hypovitaminosis D in ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-013-2996-5
更新日期：2013-09-01 00:00:00
abstract：:In 1941, Bosworth introduced a new method of repairing acute complete acromioclavicular dislocations in which a noncannulated coracoclavicular lag-screw was inserted by a blind technique. The author reintroduces the percutaneous coracoclavicular fixation concept. A cannulated screw was specially designed, and the tech...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1989-06-01 00:00:00
abstract：:Frederic Jay Cotton (Fig. 1) was born in Prescott, Wisconsin, and educated at Harvard. After postgraduate study in New York and in Europe, he returned to Boston where he had an association with most of the important hospitals. In addition to great surgical talent, he also was an able administrator and medical politici...
journal_title：Clinical orthopaedics and related research
pub_type： 传,古典文章,历史文章,杂志文章
doi：
更新日期：1987-12-01 00:00:00
abstract：BACKGROUND:Developmental hip disorders (DHDs), eg, developmental dysplasia of the hip, slipped capitis femoris epiphysis, and femoroacetabular impingement, can be considered morphology variants of the normal hip. The femoroacetabular morphology of DHD is believed to induce osteoarthritis (OA) through local cumulative m...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1007/s11999-012-2511-4
更新日期：2012-12-01 00:00:00
