Abstract：
BACKGROUND:Diffuse-type pigmented villonodular synovitis (PVNS) has a high local recurrence rate and as such can lead to erosive destruction of the involved joint. Multiple surgical modalities exist, but it is unknown which technique best minimizes local recurrence and surgical morbidity. QUESTIONS/PURPOSES:We compared recurrence rates, arthritis progression, and complications between arthroscopic and open modalities for diffuse PVNS of the knee. METHODS:We retrospectively identified 103 patients with PVNS treated between 1993 and 2011. Of these, 48 had diffuse-type PVNS of the knee treated by all-arthroscopic, open posterior with arthroscopic anterior, or open anterior and open posterior synovectomy. We recorded patient demographics, treatment profiles, recurrence rates, and arthritic progression. Minimum followup was 3 months (median, 40 months; range, 3-187 months). RESULTS:Recurrence rates were lower in the open/arthroscopic group compared with the arthroscopic or open/open groups: 9% versus 62% versus 64%, respectively. Arthritic progression occurred in 17% of the total study group with 8% going onto total knee arthroplasty within the followup period. We detected no difference between groups with regard to arthritic progression or progression to arthroplasty. The most common complication was hemarthrosis, which we drained in three patients (6% of the total study group), but there were no detectable differences between groups. CONCLUSION:Open posterior with arthroscopic anterior synovectomy is a viable, comprehensive approach to diffuse PVNS of the knee and provides both low recurrence rates and a low postoperative complication profile. Greater numbers of recurrences may be partially explained in the arthroscopic group by technical challenges associated with posterior arthroscopic synovectomy and in the open/open group by selection bias toward more aggressive disease. LEVEL OF EVIDENCE:Level III, 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
Colman MW,Ye J,Weiss KR,Goodman MA,McGough RL 3rddoi
10.1007/s11999-012-2589-8subject
Has Abstractpub_date
2013-03-01 00:00:00pages
883-90issue
3eissn
0009-921Xissn
1528-1132journal_volume
471pub_type
杂志文章abstract：:A series of 205 pediatric patients affected by osteosarcoma, Ewing's sarcoma, fibrosarcoma, and malignant fibrous histiocytoma of bone were treated from 1978 to 1988. Ninety-eight percent of the patients received chemotherapy and 63% had a surgical resection. Sixty-five percent of all patients were alive at 30 months ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1991-03-01 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：:Patients with cystic fibrosis have an increased risk for developing kyphosis and scoliosis. The risk for both kyphosis and scoliosis increases with age. The severity of kyphosis did not appear greater in the older age groups. Patients with retarded bone age may be more likely to have a significant spinal deformity. Th...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-03-01 00:00:00
abstract：:Ten patients with femoral head fractures were evaluated with conventional hip radiographs, computed axial tomography (CT), and pelvic oblique radiographs. The CT scan was used to determine the plane of the fracture within the femoral head. The patient was then positioned with the fracture line parallel to the radiogra...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-11-01 00:00:00
abstract：BACKGROUND:Previous studies have shown that perioperative blood transfusion increases cancer recurrence and decreases patient survival after resection of primary malignancies. The question arises whether this association also exists in patients with already disseminated disease undergoing surgery for metastatic long-bo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-015-4167-3
更新日期：2015-07-01 00:00:00
abstract：:Two patients with Charcot joints developed septic arthritis. The infection in the first patient was treated successfully by repeated needle aspirations and parenteral oxacillin administration. In the second patient closed drainage and parenteral penicillin were not successful in eradicating the infection, and surgical...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1980-03-01 00:00:00
abstract：:Experience with a 9-year-old girl with Dysplasia Epiphysealis Hemimelica in the right lower extremity demonstrates that avoidance of confusion leading to medical--legal problems and promotion of effective management would have been possible by early recognition of the condition. ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1976-05-01 00:00:00
abstract：UNLABELLED:The treatment and prognosis of labral tears of the hip depend primarily on whether there is concomitant injury of the adjacent acetabular articular cartilage. We asked whether a delamination cyst on the preoperative plain radiographs correlated with delamination of the acetabular articular cartilage at the t...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0564-1
更新日期：2009-04-01 00:00:00
abstract：:Gluteal muscle contracture is common after repeated intramuscular injections and sometimes is sufficiently debilitating to require open surgery. We asked whether arthroscopic release of gluteal muscle contracture using radiofrequency energy would decrease complications with clinically acceptable results. We retrospect...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0595-7
更新日期：2009-03-01 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：BACKGROUND:Historically, achieving stability for the unstable total hip arthroplasty (THA) with revision surgery has been achieved inconsistently. Most of what we know about this topic comes from reports of high-volume surgeons' results; the degree to which these results are achieved in the community is largely unknown...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-013-3344-5
更新日期：2014-03-01 00:00:00
abstract：:Femoroacetabular impingement due to metaphyseal prominence is associated with the slippage in patients with slipped capital femoral epiphysis (SCFE), but it is unclear whether the changes in femoral metaphysis morphology are associated with range of motion (ROM) changes or type of impingement. We asked whether the fem...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0477-z
更新日期：2009-03-01 00:00:00
abstract：:Anteroposterior pelvic roentgenograms of 790 patients admitted for treatment of alcoholism were examined for evidence of osteonecrosis of the femoral head. Laboratory data on these patients, obtained shortly after admission, demonstrated that average serum cholesterol levels were within normal limits and average serum...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1979-09-01 00:00:00
abstract：:The discoid menisci is a common abnormalitiy of the knee seen by pediatric and general orthopaedists. This aberration of the fibrocartilaginous meniscus can occur medially, but is most common on the lateral side. Because of unusual biomechanical stresses, all discoid menisci are at increased risk for meniscal tears. T...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/BLO.0b013e31802c29bd
更新日期：2007-03-01 00:00:00
abstract：:The cases of 11 patients with the syndrome of thrombocytopenia and absent radius (TAR syndrome) who presented at two institutions between 1970 and 1996 were reviewed. Knee deformities have been well documented in thrombocytopenia and absent radius syndrome, but an inordinate frequency of other lower extremity problems...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200006000-00024
更新日期：2000-06-01 00:00:00
abstract：BACKGROUND:Alternative dispute resolution (ADR) refers to techniques used to resolve conflicts without going to the courtroom. As healthcare and malpractice costs continue to rise, there is growing interest in tactics such as early apology, mediation, and arbitration in the medical arena. QUESTIONS/PURPOSES:(1) Why is...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-2206-2
更新日期：2012-05-01 00:00:00
abstract：:A study of 281 patients evaluated for a meniscus pathologic condition was performed to assess the accuracy of the clinical diagnosis and arthrogram and delineate the role of arthroscopy. Following the clinical examination, the surgeon stated his level of confidence in his diagnosis, as did the radiologist in his inter...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1982-03-01 00:00:00
abstract：:The alkaline phosphatase in leukocytes (LAP) was measured in patients who had undergone various types of total arthroplasty of the hip, in patients who had undergone synovectomy and in whom tibial fractures had been treated conservatively. The LAP-Score increased rapidly and reached a maximum within a few days and ret...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1976-01-01 00:00:00
abstract：BACKGROUND:Positive-pressure exhaust suits cost more than standard surgical gowns, and recent evidence suggests that they do not decrease infection risk. As a result, some hospitals and surgeons have abandoned positive-pressure exhaust suits in favor of less expensive alternatives. We propose that in addition to their ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999.0000000000000253
更新日期：2018-06-01 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：: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：:Longstanding untreated congenital torticollis in adults is uncommon and surgical release in such a case can be hazardous or fraught with many possible complications. A two-stage, open, bipolar surgical division of the contracted sternocleidomastoid muscle in a 33-year-old woman who developed pain and paresthesiae in t...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-03-01 00:00:00
abstract：UNLABELLED:To determine whether inferior vena cava (IVC) filter placement protects patients with musculoskeletal tumors from fatal pulmonary embolisms (PE), we retrospectively analyzed the records of 81 patients who underwent surgery for pelvic and lower extremity malignancies. All 81 patients received an IVC filter an...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0607-7
更新日期：2009-01-01 00:00:00
abstract：:The origin of the osteoclast has long been controversial. Various approaches such as traditional light microscopy, electron microscopy, microcinephotography, autoradiography, parabiosis, quail-chick nuclear marker, etc, have been used in attempts to resolve the problem. There are 2 major concepts: the view of skeletal...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1979-11-01 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：:Ninety-two patients with congenital pseudoarthrosis (infantile nonunion) were treated with pulsing electromagnetic fields (PEMF) in the United States and Europe in the past eight years. This represents the largest group of patients with infantile nonunions in which a common treatment modality has been used. Excluding ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1982-05-01 00:00:00
abstract：BACKGROUND:There is a general perception in practice that a vascular supply should be used when large pieces of bone graft are used, particularly those greater than 6 cm in length for long-bone and large-joint reconstructions. However, the scientific source of this recommendation is not clear. QUESTIONS/PURPOSES:We wi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1007/s11999-016-4769-4
更新日期：2016-05-01 00:00:00
abstract：:A multicenter retrospective review was performed analyzing 1081 primary total hip replacements in 944 patients using the Harris Galante-I cementless acetabular component with screw fixation. All patients were followed up for a minimum of 5 years with a mean followup of 81 months. Linear polyethylene wear averaged 0.11...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,多中心研究
doi：10.1097/00003086-199912000-00016
更新日期：1999-12-01 00:00:00
abstract：:A case of an osteoid osteoma occurring in the cervical spine and presenting as scapular and arm pain has been described. Correct diagnosis was delayed for 2 years. Plain radiographs may fail to demonstrate a lesion in the spine. Radiographic evaluation, when osteoid osteoma is a possibility, should include bone scanni...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1977-11-01 00:00:00
abstract：:The acute effects of immobilization on cortical and trabecular bone formation were studied in juvenile male rhesus monkeys (Macaca mulatta). Four animals were immobilized for two weeks by application of total body casts. Two control monkeys were housed in separate metabolic cages under similar environmental and dietar...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-12-01 00:00:00
