Abstract：
BACKGROUND:During hip arthroplasties for treating proximal femur metastases, a long femoral stem frequently is used, presumably protecting the entire femur against progression of the existing lesions or development of new lesions. However, it is unclear whether a long stem is really required. QUESTIONS/PURPOSES:We therefore determined in patients with proximal femur metastases (1) the reoperation rate related to different stem lengths after hip arthroplasty, (2) the risk of tumor progression in the same femur (the progression of preexisting lesions and the development of new distal femur lesions), and (3) complications. METHODS:We retrospectively reviewed 203 patients (206 femurs) with proximal femur metastases treated with hip arthroplasty. These femurs were divided into three groups based on femoral stem length: short stem (SS), 12 to 14 cm; medium stem (MS), 20 to 24 cm; and long stem (LS), 25 to 35 cm. We reviewed reoperations, disease progression in the same femur, and complications. Minimum followup was 2 days (median, 487 days; range, 2-4853 days), with most patients followed to their death. RESULTS:Only three femurs were revised owing to tumor progression, with no difference among the SS, MS, and LS groups. Two SS prostheses were revised for nononcologic reasons. Tumor progression in the same femur was uncommon during the patient's survival, with 11 femurs showing progression of the proximal lesion and five femurs showing new distal lesions. The complication rate was higher in the LS group (28%) than the combined rate in the MS and SS groups (16%), especially acute cardiopulmonary complications (18% versus 7.5%). CONCLUSIONS:Reoperation after hip arthroplasty for proximal femur metastases is uncommon and not correlated with femoral stem length. Considering the high complication rate associated with a LS hip prosthesis, we do not believe its routine use is justified.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Xing Z,Moon BS,Satcher RL,Lin PP,Lewis VOdoi
10.1007/s11999-013-2790-4subject
Has Abstractpub_date
2013-05-01 00:00:00pages
1622-7issue
5eissn
0009-921Xissn
1528-1132journal_volume
471pub_type
杂志文章abstract：:Osteogenic sarcoma, a highly malignant tumor of bone, is generally treated by amputation. This is a report of 19 cases of excision of the entire femur because of skip areas which are occasionally seen. The femur usually has the lowest cure rate according to site of involvement. In total femur replacement, the whole bo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1977-07-01 00:00:00
abstract：:The forces and torques that occur during walking gait, particularly during toe-off, promote articulation in the posteromedial quadrant of tibial inserts. Retrieved components of failed knee arthroplasties show ultrahigh molecular weight polyethylene damage patterns in this region. Component-designed constraint, compro...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000063597.67412.e9
更新日期：2003-05-01 00:00:00
abstract：UNLABELLED:While the literature suggests lateral unicondylar knee arthroplasty (UKA) improves function in the short- and medium-term, it is less clear on longer-term function. We asked (1) whether lateral UKA improved longer-term Knee Society scores and return to previous activity level); (2) whether there were any con...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0351-z
更新日期：2008-11-01 00:00:00
abstract：:Twenty-one distal biceps ruptures in 20 patients were treated during a 10-year period. All patients were men with an average age of 47 years (range, 37-70 years). Long term results (average, 44 months) were assessed using the American Academy of Orthopaedic Surgeons Disabilities of the Arm, Shoulder, and Hand outcomes...
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：UNLABELLED:The outcome of isolated patellar component revisions after metal-backed patellar failure is variable with satisfactory results reported from 78% to 100%. To supplement information in the literature we determined the failure rate and the functional outcome based on the Knee Society clinical and roentgenograph...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0414-1
更新日期：2008-11-01 00:00:00
abstract：:Radiocarpal fracture-dislocation was associated with fracture of the distal articular surface of the radius in five patients (six extremities). Closed manipulation resulted in satisfactory reduction of both the dorsal dislocation of the carpus on the distal radius and displaced articular fracture fragment(s) in two of...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1985-07-01 00:00:00
abstract：:Eight patients with unstable fractures involving the articular surface and metaphyseal-diaphyseal bone of the proximal or distal tibia associated with severe soft-tissue injury or compounding wound were treated with irrigation, debridement, tetanus inoculation, antibiotic prophylaxis, and combined internal fixation wi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1990-07-01 00:00:00
abstract：:The Hall model of experimental arthritis of the knee (excision of the lateral femoral condyle) offers a unique way of investigating the earliest changes of degenerative arthritis. Predictable degeneration of the lateral tibial plateau occurs when there is lack of contact with an opposing surface. Previous work by Hall...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1977-06-01 00:00:00
abstract：:Thirty-five patients with a benign lesion of the femoral neck or trochanter were treated and seen in followup at the authors' institution from 1988 to 1991. Sixteen men and 19 women between the ages of 18 and 54 years (average, 27 years) were seen at an average followup of 3 years 6 months (range, 2-5 years). Eight pa...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199607000-00034
更新日期：1996-07-01 00:00:00
abstract：:The effects of postoperative epidural infusions using local anesthetic and narcotic were assessed in reference to lower extremity blood flow. Nineteen patients who underwent unilateral total hip arthroplasty were randomly assigned to receive a postoperative epidural infusion of either 5 microg/ml fentanyl or 5 microg/...
journal_title：Clinical orthopaedics and related research
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1997-01-01 00:00:00
abstract：:Arthrodesis of the carpometacarpal joint of the thumb is useful in reconstruction of hand deficiencies and in eliminating pain at this site. The author has speculated that fusion of the carpometacarpal joint might lead to pantrapezial arthritis in later years. No patients with painful arthritis received this operation...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1987-07-01 00:00:00
abstract：:By the use of modern techniques, the nature of the immunological response to bone and cartilage grafts is becoming clear. Fresh bone, whether cancellous or cortical, will elicit a cell-mediated immunological response; removal of the bone marrow has little effect in reducing immunogenicity. Antibodies against cellular ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1976-10-01 00:00:00
abstract：:The successful treatment of osteomyelitis with commercially prepared gentamicin-polymethylmethacrylate (PMMA) (Septopal) beads and surgical debridement has led to the use of this technique in the United States. However, commercially prepared gentamicin-PMMA beads are not currently available to orthopedic surgeons in t...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-11-01 00:00:00
abstract：:Load-bearing porous-surfaced implants in dogs which failed were not incorporated by bone ingrowth. The implants were incorporated only by fibrous tissue ingrowth. Collagen fiber orientation within this fibrous tissue and Sharpey's fiber-like features at the interface between the fibrous tissue and a surrounding layer ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1981-05-01 00:00:00
abstract：:Although the primary goal of total knee arthroplasty is to relieve pain, the attainment of high flexion has emerged as an important secondary goal. Clinical pathways are evolving and focus on rapid recovery. The entire perioperative process for the patient and family, including office and hospital procedures, has been...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000238824.56024.7a
更新日期：2006-11-01 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：:Reasons for reoperation after knee revision surgery are implant loosening, sepsis, extensor mechanism problems, fractures of bone or prosthetic components, wear debris, and limited range of motion. The purpose of this study was to review the complications requiring reoperation in a large number of condylar revision to...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-01-01 00:00:00
abstract：:Numerous studies document vibrations emanating from joints during active or passive motion. It has been proposed these vibrations, termed vibroarthrographic signals, are associated with changes in the shape or quality of tissues in and around the joint. Vibroarthrographic signals in articular joints have been tested t...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/BLO.0b013e31802c3423
更新日期：2007-03-01 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：UNLABELLED:Information on the microbiology of infections after operative ankle fractures, on the details of a treatment protocol used when the ankle joint is preserved, and on the outcome of this protocol will be helpful for the physicians managing patients with this complex problem. We therefore determined the most co...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-009-0743-8
更新日期：2009-07-01 00:00:00
abstract：BACKGROUND:Reconstruction of the extensor mechanism after resection of the proximal tibia is challenging, and several methods are available. A medial gastrocnemius flap commonly is used, although it may be associated with an extensor lag. This problem also is encountered, although perhaps to a lesser extent, with other...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-013-2851-8
更新日期：2013-07-01 00:00:00
abstract：UNLABELLED:Information regarding national trends in bilateral TKAs is needed for a rational allocation of resources, policy making, and research. Therefore, we analyzed data from the National Hospital Discharge Survey to elucidate temporal changes in the demographics, comorbidity profiles, hospital stay, and in-hospita...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0610-z
更新日期：2009-06-01 00:00:00
abstract：:Culture selected and expanded osteoblastic cells may be able to be reintroduced into massive skeletal defects to accelerate cell mediated regeneration of skeletal tissues, especially in bone ingrowth in total joint replacement, fracture healing, and osteoporosis. In vitro osteogenic cell culture is a useful model in s...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1998-03-01 00:00:00
abstract：UNLABELLED:Impaction grafting is controversial in the presence of segmental and cavitary acetabular defects and requires the use of supplemental devices to close segmental defects. This approach, however, would allow treating combined deficiencies that could not be managed with impacted cancellous bone alone. We raised...
journal_title：Clinical orthopaedics and related research
pub_type： 临床试验,杂志文章
doi：10.1007/s11999-008-0442-x
更新日期：2008-10-01 00:00:00
abstract：:The importance of prompt surgical repair of complete ligament ruptures was quantitated using 38 rabbits with standardized transection injuries ofthe medial collateral ligament of one knee. Tensile testing of the mechanical properties, coupled with histological evaluation allowed assessment of the integrity of suture r...
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：:The standard of care for femoral fractures is an intramedullary nail, placed in an antegrade approach. This has produced high rates of healing and low complication rates. The use of retrograde nailing for femoral shaft fractures is a relatively new technique, previously described as an extraarticular approach. Forty-o...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199611000-00013
更新日期：1996-11-01 00:00:00
abstract：:The pathogenic potential of Propionibacterium acnes in implant-associated spine infections is increasingly recognized. However, the clinical findings and outcomes associated with this pathogen in nonimplant-associated spine infections are unknown. We retrospectively reviewed nine male patients who met our strict case ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/BLO.0b013e318073c25d
更新日期：2007-08-01 00:00:00
abstract：:The impact of preoperative gait analysis on the orthopaedic care of 97 patients (101 gait analyses) at the authors' institution was evaluated. For the 70 patients for whom a specific treatment plan had been outlined before the preoperative gait study, the treatment plan was altered in 62 (89%) after the gait analysis ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200003000-00023
更新日期：2000-03-01 00:00:00
abstract：:Evidence suggests neovascularization is involved in the etiology of spontaneous Achilles tendon rupture. Therefore we investigated expression of the receptors of one of the most important angiogenic factors, the vascular endothelial growth factor in normal and pathologic human Achilles tendons by immunohistochemical a...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200403000-00040
更新日期：2004-03-01 00:00:00
abstract：:Degenerative changes in the spine, specifically disc degeneration and facet arthrosis, and osteoporosis are conditions that primarily affect the elderly and may significantly impact the quality of life. The relationship between osteoporosis and degenerative changes in the hip joint has been studied, but their correlat...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199603000-00017
更新日期：1996-03-01 00:00:00
