Abstract:
BACKGROUND:Metal-on-metal (MOM) THA bearing technology has focused on improving the arc of motion and stability and minimizing wear compared with traditional metal-on-polyethylene (MOP) bearing couples. It is unclear whether this more costly technology adds value in terms of improved implant survival. QUESTIONS/PURPOSES:This study evaluated Kaplan-Meier survival, revisions for dislocation, and cost of MOM THA compared with metal-on-cross-linked polyethylene (MOXP) THA in a community joint registry, with subset analysis of the recalled Depuy ASR™ implant. METHODS:All MOM THAs (resurfacings excluded) performed between January 2002 and December 2009 were included (n = 1118) and compared with a control group of MOXP THAs (n = 1286) done during the same time. Analysis was performed to compare age, gender, cost of implant, length of stay, year of index procedure, diagnosis, head size (< 32 mm versus ≥ 32 mm), revision and revision reason for both groups. Analysis at a mean of 3.6 years was done using Wilcoxon rank sum tests, Pearson's chi-square tests, Kaplan Meier methods, and Cox regression. RESULTS:The cumulative revision rate (CRR) was higher in MOM implants than in MOXP implants (MOM CRR = 13%; MOXP CRR = 3%). MOM implants were three times as likely to be revised as MOXP implants after adjustment for age, head size, and year of procedure. The recalled DePuy ASR™ implant was six times as likely to be revised as other MOM THAs. After removing the ASR™ implants from analysis, survivorship of MOM implants was not better than that of the MOXP hips. CONCLUSIONS:During the study time, MOM THAs showed inferior survival to MOXP THAs after adjusting for age, head size, and year of procedure. Longer followup is necessary to see whether MOM THAs add value in younger patient groups.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Huang DC,Tatman P,Mehle S,Gioe TJdoi
10.1007/s11999-013-2821-1subject
Has Abstractpub_date
2013-06-01 00:00:00pages
1920-5issue
6eissn
0009-921Xissn
1528-1132journal_volume
471pub_type
杂志文章abstract::The progression from chronic anterior cruciate instability to degeneration of the knee has been well documented in animal studies. However, the literature is unclear as to the overall consequences with respect to the development of osteoarthritis. The long-term consequences of the anterior cruciate insufficient knee w...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1988-02-01 00:00:00
abstract:BACKGROUND:Degenerative rotator cuff tears are increasing with the aging population, and healing is not uniform after surgery. Rotator cuffs may show improved healing when biologic factors are added during surgery. QUESTIONS/PURPOSES:We asked: (1) What cellular processes are involved in normal bone-to-tendon healing? ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1007/s11999-010-1323-7
更新日期:2010-06-01 00:00:00
abstract::State of the art techniques for perioperative pain management in orthopaedic surgery have evolved from cumulative advances in basic sciences, technology, psychology, and changes in physician and nursing practices. Each advance in the understanding of pain physiology and pharmacology and the pain experience has suggest...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1994-08-01 00:00:00
abstract::During a ten-year period (1978-1988), 143 of 1386 patients with proximal humeral fractures were treated with internal osteosynthesis. Ninety-seven proximal humeral osteosynthesis cases had adequate documentation, and 77 (80%) were available for clinical review. The 97 fractures were graded by the AO/ASIF classificatio...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1993-07-01 00:00:00
abstract::A new spinal implant has been designed and biomechanical testing completed, intended for application to "short-segment" spinal defects such as disc degeneration, fracture, spondylolisthesis, or tumor. Major improvements over currently available devices include: only 2-3 vertebrae are spanned, not 5-7 as with Harringto...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-02-01 00:00:00
abstract:BACKGROUND:MRI is the gold standard for evaluating the relationship of disc material to soft tissue and neural structures. However, terminologies used to describe lumbar disc herniation and nerve root compression have always been a source of confusion. A clear understanding of lumbar disc terminology among clinicians, ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1007/s11999-014-3674-y
更新日期:2015-06-01 00:00:00
abstract::Tissue biopsy alone is diagnostic in less than 10% of cases of metastatic bone disease with an unknown primary tumor. Accordingly, to delineate the neoplastic process in cases of metastatic bone disease, where the primary tumor cannot be determined with conventional modalities, new tools are attractive. Complementary ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000093060.96273.db
更新日期:2003-10-01 00:00:00
abstract::Fourteen boys (56%) and 11 girls (44%) 4 to 17 years of age (mean, 12.2 years) who had osteosarcoma and open epiphyseal plates were studied. A possible correlation between transepiphyseal spread of osteosarcoma and radiologic and histopathologic findings was investigated. Epiphyseal plate invasion was detected radiolo...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200004000-00006
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND:Although postoperative spinal epidural hematoma (SEH) is not uncommon, hematomas that require surgery are rare. Cauda equina syndrome (CES) may be associated with postoperative SEH. In these cases, early recognition and emergency decompression can prevent further damage and better neurologic recovery. CASE ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-2031-7
更新日期:2012-06-01 00:00:00
abstract::A deeper understanding of skeletal development comes from knowledge of the molecular components, cell and tissue structure, and biophysical and vascular mechanisms underlying physiologic function. Endochondral and intramembranous bone formation mechanisms are active during long bone synthesis. Most endochondral growth...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:2005-03-01 00:00:00
abstract::Posttraumatic avascular humeral head necrosis may require salvage shoulder arthroplasty in symptomatic cases. We tested the hypothesis that associated tuberosity malunion negatively influences the final clinical outcome after shoulder arthroplasty. Thirty-eight patients with posttraumatic avascular necrosis of the hum...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/BLO.0b013e318159cb7a
更新日期:2007-12-01 00:00:00
abstract::In 20 patients, the torn posterior cruciate ligament (PCL) was repaired without reinforcement within two weeks after injury. Fourteen patients had a midsubstance tear, and in six the ligament was avulsed from the femur without bone. There were 11 isolated and nine combined injuries. The follow-up period ranged from tw...
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::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 variability in alignment of the natural patellar groove was determined about various anatomic axes of the femur, using 3 plane radiographs and electronic digitization. After the patellar groove was identified and marked on 15 anatomic specimen femurs, radiographs were taken in the coronal, sagittal, and transverse...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199610000-00009
更新日期:1996-10-01 00:00:00
abstract::Clonal cell lines of murine osteosarcomas were established and have been maintained in vitro for over a year. By implanting these cultured cells into mice, osteosarcomas, whose histological picutres were exactly the same as those of the original tumors, were easily reproduced. The cultured cells of murine osteosarcoma...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-197511000-00026
更新日期:1975-11-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-009-1159-1
更新日期:2010-05-01 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:BACKGROUND:Complicated tibial fractures with severe soft tissue trauma are challenging to treat. Frequently associated acute compartment syndrome can result in scarring of muscles with impaired function. Several studies have shown a relationship between angiogenesis and more effective muscle regeneration. Vascular endo...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-012-2456-7
更新日期:2012-12-01 00:00:00
abstract::In recent years the treatment of fractures of the hip in elderly patients has been almost exclusive surgical. However, there are occasions when either because of medical conditions or other surgical problems it is not possible to operate on these patients. An alternative method of handling such patients is the use of ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1980-09-01 00:00:00
abstract::The results of 65 consecutive revision total knee arthroplasties performed for mechanical failure were reviewed. Fifty-nine of the knees were followed for an average of five years (range, 2-10 years). The types of implants used included: total condylar, posterior stabilized, total condylar III, and the kinematic rotat...
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::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::To investigate the periosteal contribution to the integrity of the growth plate, the authors subjected the proximal tibias of 110 male and female Sprague-Dawley rats between the ages of 25 and 65 days to axial and perpendicular forces to produce epiphysiolysis by use of a slow-loading technique and a cross-head speed ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1985-04-01 00:00:00
abstract::A long-term clinical study of 41 Flatt metallic hinged prostheses inserted in the metacarpophalangeal joints of ten rheumatoid patients was completed to provide a historic and clinical perspective of the ongoing clinical performance of this prosthesis. Postsurgical analysis performed an average of 138 months after ope...
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: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::Quality of life measures have neglected to include a critical self-assessment component in pediatric sarcoma patients. Our report shows how children rate their own quality of life and how that varies over time after surgery. Using the Pediatric Outcomes Data Collection Instrument, quality of life data was prospectivel...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/BLO.0b013e31804f545d
更新日期:2007-06-01 00:00:00
abstract::Epiphyseal stapling is considered a safe, effective method of correcting angular deformities of the knee in growing children. A study of the underlying biochemical events would contribute to a better understanding of the control of longitudinal growth rate in epiphyseal growth plates and of the molecular pathology of ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-05-01 00:00:00
abstract:UNLABELLED:New prostheses should be evaluated for stability and clinical performance. In a prospective randomized clinical trial, we implanted 22 titanium (Ti) and 20 hydroxyapatite-coated (HA) ProxiLock femoral hip prostheses during total hip arthroplasty in 42 patients. The patients were followed for 24 months with c...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.blo.0000224011.12175.83
更新日期:2006-07-01 00:00:00
abstract::Thirty-two rabbits were used experimentally to study the effect of cortisone in bone, lungs, kidneys, and liver. Cortisone does induce abnormal increases in the serum cholesterol, fatty metamorphosis of the liver and the fatty emboli of the subchondral vessels of the femoral heads. Clofibrate therapy appeared to modif...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract::This is a report of replantation of a completely severed forefoot which was divided through the distal tarsus by a samurai sword cut. Primary reconstruction of bone, vessels, nerve and skin was carried out 2 hours following amputation. Neither the long extensor nor the long flexor tendons were repaired. Three years fo...
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::Isolated capitellar fractures are rare, intraarticular fractures requiring an aggressive management regimen. Several treatment options have been described for the Type 1 fracture. A new technique of direct anatomic reduction and fixation of the fracture using a maxillofacial plate is reported. Advantages of this new t...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:2001-03-01 00:00:00