Abstract:
BACKGROUND:During lower limb lengthening, poor bone regeneration is a devastating complication. Several local or systemic applications have been used to promote osteogenesis, and biologic stimulations are gaining attention, but their utility has not been proven in this setting. QUESTIONS/PURPOSES:In patients undergoing bilateral tibial lengthening, we compared those receiving an osteotomy site injection of autologous bone marrow aspirate concentrate (BMAC) plus platelet-rich plasma (PRP) with those not receiving such an injection in terms of external fixator index (time in external fixation divided by amount of lengthening), full weightbearing index (time until a patient was permitted to do full weightbearing divided by amount of lengthening), four cortical healing indexes (time until each cortical union divided by amount of lengthening), and callus shape and type. METHODS:Twenty-two patients (44 tibias) undergoing bilateral tibial lengthening enrolled in this randomized trial. Two patients were excluded, one due to insufficient radiographic evaluation and one who was lost to followup, leaving 20 patients (40 segments) for inclusion. Ten patients (20 segments) received BMAC combined with PRP injection (treatment group) and 10 patients (20 segments) received no injection (control group). All patients underwent stature lengthening for familial short stature with the lengthening over nail technique. Autologous BMAC combined with PRP was injected at the tibial osteotomy site at the end of the index surgery. Mean distraction rates were similar between groups (0.75 mm/day in the treatment group versus 0.72 mm/day in the control group; p = 0.24). Full weightbearing was permitted when we observed radiographic evidence of healing at two cortices; this assessment was made by the surgeon who was blinded to the treatment each patient received. Minimum followup was 24 months (mean, 28 months; range, 24-34 months). RESULTS:There was no difference in mean external fixator index between groups. However, mean cortical healing indexes (anterior/posterior/medial/lateral) were 1.14/0.81/0.96/0.88 months/cm in the treatment group and 1.47/1.26/1.42/1.22 months/cm in the control group (all p < 0.001), showing faster healing in the treatment group at each cortex. Full weightbearing was permitted earlier in the treatment group than in the control group (index: 0.99 months/cm and 1.38 months/cm, respectively, p < 0.001). Callus shape and type were not different between groups. CONCLUSIONS:Autologous BMAC combined with PRP injection at the osteotomy site helped improve bone healing in distraction osteogenesis of the tibia, although the effect size was small. LEVEL OF EVIDENCE:Level I, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Lee DH,Ryu KJ,Kim JW,Kang KC,Choi YRdoi
10.1007/s11999-014-3548-3subject
Has Abstractpub_date
2014-12-01 00:00:00pages
3789-97issue
12eissn
0009-921Xissn
1528-1132journal_volume
472pub_type
杂志文章,随机对照试验abstract::Twenty-eight patients who underwent unilateral total knee arthroplasty and 20 patients who underwent simultaneous bilateral total knee arthroplasties participated in this study and were randomized to have either a fluted or round 10-mm diameter femoral intramedullary alignment rod used during surgery. The intramedulla...
journal_title:Clinical orthopaedics and related research
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003086-199811000-00022
更新日期:1998-11-01 00:00:00
abstract::The authors introduce a new functional classification of rheumatoid arthritis of the wrist. Unlike the classifications used today, it includes the aspect of the natural course of rheumatoid arthritis. The goal of this paper is to identify radiologic indicators that will classify rheumatoid arthritis into stable forms ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1999-09-01 00:00:00
abstract::The optimal treatment for displaced femoral neck fractures in elderly patients is a matter of controversy. Four surgical options are well supported in the orthopaedic literature: reduction with internal fixation, unipolar hemiarthroplasty, bipolar hemiarthroplasty, and total hip arthroplasty. Based on a review of the ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200102000-00027
更新日期:2001-02-01 00:00:00
abstract::The use of a peritoneal catheter enhances diagnosis using arthroscopy by affording a clear visibility of the knee joint. The accuracy in diagnosis is significantly enhanced using this method of irrigation. No better method of irrigation is available for cases of acute knee joint injuries. ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1977-10-01 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:UNLABELLED:Allograft ankle arthrodesis using a retrograde intramedullary tibial nail is a new strategy in limb salvage for treatment of distal intraarticular tibial tumors. After tumor resection, the ankle is reconstructed using an intercalary allograft and retrograde intramedullary fixation. We retrospectively reviewe...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000176449.77149.81
更新日期:2005-11-01 00:00:00
abstract::Successful outcome of total shoulder arthroplasty depends on a well-designed and a well-executed physical therapy program. For maximal benefit, the program is usually initiated immediately after surgery and follows a logical pattern of joint mobilization followed by muscle strengthening. The process proceeds through a...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1994-10-01 00:00:00
abstract::For reappraisal of total hip arthroplasty (THA) in the treatment of nontraumatic osteonecrosis (ON) of the femoral head, 29 hips in 23 patients with ON were surveyed in a comparison with 63 osteoarthritic (OA) hips treated in the same manner during the same period; the hips were selected according to the same criteria...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1989-07-01 00:00:00
abstract::Degradation of yttria-stabilized zirconia femoral heads in vivo has been linked to increased roughening and even fracture of the femoral head. To determine whether magnesia-stabilized zirconia is better suited to resist degradation, we characterized the monoclinic phase concentration, surface topography, and microhard...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/BLO.0b013e318158b4d3
更新日期:2007-12-01 00:00:00
abstract::Glucocorticoid injection is widely used in tendon disorders. Despite previous studies on the histologic and biomechanical changes in tendons after glucocorticoid injections, the role of glucocorticoid in tendon rupture still is controversial. It was hypothesized that glucocorticoid has a direct deleterious effect on h...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000118184.83983.65
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:Bone cancer pain is very common, and patients with this type of pain may be difficult to treat. Development of an experimental model for studying this condition is critical to advancing an understanding of the mechanisms that cause pain in patients with malignant disease. METHODS:A murine model of bone canc...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/01.blo.0000093059.96273.56
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND:Preoperative depressive symptoms have been shown in some but not all studies to be associated with poor self-reported pain and function outcomes. In addition, depressive symptoms after surgery have been shown to improve relative to preoperative levels. QUESTIONS/PURPOSES:We hypothesized that (1) preoperativ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,多中心研究
doi:10.1007/s11999-015-4203-3
更新日期:2015-11-01 00:00:00
abstract::External malrotation is a frequent complication following Ender nailing. Biomechanical studies demonstrate that the standard Ender nail tends to produce external malrotation when the fracture is unstable. This type of malrotation does not develop to the same degree if the nails are bent into a 25 degree angle of antev...
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::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::Sixteen porous polysulfone-coated canine femoral stems were inserted into 14 dogs. Coatings were approximately 40% porous, with an average pore size of 125 or 250 microns. Bone was formed within at least about 30% of the surface pores of the implants. The tissue ingrowths filling the pores included marrow and fibrous ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-06-01 00:00:00
abstract::A consecutive series of 125 hybrid total hip arthroplasties were performed in 120 patients by a single surgeon and were observed for an average of 8.6 years (range, 7-11 years). There were 38 men and 82 women with an average age of 71 years (range, 25-87 years) at the time of surgery. The diagnoses included primary an...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1996-12-01 00:00:00
abstract:BACKGROUND:Local drug delivery has substantial potential to prevent infections compared with systemic delivery. Although calcium sulfate (CaSO(4)) has been studied for local drug delivery and two types are commercially available, it is unknown whether they differentially release antibiotics. QUESTIONS/PURPOSES:We dete...
journal_title:Clinical orthopaedics and related research
pub_type:
doi:10.1007/s11999-011-1911-1
更新日期:2011-11-01 00:00:00
abstract::A diskoid medial meniscus is a rare finding occurring in approximately 0.3% of the general population. Bilateral medial diskoid menisci are even less common, with only three other cases appearing in the literature. This may be the first reported case of bilateral medial diskoid menisci diagnosed by magnetic resonance ...
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::Numerous important developments in tissue engineering of new bone during the last 10 years are reviewed. Early efforts to combine cells with biocompatible materials are described and applications of this technology are presented with particular focus on uses in orthopaedics and maxillofacial surgery. Basic principles ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/00003086-199910001-00036
更新日期:1999-10-01 00:00:00
abstract::Fourteen patients with separation of the distal clavicular metaphysis from the epiphysis were reviewed. These injuries, especially in the older child and adolescent, mimic acromioclavicular separation. However, they are really growth-plate injuries in which the epiphysis and physis maintain their normal anatomic relat...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1984-09-01 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 tensile and histologic characteristics of sharply transected Achilles tendons treated by cast immobilization, surgical repair, and surgical repair reinforced with polyglactin mesh were evaluated in 31 rabbits. All modes of tendon treatment resulted in tensile failure at significantly lower loads than in the contra...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-12-01 00:00:00
abstract::The evaluation of medical students consists, in part, of a transparent academic record of grades, awards, and any publications or special clinical activities. In addition, however, each student is evaluated through more opaque processes within a medical school that speak to the behavior, character, and developing prof...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/01.blo.0000229271.36076.77
更新日期:2006-08-01 00:00:00
abstract::In adult rabbits, a unilateral subcapital osteotomy of the femoral neck was performed to induce avascularity. One half of the osteotomy sites were fixed with a magnetic resonance imaging (MRI) compatible absorbable pin and the other osteotomies had no fixation. The femoral heads were studied at three, five, and 12 day...
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:UNLABELLED:Fractures of the proximal humerus can be treated effectively but require proper characterization. None of the existing classifications intended to facilitate characterization have been satisfactory. We studied proximal humerus fractures using radiographs alone and radiographs plus computed tomography scans t...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000205899.28856.98
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:It is easy to accurately measure web site usage and to quantify key parameters such as page views, site visits, and more complex variables using commercially available tools that analyze web site log files and search engine use. This information can be used strategically to guide the design or redesign of a ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1333-5
更新日期:2010-10-01 00:00:00
abstract::Osteonecrosis (aseptic or avascular necrosis of bone) is an entity with many causes that can occur at a variety of sites. It is a known complication of corticosteroid therapy, either alone or combined with other drugs in the treatment of malignancy. Osteonecrosis associated with chemotherapy that does not include cort...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-03-01 00:00:00
abstract::The purpose of this study was to explore the relationship between the integrity of collagen and biomechanical properties of bone. In this study, age (range, 5-26 years old) and gender related changes in cortical bone samples from 33 baboon femurs (15 males and 18 females) were examined. The percentage of denatured col...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200002000-00027
更新日期:2000-02-01 00:00:00
abstract::This study evaluated the quality and quantity of osseointegration of two thicknesses of hydroxyapatite coating on press-fit, porous-coated titanium implants in a canine hip model. In 12 dogs, titanium press-fit porous-coated prostheses were implanted. The stems had a 50-microm thickness hydroxyapatite coating, 100-mic...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200111000-00058
更新日期:2001-11-01 00:00:00
abstract::Periosteal osteosarcoma is a surface lesion without evidence of medullary involvement. This report extends the Mayo Clinic series of periosteal osteosarcoma cases from 11 to 22 cases. In a review of demographic information from our 22 cases and from 30 additional cases, referred only for pathologic diagnosis, the aver...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-06-01 00:00:00