Abstract:
:Mineralization processes in the body are controlled by physicochemical and cellular regulation of hydroxyapatite (HA) nucleators and inhibitors. The chemical mechanism of action of HA inhibitors has been studied in vitro using solution pH-stat techniques or Types I and II collagen gel diffusion systems. Three biologically relevant systems are used with these methodologies: (1) transformation of amorphous calcium phosphate (ACP) to crystalline HA; (2) direct formation of HA; and (3) growth of HA crystals. Several different mechanisms have been identified for HA inhibition. Condensed phosphates (containing P-O-P linkages) and diphosphonates (containing P-C-P linkages) bind strongly to the surface of forming HA nuclei and crystals and poison growth sites at concentrations as low as 10(-6) M, blocking HA formation. From this in vitro work, diphosphonates have been developed for the treatment of Paget's disease. Proteoglycans, found in cartilage, delay HA formation by a steric effect whereby large volumes of solution become unavailable for HA formation and growth as these enormous macromolecules tumble about. Mg ions enter the structure of forming HA nuclei by replacing Ca, resulting in a distorted atomic structure that slows subsequent growth to HA. Al ions delay HA formation, not by entering the structure of forming HA nuclei, but by adsorbing on the surface of growing HA crystals. Serum proteins slow the transformation of ACP to HA by adsorbing on the ACP surface, which decreases its dissolution rate. Metal-citrate complexes can inhibit HA formation and growth at concentrations as low as 10(-5) to 10(-6) M. Phosphorylated molecules such as acidic proline-rich phosphoproteins and statherins found in saliva suppress HA crystal growth on tooth surfaces by adsorbing on active surface sites. Future research in this field lies in the study of interactions of HA inhibitors found together in calcifying tissues.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Blumenthal NCsubject
Has Abstractpub_date
1989-10-01 00:00:00pages
279-89issue
247eissn
0009-921Xissn
1528-1132pub_type
杂志文章,评审abstract::Thirty revisions were performed on loose total hip replacements with a specific acetabular reconstruction technique combining the use of a bovine bone substitute and a support ring. One patient died of a cause unrelated to the procedure. No migration of the acetabular implant or bone lysis of the heterograft was seen ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199609000-00013
更新日期:1996-09-01 00:00:00
abstract::Eleven patients with a previous patellectomy and primary total knee arthroplasty (TKA) had chart reviews, recent clinical examinations, evaluation of roentgenograms, rating of knee arthroplasty on a standard scale, and quantitation of quadriceps and hamstring torque using an isokinetic dynamometer. Good to excellent r...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-10-01 00:00:00
abstract::The burgeoning of major research related to the effectiveness and appropriateness of clinical treatment methods as part of efforts to improve the quality of patient care provides added emphasis to consumer needs for certification and recertification. While there are multiple factors involved, the prime consumer questi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1990-08-01 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: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
abstract:BACKGROUND:Chronic exertional compartment syndrome is diagnosed based on symptoms and elevated intramuscular pressure and often is treated with fasciotomy. However, what contributes to the increased intramuscular pressure remains unknown. QUESTIONS/PURPOSES:We investigated whether the stiffness or thickness of the mus...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-2073-x
更新日期:2011-12-01 00:00:00
abstract::Placement of a Steinmann pin in the calcaneus is indicated in various orthopaedic conditions. Planning the point of entry and the direction of transcalcaneal pin insertion is crucial for avoidance of neurovascular injury, tendon injury, and subtalar joint violation. Fifteen cadaveric feet were studied in which transfi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199611000-00033
更新日期:1996-11-01 00:00:00
abstract::With the resurgence of metal-on-metal bearings, there is renewed interest in total hip resurfacing. A cementless acetabular component used for resurfacing with a wall thickness of fewer than 5 mm is comparable in size to acetabular components used for total hip replacement. The fixation of a porous-ingrowth acetabular...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/01.blo.0000150319.35347.2d
更新日期:2004-12-01 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::Indwelling prosthetic joints may become colonized by microbial biofilms, although the biofilm structure, composition of the microbial community, and physiologic activity of the organisms in these devices are not well understood. New approaches that rely on the use of fluorescent stain technology can be used to charact...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/01.blo.0000175120.66051.29
更新日期:2005-08-01 00:00:00
abstract::Chronic extensor mechanism ruptures are uncommon but challenging clinical problems. Previously published procedures for treating chronic extensor mechanism ruptures assume an intact patella is available to anchor the repair. A case is presented of a patient who had a previous patellectomy, followed by rupture of the e...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199812000-00018
更新日期:1998-12-01 00:00:00
abstract::With the use of a stereoscopic microscope, observations were made on the course of the proper digital nerve of the thumb on ten upper limbs in adult cadavers. By observation from the dorsal side after removal of the bone, it was possible to clearly see the ramification of the digital nerve from the subcutaneous tissue...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1985-09-01 00:00:00
abstract::There are numerous newer techniques that have been developed for the internal fixation of the cervical spine in recent years. Wiring techniques are still appropriate for posterior stabilization of the cervical spine. The halo vest is still widely used for the conservative management of cervical fractures and for posto...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1997-02-01 00:00:00
abstract::This biographical sketch on Themistocles Gluck corresponds to the historic text, The Classic: Report on the positive results obtained by the modern surgical experiment regarding the suture and replacement of defects of superior tissue, as well as the utilization of re-absorbable and living tamponade in surgery (1891),...
journal_title:Clinical orthopaedics and related research
pub_type: 传,历史文章
doi:10.1007/s11999-011-1836-8
更新日期:2011-06-01 00:00:00
abstract::Removal of broken femoral stems continues to be a difficult technical procedure in hip replacement surgery, despite the development of metal drilling devices and special extractors placed into the drill hole. The window technique for the removal of broken femoral stems is technically easier than the metal drilling tec...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-11-01 00:00:00
abstract::Roentgenographic analysis showed that centrifugation significantly reduced the gross and regional porosity of the cement compared with hand-mixed controls in a simulated total hip arthroplasty model. Static failure test of the prosthetic system demonstrated that the centrifuged cement had significantly greater strengt...
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::Lyophilized radiation-sterilized bone graft operations were analyzed according to 27 variables in 1014 patients with two-year follow-up results. In 91.3% of patients, the result of treatment was "very good" (full-health restoration) or "satisfactory" (restoration with some small disorders). In 5.1%, the results were u...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1991-11-01 00:00:00
abstract::Pulled elbow and hypermobility of joints are frequently seen in young children, the latter occurring in 5% of the general population. A group of 100 children with pulled elbows, composed of 64 girls and 36 boys with a mean age of 25.5 months, and their parents were checked for joint hypermobility in a prospective stud...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1990-08-01 00:00:00
abstract::Rheumatoid arthritis frequently involves the hindfoot. It may produce a proliferative synovial hypertrophy around the tendons and a gradual destruction of the joints. Unfortunately, this part of the foot frequently is overlooked when caring for these patients who often have multiple areas of involvement giving pain an...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199707000-00009
更新日期:1997-07-01 00:00:00
abstract::Despite the high level of survivorship of cemented and uncemented stemmed components, there is a need for a joint prosthesis that does not invade the femoral canal. This type of prosthesis would be useful in treating younger and more active patients, in whom the use of such a design would usefully prolong the time bef...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200512000-00047
更新日期:2005-12-01 00:00:00
abstract::Various guidelines have been proposed regarding which portions of a surgical gown may be considered sterile. Unfortunately, the validity of these recommendations has not been definitively established. We therefore evaluated gown sterility after major spinal surgery to assess the legitimacy of these guidelines. We used...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-008-0341-1
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:The elbow is more susceptible to loss of motion after trauma than any other joint. Open arthrolysis often is performed for posttraumatic elbow stiffness if the stiffness does not improve with nonsurgical treatment, but the midterm results of this procedure and factors that may limit recovery have not been wi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/CORR.0000000000000726
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:The incidence of acetabular fractures in osteoporotic patients is increasing. Immediate total hip arthroplasty (THA) has potential advantages, but achieving acetabular component stability is challenging and, at early followup, reported revision rates for loosening are high. QUESTIONS/PURPOSES:This study mea...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-015-4460-1
更新日期:2015-12-01 00:00:00
abstract::Abduction contracture of the hip (frog-leg deformity) is caused by contracture of the gluteus maximus muscle. A simple operation consisting of complete detachment of involved fibrous portions of the gluteus maximus from the greater trochanter to the ischial tuberosity is sufficient to release the contracture and enabl...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1982-01-01 00:00:00
abstract::Osteoid osteoma seems to have been reported only twice before in a Negro child. The lesion is also unusual in the ulna. Treatment by en bloc resection bone graft of a large surgical defect was successful. ...
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:Multiple studies have reported favorable short-term results after treatment of spondylolisthesis and other degenerative lumbar diseases with minimally invasive transforaminal lumbar interbody fusion. However, to our knowledge, results at a minimum of 5 years have not been reported. QUESTIONS/PURPOSES:We det...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-013-3241-y
更新日期:2014-06-01 00:00:00
abstract::The increasing number of hip and knee arthroplasties implies a greater likelihood of periprosthetic fractures and need for successful treatment options. We asked whether in situ effective lengthening of the indwelling prosthesis by a custom-made slotted hollow intramedullary nail provided a reasonable alternative to t...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/BLO.0b013e3181468b20
更新日期:2007-10-01 00:00:00
abstract::Giant sacral schwannomas (GSS) are extremely rare. Complete resection of benign but neurologically devastating tumors has been recommended. A 48-year-old man with GSS had a tumor so large that a total sacrectomy was necessary. A special method of lumbar iliac fixation was devised. Two years and nine months after surge...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-09-01 00:00:00
abstract::A screw-shaped titanium chamber has been designed for serial in vivo observations of the bone-implant interface. First, the chamber is implanted; later a test substance, e.g. bone cement, is inserted in the chamber and brought in contact with the bone with minimal trauma. Both acute and long-term effects can be intrav...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1981-09-01 00:00:00
abstract::The percentage of necrosis in a primary osteosarcoma after the patient has received preoperative chemotherapy is prognostic and is usually used to select subsequent chemotherapy. However, the percentage of necrosis that occurs spontaneously, without preoperative chemotherapy, has not been adequately studied. The exami...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1991-02-01 00:00:00