Abstract：
:Reconstruction of massive proximal tibial defects caused by failed cemented total knee arthroplasty (TKA) was evaluated using cancellous allograft and a rigidly fixed tibial component. Twenty patients with massive tibial defects requiring revision TKA were operated on using this technique from December 1984 to December 1986. All these had tight mediolateral capsular structures so that satisfactory varus-valgus stability was achieved. Only three had competent posterior cruciate ligaments. The tibial component had a cobalt chromium tray with a six-inch-long smooth stem, porous undersurface, and peripheral smooth pegs. Fixation was augmented with four cancellous screws that passed through the periphery of the tray and penetrated the cortical surface of the tibia. Good fixation of the tibial component was achieved in all cases at the time of surgery. All patients achieved full weight bearing within six months, and all but two were free of walking aids at one year postoperation. None of the patients developed apparent loosening of the femoral or tibial components. Two patients complained of mild pain and one who had revision of a painful but nonloosened cemented TKA complained of severe pain. Range of motion was 93 degrees +/- 7.6 degrees. Roentgenographic evaluation showed progressive increase in radiodensity in the grafted areas one year after surgery in all knees. One knee was revised for recurrent dislocation one year postoperation and had a biopsy of the allografted area. This biopsy showed trabeculae with empty lacunae surrounded by viable new bone. Allograft reconstruction of the proximal tibia for failed cemented TKA was highly successful using morselized allograft and rigid fixation of the tibial component.(ABSTRACT TRUNCATED AT 250 WORDS)
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Whiteside LAsubject
Has Abstractpub_date
1989-11-01 00:00:00pages
80-6issue
248eissn
0009-921Xissn
1528-1132pub_type
杂志文章abstract：BACKGROUND:A porous Ti6Al4V implant that is manufactured using selective laser melting (SLM) has broad potential applications in the field of orthopaedic implants. The pore structure of the SLM porous Ti6Al4V implant allows for cell migration and osteogenic differentiation, which is favorable for bone ingrowth and osse...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/CORR.0000000000000954
更新日期：2019-12-01 00:00:00
abstract：BACKGROUND:Recent popularity of intramedullary nails over sliding hip screws for treatment of intertrochanteric fractures is concerning given the absence of evidence for clinical superiority for nailing yet the presence of reimbursement differences. QUESTIONS/PURPOSES:We describe the change in outcomes of both procedu...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2694-8
更新日期：2013-04-01 00:00:00
abstract：:This report is a prospective review of 450 low-friction arthroplasties (LFAs) performed by a single surgeon from 1972 to 1983 in a community hospital. The clinical results show sustained quality of the result over a maximum follow-up period of 11 years. The radiologic review shows a slight increase in the number and s...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-10-01 00:00:00
abstract：:A bolt-plate device for fixation of distal thoracic and proximal lumbar vertebral bodies has proved effective in a variety of surgical situations. The instrumentation is designed to obtain the optimum conditions for the healing of cancellous bone, namely, rigid immobilization and, if possible, close apposition of surf...
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：: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：:Delayed onset tuberculosis infection appeared in a total knee implant in a 61-year-old former coal miner. After a five-day interval the knee was salvaged by removal, aggressive debridement, suction-irrigation, and reinsertion. Antituberculosis drugs were administered immediately following surgery on the basis of the c...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1985-12-01 00:00:00
abstract：:Since World War II, the incidence of chronic low back disability has increased dramatically, at a rate disproportionate to all other health conditions. The factors that contribute to this disability are reviewed. Psychosocial and work environmental factors are far more accurate predictors of disability than physical f...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1992-06-01 00:00:00
abstract：:A 40-year-old man with a total hip arthroplasty was injured in an auto accident. The injury was a posterior fracture-dislocation of the total hip and produced migration of a dislocated acetabular prosthesis. A large hematoma extended from the hip to the medial aspect of the thigh. This unusual case illustrates the imp...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-06-01 00:00:00
abstract：BACKGROUND:After resecting tumors confined to one femoral condyle, a unicondylar osteoarticular allograft can be used for reconstruction without sacrificing the uninvolved condyle. However, unicondylar osteoarticular allografts have been associated with a high rate of joint degeneration. We describe a unicondylar osteo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2455-8
更新日期：2012-12-01 00:00:00
abstract：:Reports using the Constant-Murley score often lack details regarding how strength measurement was performed, which may have an important impact on the results obtained. A description of the measurement is especially important when patients are unable to adopt the prescribed position of 90 degrees shoulder abduction, l...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-009-1007-3
更新日期：2010-06-01 00:00:00
abstract：BACKGROUND:Total joint arthroplasty (TJA) has been identified as a procedure with substantial variations in inpatient and postacute care payments. Most studies in this area have focused primarily on the Medicare population and rarely have characterized the younger commercially insured populations. Understanding the inp...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-017-5444-0
更新日期：2017-11-01 00:00:00
abstract：:A new total knee rating system has been developed by The Knee Society to provide an up-to-date more stringent evaluation form. The system is subdivided into a knee score that rates only the knee joint itself and a functional score that rates the patient's ability to walk and climb stairs. The dual rating system elimin...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1989-11-01 00:00:00
abstract：:Increasing knowledge of instability in the shoulder has created a more complex evaluation sequence. The history continues to be important. Many physical examination maneuvers are available to further define the problem. Routine roentgenographic examination has been extended to include views specifically designed to de...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1987-10-01 00:00:00
abstract：:Intracapsular fractures of the hip have been classified by different authors with a basis on various concepts. Pauwels classified these fractures according to the angle of inclination; Linton used trabecular disposition among the fractural fragments, and Garden described four types according to the order of displaceme...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-200206000-00004
更新日期：2002-06-01 00:00:00
abstract：:During the past 30 years, the orthopaedic oncology group at the Massachusetts General Hospital has treated 648 patients with osteosarcoma centrally located in the bone. Using records maintained in a specifically designed computer system, a study was done to assess the factors that seemed to influence the survival outc...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000145991.65770.e6
更新日期：2004-12-01 00:00:00
abstract：UNLABELLED:Grade III Campanacci lesions are traditionally treated with wide resections based on their postulated aggressiveness and potential for local recurrence and metastasis. The purpose of this study was to determine if there was a difference in local recurrence rates of Grade II and III lesions treated with intra...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000180051.27961.c3
更新日期：2005-09-01 00:00:00
abstract：:Endoprosthetic proximal femur replacement is a well-accepted method for treatment of primary bone tumors; however the functional results of treatment are not well documented. To evaluate functional outcomes, we recorded the Toronto Extremity Salvage Score and Musculoskeletal Tumor Society 1987 and 1993 scores in 29 pa...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000136840.67864.78
更新日期：2004-09-01 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：:Records were reviewed for 96 patients who received distal femoral osteoarticular allografts to reconstruct femurs after wide resections of benign and malignant bone tumors. Thirteen of these were excluded from the study because of death or local recurrence. The mortality rate for all patients was 11%; for those with o...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1994-06-01 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：:The majority of patients with prosthetic joint replacement (arthroplasty) experience dramatic relief of pain and restoration of satisfactory joint function. In the United States, more than.5 million people have a primary arthroplasty each year. Less than 10% of prosthesis recipients have complications develop during t...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/01.blo.0000087324.60612.93
更新日期：2003-09-01 00:00:00
abstract：BACKGROUND:The indication for hip arthrotomy accompanied by intraarticular work during periacetabular osteotomy (PAO) has not been precisely defined. To validate a role for routine hip arthrotomy accompanied by intraarticular work, frequent intraarticular pathology must exist, and the adjunct procedures must not be ass...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2602-2
更新日期：2013-02-01 00:00:00
abstract：UNLABELLED:The success of metal-on-metal hip resurfacing in the medium term in young and active patients is becoming evident. The procedure now can be done using a minimal approach developed by the senior author using a single posterior incision. This mini-incision resurfacing arthroplasty of the hip has made resurfaci...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000192034.37049.83
更新日期：2005-12-01 00:00:00
abstract：:Several lines of evidence suggest that the insulinlike growth factors play a role in fracture healing. They promote cell proliferation and matrix synthesis by chondrocytes and osteoblasts, the two cell types largely responsible for the formation of fracture callus. Circulating levels of insulinlike growth factor I and...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-199810001-00031
更新日期：1998-10-01 00:00:00
abstract：:Spinal cord injury (SCI) results in multiple degenerative changes that may in part be related to physical inactivity. There are indications that some of these changes may be reversed by exercise and fitness training. Computerized functional electrical stimulation (FES) allows active exercise of limbs paralyzed by uppe...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-08-01 00:00:00
abstract：BACKGROUND:Bone marrow stimulation techniques in cartilage repair such as drilling are limited by the formation of fibrous to hyaline-like repair tissue. It has been suggested such techniques can be enhanced by covering the defect with scaffolds. We present an innovative approach using a polyglycolic acid (PGA)-hyaluro...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-2107-4
更新日期：2012-03-01 00:00:00
abstract：:In view of the increasing incidence of stem-type femoral component loosening, a detailed retrospective radiographic zonal analysis of 389 total hip replacements indicated a 19.5% incidence (76 hips) of radiological evidences of mechanical looseness, i.e., fractured acrylic cement and/or a radiolucent gap at the stem-c...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1979-06-01 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：:High variability in the time required for patients to have substantial pain relief after Neer-type subacromial impingement tests might help explain conflicting data regarding their effectiveness in guiding treatment and predicting surgical outcomes. To focus on quantifying temporal variability associated with a modifi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/BLO.0b013e31804a8581
更新日期：2007-07-01 00:00:00
abstract：:Posterior interosseous nerve palsy can occur following a Monteggia fracture by a variety of mechanisms. In this case report of a 35-year-old man the nerve became wrapped around an anterolaterally dislocated radial head in the course of an unsuccessful attempt as closed reduction. Cadaveric dissections demonstrated how...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1977-01-01 00:00:00
