Abstract：
:To update the status of chymopapain in the treatment of herniated intervertebral discs, a review of the current literature and data from an unpublished Texas study are presented. Studies in animals and humans have consistently demonstrated that chymopapain can dissolve the nucleus pulposus. Twenty-eight uncontrolled and unblinded clinical trials involving 2845 patients showed a positive response rate of 75%. Side effects occurred in 2.4% of chymopapain-treated patients. Anaphylaxis, the most serious adverse reaction associated with chemonucleolysis, was noted in less than 1% of patients. No deaths were reported. The first double-blind, placebo-controlled study of chymopapain in the United States demonstrated no significant efficacy, but both the design and execution of the study have been criticized. Two recent double-blind, placebo-controlled studies showed success rates of 73% and 80% for chymopapain, significantly higher than for placebo treatment. Postinjection back pain and muscle spasm were the most common side effects related to chymopapain administration in one of the trials. In the uncontrolled Texas study the success rate in 408 patients treated by chymopapain was 93%. Chemonucleolysis has achieved a success rate comparable with that of surgery in the treatment of symptomatic herniated discs. Appropriate use of chymopapain can result in substantial savings in time and hospital costs.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Simmons JW,Stavinoha WB,Knodel LCsubject
Has Abstractpub_date
1984-03-01 00:00:00pages
51-60issue
183eissn
0009-921Xissn
1528-1132pub_type
临床试验,杂志文章,评审abstract：BACKGROUND:The navigation system was introduced to orthopaedic surgery in the 1990s. More recently, CT-based navigation systems have been used more commonly in spine and joint replacement surgery because of their precision. QUESTIONS/PURPOSES:The aim of our study was to evaluate the accuracy and efficacy of navigation...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-2094-5
更新日期：2012-01-01 00:00:00
abstract：:Preventive measures in orthopedic surgery are best accomplished by full knowledge of potential complications, thoughtful preoperative planning, the careful and precise execution of the operative procedure, meticulous hemostasis, and the implementation of appropriate measures in the postoperative period. ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1987-09-01 00:00:00
abstract：:The wear particles of cobalt chrome alloy and titanium alloy have been implicated as a cause of aseptic loosening of prostheses. It is thought that their ability to induce either cell death or the release of mediators that induce bone resorption contributes to this loosening. This study was designed to test the hypoth...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199602000-00045
更新日期：1996-02-01 00:00:00
abstract：:Patients with shoulder arthritis present to the orthopedic surgeon due to joint pain and loss of shoulder motion. A differential diagnosis is established, based on the history and physical examination and selected laboratory tests and roentgenograms. Synovial fluid analysis is often very helpful in the diagnosis of sh...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-03-01 00:00:00
abstract：:Marlex mesh is a synthetic material which has been used clinically to replace ligamentous structures. It serves as a scaffold for infiltration of the fibroblasts eventually becoming mature fibrocytes. In dogs, almost totally mature fibrocytes appear within the framework of the Marlex mesh prosthesis by the end of 3 mo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-11-01 00:00:00
abstract：:Exogenous steroids are known to induce aseptic necrosis in the femoral head of adults. This case report of a 9-year-old girl with corticosteroid induced femoral head necrosis demonstrates effective treatment with an abduction device in a manner similar to that prescribed for the treatment of Legg-Calve-Perthes disease...
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：:Minimizing the surgical approach in treating patients with spinal infections by using local antibiotic treatment and avoiding a ventral approach reduces the anesthesia and surgical risks in patients with comorbidities. In this study we used calcium sulphate pellets (OsteoSet T and the OsteoSet Bone-void Filler kit) as...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000182247.37454.fb
更新日期：2005-10-01 00:00:00
abstract：:The existence of a specific inorganic pyrophosphatase (PPi ase), distinct from alkaline phosphatase in bone has been suggested but is often regarded as questionable. In the present investigation, several features of PPi ase activity have been demonstrated, which suggest that it represents an enzyme protein different f...
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：:Axillary nerve injury remains the most common peripheral nerve injury to affect the shoulder. It most often is seen after glenohumeral joint dislocation, proximal humerus fracture, or a direct blow to the deltoid muscle. Compression neuropathy has been reported to occur in the quadrilateral space syndrome, although th...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1999-11-01 00:00:00
abstract：:Ectopic bone formation (EBF) is a well-known complication of total hip arthroplasty (THA). The etiology and pathogenesis are still obscure. An analysis of 119 consecutive patients with 129 primary THAs was performed to identify factors predisposing to ectopic bone formation, its frequency, and its effect on the result...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-03-01 00:00:00
abstract：:The repair of full thickness rotator cuff tears traditionally has included acromioplasty and coracoacromial ligament section. Acromioplasty can be complicated by deltoid detachment, compromise of the deltoid lever arm, anterosuperior instability, and adhesions of the rotator cuff tendons under the bleeding cancellous ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-200109000-00017
更新日期：2001-09-01 00:00:00
abstract：:Ankle arthrodesis treated by external fixation frequently results in complications from pin tract infections, loss of position, nonunion, and malunion. A method of ankle arthrodesis using 6.5-mm cancellous screws as the primary fixation hardware was developed. The most important screw is placed from the posterior mall...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1991-07-01 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
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:Decision-making regarding nonoperative versus operative treatment of patients with thoracolumbar burst fractures in the absence of neurologic deficits is controversial. Lack of evidence-based practice may result in patients being treated inappropriately and being exposed to unnecessary adverse consequences. ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,meta分析,评审
doi：10.1007/s11999-011-2157-7
更新日期：2012-02-01 00:00:00
abstract：UNLABELLED:Flexion instability after cruciate-retaining total knee arthroplasty has been well documented. We identified an analogous patient group with symptomatic flexion instability without dislocation after primary posterior stabilized total knee arthroplasty. We sought to determine the typical symptoms and exam fin...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200511000-00018
更新日期：2005-11-01 00:00:00
abstract：UNLABELLED:THA in young patients is challenging regarding restoration and survival because patients are young, active, and tend to have disturbed anatomy. We asked whether a three-dimensional custom cementless stem could restore hip function, decrease osteolysis and wear, and enhance stem survival in young patients. We...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-009-1045-x
更新日期：2010-03-01 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：:The osseous tunnel technique of anterior cruciate ligament (ACL) reconstruction was compared to the over-the-top (OTT) technique in vivo. A prosthesis replaced the ACL in 35 dogs by one of three methods: double osseous tunnels, OTT, or a combined method utilizing the unique Y shape of the prosthesis by placing one for...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-06-01 00:00:00
abstract：:While the entity of nonsecretory myeloma is rare, its diagnosis may be delayed or remain undetected if too much reliance is placed on the presence of a serum or urinary M component, which traditionally has been considered an important, if not essential, feature of plasma cell myelomatosis. Nonsecretory myeloma is char...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1982-11-01 00:00:00
abstract：:Many situations in revision THA require the exchange of a PE liner in the setting of a well-fixed cementless acetabular shell. Unfortunately, a replacement liner is not always available, the locking mechanism of the metal shell may be damaged or incompatible with the desired liner, or the shell is malpositioned. Revis...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/01.blo.0000096805.78689.8b
更新日期：2003-12-01 00:00:00
abstract：:Twenty patients underwent operative arthroscopic procedures of the hip joint. All procedures were performed with the patient in the supine position on a standard fracture table using fluoroscopy through three arthroscopic portals (anterolateral, anterior paratrochanteric, and posterior paratrochanteric). The initial i...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199808000-00018
更新日期：1998-08-01 00:00:00
abstract：BACKGROUND:The lower limb osteometry of Chinese differs from that of whites. The joint line of the knee in the coronal plane in Chinese is more medially inclined and the posterior condylar angle of the distal femur in the axial plane is larger. However, it is unclear whether there is any direct association between the ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2698-4
更新日期：2013-05-01 00:00:00
abstract：:The purpose of the current investigation was to present a standard method by which an orthopaedic practice can analyze its practice expenses. To accomplish this, a five-step process was developed to analyze practice expenses using a modified version of activity-based costing. In this method, general ledger expenses we...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200003000-00033
更新日期：2000-03-01 00:00:00
abstract：:Kinematic and kinetic parameters of gait have a significant dependency on subject age and walking velocity. Hip flexion-extension, stride length, hip resultant force, hip resultant moment, and hip contact force all increase with increasing velocity. All of these parameters except hip resultant force are significantly ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-05-01 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：:Despite the implication that mechanical overload is fundamental to the development of plantar fasciitis, gait analysis has revealed inconsistent findings regarding its effect on lower limb loading. The aim of the current study was to evaluate the regional vertical ground reaction force in patients with and without pla...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000057989.41099.d8
更新日期：2003-04-01 00:00:00
abstract：BACKGROUND:Although navigated THA provides improved precision in implant positioning and alignment, it is unclear whether these translate into long-term implant survival. QUESTIONS/PURPOSES:We compared survivorship, dislocation rate, and incidence of radiographic failures such as loosening and bearing breakage after T...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2378-4
更新日期：2012-11-01 00:00:00
abstract：:In a search for factors predisposing to the occurrence of spontaneous fractures in the renal organ transplant patient, a comparison has been made of 38 recipients sustaining spontaneous fractures and 106 without this complication. The comparison was made with regard to the clinical findings, the immunosuppressive ther...
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：:Canes may be used to reduce hip pain by reducing the joint contact force. Previous estimates suggest that this force could be reduced to 17-26% of normal. We have calculated 3-dimensional hip contact forces during gait in 4 groups: normals, preoperative hip patients walking without a cane, preoperative hip patients wa...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1980-03-01 00:00:00
