Abstract:
:Twenty consecutive cases of infected total knee replacements surgically treated between 1990 and 1993 in which complete clinical and financial data were available were reviewed to determine the resources required of the hospital and the surgeon. These results were compared with a similar analysis of a stratified, unselected sample 30 cases each of primary total knee arthroplasty and nonseptic revision total knee arthroplasty during the same period. Parameters compared between the infected total knee replacement, noninfected revision total knee replacement, and primary total knee replacement included number of surgical procedures performed, number of hospitalizations, number of hospital days, total operative time, and total intraoperative blood loss. Financial data included the amount charged and reimbursed by the hospital and by the surgeon. The actual hospital cost was estimated as well. Based on all parameters measured, surgical treatment of the infected total knee implant required 3 to 4 times the resources of the hospital and the surgeon compared with a primary total knee implant and approximately twice the resources of a nonseptic revision total knee implant. The reimbursement received resulted in an estimated net loss of approximately $15,000 per case to the hospital for the group as a whole, but approximately $30,000 per case per Medicare patient.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Hebert CK,Williams RE,Levy RS,Barrack RLdoi
10.1097/00003086-199610000-00019subject
Has Abstractpub_date
1996-10-01 00:00:00pages
140-5issue
331eissn
0009-921Xissn
1528-1132pub_type
杂志文章abstract::Elbow dislocations are relatively uncommon in children. Rupture of the brachial artery associated with closed elbow dislocations in children is rare. This is a report of an 8-year-old boy, the youngest patient ever to be reported to have a closed posterior dislocation of the elbow associated with a brachial artery lac...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-11-01 00:00:00
abstract::Symptomatic (Stage II) impingement of the rotator cuff against the coracoacromial arch has been treated with anterior acromioplasty in 60 shoulders in 56 patients. Patient selection is crucial. Arthrography of the shoulder was routinely included in the preoperative diagnostic tools to rule out a tear of the rotator cu...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00
abstract::A series of 205 pediatric patients affected by osteosarcoma, Ewing's sarcoma, fibrosarcoma, and malignant fibrous histiocytoma of bone were treated from 1978 to 1988. Ninety-eight percent of the patients received chemotherapy and 63% had a surgical resection. Sixty-five percent of all patients were alive at 30 months ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1991-03-01 00:00:00
abstract::Three patients with osteonecrosis of the femoral head in whom the extent of necrosis increased by repeated episodes of osteonecrosis are described. In all cases the evidence of two attacks of osteonecrosis was detected clearly on magnetic resonance images. The significance of the recurrent attacks of osteonecrosis is ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000037441.23683.ee
更新日期:2003-01-01 00:00:00
abstract::Experience with cementless fixation over the last six years indicates that the technique offers greater opportunities for bone conservation. Thus, when cement is used, and especially if it is forced into the skeleton under pressure, the amount of bone incorporated into the implant is considerable. Conversely, if no ce...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::The goal of subtotal arthrodesis of the wrist is to provide a stable and pain-free joint, with preservation of a limited but useful range of motion. Experience indicates that the available mobility of the joints that are left unfused tends to increase with time and use of the extremity, and that accelerated wear of th...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1984-07-01 00:00:00
abstract::Dissociation of the polyethylene liner from its metal shell has been reported as a rare occurrence. During a 4-year period, six hips in five patients who had the Harris-Galante II porous acetabular component implanted as part of a primary or revision total hip arthroplasty presented with acute onset of pain and diffic...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200105000-00021
更新日期:2001-05-01 00:00:00
abstract::External fixation is the treatment of choice for fractures of the leg involving severe damage to the soft tissue. Each of the various patterns of application has advantages and disadvantages. Based on various biomechanical studies and clinical experience, the authors use a right-angle arrangement for the screws. If th...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-09-01 00:00:00
abstract::The formation of heterotopic bone within soft connective tissue is a common feature of at least three distinct genetic disorders of osteogenesis in humans: fibrodysplasia ossificans progressiva; progressive osseous heteroplasia; and Albright hereditary osteodystrophy. The pathobiologic characteristics of osteogenic in...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/00003086-200005000-00028
更新日期:2000-05-01 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::The osteopenia associated with advanced age appears to be a universal phenomenon in humans and animals, but the mechanisms by which it occurs are understood incompletely. However, the explanation must lie in an absolute or relative diminution in the level of osteoblastic bone-forming activity when compared with osteoc...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1995-04-01 00:00:00
abstract:UNLABELLED:Information regarding national trends in bilateral TKAs is needed for a rational allocation of resources, policy making, and research. Therefore, we analyzed data from the National Hospital Discharge Survey to elucidate temporal changes in the demographics, comorbidity profiles, hospital stay, and in-hospita...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-008-0610-z
更新日期:2009-06-01 00:00:00
abstract::Comprehension of the hypermobile flatfoot deformity depends on an understanding of the three structural deformities of the foot associated with the condition: (1) abduction of the forefoot relative to the weight-bearing line; (2) supination of the forefoot; and (3) heel valgus. Evaluation of the hypermobile flatfoot d...
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:BACKGROUND:While acetabular structural allografts provide an important alternative for reconstructions, concerns remain with long-term graft resorption, collapse, and failure. Midterm studies of minor column (shelf) allograft suggest reasonable survival but long-term survival is unknown. QUESTIONS/PURPOSES:We therefor...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1591-2
更新日期:2010-12-01 00:00:00
abstract::Twenty knee dislocations in 19 patients (one bilateral) occurred over a period of 20 years. The age range was 21 to 65 years, with an average age of 40.8 years. There were two popliteal artery and eight peroneal nerve injuries in the group. All patients were managed by early closed reduction at the scene of the accide...
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::Between 1977 and 1982, 19 cases of congenital dislocation of the hip (CDH) were encountered in black infants. Six of these cases were associated with other anomalies (atypical CDH); 13 were typical CDH. The incidence of complete CDH in the white population studied is 1.5/1000; in the black population studied it is 0.4...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::Anterior approaches to the ulna were studied on 22 cadaveric forearms as alternative approaches to the ulnar shaft. An anterior approach is indicated when there is extensive posterior scar tissue, or extensive soft tissue loss in the posterior forearm as in some fresh fractures, or when a tumor is resected from the an...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1995-09-01 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::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::The precise nature of the motion of the knee during a pivot shift is of interest when types of knee instability are correlated with specific injuries. Ten subjects with anterior cruciate ligament injuries and demonstrable pivot shift instabilities were examined with a triaxial electrogoniometer to detect angular motio...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1984-03-01 00:00:00
abstract::Hip fractures are common injuries in the elderly and are associated with considerable morbidity and mortality. Although technical advances in the treatment of the elderly have resulted in improved fracture fixation and surgical outcomes, clinical pathways have been developed to further improve patient outcome while sh...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000132266.59787.d2
更新日期:2004-08-01 00:00:00
abstract::Habitual dislocation of the hip occurred in a nine-year-old girl. The nomenclature of the literature on this disorder and other related conditions is confusing. The following simple classification is therefore proposed: (1) recurrent dislocation (posttraumatic, nonvoluntary); (2) voluntary dislocation (nonhabitual, as...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-05-01 00:00:00
abstract:BACKGROUND:Open reduction and stabilization of dorsal pelvic ring injuries is accompanied by a high rate of soft tissue complications. Minimally invasive techniques have the potential to decrease soft tissue trauma, but the risk of iatrogenic nerve and vessel damage through the reduced surgical exposure should be consi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-1922-y
更新日期:2011-11-01 00:00:00
abstract::In Greece, despite efforts toward early diagnosis of congenital dislocation of the hip (CDH) during the last 20 years, treatment of 75% of infants so diagnosed has not been begun until they are 2 to 9 months of age, with an average treatment onset age of 4.6 months. Five hundred eighty-seven infants (947 hips) two to ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1989-09-01 00:00:00
abstract::This study evaluates the role of magnetic resonance imaging in assessing the factors affecting the rate and healing time in scaphoid nonunions after surgery. Nineteen patients were assessed before surgery by radiographs, tomography, and magnetic resonance imaging. Fifteen had viable bone marrow and 4 patients had nonv...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199703000-00032
更新日期:1997-03-01 00:00:00
abstract::Sixteen patients (mean age, 31.6 years) whose elbow flexor power was absent or inadequate were treated with the following muscle transfer procedures: (1) bipolar pectoralis major transfer in five, (2) unipolar or bipolar latissimus dorsi transfer in five, (3) free latissimus dorsi transfer in three, and (4) triceps-to...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1989-08-01 00:00:00
abstract::Tension is necessary to maintain and restore the mechanical properties of soft connective tissues. Conversely, reduced tension states such as produced by immobilization weaken mechanical properties and facilitate joint contracture. We assessed the effect of low torque-long duration stretching to increase the range of ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/BLO.0b013e31803212bf
更新日期:2007-03-01 00:00:00
abstract::Chronic osteomyelitis has been a difficult problem for patients and the treating physicians. Appropriate antibiotic therapy is necessary to arrest osteomyelitis along with adequate surgical therapy. Factors involved in choosing the appropriate antibiotic(s) include infection type, infecting organism, sensitivity resul...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/00003086-199903000-00008
更新日期:1999-03-01 00:00:00
abstract::The geometric total knee prosthesis was used in the reconstruction of 70 damaged knee joints in 56 patients from November 1973 through March 1979. The average follow-up period extended to six years and seven months. Eleven patients had died and four could not be located. Eighty-one percent of the remaining knees had l...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract::Several new imaging modalities have been found useful in clinical evaluation of patients with rheumatoid arthritis (RA). Magnetic resonance (MR) imaging has proven to be an excellent noninvasive method to evaluate the spine, shoulder, hip, and knees; its use for the evaluation of smaller joints is still being investig...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1991-04-01 00:00:00