Abstract：
:A cross sectional study was performed to try to identify various demographic and radiologic risk factors for disease progression in 50 patients (79 hips) with corticosteroid associated osteonecrosis of the femoral head who had a core decompression. Thirty-one of the hips were in 18 patients who had systemic lupus erythematosus and were compared with the remaining group of 48 hips in 32 patients who were taking corticosteroids for other reasons. All patients in the study had been taking greater than 30 mg of prednisone for at least 2 weeks at least 6 months before the onset of osteonecrosis. Patients underwent a core decompression and were then observed for an average of 12 years (range, 4-18 years). Overall, 42 of the 79 hips (53%) had satisfactory outcomes. Of the 31 hips in patients with systemic lupus erythematosus, 21 (68%) were converted to a total hip replacement. In the patients without systemic lupus erythematosus taking corticosteroids, 16 of 48 hips (33%) progressed to arthroplasty. A subset of 25 hips from each group (systemic lupus erythematosus and without systemic lupus erythematosus) were matched for age, gender, prednisone dose, Ficat and Arlet Stage, and length of followup. The matched group without systemic lupus erythematosus had 44% survival (11 of 25 hips), which was not statistically different when compared with the 36% survival (9 of 25 hips) found in the systemic lupus erythematosus group. The major risk factors for disease progression were late stage of disease (Stage III) at presentation and radiographic extent of the lesion (>200 degrees), regardless of diagnosis. None of the factors that have been found to be associated with osteonecrosis in patients with systemic lupus erythematosus could be associated with disease progression. Because cause seems to be less significant than the onset and extent of the disease, the clinician should make the diagnosis of osteonecrosis as promptly as possible so that treatment can be started at the earliest possible time, when it will be most efficacious.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Mont MA,Fairbank AC,Petri M,Hungerford DSsubject
Has Abstractpub_date
1997-01-01 00:00:00pages
91-7issue
334eissn
0009-921Xissn
1528-1132pub_type
杂志文章abstract：:Osteoarthropathy in congenital sensory neuropathy with anhidrosis (CSNA) is not only a rare complication but also difficult to treat. Two patients with CSNA, a three-year-old boy and a 24-year-old woman, were treated as follows. The boy was affected in his left knee and left heel and required reduction of recurrent bi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1990-09-01 00:00:00
abstract：:A cementless porous-coated femoral prosthesis with a long stem was implanted in seven patients who had untreated comminuted unstable intertrochanteric fractures of the femur associated with a posterior dislocation of the femoral head. The average age of the patients was 35 years (range, 25-52 years). The length of fol...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-04-01 00:00:00
abstract：:A study of the injury fatality rate in an adult population was done in the Moscow region. Investigators determined that side by side with the severity of injury, the direct causes of death were erroneous diagnosis, ungrounded delay of surgical interventions, and lack of and insufficient use of necessary medical care. ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1995-11-01 00:00:00
abstract：:Regan and Morrey proposed a 3-type coronoid fracture classification observing that the incidence of concommitant elbow dislocation was proportional to fragment size. Elbow instability associated with coronoid fractures presumably is related to disrupted bony architecture and ineffective stabilizers attached to the fre...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1995-11-01 00:00:00
abstract：:Ninety-one cases of histologically confirmed osteoid osteoma were collected during an 11-year period; of them, seven (7.6%) had onset of symptoms while younger than five years of age. Special diagnostic difficulties were found in this specific age group: most cases were misdiagnosed or diagnosed incorrectly. The time ...
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：BACKGROUND:While the primary objective of joint arthroplasty is to improve patient quality of life, pain, and function, younger active patients often demand a return to higher function that includes sporting activity. Knowledge of rates and predictors of return to sports will help inform expectations in patients antici...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-2198-y
更新日期：2012-02-01 00:00:00
abstract：BACKGROUND:The literature suggests that a cemented long-stem femoral arthroplasty is associated with increased intraoperative and perioperative risks. Embolic events may precipitate cardiopulmonary complications and even death; by contrast, others have reported that the use of a cemented long-stem femoral arthroplasty ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-013-3113-5
更新日期：2013-10-01 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 results of two-stage flexor tendon reconstruction in the hand, evaluated in 25 fingers in 20 patients with an average followup of 5 months, were graded on the basis of total range of active flexion and combined extension loss. Two-stage flexor tendon reconstruction can significantly improve the functional status o...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-03-01 00:00:00
abstract：BACKGROUND:The ideal pedicle entry point for the thoracic spine is described as the base of the superior facet at the junction of the lateral and middle thirds of the pedicle. Investigators have reported its accuracy in curves less than 90 degrees . QUESTIONS/PURPOSES:Our aim was to measure the accuracy of this entry ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-010-1280-1
更新日期：2010-07-01 00:00:00
abstract：:The objective of this study was to evaluate the effect of muscle force and the posterior cruciate ligament on screw home motion in patients with total knee replacement in a posterior cruciate ligament retaining prosthesis (10 knees) and a posterior cruciate ligament substituting prosthesis (10 knees). Screw home motio...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1999-01-01 00:00:00
abstract：:Based on the follow-up evaluation of 350 patients in whom lumbar disc herniation was treated by anterior discectomy and interbody fusion from 1955 to 1982, 94.3% of the patients obtained bony union and justified the principle of interbody stabilization of the spine. The normalization of the myelographic pattern observ...
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：BACKGROUND:To prevent symptomatic heterotopic ossification (HO) and guide primary prophylaxis in patients with combat wounds, physicians require risk stratification methods that can be used early in the postinjury period. There are no validated models to help guide clinicians in the treatment for this common and potent...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-015-4302-1
更新日期：2015-09-01 00:00:00
abstract：:Recurrent traumatic anterior shoulder dislocation results in soft tissues lesions around the glenohumeral joint. The subscapularis muscle is a major active stabilizer of the shoulder and the hypothesis of the current study is that one would expect pathologic changes within its substance secondary to the trauma. A hist...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：2002-05-01 00:00:00
abstract：BACKGROUND:Fracture-dislocations of the proximal interphalangeal joint are vexing because subluxation and articular damage can lead to arthrosis and the treatments are imperfect. Ideally, a surgeon could advise a patient, based on radiographs, when the risk of problems merits operative intervention, but it is unclear i...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-015-4394-7
更新日期：2015-12-01 00:00:00
abstract：:The ability to forecast the course and outcome of severe mechanical trauma would aid clinicians in making decisions concerning the treatment of patients. Multifactorial regression models, developed from data obtained from 933 patients with polytrauma and shock, have a high predictive value. A two-part data sheet was d...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1991-05-01 00:00:00
abstract：:The mechanism of injury and long-term effects in three cases suggest that a specific type of intercondylar injury of the femur, i.e., cleavage fracture, is caused by force transmitted through the patella. Treatment is conservative. The fracture does not appear to have been mentioned previously in the English literatur...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1981-10-01 00:00:00
abstract：:The goals of treatment for patients with metastatic disease are control of pain and maintenance of function. Prosthetic arthroplasty is a useful technique for selected indications. Specific indications include (1) reconstruction of large destructive areas that are not amenable to internal fixation, (2) salvage of fail...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1995-03-01 00:00:00
abstract：:Morphologic changes observed in osteoarthritis include cartilage erosion and a variable degree of synovial inflammation. Proinflammatory cytokines such as interleukin-1 beta, locally produced by the inflamed synovium, also likely contribute to these alterations. Despite an extensive armamentarium and numerous surgical...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：2000-10-01 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：:Fourteen knees were studied by a method called spatial location, to determine the contact and load-bearing areas between the femur and the upper tibia in non-loaded and loaded conditions, at various angles of flexion. Under no load, contact occurred primarily on the menisci; the lateral aspects contacted at 0 degrees...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-197506000-00027
更新日期：1975-01-01 00:00:00
abstract：:Monosegmental cervical spondylosis with radiculopathy requiring operative intervention responds well to anterior disc excision and fusion with autograft. However, there is a 20% to 25% morbidity from the donor site. Several new surgical techniques using biomechanical spacers or internal fixation have been developed th...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-199902000-00008
更新日期：1999-02-01 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：:Isometric elbow strength was measured with torque cell dynamometers in a group of 104 normal subjects. Their mean age was 43 years (range, 21-79 years). Test functions included elbow flexion and extension, forearm pronation and supination, and grip. In general, the men were twice as strong as the women, and the domina...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1987-09-01 00:00:00
abstract：:The effect of chymopapain injection was investigated in myelographically confirmed intervertebral disc herniation in 268 patients after ten years. Mean age is 39.4 years, 178 males and 90 females. Sixty-two patients had compensation or litigation and 12 had prior lumbar spine surgery. Discography was performed in 223 ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-05-01 00:00:00
abstract：UNLABELLED:Fractures of the femur after a knee or hip arthroplasty historically have been plagued with high complication rates. The Less Invasive Stabilization System (LISS) has theoretical advantages of improved biomechanics and limited insult to the bone's vascular supply. We theorized that the LISS would have a lowe...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000223987.59702.17
更新日期：2006-09-01 00:00:00
abstract：BACKGROUND:Sacrectomy may offer curative potential for primary sarcomas of the sacrum. However, it is unclear whether and to what extent sacrectomies achieve local control. QUESTIONS/PURPOSE:We therefore determined the curative potential, walking ability, continence control, and quality of life for children after sacr...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-2199-x
更新日期：2012-05-01 00:00:00
abstract：:Microfilaments, especially actin, have been demonstrated in a variety of noncontractile cells. In earlier studies, the quantity as well as the distribution of these microfilaments has been used to differentiate normal murine fibroblasts from virally transformed cells. This study examines these differences in cells fro...
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：:Osteogenic proteins, also referred to as BMPs, are a family of bone matrix polypeptides isolated from a variety of mammalian species. These proteins are members of the transforming growth factor-beta superfamily of molecules that contain a highly conserved 7 cysteine transforming growth factor-beta domain in their C-t...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1996-03-01 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
