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T : 목차정보

Journal of orthopaedics 60건

  1. [해외논문]   Restoring femoral offset is the most important technical factor in preventing total hip arthroplasty dislocation  

    Forde, Braxton (The Johns Hopkins University School of Medicine, Baltimore, MD, United States ) , Engeln, Kathleen (Baylor College of Medicine, Houston, TX, United States ) , Bedair, Hany (Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States ) , Bene, Nicholas (Tufts University School of Medicine, Boston, MA, United States ) , Talmo, Carl (New England Baptist Hospital, Boston, MA, United States ) , Nandi, Sumon (The University of Toledo College of Medicine and Life Sciences, Toledo, OH, United States)
    Journal of orthopaedics v.15 no.1 ,pp. 131 - 133 , 2018 ,

    초록

    Abstract Purpose Our aim was to determine if acetabular component position, femoral offset restoration, or leg-length equality is most important for total hip arthroplasty (THA) stability. Methods A matched case (n = 67)-control (n = 247) design and conditional logistic regression model were used to examine risk factors for dislocation in primary THA. Results When femoral offset was at least 3 mm greater than that of the contralateral hip, risk of dislocation was lower (p = 0.0192). Neither leg-length difference nor acetabular component abduction or version angle was associated with dislocation. Conclusions Our data suggest restoring femoral offset is the most important technical factor in preventing THA dislocation.

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  2. [해외논문]   Effect of stem alignment on long-term outcomes of total hip arthroplasty with cementless Bi-Metric femoral components  

    Shishido, Takaaki (Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan ) , Tateiwa, Toshiyuki (Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan ) , Takahashi, Yasuhito (Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan ) , Masaoka, Toshinori (Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan ) , Ishida, Tsunehito (Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan ) , Yamamoto, Kengo (Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan)
    Journal of orthopaedics v.15 no.1 ,pp. 134 - 137 , 2018 ,

    초록

    Abstract We investigated the effects of varus-valgus alignment on the long-term outcomes after cementless total hip arthroplasty (THA) using a porous coated version of Bi-Metric ? femoral stems. The Kaplan-Meier survival analysis was performed in 71 hips. The survival rate with femoral revision for aseptic loosening as the end point was 100% at 17 years. Nevertheless, the initial stem alignment was more valgus in patients with the Engh grade III–IV stress shielding than patients with the Engh grade I–II. Our results suggest that valgus misalignment of cementless Bi-Metric stem might be a potential risk factor for the progression of stress shielding.

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  3. [해외논문]   Bizarre parosteal osteochondromatous proliferation: 16 Cases with a focus on histologic variability  

    Cocks, Margaret (Department of Pathology, Johns Hopkins University, United States ) , Helmke, Elizabeth (Department of Pathology, Johns Hopkins University, United States ) , Meyers, Carolyn A. (Department of Pathology, Johns Hopkins University, United States ) , Fayad, Laura (Department of Radiology, Johns Hopkins University, United States ) , McCarthy, Edward (Department of Pathology, Johns Hopkins University, United States ) , James, Aaron W. (Department of Pathology, Johns Hopkins University, United States)
    Journal of orthopaedics v.15 no.1 ,pp. 138 - 142 , 2018 ,

    초록

    Abstract Bizarre parosteal osteochondromatous proliferation (BPOP) is a benign bone and cartilage forming tumor occurring on the surface of bones, predominantly on the hands and feet. A defining feature of BPOP is the purplish-blue mineralization of cartilaginous tissue, known as ‘blue bone.’ Here, we report on an institutional series of 16 cases of BPOP, including radiographic, histologic, and histomorphometric features. All tumors were composed of some element of bone, cartilage, fibrous tissue and ‘blue bone,’ though the amount of each tissue sub-type varied widely. Some cases showed focal ‘blue bone’ only, however this was a defining feature in all cases.

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  4. [해외논문]   Ground reaction vector re-adjustment–the secret of success in treatment of medial compartment knee osteoarthritis by novel high fibular osteotomy  

    Xie, Wenjun (Corresponding author.) , Zhang, Yu , Qin, Xiaodong , Song, Lijun , Chen, Qun
    Journal of orthopaedics v.15 no.1 ,pp. 143 - 145 , 2018 ,

    초록

    Abstract High fibular osteotomy has been preliminarily proved to be an effective treatment of knee osteoarthritis by excising a segment of bone at the proximal part of fibula. This imaginative procedure is clinical validated by its instant and explicit knee pain resorption and eventually deformity correction. The rationale of this treatment is named non-uniform settlement of the tibial plateau and used to elucidate the cause of knee joint degeneration, but cannot illuminate the reason of prompt postoperative pain resorption faithfully. To assist in better understanding of this therapeutic method and raising alert to possible unexpected complications, we proposed a new theory to elucidate the pain relief mechanism.

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  5. [해외논문]   Templating in uncemented THA. On accuracy and postoperative leg length discrepancy  

    Strøm, Nils J. (Orthopaedic Department, Oslo University Hospital, Radiumhospitalet, N-0027 Oslo, Norway ) , Reikerå (Orthopaedic Department, Oslo University Hospital, Rikshospitalet, N-0027 Oslo, Norway) , s, Olav
    Journal of orthopaedics v.15 no.1 ,pp. 146 - 150 , 2018 ,

    초록

    Abstract Purpose This study examines the accuracy of digital templating in uncemented total hip arthroplasty (THA), i.e., whether the templated components where actually inserted during surgery. The surgical outcome was evaluated on the basis of limb length equality. Methods We retrospectively examined digital x-rays of 41 patients scheduled for uncemented THA. These were templated using templating software. The template was compared to the surgical choice of implant registered in the patients’ journal. Postoperative x-rays were evaluated for limb length equality. The data underwent statistical analysis to assess accuracy. Results The acetabular component was templated accurately in 7.3%, while 41% was within +/− 1 component size difference, and 73% was within +/−2 size differences. The femoral stem was templated accurately in 34%, while 76% was within +/− 1 component size difference, and 90% was within +/−2 size differences. The neck length was templated accurately in 29%, while 88% was within +/−1 component size difference, and 100% was within +/−2 size differences. Fifty four percent of patients experienced radiologic equalization within +/− 5 mm, and 85% within 10 mm. Fifteen percent had leg length discrepancy of more than 10 mm postoperatively. There was no systematic tendency to overestimate or underestimate leg length peroperatively. Conclusions We find that the accuracy of digital templating in uncemented THA is acceptable for the femoral stem, but somewhat inferior for the acetabular shell and poor for neck length. Templating is a useful tool in preoperative planning, but cannot be regarded as a blueprint for the operative choice.

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  6. [해외논문]   Inadvertent hypothermia in hip and knee total joint arthroplasty  

    Williams, M. (Department of Trauma and Orthopaedic Surgery, Torbay Hospital, Torquay, Devon, TQ2 7AA, United kingdom ) , El-Houdiri, Y. (Department of Trauma and Orthopaedic Surgery, Torbay Hospital, Torquay, Devon, TQ2 7AA, United kingdom)
    Journal of orthopaedics v.15 no.1 ,pp. 151 - 158 , 2018 ,

    초록

    Abstract Background This clinical study aims to establish rates of inadvertent hypothermia (IH) in both primary and revision total hip/knee arthroplasty (THA/TKA and rTHA/rTHA). We postulate differences exist between demographic, surgical and anesthetic variables and outcomes for IH and normothermic patients. Methods We conducted a single centre, retrospective study of 2431 total joint arthroplasty (TJA) patients having undergone THA (n = 1096), TKA (n = 1083), rTHA (n = 165) and rTKA (n = 87) from March 2013 to December 2016. Outcomes include length of stay (LOS), 31-day complication rates for thrombotic events and infection and 31-day readmission rates (RR). Results Overall rates of IH were 11.7%; with cohort analysis demonstrating rates of 13.2%, 11.2%, 8.3% and 3.9% in THA, TKA, rTHA and rTKA respectively. Patients with body mass index (BMI) 2 and undergoing THA were at risk of IH. For all TJA, no difference was observed in 31-day complications (1.6% vs. 2.8%, p = 0.19), 31-day RR (3.3% vs. 4.5%, p = 0.50) or LOS (4.6 ± 2.9 vs. 5.1 ± 4.5, p = 0.11). IH was associated with higher RR for haematoma in TKA (2.9% vs. 0.4%, p = 0.021) and higher deep infection rates in rTHA (20% vs 0%, p = 0.006). Conclusion Our study demonstrates a 3.9% to 13.2% rate of IH in TJA, with lower BMI, THA and primary cases as risk factors. We recommend protective steps are taken to maintain patient normothermia in these groups.

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  7. [해외논문]   Stress radiographs for evaluating acromioclavicular joint separations in an active-duty patient population: What have we learned?  

    Shaw, K. Aaron (Corresponding author at: Department of Orthopaedic Surgery, 300 East Hospital Road, Fort Gordon, GA, 30905, United States.) , Synovec, John , Eichinger, Josef , Tucker, Christopher J. , Grassbaugh, Jason A. , Parada, Stephen A.
    Journal of orthopaedics v.15 no.1 ,pp. 159 - 163 , 2018 ,

    초록

    Abstract Introduction Acromioclavicular (AC) joint separation is a common entity in athletic patient populations. The surgical treatment of these injuries varies based upon extent of injury, with numerous imaging modalities recommended to differentiate injury severity and treatment options. The use of weighted stress radiographs is controversial in the diagnostic evaluation of AC separation with previous consensus recommending against their use. No study to date has investigated the clinical utilization of diagnostic studies in the evaluation of AC joint separations in a military surgeon population. Methods Thirty-eight shoulder or sports medicine sub-specialty certified orthopaedic surgeons on active service in the Army, Air Force, and Navy were surveyed on their evaluation and treatment protocols for AC joint injuries. Specifically analyzed were imaging choice including the use of weighted stress radiographs as well as treatment recommendations based upon Rockwood grade. Responses were recorded in addition to surgeon descriptive data. Responses were analyzed with descriptive statistics. Results Thirty-seven of the identified thirty eight surgeons responded to the survey, for a 97% response rate. Of the group, 70% of surgeons were within 10 years of completing fellowship with an estimated average of 15 AC joint separations treated annually. Plain radiographic examination was relied upon by 48% of surgeons for treatment of AC joint separation with 13% using weighted stress radiographs. Overall, 10% of surgeon stated that their treatment plan would vary based upon results from a weighted stress view. 51% of surgeons included magnetic resonance imaging in their diagnostic approach of these injuries. Treatment recommendation varied according to injury severity with 78% preferring nonoperative treatment for acute Grade III injuries with 86% waiting a minimum of 3 months before proceeding with operative treatment. For Grade V injuries, 81% of surgeon preferred operative treatment, with 59% incorporating a soft-tissue graft in their repair or reconstructive procedure. Discussion This study identified substantial practice variation amongst military surgeons treating a relatively homogenous population with AC joint separations, reflective of a lack of definitive evidence to guide diagnosis and treatment. Overall, nonoperative management is the preferred initial approach for Type III injuries and operative treatment is the preferred initial approach for Type V injuries. The diagnostic evaluation varied across the surgeon cohort, but 87% elected against the use of weighted stress radiographs for the evaluation of AC joint separations, with only 10% relying upon them to dictate their recommended treatment. Future research identifying optimal diagnosis and treatment of AC joint separations is needed.

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  8. [해외논문]   A quality improvement project decreases incidence of pulmonary embolism following arthroplasty  

    Eid, Iyad (Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia ) , Moran, Dane (Johns Hopkins University School of Medicine, Baltimore, MD, USA ) , Morrison, Lynn (Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia ) , HajHussein, Eyad (Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia ) , Hill, Hanna (Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia ) , Ansari, Rasha (Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia ) , Williams, Tammy (Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia ) , Manzary, Mojieb (Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia)
    Journal of orthopaedics v.15 no.1 ,pp. 164 - 167 , 2018 ,

    초록

    Abstract Objective To develop a quality improvement initiative to reduce the incidence of pulmonary embolism (PE) following elective lower extremity joint replacement surgery. Methods 866 Patients undergoing a total knee or total or partial hip replacement surgery at a from 2014 to 2016 were included in this prospective pre-post interventional study. Results There were 13 PE’s before the intervention and 2 after the intervention. The incidence of PE was significantly higher prior to the intervention (2.8% vs. 0.7%; p = 0.044). Conclusions Our results suggest that our bundle of interventions was successfully implemented and helped to reduce the incidence of pulmonary embolism following surgery.

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  9. [해외논문]   Growth modulation for coronal deformity correction by using Eight Plates—Systematic review  

    Kumar, Sanjay (Department of Orthopaedics, United Lincolnshire Hospitals NHS Trust, Greetwell Rd, Lincoln LN2 5QY, United Kingdom ) , Sonanis, S.V. (Department of Orthopaedics, Hywel Dda University Health Board, Caradoc Road, Aberystwyth SY23 1ER, United Kingdom)
    Journal of orthopaedics v.15 no.1 ,pp. 168 - 172 , 2018 ,

    초록

    Abstract Introduction Coronal deformities are commonly encountered in paediatric orthopaedics and surgical treatment is indicated for severe deformities causing pain, function and cosmetic problems. In a growing bone, major surgical intervention like osteotomy with internal or external fixation can be avoided by growth modulation (hemiepiphysiodesis) using 8-plates. Our aim is to review the published literature on the use of 8-plates for deformity correction. Methods We conducted a systematic review on 8-plate growth modulation for coronal deformity correction. We carried out detailed literature search on PubMed, Google Scholar, EMBASE, and Cochrane databases. We analysed selected studies for patient demographics, rate of deformity correction, clinical outcome and complications. Results We identified seven studies using 8-plate for deformity correction involving 215 patients (350 Limbs). The mean age was 9.5 years (2–16 years M/F Ratio 1.1:1); underlying aetiology was Idiopathic in 33% and Pathological 67% cases. The deformities were successfully corrected in 196/215 patients (91.2%) and partial/no correction in 19/215 patients (8.8%). The mean time to correction was 15.3 Months (10.3–25) and follows up of 18.9 months (12.4–24). The deformity corrected at 1.28 °/month (0.93–1.53), lateral distal femoral angle changed at 0.87°/month (0.65–1.0) and medial proximal tibial angle changed at 0.72 (0.5–1). Complications were reported in 12/215 patients (5.6%) including hardware failure in 5, overcorrection/leg length difference in 5, infection 1 and stiffness 1. The rebound was reported in 8 patients (3.7%). Conclusion Growth modulation with 8-plates has high efficacy and low complications for deformity correction; and has been used widely across all paediatric age groups and aetiology. The literature is mostly retrospective and heterogeneous to develop age and aetiology specific recommendations.

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  10. [해외논문]   Computed tomography findings of subchondral insufficiency fractures of the femoral head  

    Iwasaki, Kenyu (Department of Orthopaedic Surgery, Japan Community Healthcare Organization, Kyushu Hospital, 1-8-1 Kishinoura, Yahatanishi-ku, Kitakyushu, Fukuoka 806-8501, Japan ) , Yamamoto, Takuaki (Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, 12 Jonan-ku, Fukuoka, Japan ) , Motomura, Goro (Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan ) , Karasuyama, Kazuyuki (Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan ) , Sonoda, Kazuhiko (Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan ) , Kubo, Yusuke (Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan ) , Nakashima, Yasuharu (Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan)
    Journal of orthopaedics v.15 no.1 ,pp. 173 - 176 , 2018 ,

    초록

    Abstract Objectives The objective of this study was to describe the appearance of Subchondral insufficiency fracture (SIF) by computed tomography (CT). Methods Images of 52 consecutive patients diagnosed with SIF were retrospectively reviewed. CT was available for five patients (7 cases). Results Corresponding to a low-intensity band on MR images, a radiolucent or sclerotic band was observed on CT images. Conclusion The present study is the first to report CT findings of SIF. A radiolucent or sclerotic band was observed on CT images. The results of the present study provide useful information for diagnosis of SIF.

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    Fig. 1 이미지

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