The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Apr 2011
Randomized Controlled Trial Multicenter StudyProspective, randomized, multicenter Food and Drug Administration investigational device exemption study of the ProDisc-L total disc replacement compared with circumferential arthrodesis for the treatment of two-level lumbar degenerative disc disease: results at twenty-four months.
Disc replacement arthroplasty previously has been shown to be an effective alternative to spine fusion for the treatment of single-level lumbar degenerative disc disease. The purpose of the present study was to determine the twenty-four-month results of a clinical trial of the ProDisc-L total disc replacement as compared with spinal fusion for the treatment of degenerative disc disease at two contiguous vertebral levels from L3 to S1. ⋯ Despite the relatively short duration of follow-up and design limitations, the present study suggests that two-level lumbar disc arthroplasty is an alternative to and offers clinical advantages in terms of pain relief and functional recovery in comparison with arthrodesis. Longer-term follow-up is needed to determine the risks for implant wear and/or degenerative segment changes.
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J Bone Joint Surg Am · Apr 2011
Midterm results of osteochondral lesions of the talar shoulder treated with fresh osteochondral allograft transplantation.
With osteochondral lesions of the talar shoulder, their size, the articular cartilage geometry, and the loss of the medial or lateral articular buttress often preclude treatment with traditional osteochondral autograft techniques. We hypothesized that fresh, large osteochondral allograft transplantation is a viable treatment option for patients with such lesions. ⋯ These midterm results in a small group of patients indicate that structural fresh allograft transplantation can be a successful surgical option in the treatment of large osteochondral defects of the talar shoulder [corrected].
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J Bone Joint Surg Am · Apr 2011
Risk factors for chondrolysis of the glenohumeral joint: a study of three hundred and seventy-five shoulder arthroscopic procedures in the practice of an individual community surgeon.
Glenohumeral chondrolysis is a complication of arthroscopic shoulder surgery characterized by the dissolution of the articular cartilage of the glenoid and the humeral head. An analysis of 375 intra-articular shoulder arthroscopic surgical procedures by an individual community orthopaedic surgeon was performed to explore which factors or combinations of factors might be associated with glenohumeral chondrolysis. ⋯ To our knowledge, this is the first Level-II retrospective cohort study of the factors associated with the development of post-arthroscopic glenohumeral chondrolysis. In this cohort of intra-articular shoulder arthroscopic procedures, chondrolysis was observed only in cases in which either Marcaine or lidocaine had been infused into the joint during the postoperative period. Avoiding such a postoperative infusion may reduce the risk of chondrolysis.