The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · May 2008
Multicenter Study Comparative StudyLocal recurrence of giant cell tumor of bone after intralesional treatment with and without adjuvant therapy.
The use of adjuvants after curettage has been well established for the treatment of giant cell tumor of bone. The purpose of this study was to analyze the rates of recurrence following different types of treatment as well as the influence of various factors of tumor presentation on those rates. ⋯ Use of polymethylmethacrylate as an adjuvant significantly reduces the recurrence rate following intralesional treatment of benign giant cell tumors, and it appears to be the therapy of choice for primary as well as recurrent giant cell tumors of bone. The significantly better results following treatment of recurrent tumors without adjuvants compared with the results of the same treatment of primary tumors were probably related to increased surgical thoroughness brought about by the surgeon's awareness of dealing with a riskier tumor.
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J Bone Joint Surg Am · Mar 2008
Randomized Controlled Trial Multicenter Study Comparative StudyNonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. Surgical technique.
Recent studies have shown a high prevalence of symptomatic malunion and nonunion after nonoperative treatment of displaced midshaft clavicular fractures. We sought to compare patient-oriented outcome and complication rates following nonoperative treatment and those after plate fixation of displaced midshaft clavicular fractures. ⋯ Operative fixation of a displaced fracture of the clavicular shaft results in improved functional outcome and a lower rate of malunion and nonunion compared with nonoperative treatment at one year of follow-up. Hardware removal remains the most common reason for repeat intervention in the operative group. This study supports primary plate fixation of completely displaced midshaft clavicular fractures in active adult patients.
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J Bone Joint Surg Am · Nov 2007
Multicenter StudyNon-neurologic complications following surgery for adolescent idiopathic scoliosis.
The reported prevalence of non-neurologic complications following corrective surgery for adolescent idiopathic scoliosis ranges from 0% to 10%. However, most studies were retrospective evaluations of treatment techniques and did not focus solely on complications. The purpose of this study was to determine the prevalence of non-neurologic complications following surgery for adolescent idiopathic scoliosis and to identify preoperative and operative factors that can increase this risk. ⋯ The prevalence of non-neurologic postoperative complications following surgery for correction of adolescent idiopathic scoliosis in this study was 15.4%. The few factors noted to significantly increase the rate of complications include a history of renal disease, increased operative blood loss, prolonged posterior surgery time, and prolonged anesthesia time.
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J Bone Joint Surg Am · Jul 2007
Randomized Controlled Trial Multicenter StudyCan vitamin C prevent complex regional pain syndrome in patients with wrist fractures? A randomized, controlled, multicenter dose-response study.
Complex regional pain syndrome type I is treated symptomatically. A protective effect of vitamin C (ascorbic acid) has been reported previously. A dose-response study was designed to evaluate its effect in patients with wrist fractures. ⋯ Vitamin C reduces the prevalence of complex regional pain syndrome after wrist fractures. A daily dose of 500 mg for fifty days is recommended.
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J Bone Joint Surg Am · Jun 2007
Multicenter StudyImpact of psychological distress on pain and function following knee arthroplasty.
Preoperative psychological distress has been reported to be an important risk factor for poor outcome following lower-extremity arthroplasty. We determined the independent impact of preoperative psychological distress on three, twelve, and twenty-four-month WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) pain and function scores and on change scores over those time periods. ⋯ Prognostic Level I.