The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jul 2006
Revision total knee arthroplasty: 1990 through 2002. A review of the Finnish arthroplasty registry.
National and regional arthroplasty registries have been used to study the results of primary total knee arthroplasties. The purpose of this paper was to present the results of revision total knee replacements and describe predictors of survival of those replacements, with repeat revision as the end point. ⋯ Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Jul 2006
Fractures of the dorsal articular margin of the distal part of the radius with dorsal radiocarpal subluxation.
Fractures of the volar articular margin of the distal part of the radius with volar radiocarpal subluxation (Barton fractures) are well recognized, and substantial data are available to guide their treatment. In contrast, fractures of the dorsal articular margin of the distal part of the radius with dorsal radiocarpal subluxation (sometimes referred to as dorsal or reverse Barton fractures) are rarely mentioned, and there are very little data to guide their treatment. ⋯ Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Jul 2006
Recombinant human osteogenic protein-1 induces bone formation in a chronically infected, internally stabilized segmental defect in the rat femur.
Recombinant human osteogenic protein-1 (rhOP-1), combined with a collagen carrier, has been shown to induce new-bone formation in a variety of animal models. The purpose of the present investigation was to test the hypotheses that rhOP-1 would accelerate bone formation in an internally stabilized, chronically infected, critical-size defect in the rat femur and that this effect would be enhanced by the administration of systemic antibiotic. ⋯ The treatment of an infection at the site of a fracture often necessitates removal of internal fixation. However, internal fixation is needed for fracture stability. This study presents an intervention that may accelerate fracture-healing in the presence of infection and colonized hardware, thereby permitting earlier removal of the hardware and more timely and effective treatment of the infection.
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The purpose of this study was to determine the demographics, incidence, and results of treatment of periprosthetic fractures in a nationwide observational study. ⋯ On the basis of these findings, we believe that high-risk patients should have routine radiographic follow-up. Such a routine could identify a loose implant and make intervention possible before a fracture occurred. Furthermore, we recommend an exploration of the joint to test the stability of the implant in patients with a Vancouver type-B fracture in which the stability of the stem is uncertain.
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J Bone Joint Surg Am · Jun 2006
Randomized Controlled Trial Comparative StudyRecombinant human bone morphogenetic protein-2 in open tibial fractures. A subgroup analysis of data combined from two prospective randomized studies.
The use of recombinant human bone morphogenetic protein-2 (rhBMP-2) to improve the healing of open tibial shaft fractures has been the focus of two prospective clinical studies. The objective of the current study was to perform a subgroup analysis of the combined data from these studies. ⋯ The addition of rhBMP-2 to the treatment of type-III open tibial fractures can significantly reduce the frequency of bone-grafting procedures and other secondary interventions. This analysis establishes the clinical efficacy of rhBMP-2 combined with an absorbable collagen sponge implant for the treatment of these severe fractures.