The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · May 2006
Proximal femoral allograft treatment of Vancouver type-B3 periprosthetic femoral fractures after total hip arthroplasty.
Periprosthetic femoral fractures following total hip arthroplasty are becoming more prevalent. When a fracture occurs in a femur with substantial proximal bone deficiency, the surgical options for revision are limited. One option includes the use of a proximal femoral allograft. ⋯ The use of a proximal femoral allograft for the treatment of a Vancouver type-B3 periprosthetic femoral fracture can provide a satisfactory result in terms of pain relief and function at five years.
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J Bone Joint Surg Am · May 2006
Risk factors for respiratory failure following operative stabilization of thoracic and lumbar spine fractures.
Respiratory failure is a serious complication that can adversely affect the hospital course and survival of multiply injured patients. Some studies have suggested that delayed surgical stabilization of spine fractures may increase the incidence of respiratory complications. However, the authors of these studies analyzed small sets of patients and did not assess the independent effects of multiple risk factors. ⋯ Independent risk factors for respiratory failure were identified in an analysis of a large cohort of patients who had undergone operative stabilization of thoracic and lumbar spine fractures. Early operative stabilization of these fractures, the only risk factor that can be controlled by the physician, may decrease the risk of respiratory failure in multiply injured patients.
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J Bone Joint Surg Am · May 2006
Biography Historical ArticleFailed spine surgery syndrome in the life and career of John Fitzgerald Kennedy.
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J Bone Joint Surg Am · Apr 2006
Multicenter StudyPredictors of functional outcome two years following revision hip arthroplasty.
Little is known about factors that might predict functional outcome following revision hip arthroplasty. The purpose of this study was to identify predictors of pain and physical function at two years following revision total hip arthroplasty and to evaluate whether the time that the patient waited for the surgery and whether the patient had complications were significant predictors of outcome. ⋯ Patients with better preoperative pain scores and fewer comorbidities have better outcomes following revision total hip arthroplasty. Although the time that the patient waited for the revision was not predictive of the ultimate WOMAC pain and function scores, we believe that performing revision arthroplasty before the patient has substantial functional compromise potentially improves the outcome.
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J Bone Joint Surg Am · Apr 2006
Review Comparative StudyPain generation in lumbar and cervical facet joints.
Facet joints are implicated as a major source of neck and low-back pain. Both cervical and lumbar facet syndromes have been described in the medical literature. Biomechanical studies have shown that lumbar and cervical facet-joint capsules can undergo high strains during spine-loading. ⋯ To answer this question, recent studies indicate that low stretch levels activate proprioceptors in the facet-joint capsule. Excessive capsule stretch activates nociceptors, leads to prolonged neural afterdischarges, and can cause damage to the capsule and to axons in the capsule. In instances in which a whiplash event is severe enough to injure the joint capsule, facet capsule overstretch is a possible cause of persistent neck pain.