The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Oct 2005
Randomized Controlled Trial Comparative Study Clinical TrialQuality-of-life outcome following hemiarthroplasty or total shoulder arthroplasty in patients with osteoarthritis. A prospective, randomized trial.
Both total shoulder arthroplasty and hemiarthroplasty have been used commonly to treat severe osteoarthritis of the shoulder; however, their effect on disease-specific quality-of-life outcome is unknown. The purpose of this study was to compare the quality-of-life outcome following hemiarthroplasty with that following total shoulder arthroplasty in patients with osteoarthritis of the shoulder. ⋯ Therapeutic Level I.
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J Bone Joint Surg Am · Oct 2005
Randomized Controlled Trial Comparative Study Clinical TrialShould acute scaphoid fractures be fixed? A randomized controlled trial.
With the proliferation of different fixation screws, there is an increasing trend to recommend early internal fixation of the broken scaphoid even if the fracture is not displaced. The benefits and risks of early fixation of scaphoid fractures have not been established. These were investigated in eighty-eight patients who were of working age with clearly defined minimally displaced or undisplaced bicortical fractures of the waist of the scaphoid. ⋯ Therapeutic Level I.
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J Bone Joint Surg Am · Sep 2005
Measuring improvement following total hip and knee arthroplasty using patient-based measures of outcome.
Patient-derived outcome scales have become increasingly important to physicians and clinical researchers for measuring improvement in function after surgery. The goal of the present study was to evaluate the ability of health-status instruments to measure early functional recovery after total hip and total knee arthroplasty. ⋯ The MODEMS, Oxford, and WOMAC scales all demonstrated a ceiling effect following total knee and total hip arthroplasty. These scores likely reflected the patients' perception of the status of the knee or hip rather than an inability to measure their improvement beyond the highest possible score. The Physical Component Summary score of the SF-36 had similar standardized response means when compared with hip and knee-specific instruments, and, therefore, consideration should be given to using this scale without a joint-specific scale for the measurement of improvement following total knee and total hip replacement, as a way to decrease responder burden (that is, the time required to complete the questionnaires).
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J Bone Joint Surg Am · Sep 2005
Angle stable locking reduces interfragmentary movements and promotes healing after unreamed nailing. Study of a displaced osteotomy model in sheep tibiae.
Large interfragmentary movements may delay bone-healing. The hypothesis of the present study was that a reduction of interfragmentary movements, especially of torsional rotation and bending angles, would support the healing process and lead to improved healing following unreamed tibial nailing. The objective of this study was to investigate healing of an unstable tibial osteotomy site following stabilization with unreamed nailing with a modified tibial device that had angle stable holes for the locking bolts. We compared those findings with healing after stabilization of such sites with standard unreamed tibial nailing. The duration of the study period was nine weeks. ⋯ Use of an angle stable tibial nail may help to reduce interfragmentary movements in vivo and thus lead to superior bone-healing compared with that following standard unreamed tibial nailing.