The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Feb 2003
Randomized Controlled Trial Comparative Study Clinical TrialPatellar resurfacing in total knee arthroplasty. A prospective, randomized study.
Anterior knee pain following total knee arthroplasty is a common complaint and typically is attributed to the patellofemoral joint. The purpose of the present study was to compare the outcome of resurfacing and nonresurfacing of the patella, particularly with regard to anterior knee pain, and to clarify the indications for patellar resurfacing at the time of total knee arthroplasty. ⋯ As the present study showed a significantly higher rate of anterior knee pain following arthroplasty without patellar resurfacing, we recommend patellar resurfacing at the time of total knee replacement when technically possible.
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J Bone Joint Surg Am · Feb 2003
Comparative StudyExperimental tibial plateau fractures augmented with calcium phosphate cement or autologous bone graft.
Depression fractures of the tibial plateau are often managed with use of internal fixation and autologous bone-grafting to maintain an anatomical reduction. Bone-grafting, however, provides only limited stability. As calcium phosphate cements have appropriate mechanical properties, they may provide a more suitable alternative. The objective of this study was to compare the effect of a calcium phosphate cement with that of impacted cancellous autograft for maintaining an anatomical reduction in an experimental model of a tibial plateau fracture. ⋯ Cancellous autograft did not maintain an anatomical reduction of the tibial plateau fractures in this model. In contrast, augmentation with calcium phosphate cement prevented subsidence of the fracture fragment and maintained articular congruency as the fracture healed. The improved articular congruency reduced the prevalence and severity of degenerative changes in the joint.
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J Bone Joint Surg Am · Feb 2003
Total hip arthroplasty in adult patients who had childhood infection of the hip.
Adult patients with a history of infection of the hip in childhood present a challenge as candidates for total hip arthroplasty because of abnormal bone development, soft-tissue contractures, the possibility of reinfection, and their relative youth. The purpose of this study was to analyze the mid-term results of primary total hip arthroplasty in adult patients who had had infection of the hip in childhood. ⋯ There was no recurrence of infection after total hip arthroplasty in the patients with a quiescent period of infection of more than ten years. These young, active patients with technically difficult arthroplasties were at considerable risk for aseptic loosening. The prevalence of polyethylene wear and osteolysis was attributable to the less than optimal prosthetic designs and materials used during the time-period of this study.
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J Bone Joint Surg Am · Feb 2003
Total knee arthroplasty in patients with a prior fracture of the tibial plateau.
A fracture of the tibial plateau may predispose the knee to the development of posttraumatic arthritis. Malunion, intra-articular chondro-osseous defects, limb malalignment, retained internal fixation devices, and poor surrounding soft tissues may in turn compromise the outcome of total knee arthroplasty. The aim of our study was to evaluate the results of total knee arthroplasty in patients with a previous fracture of the tibial plateau. ⋯ The vast majority of patients treated with total knee arthroplasty after a previous fracture of the tibial plateau have substantial improvement in function and relief of pain. However, these patients are at increased risk for perioperative complications, as evidenced by the high reoperation rate of 21% in this study.
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J Bone Joint Surg Am · Feb 2003
Anterior femoro-acetabular impingement due to acetabular retroversion. Treatment with periacetabular osteotomy.
This study was performed to evaluate whether symptomatic anterior femoro-acetabular impingement due to acetabular retroversion can be treated effectively with a periacetabular osteotomy. ⋯ Periacetabular osteotomy is an effective way to reorient the acetabulum in young adults with symptomatic anterior femoro-acetabular impingement due to acetabular retroversion