Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jun 2014
Comparative StudyAneurysmal bone cysts: do simple treatments work?
Primary aneurysmal bone cysts (ABCs) are benign, expansile bone lesions commonly treated with aggressive curettage with or without adjuvants such as cryotherapy, methacrylate cement, or phenol. It has been reported that occasionally these lesions heal spontaneously or after a pathologic fracture, and we observed that some ABCs treated at our center healed after biopsy alone. Because of this, we introduced a novel biopsy technique we call "curopsy," which is a percutaneous limited curettage at the time of biopsy, obtaining the lining membrane from various quadrants of the cyst leading to consolidation (curopsy = biopsy with intention to cure). ⋯ Level III, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Jun 2014
Migration inhibitory factor enhances inflammation via CD74 in cartilage end plates with Modic type 1 changes on MRI.
Type 1 Modic changes are characterized by edema, vascularization, and inflammation, which lead to intervertebral disc degeneration. Macrophage migration inhibitory factor (MIF) is a proinflammatory cytokine closely related to the inflammatory cytokines detected in degenerative intervertebral disc tissues. However, the existence and role of MIF and its receptor CD74 in intervertebral disc degeneration have not been elucidated. ⋯ The MIF/CD74 pathway may represent a crucial target for treating disc degeneration since inhibiting the function of MIF with its antagonist ISO-1 can reduce MIF-induced inflammation and exert potent therapeutic effects.
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Clin. Orthop. Relat. Res. · Jun 2014
ReviewMinimally invasive surgical techniques in adult degenerative spinal deformity: a systematic review.
Minimally invasive surgery (MIS) approaches have the potential to reduce procedure-related morbidity when compared with traditional approaches. However, the magnitude of radiographic correction and degree of clinical improvement with MIS techniques for adult spinal deformity remain undefined. ⋯ The literature on these techniques is scanty; only two of the 13 studies that met inclusion criteria were considered high quality; CT scans were not generally used to evaluate fusion, deformity correction was inconsistent, and complication rates were high. Future directions for analysis must include comparative trials, longer-term followup, and consistent use of CT scans to assess for fusion to determine the role of MIS techniques for adult spinal deformity.
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Clin. Orthop. Relat. Res. · Jun 2014
Comparative StudyNationwide Inpatient Sample and National Surgical Quality Improvement Program give different results in hip fracture studies.
National databases are being used with increasing frequency to conduct orthopaedic research. However, there are important differences in these databases, which could result in different answers to similar questions; this important potential limitation pertaining to database research in orthopaedic surgery has not been adequately explored. ⋯ Level II, prognostic study. See the Instructions for Authors for a complete description of levels of evidence.