Journal of Bone and Joint Surgery-british Volume最新文献_第8页

Mid-term equivalent survival of medial and lateral unicondylar knee replacement: an analysis of data from a National Joint Registry. 内侧和外侧单髁膝关节置换术的中期等效生存期:来自国家关节登记处的数据分析。

Journal of Bone and Joint Surgery-british Volume Pub Date : 2012-12-01 DOI: 10.1302/0301-620X.94B12.29416

P N Baker, S S Jameson, D J Deehan, P J Gregg, M Porter, K Tucker

{"title":"Mid-term equivalent survival of medial and lateral unicondylar knee replacement: an analysis of data from a National Joint Registry.","authors":"P N Baker, S S Jameson, D J Deehan, P J Gregg, M Porter, K Tucker","doi":"10.1302/0301-620X.94B12.29416","DOIUrl":"https://doi.org/10.1302/0301-620X.94B12.29416","url":null,"abstract":"Current analysis of unicondylar knee replacements (UKRs) by national registries is based on the pooled results of medial and lateral implants. Consequently, little is known about the differential performance of medial and lateral replacements and the influence of each implant type within these pooled analyses. Using data from the National Joint Registry for England and Wales (NJR) we aimed to determine the proportion of UKRs implanted on the lateral side of the knee, and their survival and reason for failure compared with medial UKRs. By combining information on the side of operation with component details held on the NJR, we were able to determine implant laterality (medial versus lateral) for 32 847 of the 35 624 unicondylar replacements (92%) registered before December 2010. Of these, 2052 (6%) were inserted on the lateral side of the knee. The rates of survival at five years were 93.1% (95% confidence interval (CI) 92.7 to 93.5) for medial and 93.0% (95% CI 91.1 to 94.9) for lateral UKRs (p = 0.49). The rates of failure remained equivalent after adjusting for patient age, gender, American Society of Anesthesiologists (ASA) grade, indication for surgery and implant design using Cox's proportional hazards method (hazard ratio for lateral relative to medial replacement = 0.88 (95% CI 0.69 to 1.13); p = 0.32). Aseptic loosening/lysis and unexplained pain were the main reasons for revision in both groups, although the reasons did vary depending on whether a mobile- or a fixed-bearing design was used. At a maximum of eight years the mid-term survival rates of medial and lateral UKRs are similar.","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"94 12","pages":"1641-8"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1302/0301-620X.94B12.29416","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31079342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 74

Increased one-year risk of symptomatic venous thromboembolism following total hip replacement: a nationwide cohort study. 全髋关节置换术后一年症状性静脉血栓栓塞风险增加:一项全国性队列研究。

Journal of Bone and Joint Surgery-british Volume Pub Date : 2012-12-01 DOI: 10.1302/0301-620X.94B12.29358

A B Pedersen, S P Johnsen, H T Sørensen

{"title":"Increased one-year risk of symptomatic venous thromboembolism following total hip replacement: a nationwide cohort study.","authors":"A B Pedersen, S P Johnsen, H T Sørensen","doi":"10.1302/0301-620X.94B12.29358","DOIUrl":"https://doi.org/10.1302/0301-620X.94B12.29358","url":null,"abstract":"We examined the one-year risk of symptomatic venous thromboembolism (VTE) following primary total hip replacement (THR) among Danish patients and a comparison cohort from the general population. From the Danish Hip Arthroplasty Registry we identified all primary THRs performed in Denmark between 1995 and 2010 (n = 85 965). In all, 97% of patients undergoing THR received low-molecular-weight heparin products during hospitalisation. Through the Danish Civil Registration System we sampled a comparison cohort who had not undergone THR from the general population (n = 257 895). Among the patients undergoing THR, the risk of symptomatic VTE was 0.79% between 0 and 90 days after surgery and 0.29% between 91 and 365 days after surgery. In the comparison cohort the corresponding risks were 0.05% and 0.12%, respectively. The adjusted relative risks of symptomatic VTE among patients undergoing THR were 15.84 (95% confidence interval (CI) 13.12 to 19.12) during the first 90 days after surgery and 2.41 (95% CI 2.04 to 2.85) during 91 to 365 days after surgery, compared with the comparison cohort. The relative risk of VTE was elevated irrespective of the gender, age and level of comorbidity at the time of THR. We concluded that THR was associated with an increased risk of symptomatic VTE up to one year after surgery compared with the general population, although the absolute risk is small.","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"94 12","pages":"1598-603"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1302/0301-620X.94B12.29358","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31079414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 19

Cemented polyethylene and cementless porous-coated acetabular components have similar outcomes at a mean of seven years after total hip replacement: a prospective randomised study. 一项前瞻性随机研究表明，全髋关节置换术后平均7年，骨水泥聚乙烯和无骨水泥多孔涂层髋臼假体的结果相似。

Journal of Bone and Joint Surgery-british Volume Pub Date : 2012-12-01 DOI: 10.1302/0301-620X.94B12.28060

D S Angadi, S Brown, E J P Crawfurd

{"title":"Cemented polyethylene and cementless porous-coated acetabular components have similar outcomes at a mean of seven years after total hip replacement: a prospective randomised study.","authors":"D S Angadi, S Brown, E J P Crawfurd","doi":"10.1302/0301-620X.94B12.28060","DOIUrl":"https://doi.org/10.1302/0301-620X.94B12.28060","url":null,"abstract":"The aim of this prospective randomised study was to compare the clinical and radiological results of a cemented all-polyethylene Ultima acetabular component with those of a cementless porous-coated acetabular component (PFC) following total hip replacement (THR). A total of 287 patients received either a polyethylene acetabular component (group A) or a cobalt-chromium porous-coated component (group B) with an identical cemented femoral component and 28 mm cobalt-chromium head, thus making it the largest study of its type. Patients were evaluated radiologically and clinically using the Harris hip score (HHS). Group A comprised 183 patients (73 male, 110 female) with a mean age of 71.3 years (55 to 89). Group B comprised 104 patients (48 male, 56 female) with a mean age of 69.8 years (56 to 89). A total of 16 patients (13 in Group A, three in Group B) did not have post-operative data for analysis. The mean follow-up in group A was 7.52 years (0.4 to 15.0) and in Group B 7.87 years (0.5 to 14.0). At final follow-up the mean HHS was similar between groups A and B (74.5 (25 to 100) and 78.0 (37 to 100), respectively; p = 0.068). The total number of revisions for any cause was 28, 17 of which were in group A and 11 in group B. The ten-year survivorship was 86.8% (95% confidence interval (CI) 78.4 to 92.1) and 89.2% (95% CI 78.3 to 94.8) for groups A and B, respectively (log-rank p-value = 0.938). A total of 20 cemented and two cementless acetabular components had evidence of acetabular radiolucencies or acetabular component migration at last follow-up (p = 0.001). These results indicate that patients with a cemented all-polyethylene and cementless porous-coated polyethylene lined acetabular component have similar long-term clinical outcomes.","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"94 12","pages":"1604-10"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1302/0301-620X.94B12.28060","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31079415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 18

The treatment of complex tibial shaft fractures by the Ilizarov method. Ilizarov法治疗复杂胫干骨折。

Journal of Bone and Joint Surgery-british Volume Pub Date : 2012-12-01 DOI: 10.1302/0301-620X.94B12.29266

P A L Foster, S B Barton, S C E Jones, R J M Morrison, S Britten

{"title":"The treatment of complex tibial shaft fractures by the Ilizarov method.","authors":"P A L Foster, S B Barton, S C E Jones, R J M Morrison, S Britten","doi":"10.1302/0301-620X.94B12.29266","DOIUrl":"https://doi.org/10.1302/0301-620X.94B12.29266","url":null,"abstract":"We report on the use of the Ilizarov method to treat 40 consecutive fractures of the tibial shaft (35 AO 42C fractures and five AO 42B3 fractures) in adults. There were 28 men and 12 women with a mean age of 43 years (19 to 81). The series included 19 open fractures (six Gustilo grade 3A and 13 grade 3B) and 21 closed injuries. The mean time from injury to application of definitive Ilizarov frame was eight days (0 to 35) with 36 fractures successfully uniting without the need for any bone-stimulating procedure. The four remaining patients with nonunion healed with a second frame. There were no amputations and no deep infections. None required intervention for malunion. The total time to healing was calculated from date of injury to removal of the frame, with a median of 166 days (mean 187, (87 to 370)). Minor complications included snapped wires in two patients and minor pin-site infections treated with oral antibiotics in nine patients (23%). Clinical scores were available for 32 of the 40 patients at a median of 55 months (mean 62, (26 to 99)) post-injury, with 'good' Olerud and Molander ankle scores (median 80, mean 75, (10 to 100)), 'excellent' Lysholm knee scores (median 97, mean 88, (29 to 100)), a median Tegner activity score of 4 (mean 4, (0 to 9)) (comparable to 'moderately heavy labour / cycling and jogging') and Short Form-12 scores that exceeded the mean of the population as a whole (median physical component score 55 (mean 51, (20 to 64)), median mental component score 57 (mean 53, (21 to 62)). In conclusion, the Ilizarov method is a safe and reliable way of treating complex tibial shaft fractures with a high rate of primary union.","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"94 12","pages":"1678-83"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1302/0301-620X.94B12.29266","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31077548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 58

Total meniscectomy in adolescents: a 40-year follow-up. 青少年全半月板切除术:40年随访。

Journal of Bone and Joint Surgery-british Volume Pub Date : 2012-12-01 DOI: 10.1302/0301-620X.94B12.30562

I P Pengas, A Assiotis, W Nash, J Hatcher, J Banks, M J McNicholas

{"title":"Total meniscectomy in adolescents: a 40-year follow-up.","authors":"I P Pengas, A Assiotis, W Nash, J Hatcher, J Banks, M J McNicholas","doi":"10.1302/0301-620X.94B12.30562","DOIUrl":"https://doi.org/10.1302/0301-620X.94B12.30562","url":null,"abstract":"We continued a prospective longitudinal follow-up study of 53 remaining patients who underwent open total meniscectomy as adolescents and who at that time had no other intra-articular pathology of the knee. Their clinical, radiological and patient-reported outcomes are described at a mean follow-up of 40 years (33 to 50). The cohort of patients who had undergone radiological evaluation previously after 30 years were invited for clinical examination, radiological evaluation and review using two patient-reported outcome measures. A total of seven patients (13.2%) had already undergone total knee replacement at the time of follow-up. A significant difference was observed between the operated and non-operated knee in terms of range of movement and osteoarthritis of the tibiofemoral joint, indicating a greater than fourfold relative risk of osteoarthritis at 40 years post-operatively. All patients were symptomatic as defined by the Knee Injury and Osteoarthritis Outcome Score. This study represents the longest follow-up to date and it can be concluded that meniscectomy leads to symptomatic osteoarthritis of the knee later in life, with a resultant 132-fold increase in the rate of total knee replacement in comparison to their geographical and age-matched peers.","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"94 12","pages":"1649-54"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1302/0301-620X.94B12.30562","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31079343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 116

Medial patellofemoral ligament reconstruction for patellar instability in patients with hypermobility: a case control study. 髌骨内侧股韧带重建治疗活动过度患者髌骨不稳:一项病例对照研究。

Journal of Bone and Joint Surgery-british Volume Pub Date : 2012-12-01 DOI: 10.1302/0301-620X.94B12.29562

N R Howells, J D Eldridge

{"title":"Medial patellofemoral ligament reconstruction for patellar instability in patients with hypermobility: a case control study.","authors":"N R Howells, J D Eldridge","doi":"10.1302/0301-620X.94B12.29562","DOIUrl":"https://doi.org/10.1302/0301-620X.94B12.29562","url":null,"abstract":"Hypermobility is an acknowledged risk factor for patellar instability. In this case control study the influence of hypermobility on clinical outcome following medial patellofemoral ligament (MPFL) reconstruction for patellar instability was studied. A total of 25 patients with hypermobility as determined by the Beighton criteria were assessed and compared with a control group of 50 patients who were matched for age, gender, indication for surgery and degree of trochlear dysplasia. The patients with hypermobility had a Beighton Score of ≥ 6; the control patients had a score of < 4. All patients underwent MPFL reconstruction performed using semitendinosus autograft and a standardised arthroscopically controlled technique. The mean age of the patients was 25 years (17 to 49) and the mean follow-up was 15 months (6 to 30). Patients with hypermobility had a significant improvement in function following surgery, with reasonable rates of satisfaction, perceived improvement, willingness to repeat and likelihood of recommendation. Functional improvements were significantly less than in control patients (p < 0.01). Joint hypermobility is not a contraindication to MPFL reconstruction although caution is recommended in managing the expectations of patients with hypermobility before consideration of surgery.","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"94 12","pages":"1655-9"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1302/0301-620X.94B12.29562","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31079344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 42

The painful hip: diagnosis and deliverance. 髋关节疼痛:诊断和治疗。

Journal of Bone and Joint Surgery-british Volume Pub Date : 2012-11-01 DOI: 10.1302/0301-620X.94B11.30825

T P Schmalzried

引用次数: 14

Current guidelines for total joint VTE prophylaxis: dawn of a new day. 静脉血栓栓塞联合预防的现行指南:新的一天开始了。

Journal of Bone and Joint Surgery-british Volume Pub Date : 2012-11-01 DOI: 10.1302/0301-620X.94B11.30824

R L Barrack

{"title":"Current guidelines for total joint VTE prophylaxis: dawn of a new day.","authors":"R L Barrack","doi":"10.1302/0301-620X.94B11.30824","DOIUrl":"https://doi.org/10.1302/0301-620X.94B11.30824","url":null,"abstract":"Venous thromboembolism (VTE) remains an immediate threat to patients following total hip and knee replacement. While there is a strong consensus that steps should be taken to minimise the risk to patients by utilising some forms of prophylaxis for the vast majority of patients, the methods utilised have been extremely variable. Clinical practice guidelines (CPGs) have been published by various professional organisations for over 25 years to provide recommendations to standardise VTE prophylaxis. Historically, these recommendations have varied widely depending in underlying assumptions, goals, and methodology of the various groups. This effort has previously been exemplified by the American College of Chest Physicians (ACCP) and the American Academy of Orthopaedic Surgeons (AAOS). The former group of medical specialists targeted minimising venographically proven deep vein thrombosis (DVT) (the vast majority of which are asymptomatic) as their primary goal prior to 2012. The latter group of surgeons targeted minimising symptomatic VTE. As a result prior to 2012, the recommendations of the two groups were widely divergent. In the past year, both groups have reassessed the current literature with the principal goals of minimising symptomatic VTE events and bleeding complications. As a result, for the first time the CPGs of these two major subspecialty organisations are in close agreement.","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"94 11 Suppl A","pages":"3-7"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1302/0301-620X.94B11.30824","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31020129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 38

Management of extensor mechanism rupture after TKA. TKA术后伸肌机构断裂的处理。

Journal of Bone and Joint Surgery-british Volume Pub Date : 2012-11-01 DOI: 10.1302/0301-620X.94B11.30823

A G Rosenberg

{"title":"Management of extensor mechanism rupture after TKA.","authors":"A G Rosenberg","doi":"10.1302/0301-620X.94B11.30823","DOIUrl":"https://doi.org/10.1302/0301-620X.94B11.30823","url":null,"abstract":"Disruption of the extensor mechanism in total knee arthroplasty may occur by tubercle avulsion, patellar or quadriceps tendon rupture, or patella fracture, and whether occurring intra-operatively or post-operatively can be difficult to manage and is associated with a significant rate of failure and associated complications. This surgery is frequently performed in compromised tissues, and repairs must frequently be protected with cerclage wiring and/or augmentation with local tendon (semi-tendinosis, gracilis) which may also be used to treat soft-tissue loss in the face of chronic disruption. Quadriceps rupture may be treated with conservative therapy if the patient retains active extension. Component loosening or loss of active extension of 20° or greater are clear indications for surgical treatment of patellar fracture. Acute patellar tendon disruption may be treated by primary repair. Chronic extensor failure is often complicated by tissue loss and retraction can be treated with medial gastrocnemius flaps, achilles tendon allografts, and complete extensor mechanism allografts. Attention to fixing the graft in full extension is mandatory to prevent severe extensor lag as the graft stretches out over time.","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"94 11 Suppl A","pages":"116-9"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1302/0301-620X.94B11.30823","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31020530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 64

Single stage revision: regaining momentum. 单阶段修正:恢复动力。

Journal of Bone and Joint Surgery-british Volume Pub Date : 2012-11-01 DOI: 10.1302/0301-620X.94B11.30746

S Gulhane, I S Vanhegan, F S Haddad

引用次数: 44