bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE USEFULNESS OF MRI IN EVALUATING MENISCI AFTER MENISCUS REPAIR
Authors: Bronstein Robert , Kirk Patrick , Hurley John 
Published: April 2021

ABSTRACT
We reviewed magnetic resonance imaging (MRI) scans of 15 asymptomatic patients at 6 months to 1 year following meniscal repair procedures. All of the patients were found to have persistent MRI signals in the region of the repair. Nine of the 17 meniscal repairs in the 15 patients had persistent grade 3 signals. Arthrograms were performed on six patients (eight meniscal repairs). Seven of these postoperative menisci showed grade 3 signals on MJRI. Only one meniscus was shown to have a complete tear by arthrogram. There were no false negative scans. The overall accuracy, defined as the percentage of postoperative menisci correctly diagnosed by MRI, was 38% (3/8). MRI is a useful preoperative diagnostic study following knee injury. This report demonstrates, however, that present MRI modalities are unable to distinguish between scar tissue of healed meniscal repairs and meniscal tears. Therefore, it is not a useful diagnostic tool in evaluating reinjury following successful meniscal repair.
CHARNLEY LOW-FRICTION ARTHROPLASTY: 19- to 25-YEAR RESULTS
Authors: Wroblewski B M , Taylor G W , Siney P 
Published: April 2021

ABSTRACT
Our review of 54 patients (57 Charnley low friction arthroplasties) with a 19 to 25 year follow up shows that clinical results remain excellent; clinical results bear no relation to the radiologic appearances of the bonecement interface on the acetabular side; and the long-term problem is socket wear. The need for regular follow up and study of factors affecting socket wear is emphasized.
MRI CLASSIFICATION OF LUMBAR HERNIATED INTERVERTEBRAL DISC
Authors: Kim Key Yong , Kim Yung Tae , Lee Choon Sung , Shin Myung Jin 
Published: April 2021

ABSTRACT
A consecutive series of 28 patients with lumbar herniated intervertebral disc (HIVD) who exhibited positive magnetic resonance imaging (MRI) findings was analyzed and compared with operative findings to define the type of disc herniation. This prospective study showed that the overall accuracy of MRI in predicting the types of HIVD was 80.6%. Proton density image was the most helpful in differentiating protruded discs from extruded ones. Disruption of "posterior longitudinal ligament une," defined on T2-weighted sagittal image, was reliable in differentiating a transligamentous disc from subligamentous one. Sequestered disc could be more accurately diagnosed with Gadolinium-DTPA enhancement, which showed anterior rim enhancement of the sequestered portion on T1- weighted axial image.
IMPENDING FRACTURE ASSOCIATED WITH BONE DESTRUCTION
Authors: Thompson Roby C 
Published: April 2021

ABSTRACT
In the patient with metastatic bone disease, destruction of bone threatens the structural support of the skeletal system. Osteoporosis, stress-risers, and the open-section effect result in pain, immobilization, and fractures. The establishment of more clear-cut indications for prophylactic fixation will lessen the morbidity associated with a pathologic fracture.
GENERAL PERSPECTIVES, PATHOGENESIS, PATHOPHYSIOLOGY AND SKELETAL DYSFUNCTION
Authors: Frassica Frank J , Sim Franklin H 
Published: April 2021

ABSTRACT
A better understanding of the pathogenesis and pathophysiology of the metastatic process is leading to improvements in diagnosis and treatment. Evaluation of specific areas of disorder of skeletal function, including hematopoiesis, mineral metabolism, and structural support, is important. Continued developments are necessary to minimize or prevent effects on the skeleton related to the metastatic process.
METASTATIC DISEASE OF THE SPINE
Authors: O'Connor Mary J , Currier Bradford L 
Published: April 2021

ABSTRACT
Advances in imaging studies and techniques of spinal stabilization permit improved surgical treatment of patients with metastatic disease of the spine. Preoperative evaluation, selection of patients for operative management, and results of published clinical series are reviewed. Surgical approaches for optimal tumor excision, neural decompression, and spinal stabilization are discussed.
METASTATIC DISEASE OF THE FEMUR
Authors: Wilkins Ross M , Sim Franklin H , Springfield Dempsey S 
Published: April 2021

ABSTRACT
Metastatic involvement of the femur is a common clinical problem and accounts for the third highest incidence after the spine and pelvis. These patients are confronted with the possibility of losing the ability to ambulate during their remaining months. However, with improved prosthetic implants and internal fixation devices, most patients can resume their previous activities after operative treatment of their femoral fractures.
SUPRACONDYLAR FRACTURES OF THE HUMERUS IN CHILDREN
Authors: Harris Irwin E 
Published: April 2021

ABSTRACT
Supracondylar fractures of the humerus in children are either flexion or extension in type. Associated nerve or vascular injury is common. Fractures that remain stable after reduction can be treated with elbow flexion. If the fracture is unstable or if circulation is compromised, percutaneous pinning or traction treatment is utilized. The ischemic hand is always evaluated for brachial artery damage or for the presence of a compartment syndrome. Varus positioning should always be avoided, but other malalignments either remodel or are not of functional significance.
SEPARATION OF TENDON ENDS AFTER ACHILLES TENDON REPAIR: A PROSPECTIVE, RANDOMIZED, MULTICENTER STUDY
Authors: Mortensen Niels Henrik Maagaard , Saether Jan , Steinke Martin Soe , Staehr Henrik , Mikkelsen Soren Sondergård 
Published: April 2021

Abstract
Fifty-seven patients treated for an acute rupture of the Achilles tendon were studied. The patients were randomized into a Mason suture technique or a reinforced continuous six-strand suture technique, and markers were attached to each tendon end perioperatively. The postoperative separation of the markers was studied by repeat radiographic examination. Despite immobilization, separation developed after a Diphasic course, and after 7 weeks the mean separation was 10.5 mm. No difference was found between the two techniques. We attempt to correlate the separation to the clinical outcome, examined at 1 year follow up.
LUMBAR HERNIATED DISK DISEASE: COMPARISON OF MRI, MYELOGRAPHY, AND POST-MYELOGRAPHIC CT SCAN WITH SURGICAL FINDINGS
Authors: Janssen Michael E , Bertrand Styles L , Joe Clarence , Levine Monroe I 
Published: April 2021

ABSTRACT
One hundred eighty patients with suspected lumbar disk disease were evaluated preoperatively with magnetic resonance imaging (MRI)9 myelography, and post-myelogram computerized tomography (CT) scan. Sixty patients underwent surgery on 102 disk levels, allowing for anatomic confirmation of the diagnosis. Eight negative explorations were performed. The correlation between preoperative interpretations of each test and the observed surgical findings was analyzed statistically. Based on this analysis, MRI accurately predicted the operative findings in 98 of 102 disk levels (96%), while the accuracy of myelography (81%) and post-myelogram CT scan (57%) was significantly less. When myelography and CT scan were utilized jointly, the accuracy was 84%, a significant improvement over either test alone, as a diagnostic modality. There was only one false positive MRI study in the evaluation of lumbar herniated disk. The results of this study reflect that MRI is a clinically superior diagnostic test in the evaluation of patients with suspected lumbar disk herniation, and that it should be the diagnostic study of choice when available. Its noninvasive nature, multiplanar capabilities, and the lack of ionizing radiation are particularly desirable for patient and physician.
HYDROXYAPATITE COATINGS
Authors: Thomas Kevin A 
Published: April 2021

ABSTRACTA series of investigations over the past several years has evaluated a number of implant materials with and without plasma-sprayed hydroxyapatite (HA) coatings for use in load-bearing implant applications. HA-coated implants have exhibited greater interface shear attachment characteristics when compared to uncoated implants; these results have been demonstrated with dense (flat), porouscoated, and macrotextured implant surfaces. Maximum attachment strength also was found to occur within a shorter period of time postoperatively with the HA-coated samples, indicating a more rapid tissue adaptation to the implant surfaces. Plasma-sprayed HA coatings provide an osteophilic and osteoconductive surface that increases both the bone-implant attachment strength, as well as the rate of bone adaptation to the HA-coated implant surface.
MICRODISKECTOMY FOR LUMBAR DISK HERNIATION: A REVIEW OF 100 CASES
Authors: Lowell Troy D , Errico Thomas J , Fehlings Michael G , DiBartolo Tracy J , Ladosi L 
Published: April 2021

ABSTRACT
One hundred patients who underwent microlumbar diskectomy over 5 years were retrospectively reviewed. L4-5 and L5-S1 were compared to determine whether a patient's post-surgical outcome is related to the level where a herniation has occurred. Overall results included 70 excellent, 19 good, 2 fair, and 9 poor. Statistical analysis showed that neither the level involved, length of follow up, nor degree of manual labor predicted outcome. Older patients and females tended to fare worse, but the trends were not significant. Three recurrent herniations occurred, 1 in the L4-L5 group and 2 in the L5-S1 group. No variable predicted recurrence.
IMPLEMENTATION OF GUIDELINES FOR PREVENTION OF DEEP VEIN THROMBOSIS IN A MANAGED CARE ENVIRONMENT
Authors: Brox W Timothy 
Published: April 2021

ABSTRACT
Implementation strategies are key factors in determining the overall success of clinical guidelines. They are important for changing physician practices and expected to result in clinical improvement or cost savings. Within an organization, the method of implementation should be a major component of the development of the guideline itself. In a group practice system, clinical guidelines must be clear and provide numeric thresholds or explicit criteria for decision points and subsequent action. Assessing the overall impact of a clinical practice guideline provides excellent feedback in determining whether goals are being met and provides guidance for finetuning strategic approaches. With regard to the prevention of deep vein thrombosis (DVT) monitoring, the overall results of a clinical practice guideline would assess guideline compliance, complications of the guideline interventions, as well as the incidence of DVT, pulmonary embolism, hospital readmissions, and mortaiïty.
BALANCING THE CLINICAL OUTCOMES AND ECONOMICS ASSOCIATED WITH THROMBOEMBOLIC PROPHYLAXIS
Authors: Carter Charles A 
Published: April 2021

ABSTRACT
The approach to the treatment of patients is being influenced by the movement towards integrating health care services. This trend presents several challenges to health care professionals as patients move through the cycles of wellness, prevention, acute treatment, and after-care. Consequently, the development of treatment guidelines based upon clinical and economic parameters is critical. Preventing thromboembolic complications is receiving a great deal of attention due to the tremendous medical and economic consequences of deep venous thrombosis and pulmonary embolism. The early discharge of patients from acute surgical and medical facilities is increasing the need to consider outpatient prophylaxis. Pharmacoeconomic modeling demonstrates that enoxaparin may be more cost-effective than warfarin for outpatient prophylaxis when used for 3 weeks or less. The requirement of a subcutaneous injection of enoxaparin is not a detraction to this recommendation. Patient self-medication is a common practice and is growing in prevalence. Patients are eager to learn about their illnesses and treatment options as a result of their attitudes regarding empowerment and responsibility for their own health care.
Low-Molecular-Weight Heparin: From the Bench to the Orthopedic Patient
Authors: Turpie A G G 
Published: April 2021

ABSTRACT
Standard heparin is widely used for the prevention and treatment of venous thromboembolism; however, it has several limitations including variable dose response, dose-dependent clearance and inhibition of platelet function. To overcome these disadvantages, standard heparin, which is composed of glycosaminoglycans of various molecular weights, has been fractionated into its low-molecular-weight component. Low-molecularweight heparin (LMWH) exhibits less binding to plasma proteins and endothelial cells than standard heparin resulting in a more predictable dose response profile, a dose-independent mechanism of clearance and a longer plasma half-life. LMWH also has a lower binding affinity for platelets and produces less microvascular bleeding. Evidence from randomized clinical trials demonstrates that LMWH is effective in the prevention of deep vein thrombosis (DVT) in high-risk orthopedic patients. There is also considerable evidence of its efficacy and safety in the initial treatment of proximal DVT. Recent studies have demonstrated the feasibility of home treatment with LMWH, which offers the advantage of greater clinical utility compared with current antithrombotic regimens and hence the possibility of cost savings.
Optimizing Hospital Reimbursement Through Physician Awareness: A Step Toward Better Patient Care
Authors: Cole Brian J , Flic Susan , Levine David B 
Published: April 2021

ABSTRACT
We instituted a training program to improve the overall accuracy of medical record coding through greater physician awareness to enhance hospital reimbursement and maintain quality patient care. A physician-targeted course reviewed the prospective payment system, diagnosis-related group guidelines, ambulatory surgery reimbursement, and the relationship between accurate physician documentation and medical record coding. Annual increases in charges from prospective surgical case assignment, proper conversion of outpatient to inpatient status, and more accurate coding of inpatient comorbidities and complications led to an estimated increase in hospital charges of $1.6 million.
The Richards Series 2 Total Hip Prosthesis: A 13-Year Study and Radiographic Evaluation
Authors: Laursen Jens Ole , Petersen Birgitte , Mossing Niels B 
Published: April 2021

ABSTRACT
This retrospective long-term study analyzes the clinical function, failures, and radiographic status of 131 Richards Series 2 prostheses in total hip arthroplasties (THAs) performed during 1981 and 1982. After a minimum follow-up period of 11 years, the results were evaluated. Sixty two (54%) patients with 71 THAs were available for follow-up; 44 (38%) patients with 49 THAs had died. Three patients with three THAs were lost to follow-up, and seven patients with eight THAs were unable to participate in the examination due to causes not related to their present hip status. Ten patients underwent revision THA during the observation period.
The median hip functional index (HFI) was 8.6 preoperatively and 15.8 at follow-up. Hip functional index correlated to radiographic signs of loosening. With revision as endpoint, the Kaplan-Meier survivorship for all 131 hips was 93% after 10 years and 91% after 12 years. The radiographic examination at follow-up revealed 5 (8%) definite loose cups and 12 (19%) definite loose stems. Including the number of aseptic loosened cups and stems confirmed at revision, aseptic loosening was found in 6% of all cups and 13% of all stems.
This radiographic evaluation confirmed that lack of containment of the cup and varus position of the stem were factors influencing the long-term stability of the prostheses, whereas etiology, type of arthritis, and ectopic ossification did not. A fixation and stability score that was modified for cemented prostheses was developed and was of value in detecting the prostheses at risk. The long-term results of the Richards Series 2 THA are acceptable and comparable with other long-term studies on conventional prosthestic designs. Ten percent to 20% revision THAs due to aseptic loosening can be expected. In addition, patients younger than age 60 at surgery and especially men were found to belong to a high-risk group with regard to revision THA. These patients must be evaluated carefully so that revision THA can be performed before the bone bed is destroyed.
Osteochondritis Dissecans of the Elbow Managed by Herbert Screw Fixation
Authors: Kuwahata Yoshio , Inoue Goro 
Published: April 2021

ABSTRACT
Seven patients (eight elbows) with osteochondritis dissecans were treated with cancellous bone grafts and internal fixation of the fragment using a Herbert screw. Average follow-up was 32 months. All patients were pain-free and returned to previous sporting activities. The postoperative range of motion of the elbow increased by an average of 18°. Radiographs showed complete reossification of the capitular cyst and normaly contoured joint surface.
Treatment of Humeral Fractures by Closed Reduction and Retrograde Intramedullary Ender Nails
Authors: Shazar Nachshon , Brumback Robert J , Vanco Bohumil 
Published: April 2021

ABSTRACT
A retrospective review of 94 humeral shaft fractures stabilized with retrograde Ender nails was performed to determine the safety and efficacy of this technique. Follow-up averaged 71 weeks. Eighty-six (91.5%) healed with no additional intervention (average: 14 weeks). There were eight (8.5%) nonunions. The functional results were good in 74 (81%), fair in 12 (1 3%), and poor in 5 (6%). There was one radial nerve palsy secondary to the operative procedure. The reoperation rate, including the repair of nonunions, was 19%. We conclude that intramedullary Ender nail fixation is a relatively simple and quick procedure, especially for the multiply injured patient, that adequately stabilizes most humeral fractures, yielding overall good results.
Follow-up of Intertrochanter Osteotomy of the Hip During a 25-Year Period
Authors: McGrory Brian J , Estok Daniel M , Harris William H 
Published: April 2021

ABSTRACT
In 1984, in reporting follow-up on 67 hips in 61 patients who underwent intertrochanteric osteotomies for osteoarthritis of the hip, we found that between 1 2 and 1 5 years after osteotomy, 34% (23) of the 67 hips remained functional and the remainder had been converted to an arthroplasty. We now report on the fate of those osteotomies over a 25-year period.
Ten patients with 10 osteotomies did not require an arthroplasty, having died without requiring conversion to total hip arthroplasty at an average of 18.3 years after osteotomy (range: 11 to 24.1 years). Two others were living at an average of 25.2 years after osteotomy without requiring conversion. Thus, for 18% of the hips, no further hip surgery was performed. For the remaining 55 hips in 49 patients, the osteotomy had served for an average of 9.8 years (range: 1 .3 to 26.1 years) before requiring arthroplasty.
The cumulative probability of osteotomy survival was 57.8% (standard error: 6.0%) at 1 0 years, 20.0% (standard error: 4.9%) at 20 years, and 5.7% (standard error: 2.9%) at 25 years by Kaplan-Meier survivorship analysis.
ACL Reconstruction in Children With Open Physes
Authors: Bisson Leslie J , Wickiewicz Thomas , Levinson Michael , Warren Russell 
Published: April 2021

ABSTRACT
Nine male patients with wide open physes who underwent intra-articular anterior cruciate ligament (ACL) reconstruction using semitendinosus and gracilis tendon grafts passed through the tibial physis and over the top of the femoral condyles were retrospectively reviewed at an average follow-up of 39 months (range: 24 to 72 months). Five patients underwent reconstruction <6 weeks following injury (range: 11 days to 41 days); the other four underwent reconstruction 2, 3, 5, and 24 months following injury. Seven patients had excellent results and fully returned to their sport. Mean Lysholm score in these patients was 99 (range: 95 to 100), and the mean maximum KT-1000 difference (available for six patients) was 2.8 mm (range: 0 to 5.5 mm). Four of six intact grafts had a mean maximum KT-1000 difference ^3.5 mm. Two grafts ruptured and were considered failures (one complete rupture at 10 months and one partial rupture at 3 years). Postoperative height increase averaged 10.7 cm (range: 4 to 22.9 cm). No patient had a clinically significant leg-length discrepancy, angular deformity, or radiographic evidence of physeal injury.
Polymethylmethacrylate Removal From the Femur Using a Crescentic Window Technique
Authors: Buehler Knute O , Walker Richard H 
Published: April 2021

ABSTRACT
This article describes a technique to aid in removal of polymethylmethacrylate during total hip arthroplasty revision. The technique is a modification of prior windowing techniques and requires no specialized instruments, offers substantial flexibility regarding cement removal and femoral prosthetic choice, and minimizes the amount and duration of stress on the femur.
The technique involves making an oblong window in the anterior or anterolateral femur. Proximal and distal osteotomies are made with a crescentic oscillating saw and connected by straight beveled anterior and posterior longitudinal osteotomies using a straight oscillating saw. Once the intramedullary canal is prepared, either a nonecmented or cemented femoral prosthesis can be placed. The cortical window is replaced with a single cable used for fixation.
Location of the Sacral Pedicle, Foramina, and Ala on the Lateral Aspect of the Sacrum: A Radiographic Study
Authors: Ebraheim Nabil A , Xu Rongming , Challgren Eric , Heck Bruce 
Published: April 2021

ABSTRACT
Twenty-one adult dry-bone sacral specimens were used to quantitatively determine the location of the sacral pedicle, foramina, and ala on the lateral radiographic view of the sacrum. The anterior and posterior sacral foramina from SI to S3, the midlines of the anterior sacrum and cephalad border of the S1 vertebral body, and the lateral limit of the lateral sacral mass were outlined with wires. A lateral radiograph was taken, and measurements were made directly from the radiograph.
The average sacral pedicle height for both male and female specimens was approximately 20 mm for Sl , 1 2 mm for S2, and 7 mm for S3. The sacral foramina height averaged approximately 1 3 mm for S1 and S2, and 10 mm for S3. The average ala and S1 body-ala angles were 88° and 35°. The distance from the ala tip to the anterior aspect of the sacrum averaged 1 2 mm, and the average anterior height of the Sl vertebral body above the ala was 11 mm. These measurements, in conjunction with inlet and outlet radiographs, may aid in the recognition of the vital structures of the sacrum on the lateral radiographic view and enhance the safety of dorsal sacral screw placement.
Treatment of Articular Cartilage Defects in Athletes: An Analysis of Functional Outcome and Lesion Appearance
Authors: Blevins Field T , Steadman J Richard , Rodrigo Juan J , Silliman Jim 
Published: April 2021

ABSTRACT
This article characterizes chondral injuries and reviews the results of microfracture treatment in high-level competitive and recreational athletes. Thirty-eight high-level and 140 recreational athletes completed functional questionnaires preoperatively and yearly postoperatively, recording symptoms, function, and activity level. Second-look arthroscopy tapes were available in 26 high-level and 54 recreational athletes.

The mean follow-up for the high-level athletes was 3.7±1.4 years. Chondral defects averaged 223±180 mm
p 2
. Lesion size and follow-up were not significantly different in the recreational group. Functional questionnaire responses demonstrated significant improvements from the time of microfracture to final follow-up. Improvement in function and symptoms was similar for the competitive and recreational athletes.