bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Role of Hip Arthroscopy in the Evaluation of Avascular Necrosis
Authors: Ruch David S , Sekiya Jon , Schaefer W Dickson , Koman L Andrew , Pope Thomas L , Poehling Gary G 
Published: April 2021

ABSTRACT
This prospective study evaluated the correlation between plain radiographs, magnetic resonance imaging (MRI), and diagnostic arthroscopy in the staging of avascular necrosis of the femoral head. Fifty-two hips in 46 patients were prospectively staged using radiographic and MRI staging systems. Patients subsequently underwent hip arthroscopy to visualize the articular surface prior to considering salvage of the femoral head and debride delaminated osteochondral fragments. Weighted Kappa analysis revealed only moderate correlation between MRI and plain radiographs (κ=.11), MRI and arthroscopy (κ=.21), and plain radiographs and arthroscopy (κ=.19). Six (46%) of 13 patients with a radiographically apparent subchondral fracture demonstrated collapse of the articular surface at arthroscopy. Four (24%) of 17 hips with >2 mm of collapse of the femoral head on plain radiographs demonstrated fragmentation of the osteochondral surface of the femoral head at arthroscopy. In 5 patients with flattening of the femoral head, 3 patients had delamination of both the femoral and acetabular surfaces. In regard to labral pathology, 5 of 22 post-collapse hips also had large bucket handle tears of the labrum. Arthroscopy of the hip revealed osteochondral degeneration that was not detected by plain radiographs or MRI in 36% of post-collapse femoral heads.
The Harris-Galante Porous Acetabular Component at Intermediate Follow-Up
Authors: D'Lima Darryl D , Yashar Arnold A , Venn-Watson Eric J , Colwell Clifford W , Walker Richard H 
Published: April 2021

ABSTRACT
Outcome of the acetabular component in 90 consecutive primary noncemented total hip arthroplasties (THAs) was prospectively studied. The acetabular cup consisted of a hemispherical titanium alloy shell with a titanium fiber-mesh porous coating and a modular polyethylene liner (Harris-Galante Porous-1, Zimmer, Warsaw, Ind). The cup was implanted using line-to-line reaming with adjunctive dome screw fixation. The femoral component consisted of a titanium alloy stem with titanium fibermesh porous coating and a 28-mm cobalt-chrome modular head. Mean patient age was 53 years (range: 27-75 years); male:female ratio was 48:42; and mean follow-up was 6 years (range: 4.5-8 years).
One acetabular component was revised for aseptic loosening. Of 81 unrevised hips available for follow-up, mean Harris hip score was 57 preoperatively and 96 at final follow-up (72% excellent, 15% good, 13% fair, and none poor). Of 61 unrevised hips with adequate radiographic follow-up, radiographic failure (complete periprosthetic radiolucency) was evident in 3 (4.9%) and periacetabular osteolysis in none. Radiographic failure did not correlate with poor clinical outcome. Linear polyethylene wear rate (mean: 0.13 mm/year) did not correlate with age, gender, weight, outcome, or cup abduction angle, but did correlate with the presence of femoral periprosthetic osteolysis (0.18 mm/year with femoral osteolysis versus 0.11 mm/year without; P=.01).
This series of porous-coated hemispherical cups demonstrated excellent intermediate-term clinical and radiographic outcome, comparable with similarly favorable results reported by the prosthesis designers. A potentially adverse effect of polyethylene wear on the longevity of a THA was supported by a positive correlation between polyethylene wear rate and femoral osteolysis.
Evaluation of Suspected Stress Fractures
Authors: Roebuck Jonathan D , Finger David R , Irvin Thomas L 
Published: April 2021

ABSTRACT
Stress fractures can occur if normal bone is exposed to repeated abnormal stress (fatigue fractures) or if normal stress is placed on bones with compromised elastic resistance (insufficiency fractures). This article describes two patients without a history of excessive stressful activity or apparent metabolic bone disease who developed bilateral distal tibial stress fractures. Different etiologies, clinical presentation, differential diagnosis, and diagnostic imaging modalities of stress fractures are discussed.
Role of FGF9 and FGF Receptor 3 in Osteochondroma Formation
Authors: Robinson D , Hasharoni A , Oganesian A , Sandell L J , Yayon A , Nevo Zvi 
Published: April 2021

ABSTRACT
Osteochondromas are chondro-osseous protuberances that occur in metaphyses of long bones. The cartilaginous cap is assumed to be responsible for the growth of the lesions during childhood and adolescence, but mitotic figures are rarely seen in the cap. Therefore, another cell population, probably mesenchymal cells, is responsible for proliferation and growth. Residual mesenchymal cells capable of rapid proliferation are difficult to detect due to lack of specific histologic features.
Two specific markers for mesenchymal cells, FGF receptor 3 (FCFR3) and collagen type Ha, have been described. Osteochondroma mesenchymal cells are found in the soft tissues overlying the cartilage cap. The surrounding areas of typical cartilage are negative for both mesenchymal cell associated antigens. The soft tissues overlying the cartilage do not have cartilaginous features. The undifferentiated cells overlying the exostosis yield in culture a rapidly proliferating homogenous population of fibroblast-like cells. Expression at the mRNA level of FGF9, FGFR3, and collagen type 11a is found in these cells, but not in skin fibroblasts from afflicted or healthy individuals. Exogenous administration of TGF^sub β1^ to cultures of hereditary multiple exostosis eliminates FGF9 expression. These results indicate fibrous regions contain the mesenchymal cells responsible for osteochondroma growth.
A Prospective Trial of Night Splinting in the Treatment of Recalcitrant Plantar Fasciitis: The Ankle Dorsiflexion Dynasplint
Authors: Berlet Gregory C , Anderson Robert B , Davis W Hodges , Kiebzak Gary M 
Published: April 2021

Abstract
Twelve patients were treated with the Ankle Dorsiflexion Dynasplint (Dynasplint Systems Inc, Severna, Md) for recalcitrant plantar fasciitis. Using a modified plantar fasciitis functional assessment scale and a visual analog pain assessment scale for evaluation, 75% of patients reported improvement of symptoms at 1-month follow-up. The average percentage of weekly sleeping hours spent in the splint was 95%. There was no tendency to deterioration of results by 6 months postsplinting. The Ankle Dorsiflexion Dynasplint is effective in the treatment of recalcitrant heel pain in a majority of patients. This study supports its use for the treatment of recalcitrant plantar fasciitis.
Coccygodynia: Treatment
Authors: Ramsey Michael L , Toohey John S , Neidre Arvo , Stromberg Lynn J , Roberts David A 
Published: April 2021

Abstract
This article presents a retrospective review of the treatment of coccygodynia. The past 5 years of conservative treatment for coccygodynia were reviewed, including local injection. The results were evaluated. Retrospectively, the past 20 years of surgical treatment for coccygodynia were reviewed and the clinical results were evaluated.
Twenty-four patients were treated with local injection and 15 patients were treated with coccygectomy. Local injection was successful in 78% of patients. Coccygectomy was successful in 87% of patients.
The results of conservative treatment with local injection for coccygodynia appear to be successful. However, no other historical literature exists to compare these results. The results of coccygectomy for coccygodynia were also highly successful, and the success rate compares favorably to previous historical data in the literature.
Anatomic and Radiographic Analysis of Arthroscopic Tack Placement into the Anteroinferior Glenoid
Authors: Ilahi Omer A , Younas Shiraz A , Trusler Marshall L , Espiritu Michael T 
Published: April 2021

Abstract
Tack location within the anteroinferior aspect of the glenoid when performing simulated repairs of anteroinferior capsulolabral avulsions (Bankart lesions) was evaluated anatomically and radiographically. Arthroscopy was performed on six fresh-frozen cadaveric shoulders, and bioabsorbable tacks were placed through an accessory anteroinferior portal coming into the joint just above the subscapularis tendon using an outside-in technique.
Tack location was studied after removal of all soft tissues. In addition to their position on the glenoid, the tacks were also evaluated for being partially or completely within bone. The tacks were recannulated with guide pins and anteroposterior, axillary, and en face glenoid radiographs of each specimen were obtained.
This study provides quantitative data about the inferior placement limitations of the insertion angle and location of fixation devices within the anteroinferior glenoid through the anteroinferior accessory portal.
Percutaneous Treatment of Long Bone Nonunions: The Use of Autologous Bone Marrow and Allograft Bone Matrix
Authors: Wilkins Ross M , Chimenti Brian T , Rifkin Robert M 
Published: April 2021

Abstract
Sixty-six patients with 69 "stiff" nonunions (no gross motion) of long bones were entered into a prospective study. The only therapeutic intervention was the percutaneous administration of a mixture of autologous bone marrow and allograft demineralized bone matrix on an outpatient basis. Sixty-one of the percutaneous treatments (88%) resulted in union at an average of 8.1 months (range: 2 months to 3 years). This method of treating nonunions is as successful as standard iliac crest autologous bone grafting and offers the distinct advantages of decreased morbidity, reduced costs, and shorter hospital stay.
The Use of Acellular Dermal Matrix as a Scaffold for Periosteum Replacement
Authors: Beniker Dan , McQuillan David , Livesey Stephen , Urban Robert M , Turner Thomas M , Blum Barbara , Hughes Kim , Haggard Warren O 
Published: April 2021

Abstract
Three preclinical models were used to evaluate GraftJacket Acellular Periosteum Replacement Scaffold (Wright Medical Technology, Inc, Arlington, Tenn). The studies assessed the ability of the acellular dermal matrix to repopulate with cells, revascularize, provide a protected environment for bone defect restoration, and minimize fibrous tissue infiltration. An athymic nude rat muscle implantation study demonstrated a steady increase in cellular repopulation through days 2-21. The formation of blood vessels occurred between days 7-14 in this study. Results from a porcine femoral drill hole study indicated that the scaffold material was intact and adherent to surrounding bone and allowed cellular repopulation and vascular infiltration at a 5-week time period. A preliminary porcine segmental bone defect model at a 6-week time period demonstrated the ability of the scaffold material to protect the bone defect site as revealed by new bone formation within the margins of the defect and adjacent to the scaffold. The segmental model also indicated minimal to no soft tissue invasion into the defect site. The combined studies provided preliminary evidence that the dermal membrane material may be used as a scaffold for periosteum regeneration by allowing for cellular repopulation, revascularization, and bone defect restoration.
Retrograde Interlocked Intramedullary Nailing of Supracondylar Distal Femur Fractures in an Average 76-Year-Old Patient Population
Authors: Armstrong Robert , Milliren Angela , Schrantz William , Zeliger Keith 
Published: April 2021

Abstract
Twenty-seven fractures of the distal femur in 27 adult patients were treated with retrograde, interlocked, intramedullary nails after intercondylar fracture extension had been reduced and treated with lag screws. Postoperatively, early mobilization exercises began immediately, but weight bearing was not allowed until clinical union was achieved, after which full weight bearing was permitted. Retrograde, interlocked, intramedullary nailing provides an excellent technique to establish union of supracondylar and distal femoral shaft fractures with a low complication rate and opportunity to regain knee motion in the mentally competent, motivated patient.
Takeoff Forces Transmitted to the Upper Extremity During Water-Skiing
Authors: Keverline Jeffrey P , Englund Richard , Cooney Timothy E 
Published: April 2021

Abstract
As data were unavailable, this study quantified the forces acting on the upper extremities during water-skiing takeoff in 10 male volunteers (mean age: 28 years). Body weight ranged between 141 and 195 lbs. Low, medium, and full-power takeoffs were used to propel each skier out of the water. Although low-power takeoffs produced significantly less peak force (P≤.Q004), they yielded a trend toward greater time under load (P=.097). As the data suggest that forces assume roughly one and one-half times body weight, individuals with pre-existing shoulder morbidity may risk exacerbation of their condition.
Effects of Selected Growth Factors on Porcine Meniscus in Chemically Defined Medium
Authors: Lietman Steven A , Hobbs William , Inoue Nozomu , Reddi A Hari 
Published: April 2021

Abstract
Some evidence shows that selected growth factors can increase proteoglycan synthesis and that fibrin clot aids in the repair of meniscal tears. A significant (P<.05) dosedependent stimulation of proteoglycan synthesis was found with platelet-derived growth factor AB (PDGF[AB]), transforming growth factor-β1 and bone morphogenetic protein-7 (osteogenic protein-l). In separate experiments, a significant increase in celiularity was found in the deep and superficial aspects of the expiants treated with PDGF-(AB) compared with those treated with basal medium alone. The current study provides data as to which growth factors might prove most useful in the maintenance and repair of menisci.
Shoulder Arthroplasty Without a Rotator Cuff
Authors: Rockwood Charles A 
Published: April 2021

Patients with glenohumeral arthritis and absent or irreparable lesions of the rotator cuff represent a therapeutic challenge for orthopedic surgeons. In the June issue of Orthopedics, Dr Gilles Walch discussed the Delta reverse design shoulder prosthesis as a method of managing this problem.
Although the Delta prosthesis is currently successful in Europe, it is not yet available in the United States. One technique for managing this problem in North America as well as Europe is a new system that uses the standard Global Advantage humeral component with the special Cuff Tear Arthropathy head.
In this issue of Orthopedics, codeveloper and inventor of the Global™ Total Shoulder Prosthesis System, Dr Charles A. Rockwood, Jr discusses treatment options, which are currently available in the United States, for patients with glenohumeral arthritis and irreparable rotator cuff defects.
Modular Junctions
Authors: Cameron Hugh U 
Published: April 2021

abstract
A concern about modular stems is that the taper will not provide an adequate seal, causing the stem distal to the taper to become part of the effective joint space. In this study, 380 primary patients and 309 revision patients were treated with a proximally modular stem. Follow-up was between 5 and 17 years (mean 9.4 years). Three patients only had distal osteolysis. All three patients had failure of proximal bone ingrowth. It was concluded that a Morse taper provides an adequate seal or gasket.
The S-ROM Modular Stem for Femoral Deformities
Authors: Mattingly David A 
Published: April 2021

abstract
Many conditions produce femoral deformities that complicate primary total hip arthroplasty (THA). In each patient, treatment must be individualized to address the level of the deformity, the type of deformity, and bone quality, as well as surgeon preference. The S-ROM femoral component (DePuy Orthopaedics, Warsaw, lnd) is useful for many deformities from the level of the greater trochanter to the diaphysis. The S-ROM stem optimizes proximal and distal implant stability, allows maximal torsional stability during osteotomies, and permits easy adjustments to anteversion, offset, and leg length to provide optimal biomechanieal reconstruction of the deformed femur in THA. Clinical results with few complications are achievable when using the S-ROM stem in complex deformities.
The Management of Malalignment in Hip Revision Surgery
Authors: Marega Luca 
Published: April 2021

abstract
When facing revision surgery, the deformation of the femur must be considered for the important implications in the strategy of the operation and the choice of the implant. Deformation can occur in varus and retroversion, or both, in different degrees. For severe varus deformations a straightening osteotomy is generally indispensable and different types of distal fixations of the implant are necessary; in milder deformations other solutions are possible. Retroversion can be generally managed with proximally modular stems, stems without metaphyseal component, or, rarely, with a derotation osteotomy.
The Rationale and Performance of Modularity in Total Hip Arthroplasty
Authors: Heim Christine S , Greenwald A Seth 
Published: April 2021

abstract
Modularity in total hip arthroplasty design is an evolving concept that continues to receive citation in the clinical literature. The advantages of these systems include off-the-shelf flexibility for customizing proximal and distal canal filling, as well as accommodation of difficult situations of femoral deformity and bone loss. Clinical concerns in the application of modular femoral stem hip designs include the maintenance of anatomical stability within the femoral canal component dissociation, structural compromise at metal-metal interconnections due to cyclic microdisplacements (fretting), and the increased potential for metallic-wear debris generation. This article reviews the rationale and performance of typical modular systems.
OrthoPilot Total Hip Arthroplasty Workflow and Surgery
Authors: Kiefer Hartmuth , Othman Aneis 
Published: April 2021

abstract
To analyze the workflow and navigation principles of the OrthoPilot total hip arthroplasty (THA) Version 2.0 (B. Braun-Aesculap, Tuttlingen, Germany), a consecutive series of 60 patients was used to compare the navigated intraoperative data and postoperative measurements of stem and cup position. Within the safe zone, 96.3% of 54 acetabular cups were positioned. The rotational accuracy of femoral instruments was 65° in 41 THAs. The femoral offset was medialized by 6.05 mm in 76% and lateralized by 2.1 mm in 14%. The data for leg length and range of motion from 60 THAs and the navigated data were similar. Thus, the first clinical validation of the workflow of the OrthoPilot THA Version 2.0 is encouraging.
Minimally Invasive Navigated Knee Surgery: A European Perspective
Authors: Gregori Alberto 
Published: April 2021

abstractEuropean surgeons and North American surgeons have different approaches to minimally invasive total knee arthroplasty (TKA). Computer-assisted navigation emphasizes these differences. In this article, the author rethinks what surgeons are trying to achieve and notes that quality control is demanded by patients and surgeons. Although minimally invasive TKA is an accepted procedure, reflection on the facts suggests that the use of minimally invasive surgery and TKA navigation are intertwined and cannot be separated.
Reducing the Risk of Deep Wound Infection in Primary Joint Arthroplasty With Antibiotic Bone Cement
Authors: Block Jon E , Stubbs Harrison A 
Published: April 2021

abstractDespite significant advances in intraoperative antimicrobial procedures, deep wound infection remains the most serious complication associated with primary, cemented total joint arthroplasty. A systematic review was conducted to evaluate studies oí antibiotic bone cement prophylaxis for reducing the risk of deep wound infection. The literature included 22 articles providing estimates of the prophylactic effectiveness of antibiotic cement. In reducing deep wound infection, antibiotic cement was consistently superior to plain cement, similar to systematic antiobiotics, and independent and additive in effect when combined with other prophylactic measures. Randomized controlled trials in particular had important methodological limitations. However, the collective results nearly unanimously favored prophylactic use of antibiotic cement in primary arthoplasty procedures.
Extramedullary Versus Intramedullary Tibial Alignment Guides for Total Knee Arthroplasty
Authors: Rottman Steven J , Dvorkin Michael , Gold David 
Published: April 2021

abstract
This retrospective study evaluated whether intramedullary or extramedullary tibial alignment guides are more accurate in assuring correct tibial component positioning in total knee arthroplasties (TKAs). Fifty-five TKAs were performed with the only difference being whether an intramedullary (31) or extramedullary (24) cutting guide was used. Pre- and postoperative tibiofemoral angle, tibial component alignment angle, and femoral component alignment angles were measured and the results were statistically analyzed. We also performed a subgroup analysis on the preoperative varus knees to determine if the presence of a varus deformity would have better results with either the intramedullary or extramedullary cutting guide. The 2-sample t test was used to compare the results of the two groups. The results showed no statistical difference in alignment of the tibial component when using the intramedullary or extramedullary guides.
The Reverse Sural Neurocutaneous Flap for Hindfoot and Ankle Coverage: Experience and Review of the Literature
Authors: Rohmiller Michael T , Callahan Barry S 
Published: April 2021

abstract
Soft-tissue defects about the ankle are common in orthopedic surgery. The wounds usually involve exposed bone or hardware, making skin grafting a poor option. Free tissue transfer remains a mainstay of treatment. Recently, the reverse sural neurocutaneous flap has gained popularity. At our institution, 1 1 fasciocutaneous flaps have been performed for defects averaging 53cm-. All flaps achieved stable coverage. One patient required repeat skin grafting. Given its reliability, easy dissection, and outpatient capability, this flap should be considered for coverage in this region.
Microcomputers Enhance Student Health Fairs
Authors: Ahijevych Karen , Boyle Kathleen Kluznik , Burger Karen 
Published: April 2021

ABSTRACT
To stimulate student interest in learning about health, faculty assigned students the task of planning and implementing a university health fair. Two questions were posed: (1) Could sophomore students effectively plan and implement a health fair as a learning opportunity? (2) Could microcomputers be used appropriately to influence client participation and to enhance the nurse-client interactions?
Literature regarding the efficacy of the health fair as a mode of health care delivery and as a student learning opportunity and literature addressing the advantages of microcomputer use were reviewed. Two health fairs were piloted. Microcomputers were employed in three areas: nutrition, stress, and substance abuse. Students, with faculty guidance, developed educational materials using principles of teaching, learning, and health promotion. Clients rated the health fair as congruent with their health needs. Students identified learning gained from the experience. Students and clients were receptive to computer use. Future directions are discussed.
Professional Nursing Education: What is its Purpose?
Authors: Butterfield Shona E 
Published: April 2021

ABSTRACT
Rogers (1970, p. 88) has written "The purpose of professional education is to provide the knowledge and tools whereby an individual may become an artist in his field. It is not to prepare the skilled practitioner." This statement is used to provide a basis for discussion of some issues involved in relation to nursing and nursing education.
The problem area is first clarified before discussion moves on to show the relevance of conceptual models and theory to professional nursing education and to look at the kinds of knowledge and tools which could be provided to promote artistry in nursing.