bluuebunny/crossref_metadata_2025_split huggingface dataset:
PES ANSERINUS TRANSPLANTATION WITHOUT A ROUTINE MEDIAL MENISCECTOMY: A REVIEW OF TWENTY-TWO CASES
Authors: Taylor Michael M , Shields Clarence L , Kerlan Robert K , Jobe Frank W , Carter Vincent S , Lombardo Stephen J 
Published: April 2021

ABSTRACT: Of 549 pes anserinus transplantations performed at the National Athletic Health Institute, Inglewood, California from 1971 through 1977, only 27 involved the transfer for anteromedial rotational instability in the presence of an intact medial meniscus. The 22 patients reviewed were evaluated with a questionnaire, physical and roentgenogram examinations, and hamstring and quadriceps muscle testing with Cybex II isokinetic dynamometer. Average length of follow-up was one year, four months. Acute anteromedial rotational instability was seen in 16 patients while six had chronic instability. All had an injury to the anterior cruciate ligament, and 12 had associated medial collateral ligament tears. One year postoperatively, 93% of the patients were participating in athletics and 70% rated their knee as above 90% of normal. The Cybex evaluation, however, revealed only 50% of the patients had 90% of normal strength in hamstrings and quadriceps. One patient developed anteromedial rotational instability, and one a torn medial meniscus, two years postsurgery. It was concluded that: I) Routine medial meniscectomy is not necessary with pes anserinus transplantation; 2) Anterolateral rotary instability does not routinely develop after pes anserinus transplantation done without medial meniscectomy; and 3) Hamstring and quadricep muscle strength below 90% of the normal extremity is not indicative of a subjective unsatisfactory functional result.
Indexing terms: pes anserinus transplant; medial meniscectomy; anteromedial rotational instability; anterior cruciate ligament; and medial collateral ligament.
A Double Blind Trial of NSAID Versus Placebo During Rehabilitation
Authors: Arvidsson Inga , Eriksson Enjar 
Published: April 2021

ABSTRACT: Forty patients participated in a randomized, parallel, double blind study of Piroxicam, 20 mg daily, versus placebo, given orally for 10 days following open partial meniscectomy. On day 1, 3, 7, 11, and 21 after surgery the following parameters were studied: quadriceps torque measured isokinetically; patients' assessment of pain; active and passive range of motion measured with goniometer; degree of swelling and irritation of the operated knee; and efficacy of the medication.
The mean values for all parameters, except for pain assessment, were in favor of the piroxicam group. This difference was most marked on day 7 and 11 and on these days highly significant. Our findings indicate that piroxicam may be able to improve early postoperative rehabilitation.
PROPHYLACTIC CERCLAGE: A METHOD OF PREVENTING FEMUR FRACTURE IN UNCEMENTED TOTAL HIP ARTHROPLASTY
Authors: Herzwurm Paul J , Walsh John , Pettine Kenneth A , Ebert Frank R 
Published: April 2021

Abstract
The incidence of femur fracture in noncemented hip arthroplasty has been reported to be between 4.1 % and 27.8%. To quantitate the hoop stress generated during insertion of a femoral broach in total hip arthroplasty and determine the effect of cerclage with both braided cable and wire, we harvested 14 pairs of embalmed cadaver femurs. These were reamed and broached to duplicate the surgical technique of inserting a straight non-cemented femoral component. Group one consisted of eight matched cadaver femurs which were tested using a single 2.0 mm chrome-cobalt cable placed around the calcar of one femur, with the other serving as a control. Group two consisted of five matched cadaver femurs which were tested using a single 18 gauge cerclage wire in the same manner. In group one, the femurs serving as controls were found to have a mean microstrain of (1425.00 ± 1 180.19). The eight femurs tested with a 2 mm cable were determined to have a mean microstrain of (4179 + 2853.89).
In group two, the femurs serving as controls were found to have a mean microstrain of (962.60 ±956.78). The five femurs in group two tested with a cerclage wire were determined to have a mean microstrain of (1112.00 ±975.66). Using a paired t-test, statistical significance was achieved with a confidence level of P=s.01 in group one. Prophylactic wiring of the proximal femur with 2 mm cable increases the hoop stress resistance and, therefore, should decrease the incidence of intraoperative femur fractures in uncemented total hip arthroplasty.
A COMPARISON OF EPIDURAL AND NON-EPIDURAL ANESTHESIA AND ANALGESIA IN TOTAL HIP OR KNEE ARTHROPLASTY PATIENTS
Authors: McQueen David A , Kelley Helen K , Wright Timothy F 
Published: April 2021

ABSTRACT
This retrospective study explores a number of variables encountered with the use of either epidural or non-epidural anesthesia and analgesia. Postoperative mobility, amount of narcotic used, incidence of blood transfusion, length of stay, and presence of urinary retention, prurjtis, nausea and vomiting, or respiratory depression were compared in a group of 101 consecutive patients scheduled for total hip or knee arthroplasty. Fifty-two patients received epidural anesthesia and analgesia; the remaining 49 received nonepidural anesthesia, followed by standard IM/IV postoperative analgesia. Epidural patients required significantly less narcotic than the non-epidural group. There were significantly fewer blood transfusions in the epidural group; however, epidural patients had significantly increased incidence of urinary retention and pruritis. The use of epidural anesthesia and analgesia for total hip and knee arthroplasty patients has definite merit, but is most safely administered in a monitored, skilled nursing unit
ARTHROSCOPIC CAPSULAR SUTURE FOR ANTERIOR INSTABILITY OF THE SHOULDER
Authors: Rhee Kwang-Jin , Ahn Sang-Rho , Lee Jeong-Koo 
Published: April 2021

ABSTRACT
We assessed the results of arthroscopic transglenoid capsular suture in eight recurrent traumatic unidirectional anterior dislocations. At an average follow up of 11 months, ranging from eight to 18 months, assessment by Rowe's scoring system were excellent or good in all shoulders. There were no redislocations and all patients achieved near full, painless range of motion. There were no complications. We propose a new classification of anterior capsular lesions (Bankart lesion) and we describe the details of the arthroscopic suture technique. We conclude that arthroscopic suture is an effective method with low surgical morbidity and low cost in the treatment of recurrent anterior dislocation of the shoulder.
Unstable Thoracolumbar Injuries
Authors: Willén Jan 
Published: April 2021

Abstract
The treatment of thoracolumbar fractures was traditionally conservative. With increasing demands for early mobilization, operative reduction and stabilization has become more popular, even in less severe injuries. The Harrington instrumentation is still useful and efficient However, in fractures with posterior element ruptures, the internal fixator is superior in stabilizing the fracture. Early mobilization in a body cast is an equivalent treatment to surgery in less severe burst fractures if the neurology is intact. A treatment program for different fractures is presented.
GIANT CELL TUMOR OF BONE TREATED BY CURETTAGE, CEMENTATION, AND BONE GRAFTING
Authors: Pals Steven D , Wilkins Ross M 
Published: April 2021

ABSTRACT
Giant cell tumor, a relatively rare, occasionally malignant tumor of bone, remains a difficult therapeutic problem for the orthopedic surgeon. Various treatment options, including curettage alone, curettage with bone grafting, radiation, and curettage with acrylic cementation have been utilized and reported. Therapeutic complications such as infection, recurrence, and loss of support of the articular surface have continued to plague the treatment of giant cell tumors. This article reports the results of 10 consecutive cases of giant cell tumor of bone treated by curettage and methyl methacrylate cementation, followed by bone grafting of the surface of the lesion with demineralized bone matrix to reconstitute the cortex at the site of the tumor. At an average follow up of 36 months, eight patients had an excellent functional result and two had a fair result as scored on the Musculoskeletal Tumor Society rating system. To date, there have been no tumor recurrences or metastases, and all patients have radiographic evidence of healing of the weight bearing cortical surface.
FRACTURES OF THE DISTAL HUMERUS
Authors: Jupiter Jesse B , Mehne David K 
Published: April 2021

ABSTRACT
We present a rational approach to the classification and surgical management of intraarticular fractures of the distal humerus. The fractures are classified on the basis of the surgical anatomy of the distal humerus, which is divided into two skeletal columns held together by the trochlea. The basic surgical aim is to restore all three elements with sufficient stability to permit functional movement The surgical tactics are presented in detail.
INITIAL MECHANICAL STABILITY OF ACETABULAR PROSTHESES
Authors: Litsky Alan S , Pophal Stephen G 
Published: April 2021

Abstract
Secure initial stability is crucial for prostheses designed for biological ingrowth; without it, subsequent tissue ingrowth is impossible. Mechanical testing was performed in vitro to measure the interface shear stability of acetabular cup prostheses. Cemented, threaded, finned, and press-fit cups, both with and without supplemental screw fixation, were tested. A mechanically consistent polyethylene foam was used as a substrate to obviate the variations inherent in cadaver bones. Ramped, eccentric rim loads were applied using a servohydraulic materials testing system. Reaming, insertion, and loading variables were carefully controlled. Cups with external threads were significantly more stable than those fixed by fins or screws. Pressfit cups were significantly looser than all other tested designs. None of the uncemented prostheses approached the initial stability of cups secured with acrylic bone cement.
THE DIABETIC NEUROPATHIC FOOT: A TRIPLE CRUSH SYNDROME-MEASUREMENT OF COMPARTMENTAL PRESSURES OF NORMAL AND DIABETIC FEET
Authors: Lower Raymond F , Kenzora John E 
Published: April 2021

ABSTRACT
The role of chronic swelling in the feet of diabetic patients with severe neuropathy is unclear. It was hypothesized that swelling might raise the compartment pressures of the foot high enough above normal to produce nerve and soft tissue injury, ie, the triple crush syndrome. Four compartment measurements were recorded in 30 feet of 15 normal patients and in 34 feet of 20 patients with severe diabetic neuropathy and normal large vessel arterial blood flow. The lateral compartments produced unreliable results and were discarded from statistical evaluation. The mean medial compartment pressure was 7.8 mm Hg (SD 2.55) in the normal feet and 9.4 mm Hg (SD 4.08) in the diabetic feet. This was not a statistically significant difference. Highly significant differences were recorded in the interosseous and central compartments where the mean pressures were 6.4 mm Hg (SD 2.72) and 5.7 mm Hg (SD 2.89), respectively, in the normal feet and 9.3 mm Hg (SD 4.75) and 8.9 mm Hg (SD 5.0) in the diabetic feet (P<.05 for each group). Furthermore, within the diabetic group, 9 of 9 patients (100%) with clinically swollen feet had at least one compartment pressure measure two standard deviations (12 mm Hg) or greater compared with 5 of 11 (45%) in those without clinical swelling. This difference is significant (P<.01). We could not correlate elevated compartment pressures directly with soft tissue pathology. Nevertheless, we infer that the presence of increased volumes of serous fluid and significantly higher than normal compartment pressures over long periods cannot produce a healthy environment for the soft tissues of the foot.
A NEW NECK PRESERVING TOTAL HIP ARTHROPLASTY FOR THE YOUNG PATIENT
Authors: Krackow Kenneth A , Mont Michael A , Maar Dean C 
Published: April 2021

ABSTRACT
A retrospective review of a femoral neck preserving custom total hip replacement was performed on seven young patients with disabling hip arthrosis. This design was created to provide greater rotational control to off-axis load and to provide greater proximal medial support to counteract varus bending forces. Eight hip arthroplasties, with a minimum follow up of 24 months, were reviewed and all had good and excellent clinical Harris scores. Presented is a treatment alternative to the standard total hip replacement.
ELECTROMYOGRAPHY AND BIOMECHANICS OF A DYNAMIC KNEE BRACE FOR ANTERIOR CRUCIATE LIGAMENT DEFICIENCY
Authors: Acierno S P , D'Ambrosia Christopher , Solomonow M , Baratta R V , D'Ambrosia Robert D 
Published: April 2021

ABSTRACT
Twelve anterior cruciate ligament (ACL)-deficient subjects performed concentric isokinetic knee extensions at maximum effort both with and without the Bledsoe Pro Shifter knee brace. EIectromyogram signals from the quadriceps, hamstrings, knee angle, and the extension force were recorded and evaluated to determine the effects of such dynamic bracing on muscle activity and joint stability. High activity, or asymptomatic, subjects (n=5) experienced no change in muscle activity, but displayed a decrease in extension force throughout the active range of the brace. Low activity, or symptomatic, subjects (n=7) exhibited increased quadriceps activity and decreased hamstrings activity, and displayed a minor increase in force in the mid-range (80° to 40° flexion). These results indicate that dynamic bracing prevents quadriceps inhibition in symptomatic subjects by exerting a posteriorly directed force to the superior tibia; thus, the brace compensates externally for the absence of the ACL.
ESTABLISHING A UNIVERSAL PROTOCOL FOR DEEP VEIN THROMBOSIS FOLLOWING ORTHOPEDIC SURGERY: TOTAL KNEE ARTHROPLASTY
Authors: Sculco Thomas P 
Published: April 2021

ABSTRACT
The incidence of deep vein thrombosis (DVT) after total knee replacement surgery is reported to occur in 84% of all unprotected patients and may be as high as 68% in patients who receive DVT prophylaxis. Moreover, controversy exists as to which pharmacologic or mechanical agent is most effective. Although the scientific literature provides some answers, many issues of DVT prophylaxis are not completely addressed, especially with regard to the duration of prophylaxis. The most recent report from the American College of Chest Physicians Consensus Conference on Antithrombotic Therapy reconfirms the recommendations offered from previous consensus groups on the importance of establishing and applying a universal protocol for the prevention of DVT in orthopedic surgery.
Primary Bone Tumors of the Pelvis Presenting as Spinal Disease
Authors: Thompson Roby C , Berg Troy L 
Published: April 2021

ABSTRACT
Low back pain and sciatica are usually attributed to localized structural pathology; however, tumors of the pelvis may also cause these symptoms. Pelvic bone neoplasms are seldom immediately diagnosed and, therefore, may result in significant morbidity and mortality. Fourteen cases of malignant primary bone tumors of the pelvis that caused spinal symptoms were referred to our Musculoskeletal Tumor Service. Several recurring characteristics of these cases that may alert the clinician to the possibility of underlying pelvic bone malignancy in a patient with low back pain were identified: 1 ) age &45 years; 2) insidious onset of symptoms without antecedent trauma; 3) prolonged symptoms for more than 1 month; 4) progressive pain that fails conservative therapy; and 5) presence of anorexia, malaise, or night pain. We suggest that in diagnosis of a patient presenting with these characteristics, the clinician Instruct that the pelvis be Included in initial radiographs. If plain radiograph Is non-diagnostic and symptoms remain unresponsive, we recommend obtaining a bone scan, and then, if necessary, computerized tomography or magnetic resonance imaging.
Pilon Fractures Treated With an Articulated External Fixator: A Preliminary Report
Authors: DiChristina Daniel , Riemer Barry L , Butterfield Spencer L , Burke Charles J 
Published: April 2021

ABSTRACT
Nine high-energy pilon fractures with severe soft tissue injuries were treated by a medial external fixator with an articulated ankle-hinge and limited internal fixation (1 .7 screws per case). A 100% union rate was achieved; however, there was a 100% complication rate associated with the fixator. Both B3 fractures required a vertical transarticular pin to maintain reduction. Seven C2 fractures suffered calcaneal screw loosening and drainage, necessitating removal of the fixator prior to union. Due to these complications, the articulated ankle hinge could not be utilized. At a minimum of 6 months follow up, eight of nine fractures had acceptable radiographic and early clinical results.
Clinical Results of the Modular Porous-Coated Anatomic (PCA) Total Knee Arthroplasty With Cement: A 5-Year Prospective Study
Authors: Knight Jonathan L , Atwater Richard D , Grothaus Louis 
Published: April 2021

ABSTRACT
Our study examines the clinical, radiographic, and patient satisfaction outcome of the cemented Modular Porous-Coated Anatomic (PCA) total knee arthroplasty with a minimum 5-year follow up. All data were gathered prospectively and consecutively. Patient satisfaction was assessed with a self-administered survey. Statistical analysis examined the effect of 1 7 patient factors, 19 surgical factors, and postoperative continuous passive motion use on range of motion (ROM) and HSS scores at 2 years.
Seventy-eight Modular PCA arthroplasties performed by 9 orthopedic surgeons on 71 patients between January 1 988 and November 1 989 are reported in this study. Preoperative HSS scores averaged 51.2 and improved to an average of 89 at 1 and 2 years, and 86 at 5 years after surgery (90% good or excellent). ROM changed after surgery through improvement in preoperative knee flexion contracture, but not in increased knee flexion. One patient underwent reoperation for patellar instability, and one patient's arthroplasty was revised at 53 months for late instability. The total reoperation rate for any reason was 7.7%. Zonal analysis for progressive radiolucency at the bone-cement interface showed Increasing frequency of narrow (<1 mm) radiolucencies concentrated on the anterior and medial aspect of the tibial tray. Ninety-eight percent of patients responded to an outcome questionnaire, and 96% rated themselves improved. The Kaplan-Meier probability of an implant surviving without loosening at 5 years was 100%. The Modular PCA TKA has a low incidence of patellofemoral problems, is clinically successful, and results are stable at a minimum 5-year follow-up examination.
Freeze-Dried Cortical Allograft in Posterior Spinal Arthrodesis: Use With Segmental Instrumentation for Idiopathic Adolescent Scoliosis
Authors: Stricker Stephen J , Sher Jerry S 
Published: April 2021

ABSTRACT
Many surgeons use cancellous or corticocancellous allogeneic bone grafts to augment spinal arthrodeses. The efficacy of onlay freeze-dried cortical allografts for posterior spinal fusions has been questioned in the past. In this report, freeze-dried, crushed cortical bone allograft was used as the sole fusion material in 32 consecutive posterior spinal fusions for idiopathic adolescent scoliosis. Absence of clinical or radiographic pseudarthrosis in all patients at an average follow up of 34 months suggests that freeze-dried, crushed cortical bone allograft is a suitable material for augmentation of the fusion mass during posterior spinal fusion with segmental instrumentation.
Magnetic Resonance Imaging and Knee Stability Following ACL Reconstruction
Authors: Kühne J-H , Dürr H R , Steinborn M , Jansson V , Refiort H J 
Published: April 2021

ABSTRACT
This study was undertaken to determine whether there is a correlation between magnetic resonance imaging (MRI) and clinical success after reconstruction of the anterior cruciate ligament (ACL). In a prospective study, 28 patients underwent clinical and MRI examination 3 to 5 years after ACL reconstruction with either the semitendinosus tendon (n=15) or patellar ligament (n=13). Knee stability was assessed both clinically and by KT-1000 arthrometer testing. Magnetic resonance imaging was performed with a 0.2-T dedicated system (Artoscan, Esaote, Italy) including sagittal and oblique coronal T1 and T2-weighted images. Magnetic resonance images were evaluated by two readers with regard to signal intensity and continuity of the ACL reconstruction and presence or absence of posterior cruciate ligament buckling. Knee stability and MRI evaluation were each summarized in a 6-point score. Statistical correlation was checked with the Spearman ranked correlation for testing non-normal distributed samples. Statistical testing of all patients' results together showed a significant correlation with a prediction value of 12%, indicating no significant correlation between clinical results and MRI evaluation. Separate statistical testing of the patellar ligament and semitendinosus patients' results showed no significant correlation in either group at all. Thus, no correlation between clinical stability and MRI could be established. Magnetic resonance images after ACL reconstruction using the techniques mentioned above should be interpreted with caution, as they may not relate to the clinical function of the ligament.
Early Results of Lower Limb Surgery for Osteogenic Sarcoma of Bone
Authors: Zunino Jorge H , Johnston James O 
Published: April 2021

ABSTRACT
Little information is available in the literature about early follow up of patients undergoing surgical procedures for osteogenic sarcoma of lower limbs as a part of their treatment protocol. In the present study the authors evaluate the functional and subjective condition of patients during a 2-year postoperative period, and analyze the nature and frequency of complications arising during that period. A scoring system was designed to represent the functional condition of the patients; compiled scores could therefore account for a given trend, which was further submitted to statistical analysis. Nature and frequency of complications following surgery were related to tumor location and to performed surgical procedures. Results of the study show that during the first 6 postoperative months, most patients have poor functional and subjective condition, which progressively improves throughout the first and second year. There is a high rate of complications during this period (46%), most frequently related to proximal femur and proximal tibia sites. Complications and functional disabilities are mainly related to mechanical disfunction of the reconstructive systems currently used.
Patellar Stabilization: A Quantitative Evaluation of the Vastus Medialis Obliquus Muscle
Authors: Raimondo Rick A , Ahmad Christopher S , Blankevoort Leendert , April Ernest W , Grelsamer Ronald P , Henry Jack H 
Published: April 2021

ABSTRACT
Twenty-one cadaveric knees were dissected to analyze the functional anatomy of the vastus medialis complex (VMC), which is composed of the vastus medialis obliquus (VMO) and the vastus medialis longus (VML) muscles. The physiologic cross-sectional area of the VMO for 20 of the knees was 29% of the total physiologic cross-sectional area for the VMC. These values differed in one knee with a dysplastic VMO. The quantitative description of the VMO provided by this study will facilitate future efforts to accurately model the physiologic function of the VMO in cadaveric investigations on patellofemoral mechanics. The effect of simulated pathologies and surgical reconstructions then may be determined with more certainty to improve patient management.