bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Press-Fit Hip Femoral Components Retrieved at Autopsy
Authors: Lester D Kevin , Campbell Pat , Ehya Anoush , Rude Robert K 
Published: April 2021

ABSTRACT
Eleven femurs with press-fit titanium hip components were retrieved at autopsy for clinical, radiographic, and histologic evaluation. Back-scattered electron microscopy (BEM), bone densitometry, and appositional bone index studies also were performed. The average patient age was 87 years; the average time in situ was 22 months (range: 2 to 60). All patients were functioning well and pain free. Radiographs and bone mineral density studies (BMD) showed mild proximal stress shielding in five cases. No cases of osteolysis or pedestal formation were observed. Histologic sections revealed an average of 26% bone-prosthesis contact. Bone surrounding the prosthesis appeared viable, and osteoclastic activity in the interfacial bone was minimal; the presence of macrophages and inflammatory cells was rare. The appositional bone index averaged 40%. Bone-prosthesis contact was seen consistently at the corners of the component in multiple regions, mostly where prosthesis-endosteal cortical contact was made. BEM demonstrated intimate contact of bone with the rough titanium surface. Bone mineral density was lower in the lesser trochanter and medial proximal regions of the implanted femur than in the contralateral femur. Evidence of bone on-growth fixation in 11 femoral components suggests that cementless, stable bone fixation may be achievable in senior individuals and that "complete fit and fill," porous-coated, cementless prostheses may not be required for prosthesis stability.
Referral Patterns of Hip Pain in Patients Undergoing Total Hip Replacement
Authors: Khan Noman Q , Woolson Steven T 
Published: April 2021

ABSTRACT
This study was undertaken to determine the most common referral patterns of hip pain in patients scheduled to undergo primary and revision total hip replacement. The exact location of pain from the hip was recorded prospectively for 323 patients (358 hips) who had primary total hip replacement and for 94 patients who had revision of a loose total hip.
Seventy-three percent of patients with primary hip disease had pain in the grain, and 27% had groin pain that referred to the knee. Eighty-nine percent of 57 patients who had femoral component loosening had thigh or knee pain, and all of the 34 patients who had a loose acetabular component with a well-fixed femoral implant had pain in the hip region without distal radiation of pain.
These results indicate that in patients who have a painful total hip, thigh pain is highly suggestive of femoral component loosening and pain located around the hip region that does not radiate distally is associated with isolated acetabular component loosening.
Comparison of Plain Radiographs and CT Scans in Instrumented Posterior Lumbar Interbody Fusion
Authors: Siambanes David , Mather Steven 
Published: April 2021

ABSTRACT
The success of posterior lumbar interbody fusion has been analyzed primarily by plain radiography. There are no widely accepted criteria for fusion, except for lack of motion, which can be obviated by instrumentation, and the appearance of continuous bridging bone in the interspace. To determine the accuracy of plain radiography in detecting posterior lumbar interbody union, the radiographs of instrumented posterior lumbar fusion performed at 22 levels were compared with reformatted computed tomography (CT) scans. Results revealed that although 17 of 22 interbody levels were classified as fused by radiograph, 10 of these 17 demonstrated a nonunion by reformatted CT scans taken an average of 13.8 months postoperatively. Only progressively increased density by radiograph correlated with a solid fusion by CT scan. We therefore conclude that plain radiographs are unreliable in reporting the results of posterior lumbar interbody fusion and that CT scanning may be more appropriate.
Comparison of Fixation Methods for Preventing Pelvic Ring Expansion
Authors: Vrahas M S , Wilson S C , Cummings P D , Paul E M 
Published: April 2021

ABSTRACT
Several methods of external and internal fixation are used in urgent situations to lessen intrapelvic bleeding associated with unstable pelvic fractures. Pelvic stabilization limits pelvic expansion and thereby restricts the space for potential blood loss. This study compared several fixation methods using cadaveric pelves to determine which method best prevents pelvic expansion. Three methods of internal fixation and three methods of external fixation were compared. Anteroposterior fixation provided the greatest control against pelvic expansion; however, it is clinically impractical for emergency use. Therefore, external fixation provided the most reliable control of pelvic expansion in the emergency setting.
An Analysis of Hylamer and Polyethylene Bearings From Retrieved Acetabular Components
Authors: Collier John P , Bargmann Lauren S , Currier Barbara H , Mayor Michael B , Currier John H , Bargmann Brian C 
Published: April 2021

ABSTRACT
Hylamer and conventional polyethylene acetabular liners of the same design, revised for a variety of reasons, were examined and compared to assess the performance of Hylamer as a bearing material. Clinical damage modes, linear wear rates, oxidation levels, and mechanical properties were measured. In both series, many liners were retrieved for dislocation. Wear/osteolysis was the most common reason for retrieval in the Hylamer series, while none of the conventional polyethylene liners were retrieved for this reason. Nearly all liners exhibited abrasion, burnishing, scratching, and creep. The Hylamer liners had more cracking, delamination, and pitting. The Hylamer liners had an average linear wear rate of 0.32 mm/year, while the conventional polyethylene liners had an average wear rate of 0.20 mm/year. Due to sample size, no statistical difference in wear rate was noted between the two groups.
In general, both the Hylamer and conventional polyethylene showed oxidation peaks subsurface, resulting from their exposure to gamma radiation in air. Liners with elevated oxidation had decreased ultimate tensile strength, elongation, and toughness. For given oxidation levels, the corresponding mechanical properties of Hylamer appeared lower than those of conventional polyethylene. The ultimate tensile strength values ranged from 14 to 33 MPa for Hylamer and 19 to 32 MPa for conventional polyethylene. Elongation ranges were 19% to 350% (Hylamer) and 80% to 375% (conventional).
The Hylamer retrievals in this study gave initial indications of performance; Hylamer appeared to behave similarly, but not superiorly, to conventional polyethylene, in the early functional period with respect to clinical wear and clinical performance. Both Hylamer and conventional polyethylene liners were degraded by gamma sterilization in air, with Hylamer liners demonstrating greater property changes.
Femoral Neck Fracture Fixation: A Biomechanical Study of Two Cannulated Screw Placement Techniques
Authors: Booth Kevin C , Donaldson Thomas K , Dai Qiang G 
Published: April 2021

ABSTRACT
This biomechanical study evaluated two different methods of femoral neck fracture fixation. Ten pairs of embalmed femora were used. A standardized midcervical osteotomy was performed. One side from each pair was fixed with either conventional (central) or calcar (cortical adjacent) screw placement. The femora pairs then were subjected to cyclic and load to failure biomechanical testing. The results demonstrated significant improved stability, load, stiffness, and displacement in all tested parameters for the group with calcar screw fixation. Grossly, the conventional fixation group tended to fail in an excessively varus position, while the calcar fixation group failed with impaction of the head on the calcar, a potentially stable position.
Radiology of Skeletal Tuberculosis
Authors: Ridley N , Shaikh M I , Remedios D , Mitchell R 
Published: April 2021

ABSTRACT
In recent years, the incidence of tuberculosis (TB) has increased, primarily in developing countries, but also in Europe and North America. The association between TB and human immunodeficiency virus infection is well-documented. In these cases, TB is more likely to be extrapulmonary. The spine is the most common site for skeletal TB. Atypical appearances may be present in immigrants. Plain radiography remains the cornerstone for imaging, but newer cross-sectional modalities such as computed tomography, ultrasonography, and magnetic resonance imaging are becoming increasingly valuable in early and accurate diagnosis. This article reviews the features of musculoskeletal TB and the role that imaging plays in diagnosis and management.
A Comparison of Plate and Pin Fixation for Arthrodesis of the Rheumatoid Wrist
Authors: Rehak David C , Kasper Paul , Baratz Mark E , Hagberg William C , McClain Edward , Imbriglia Joseph E 
Published: April 2021

ABSTRACT
This restrospective study compared plate fixation versus pin fixation in 57 patients with rheumatoid arthritis who underwent wrist arthrodesis. Fixation was achieved by using plates in 32 patients and longitudinal pins in 25 patients. Clinical follow-up averaged 29 months (range: 12-57 months) and radiographic follow-up averaged 16 months (range: 12-39 months). Union occurred in 97% of the wrists fixed with plates and in 96% of the wrists fixed with pins. There were 6 (19%) complications in the plate group and 7 (28%) complications in the pin group. Three (12%) wrists fixed with pins moved from the immediate postoperative position to a position of relative volar flexion, while radiographs showed no changes in wrist position in the plate group. With both methods, successful arthrodesis stabilized the wrist in a high percentage of patients. Plate fixation offers an excellent alternative method for arthrodesis of the rheumatoid wrist.
Custom 95° Condylar Blade Plate for Pediatric Subtrochanteric Femur Fractures
Authors: Segal Lee S 
Published: April 2021

ABSTRACT
Subtrochanteric fractures in the older child and adolescent often are not amenable to conservative methods of treatment. The anatomic constraints of the proximal femur including the small diameter of the femoral neck and the presence of the capital femoral physis may limit the type of internal fixation used in these patients. This article presents our preliminary experience with a custom 95° condylar blade plate for subtrochanteric fractures in older children and adolescents.
Posterior Stabilization of Unstable Sacroiliac Injuries With the Texas Scottish Rite Hospital Spinal Instrumentation
Authors: Korovessis Panagiotis , Stamatakis Marios , Baikousis Andreas 
Published: April 2021

ABSTRACT
This article describes a new alternative technique for stabilization of unstable sacroiliac injuries using the Texas Scottish Rite Hospital (TSRH) Instrumentation. The TSRH instrumentation was applied in 14 consecutive patients with unstable posterior pelvic ring disruptions. All patients underwent follow-up for an average of 29 months. Clinical results, using the rating system of d'Aubigne, were good in 9 and satisfactory in 5 patients. No pressure sores, infection, significant loss of correction, or hardware failures were observed postoperatively. The use of the TSRH instrumentation for stabilization of sacroiliac injuries offered sufficient stabilization of the posterior pelvic ring and permitted early mobilization without loss of correction.
Surgical Treatment of Comminuted Intra-Articular Fractures of the Distal Humerus With Double Tension Band Osteosynthesis
Authors: Zhao Jie , Wang Xinwei , Zhang Qiulin 
Published: April 2021

ABSTRACT
Intra-articular fractures of the distal humerus are usually treated with cancellous screws for the condylar metaphysis itself and two Y-shaped plates for fixation of the metaphysis to the shaft. Twenty-four patients with comminuted intra-articular fractures (class C on AO/ASIF classification) were treated with crossed K-wires for the condylar metaphysis and double tension band osteosynthesis for fixation of the metaphysis block to the shaft. Excellent or good results were achieved in 83% of patients. This technique is easier to perform and more cost effective than most other fixation methods. Additionally, it offers good stability and allows for earlier functioning of the elbow. Complication rates are comparable to other methods of internal fixation.
Early Results of Isoelastic Hemiarthroplasty in Chronic Shoulder Arthritis
Authors: Sait Suhaib , Scott William A 
Published: April 2021

ABSTRACT
Fourteen isoelastic shoulder hemiarthroplasties were studied in patients with shoulder pain due to chronic rheumatoid arthritis and osteoarthritis unresponsive to conservative means. The average follow-up was 27 months (range: 12-46 months) and the average patient age was 66.4 years (range: 54-79 years).
A Constant shoulder score was used to assess results. Pain relief was obtained in 85.7% of patients. Function scores averaged 8 preoperatively and 13 postoperatively. Subjectively, 1 2 patients improved. Average gain was 33° of abduction, 35° of flexion, and 21° of external rotation. Internal rotation improved by two levels on the spine. Total shoulder scores improved from an average of 42 points preoperatively to 7$ points postoperatively. There was 1 complication of immediate postoperative dislocation.
Early results with isoelastic (polyacetyl resin) shoulder hemiarthroplasty are encouraging. The prosthesis is inexpensive and easy to use, requires minimal bone resection, involves cementless fixation, and has established results in tumor surgery. Its long-term value for chronic arthritis will be reported as part of an ongoing prospective study.
Comparison of Arthroscopic and Open Revision Decompression for Failed Anterior Acromioplasty
Authors: Connor Patrick M , Yamaguchi Ken , Pollock Roger G , Flatow Evan L , Bigliani Louis U 
Published: April 2021

ABSTRACT
Thirty-six consecutive patients who underwent revision decompression for refractory subacromial impingement were studied retrospectively. Average interval from the primary decompression procedure to revision was 29 months. Eighteen patients underwent arthroscopic and 18 underwent open revision. Six (33%) patients in the arthroscopic group and 12 (67%) patients in the open group were workers' compensation cases.
At an average follow-up of 26 months, 17 (94%) patients in the arthroscopic group and 8 (44%) in the open group were satisfied with their procedure. Comparing workers' compensation patients, 5 of 6 in the arthroscopic group and 4 of 12 in the open group were satisfied. For nonworkers' compensation patients, all 12 patients in the arthroscopic group and 4 of 6 in the open group were satisfied. Average pain scores and postoperative range of motion was improved in both groups. Dense subacromial scarring with thick, fibrous adhesions was present in all patients. Residual, prominent bone, or an acromial spur was found in 20 (56%) patients.
Overall, revision arthroscopic subacromial decompression was superior to open revision. However, there were more workers' compensation patients in the open group. Workers' compensation patients fared worse for both groups, but a significant proportion (83%) of the arthroscopic group was satisfied. Since subacromial scarring may be the most important pathology, arthroscopy is less invasive, allowing earlier, unrestricted postoperative rehabilitation and proving more effective.
The Impact of Loading on Deformation About Posteromedial Meniscal Tears
Authors: Ganley Theodore , Arnold Christopher , McKernan D , Gregg John , Cooney Timothy 
Published: April 2021

ABSTRACT
To simulate the effects of partial weight bearing on meniscal repair, full-thickness tears were produced in the posteromedial aspect of seven ACL-intact cadaveric knees. Following suture repair, metal markers were imbedded to index the position of the tear. A radiolucent chamber was used to position and load each knee for computed tomography scanning at flexion angles of 0°, 30°, and 60° with and without a load force of 100 lb. Sutures were removed and the tests repeated. Changes in marker distances were obtained for each test condition.
Loading produced average dimensional changes of ≤0.5 ±0.6 mm in either sutured or unsutured menisci. Based on the Friedman test, neither flexion angle, loading, nor suture exerted a significant impact (P≥.52). These data support clinical accelerated rehabilitation programs previously published. Therefore, partial weight bearing during convalescence is tenable.
Operative Treatment for Maisonneuve Fracture of the Proximal Fibula
Authors: Babis G C , Papagelopoulos P J , Tsarouchas J , Zoubos A B , Korres D S , Nikiforidis P 
Published: April 2021

ABSTRACT
This study reviewed operative treatment of Maisonneuve fracture of the fibula in 26 patients. Operative treatment consisted of restoration of the fibular length, repair of the lateral and medial ankle ligamentous structures, and placement of one or two suprasyndesmotic screws. After average follow-up of 6.4 years, the clinical results were satisfactory in 23 (88.4%) patients. Operative treatment is the treatment of choice for Maisonneuve fractures, and a satisfactory outcome may be anticipated after appropriate management of any associated bony and syndesmotic injuries.
Compliant Prestress Fixation in Tumor Prostheses: Interface Retrieval Data
Authors: Bini Stefano A , Johnston James O , Martin Daniel L 
Published: April 2021

ABSTRACT
This article reports the first available human retrieval data following the use of a new fixation system for tumor prostheses. The compliant prestress (CPS) fixation system obviates the need for long intramedullary stems. The CPS was designed to provide a stable, high-pressure, motion-free bone-implant interface that would prevent aseptic loosening and allow osseointegration at the bone-implant interface. At 1 0 months, the fourth patient in the human trial required amputation. Backscatter electron microscopy revealed a buttress of new bone had formed along 70% of the bone-metal interface, with excellent bony ingrowth (average: 42%) into the transverse, porous-coated titanium interface.
Assessment of Femoral Neck Nonunion With Multiplanar Computed Tomography Reconstruction
Authors: Savolaine Edward R , Ebraheim Nabil 
Published: April 2021

ABSTRACT
Femoral neck fracture nonunion after implant fixation is usually evaluated by physical findings and serial radiography. Radiography in hip fixation is complicated by inherent anatomy and the geometry of screw placement. Computed tomography with multiplanar reconstruction offers adjunct evaluation using nonstandard imaging planes tailored to favor fracture plane projection and individual screw evaluation. Metal artifacts can be minimized and lack of fracture bridging can be excluded with confidence. Experience with seven cases of femoral neck fracture nonunion is presented along with image examples.
Outpatient Management of Low-Velocity Gunshot-Induced Fractures
Authors: Dickson Kyle , Watson Troy S , Haddad Charles , Jenne Joel , Harris Mitch 
Published: April 2021

ABSTRACT
This prospective study evaluated the efficacy of an outpatient management protocol for patients with a gunshot-induced fracture with a stable, nonoperative configuration. Forty-one patients (44 fractures) with a grade I or II open, nonoperative fracture secondary to a lowvelocity missile comprised the study population. Patients were treated by a standard protocol, which included 1 g of cefazolin administered in the emergency room and a 7-day course of oral cephalexin. Follow-up visits were performed until complete wound and fracture heaiing were achieved.
Thirty-two (78%) of 41 patients underwent full followup. Average follow-up was 5.2 months. One (2.8%) fracture (distal fibula) developed a superficial infection, which responded to an additional week of oral antibiotics, and no patient developed a deep infection. There was 1 delayed union and 2 patients with painful retained shrapnel. These results demonstrate that patients with stable, low-velocity, gunshot-induced fractures can be managed effectively and safely on an outpatient basis using this protocol.
Management of Infected Bulk Allografts With Antibiotic-Impregnated Polymethylmethacrylate Spacers
Authors: Quinn Robert H , Mankin Henry J , Springfield Dempsey S , Gebhardt Mark C 
Published: April 2021

ABSTRACT
Twenty-seven patients developed infection following bulk allograft transplantation and were treated with resection of the allograft, placement of an antibioticimpregnated polymethylmethacrylate (PMMA) spacer, and intravenous antibiotics. Overall, the infection was eradicated in 14 (52%) of 27 patients. Of the 11 patients who did not undergo allograft reimplantation, 5 underwent amputations for persistent infection in the presence of the spacer and 4 had a retained spacer at most recent follow-up.
No significant correlation was noted between successful eradication of the infection and age, sex, diagnosis, adjuvant therapy, acute or chronic infection, number of operative procedures, type of allograft procedure, duration of antibiotics, or type of organism. Although deep infection of allograft transplantations continues to result in a high rate of failure, this method of management results in successful limb salvage in almost half of the patients.
Indomethacin Versus Radiation Therapy for Heterotopic Ossification After Hip Arthroplasty
Authors: D'Lima Darryl D , Venn-Watson Eric J , Tripuraneni Prabhakar , Cowell Clifford W 
Published: April 2021

ABSTRACT
This study compared the efficacy and cost of radiation therapy with indomethacin in the prophylaxis of heterotopic ossification following total hip replacement. Twenty-two patients received a radiation dose of 1 0 Gy in five fractions, 28 patients 8 Gy in one fraction, and 27 patients 25 mg oral indomethacin three times a day for either 7 or 21 days. Patients at higher risk for heterotopic ossification were more likely to receive radiation therapy than indomethacin. At a mean follow-up of 2 years, there were no differences in failure rates between the high-risk patients treated with radiation and the low-risk patients treated with indomethacin. Currently, the patient-billed cost of radiation is $1400 whereas the cost for indomethacin is approximately $100. indomethacin appears to be as effective as radiation therapy in patients at low to moderate risk for heterotopic ossification and offers significant cost savings.
Results of the Anatomic Cementless Prosthesis With Different Types of Hydroxyapatite Coating
Authors: Santori Francesco S , Ghera Stefano , Moriconi A , Montemurro Giorgio 
Published: April 2021

ABSTRACT
This study evaluates the clinical and radiographic results and the bone-implant osteointegration obtained with the Anatomic (Zimmer, Warsaw, lnd) cementless total hip prosthesis using three different types of surface coating. Two hundred twenty-seven patients underwent total hip arthroplasty using the Anatomic prosthesis. Patients were divided into groups based on the type of surface coating: in group A (69 patients), prostheses were uncoated; in group B (90 patients), the metaphyseal region of the prostheses was coated with calcicoat (a mixture of hydroxyapatite and tricalcium phosphate) (Zimmer); and in group C (68 patients), the fiber mesh and proximal stem of the prostheses were coated with calcicoat. Prostheses coated with calcicoat yielded better clinical and radiographic results than uncoated prostheses, especially in regard to thigh pain. No significant difference was observed between groups B and C These results obtained with the Anatomic prosthesis are promising and encourage the use of implants coated with calcicoat.