bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of Risk Factors for Glenoid Bone Defect in Anterior Shoulder Instability
Authors: Milano Giuseppe , Grasso Andrea , Russo Adriano , Magarelli Nicola , Santagada Domenico A. , Deriu Laura , Baudi Paolo , Bonomo Lorenzo , Fabbriciani Carlo 
Published: June 2011

Background: Glenoid bone defect is frequently associated with anterior shoulder instability and is considered one of the major causes of recurrence of instability after shoulder stabilization. Hypothesis: Some risk factors are significantly associated with the presence, size, and type of glenoid bone defect. Study Design: Cohort study (prognosis); Level of evidence, 2. Methods: One hundred sixty-one patients affected by anterior shoulder instability underwent morphologic evaluation of the glenoid by computed tomography scans to assess the presence, size, and type of glenoid bone defect (erosion or bony Bankart lesion). Bone loss greater than 20% of the area of the inferior glenoid was considered “critical” bone defect (at risk of recurrence). Outcomes were correlated with the following predictors: age, gender, arm dominance, frequency of dislocation, age at first dislocation, timing from first dislocation, number of dislocations, cause of first dislocation, generalized ligamentous laxity, type of sport, and manual work. Results: Glenoid bone defect was observed in 72% of the cases. Presence of the defect was significantly associated with recurrence of dislocation compared with a single episode of dislocation, increasing number of dislocations, male gender, and type of sport. Size of the defect was significantly associated with recurrent dislocation, increasing number of dislocations, timing from first dislocation, and manual work. Presence of a critical defect was significantly associated with number of dislocations and age at first dislocation. Bony Bankart lesion was significantly associated with male gender and age at first dislocation. Conclusion: The number of dislocations and age at first dislocation are the most significant predictors of glenoid bone loss in anterior shoulder instability.
Cross-Sectional Analysis of Iliopsoas Muscle-Tendon Units at the Sites of Arthroscopic Tenotomies: An Anatomic Study
Authors: Blomberg Josh R. , Zellner Benjamin S. , Keene James S. 
Published: June 2011

Background Arthroscopic iliopsoas tenotomies are performed at the level of the labrum, femoral neck, and lesser trochanter. The composition and percentage of the iliopsoas muscle-tendon unit (MTU) that is released when the tendon is cut at these sites has not been reported to date. Hypothesis Cutting the iliopsoas tendon at the 3 common sites of arthroscopic tenotomies does not release the entire iliopsoas MTU. Study Design Descriptive laboratory study. Methods Forty iliopsoas MTUs from 20 embalmed cadavers were isolated at the level of the hip joint and released from their insertion on the lesser trochanter. Circumferential measurements of the composite MTU and the isolated iliopsoas tendon were then made at (1) the MTU's insertion on the lesser trochanter, (2) the Wettstein et al site of transcapsular release, and (3) the Alpert et al release site at the level of the labrum. Single proportion testing was performed using the Student t test to determine if significant differences existed between the average circumference of the iliopsoas MTUs or the isolated tendons at the 3 levels at which they were measured. Results The average circumference of the iliopsoas–muscle belly complex at the level of the labrum, the transcapsular release site, and the lesser trochanter was 68, 58, and 46 mm, respectively. The average circumference of the iliopsoas tendon at these same levels was 27, 31, and 27 mm, respectively. Thus, at the level of the labrum, transcapsular release site, and lesser trochanter, the iliopsoas MTU is composed of 40% tendon/60% muscle belly, 53% tendon/47% muscle belly, and 60% tendon/40% muscle belly, respectively. Conclusion Cutting the iliopsoas tendon at the labrum, head-neck junction, or lesser trochanter does not result in a release of the entire iliopsoas MTU. Clinical Relevance The results of this study document that releasing the iliopsoas tendon at the lesser trochanter preserves 40% of the MTU and does not result in a complete detachment of the iliopsoas MTU.
Arthroscopic Disease Classification and Interventions as an Adjunct in the Treatment of Acetabular Dysplasia
Authors: Ross James R. , Zaltz Ira , Nepple Jeffrey J. , Schoenecker Perry L. , Clohisy John C. 
Published: June 2011

Background Treatment of hip dysplasia has focused on corrective osteotomy surgery, while hip arthroscopy remains controversial. Improved understanding of intra-articular disease patterns associated with hip dysplasia will help delineate the role of arthroscopy as an adjunct to osteotomy surgery for dysplastic hips. Purpose The authors set out to describe the intra-articular disease patterns of patients undergoing combined hip arthroscopy and periacetabular osteotomy for the treatment of symptomatic acetabular dysplasia with associated mechanical symptoms. Secondly, they wanted to identify the potential role for arthroscopy in treating intra-articular problems as an adjunct to acetabular reorientation surgery. Study Design Case series; Level of evidence, 4. Methods Seventy-three hips in 71 patients undergoing arthroscopy for mechanical symptoms before a redirectional osteotomy of the acetabulum were reviewed. Radiographic findings of acetabular dysplasia were compared with intraoperative labral and chondral disease patterns. Arthroscopic interventions were recorded. Results Labral tears and acetabular cartilage lesions were present in 65.8% and 68.5% of hips, respectively. Combined acetabular articular cartilage lesions and labral disease were observed in 58.9% of hips. When disease was present, acetabular labrum and chondral lesions were primarily located at the anterior (81.0%, 76.0%) and superolateral (66.7%, 84.0%) labrochondral junctions. A lateral center-edge angle <15° was associated with an increased likelihood of acetabular chondromalacia, as well as moderate to severe acetabular cartilage disease. An acetabular inclination of >20° was associated with an increased risk of larger labral tears (>2 cm). Sixty-three percent had at least 1 arthroscopic treatment of central compartment disease, most commonly acetabular chondroplasty (30.1%), partial labral resection (26.0%), and labral repair (16.4%). Conclusion Acetabular rim disease is common in symptomatic acetabular dysplasia, and 63% of cases have a central compartment abnormality amenable to arthroscopic treatment. Lateral center-edge angle <15° and acetabular inclination >20° are associated with more severe labrochondral disease.
Radiographic Comparison of Surgical Hip Dislocation and Hip Arthroscopy for Treatment of Cam Deformity in Femoroacetabular Impingement
Authors: Bedi Asheesh , Zaltz Ira , De La Torre Katrina , Kelly Bryan T. 
Published: June 2011

Background Whether open or arthroscopic techniques are employed, the goal of femoroacetabular impingement (FAI) surgery is to achieve impingement-free range of motion. While arthroscopic approaches have improved and gained popularity, an objective evaluation of the surgical correction achieved with this approach compared with open surgery remains to be defined in the literature. Purpose This study was undertaken to compare the efficacy of arthroscopic osteoplasty and open surgical dislocation in treating FAI dysmorphology in a consecutive series of patients. Study Design Cohort study; Level of evidence, 3. Methods Surgical treatment was performed in 60 male patients under 40 years of age for symptomatic FAI refractory to nonoperative management. Patients were matched (not randomized) to treatment groups: 30 patients (15 left and 15 right hips) underwent arthroscopic cam and/or rim osteoplasty with labral debridement and/or refixation by an arthroscopic surgeon; and 30 (14 left and 16 right hips) underwent open surgical dislocation, cam and/or rim osteoplasty, and labral debridement or refixation by a hip preservation surgeon. Anteroposterior (AP) pelvis and extended-neck (Dunn) lateral radiographs were obtained and the depth of resection and arc of resection were measured by assessment of anterior femoral head-neck offset, AP and lateral α angle, and β angle on preoperative and postoperative radiographs. Results In the arthroscopic group, the extended-neck lateral α angle was reduced by a mean of 17.2° (28.3%, P < .05), AP α angle was reduced by a mean of 12.6° (16.8%), anterior head-neck offset improved 5.0 mm (111%, P < .05), and β angle increased by a mean of 23.1°. In the open dislocation group, the extended-neck lateral α angle was reduced by a mean of 21.2° (30.7%, P < .05), AP α angle was reduced by a mean of 20.1° (25.7%), anterior head-neck offset improved 6.56 mm (108%, P < .05), and β angle increased by a mean of 18.35°. Conclusion Arthroscopic osteoplasty can restore head-neck offset and achieve similar depth, arc, and proximal-distal resection with comparable efficacy to open surgical dislocation for anterior and anterosuperior cam and focal rim impingement deformity. The open technique, however, may allow greater correction of posterosuperior loss of femoral offset and may be favorable for FAI patterns that demonstrate considerable proximal femoral deformity on AP radiographs.
Arthroscopic Treatment for Acetabular Labral Tears of the Hip without Bony Dysmorphism
Authors: Haviv Barak , O'Donnell John 
Published: June 2011

Background Surgical treatment for labral tears of the hip has shown good results in patients with bony impingement lesions; however, results are also affected by the correction of bony abnormalities. This study evaluates the outcome of arthroscopic treatment for acetabular labral tears without associated dysplasia or bony impingement lesions. Hypothesis Based on the structural importance of the acetabular labrum, labral tear debridement or repair can relieve pain and improve function. Study Design Case series; Level of evidence, 4. Methods The study included 81 patients who were categorized according to 4 morphologic labral tear types. The tear type, degree of synovitis, and chondral damage were analyzed with the use of multivariate regression analysis and correlated to the clinical outcome. The outcome was assessed utilizing the modified Harris hip score (MHHS) and the nonarthritic hip score (NAHS). Results There were 81 patients (81 hips), including 20 men and 61 women, with 41 right and 40 left hips. Their mean age was 44 years. Overall, at an average follow-up of 3 years the mean MHHS had improved by 18 points (95% confidence interval [CI], 13-23) and the mean NAHS by 17 points (95% CI, 12-22). An improvement after arthroscopic treatment was noticed in all types of labral tears of the hip. The level of synovitis and of chondral lesions was found to have a significant negative effect on the clinical outcome. Conclusion Arthroscopic treatment for acetabular labral tears of the hip without dysplasia or bony impingement lesions has good short- to midterm results. The best outcome is expected in the absence of synovitis and chondral lesions.
Tears of the Ligamentum Teres
Authors: Botser Itamar B. , Martin Dorea E. , Stout Chris E. , Domb Benjamin G. 
Published: June 2011

Background The ligamentum teres (LT) anatomy has been known for many years. While its functionality remains debatable, it is well recognized that the LT can be a source of pain in the hip joint. In 1997, a landmark publication by Gray and Villar established a classification for LT tears and increased the awareness of LT disorders. However, the incidence of LT tears and the various tear types is unknown. Purpose The authors report the prevalence of LT tears in a population of patients who underwent hip arthroscopy, using both the Gray and Villar classification and a new descriptive classification. Study Design Case series; Level of evidence, 4. Methods Between February 2008 and January 2011, 616 hip arthroscopies were performed by the senior author. After excluding revision surgeries, a total of 558 surgeries (502 patients) were included in the study. Data were collected regarding patients’ demographics, mechanism of injury, range of motion, magnetic resonance results, and intraoperative findings. Preoperative hip-specific questionnaire scores and pain level were recorded as well. Ligamentum teres tears were classified according to Gray and Villar's classification, and were also categorized using a descriptive grading system as follows: 0, no tear; 1, <50% tear; 2, >50% tear; or 3, 100% tear. Results A total of 284 (51%) of the 558 surgeries in this cohort revealed LT tears. According to the descriptive grading system, 22% were grade 1, 24% were grade 2, and 5% were grade 3. According to the Gray and Villar classification 3.7% had full rupture, 43% had a partial tear, and 4.5% had a degenerative tear. Patients with LT tears were significantly older and had worse preoperative functional scores; they did, however, have a greater range of motion. Intraoperatively, an association with larger labral tear size and acetabular chondral damage was found. Magnetic resonance arthrography was found to have low accuracy and sensitivity in detection of LT tears. No correlation to the pain level was found. Conclusion Ligamentum teres tears had a higher prevalence in this study than was published in the past, most probably attributable to a lower threshold used in defining a tear. The incidence is defined both using the Gray and Villar classification, as well as a new descriptive classification system that categorizes the LT according to amount of tearing.
Preoperative and Postoperative Sagittal Plane Hip Kinematics in Patients with Femoroacetabular Impingement during Level Walking
Authors: Rylander Jonathan H. , Shu Beatrice , Andriacchi Thomas P. , Safran Marc R. 
Published: June 2011

Background Femoroacetabular impingement (FAI) has been linked to osteoarthritis. Treatment options range from nonoperative to operative, and current outcome measures are generally subjective or not conducted under actual activities of daily living. Thus, there is a need for the use of motion capture techniques to quantitatively assess the outcome of surgical intervention for those treated for FAI. Hypothesis The gait of FAI patients 1 year after operative treatment (arthroscopic hip reshaping) will be significantly closer to the normal range and pattern of hip flexion motion, relative to pretreatment. Study Design Case series; Level of evidence, 4. Methods Eleven patients between 18 and 44 years of age with diagnosed FAI were enrolled in this study. Kinematics and kinetics for this group of patients were collected using motion capture techniques before arthroscopic bone-reshaping surgery and again 1 year after surgery. Pain and perceived activity level (Tegner scale) were also collected. All collected data were compared using a paired t test. Results Overall hip sagittal plane range of motion increased on the affected side from 27.6° ± 5.0° to 30.7° ± 4.3° (P = .02). The presence of abnormal reversals (second-order change in the slope in the hip flexion/extension curve) that was present in 5 patients preoperatively disappeared or was reduced in prevalence and magnitude in 4 of the patients postoperatively. Additionally, pain decreased and activity level increased postoperatively. Conclusion The results supported the hypothesis that surgical intervention for FAI restores more normal patterns of gait and provides objective support that the surgical procedure is useful. The results help establish motion capture as a potential method for quantitatively assessing the outcome in FAI surgical interventions. The presence of abnormal reversals in hip flexion has been reported in end-stage hip osteoarthritis, and the presence of these reversals in FAI patients reinforces the idea of FAI being a precursor to hip osteoarthritis.
Waste Disposal in New Zealand—Applying the Environmental Procedures
Authors: Bailey Margaret L. 
Published: June 2011

A recent survey has shown that some 2 million tonnes of refuse are being disposed of each year to landfill in New Zealand. One-quarter of this refuse is industrial waste, whereas refuse from households accounts for nearly half of the total. Pilot surveys have produced preliminary figures leading to an estimate that there may be about 23,000 tonnes per year of wastes which could be regarded as hazardous. Statutes which provide for the management and disposal of wastes, the planning of refuse facilities, and the handling of hazardous materials are listed together with environmental enhancement and protection procedures which require a process of environmental impact assessment for projects, such as new landfill sites which will have significant environmental impacts. The way that wastes are managed is illustrated by examining the disposal of three different types of solid wastes: metropolitan refuse wastes arising from a new petrochemical industry based on natural gas and waste polychlorinated biphenyl oils.
Migration and Degradation Patterns of Volatile Organic Compounds
Authors: Cline Patricia V. , Viste Daniel R. 
Published: June 2011

The mobility and persistence of volatile, chlorinated priority pollutants has been documented at sites across the country. Examples of commonly used solvents include 1,1,1-trichloroethane, trichloroethene, tetrachloroethene and methylene chloride. At some facilities, other volatile chlorinated compounds, which were never handled or disposed at these same facilities, have been detected in significant concentrations. These other compounds include dichloroethanes, dichloroethenes, chloroethane and vinyl chloride. Recent research shows that these less commonly used solvents can be present as a result of anaerobic degradation of major contaminants (commonly used solvents) within the groundwater system. This paper presents data to help clarify the conditions under which one may anticipate finding degradation products and discusses their distribution trends. Data are presented from studies conducted at solvent recovery facilities, solid/hazardous waste landfills and solvent contamination near an industrial facility. When degradation occurs, the parent solvent compounds are at highest concentrations near the source. With distance from the source, increasing proportions of degradation products are present. Degradation products are most frequently found near a source containing high concentrations of other biodegradable organic compounds. Standard analytical protocols for measurement of volatile organic priority pollutants by GC/MS do not distinguish between trans-1,2-dichlorethene, a highly-toxic priority pollutant, and the cis isomer which is a significantly less hazardous non-priority pollutant degradation product and is the dominant degradation contaminant present at these sites.
Domestic Hygiene Behaviour of Mothers with Children Aged 0-5 Years Old in Tayabo Village, Nueva Ecija, the Philippines
Authors: Sakisaka Kayako , Wakai Susumu , Wongkhomthong Som-Arch 
Published: June 2011

A cross-sectional survey was carried out in a rural village in Nueva Ecija province in the Philippines to identify the association between mothers' hygiene behaviour and their socioeconomic status and household environment. A total of 206 mothers with children aged 0-5 years old participated in this study. Household visits with face-to-face interviews using a structured questionnaire and observation of household environments were conducted. Logistic regression analysis revealed that the frequency of water boiling in mothers was significantly associated with children aged under two years old and the availability of domestic electricity. Availability of domestic electricity, mother's educational level, possession of a private lavatory and of a private well were significant predictors of whether hand-washing with soap was practiced after defecation. For hand-washing with soap before feeding children, child's age under one year old and the volume of the water supply were statistically significant. The volume of the water supply was identified as a significant predictor. Although health educational programme participation rates were very high (83.2%), no significant association with hygiene behaviour was observed. This study indicates that improvements in water availability, household environment and health education may contribute to more frequent hand-washing. Asia Pac J Public Health 2002; 14(2): 91-98.
Supply and Demand Elasticities of Physician Services: Disequilibrium Analysis
Authors: Yang B M 
Published: June 2011

Numerous empirical works have examined the demand for and supply of physician services during the past 15 years. Almost all simultaneous equation models have used the assumption of an equilibrium condition in the physician services market. The assumption of an equilibrium market for physician services may not be realistic, at least not in the short term, because the cost of physician services is insufficiently flexible or because of the induced demand on the part of physicians. Different market assumptions will result in different model formulations and model estimations, and with different empirical implications of the estimated results. The paper has used the US aggregate time-series data, 1950 to 1980, to estimate the demand and supply relationship of physician services, similar to the model specified in the Martin Feldstein article, 1 under a disequilibrium physician services market assumption. The maximum likelihood method is used for the empirical estimation. Contrary to Feldstein's earlier findings, the price elasticity of the demand for physicians is statistically significant with expected signs under a disequilibrium condition. The elasticity of supply of physician services is also, as expected, positive and statistically significant. Economic and policy implications are discussed based on these findings. This paper should fill empirically the gap that has been noted by previous researchers on the demand for physician services.