Despite an increasing number of patients with metastatic bone disease (MBD), minimal data exist regarding outcomes of patients undergoing prophylactic femoral fixation for MBD when compared with other frequently performed orthopedic operations, such as hemiarthroplasty of the femur. The authors performed a retrospective database review evaluating these procedures due to similar operative times and patient populations and also reviewed common comorbidities such as body mass index (BMI). The goal was to provide updated results of prophylactic femoral fixation and evaluate whether certain patient risk factors (eg, BMI) altered 30-day survival for patients with MBD.
View Article and Find Full Text PDFThe aim of this study was to compare perioperative analgesia provided by single-injection adductor canal block (ACB) to continuous femoral nerve catheter (FNC) when used in a multimodal pain protocol for total knee arthroplasty (TKA). A retrospective cohort study compared outcome data for 148 patients receiving a single-injection ACB to 149 patients receiving an FNC. The mean length of stay (LOS) in the ACB group was 2.
View Article and Find Full Text PDFRecent reports have noted higher rates of heterotopic ossification (HO) with surface replacement arthroplasty (SRA) than with traditional total hip arthroplasty in the absence of postoperative HO prophylaxis. This study reports rates and grades of HO in 44 SRA patients with at least 1 year of follow-up. Heterotopic ossification prophylaxis was used in 32 (73%) of 44 cases.
View Article and Find Full Text PDFLarge-head metal-on-metal total hip arthroplasty represents novel technology, and outcome data are lacking. We prospectively compared the performance of a nonmodular metal-on-metal acetabular component (Durom; Zimmer, Warsaw, IN) with a modular titanium component (Trilogy, Zimmer). All Durom components placed at our institution with minimum 1-year follow up (n = 63) were compared with an age- and sex-matched Trilogy control group (n = 100).
View Article and Find Full Text PDFIn this 18 month in vivo canine study we compared three methods of attaching the gluteal muscles to the proximal femur during hip reconstruction with an allograft-prosthesis composite (APC). All three methods are commonly practiced in human hip revision surgery and data on their effectiveness in dogs is directly relevant to human treatment. The methods compared were host gluteal tendon sutured to allograft tendon, host greater trochanter apposed to allograft using a cable grip system, and host cortical bone shells around the allograft secured with cerclage wires.
View Article and Find Full Text PDFParenteral opioid use after total knee (TKA) and hip (THA) arthroplasty often results in substantial functional interference and side effects. This prospective study compared use of traditional intravenous patient-controlled analgesia (IV PCA) with a novel oral regimen after TKA and THA. Sixty-two patients received IV PCA and 62 received scheduled long-acting and, as needed, short-acting oral opioids postoperatively.
View Article and Find Full Text PDFConcurrent osteoarthritis of the hip and lumbar spine occurs frequently. Our study tests the hypothesis that hip anesthetic arthrograms can be used as predictive diagnostic tool before total hip arthroplasty when standard evaluation techniques fail to provide convincing evidence of the source of pain. Thirty-four consecutive hip anesthetic arthrograms were reviewed retrospectively.
View Article and Find Full Text PDFObjective: To compare expression of tartrate-resistant acid phosphatase (TRAP) and cathepsin K and histologic changes in canine cranial cruciate ligaments (CCLs) and human anterior cruciate ligaments (ACLs).
Study Population: Sections of cruciate ligaments from 15 dogs with ruptured CCLs, 8 aged dogs with intact CCLs, 14 human beings with ruptured ACLs, and 11 aged human beings with intact ACLs.
Procedure: The CCLs and ACLs were evaluated histologically, and cells containing TRAP and cathepsin K were identified histochemically and immunohistochemically, respectively.
Purpose: The purpose of this study was to evaluate chondrocyte viability and surface contouring of articular cartilage using confocal laser microscopy (CLM) and scanning electron microscopy (SEM), respectively, during different treatment time intervals with monopolar and bipolar radiofrequency energy (RFE).
Type Of Study: In vitro analysis using chondromalacic human cartilage.
Methods: Forty-two fresh osteochondral sections from patients undergoing partial or total knee arthroplasties were used to complete this study.