An analysis of blood management in patients having a total hip or knee arthroplasty.

Three hundred and thirty orthopaedic surgeons in the United States participated in a study of transfusion requirements associated with total joint arthroplasty. A total of 9482 patients (3920 patients who had a total hip replacement and 5562 patients who had a total knee replacement) were evaluated prospectively from September 1996 through June 1997. Of those patients, 4409 (46 percent [57 percent of the patients who had a hip replacement and 39 percent of the patients who had a knee replacement]) had a blood transfusion.

A case of germinal center formation by CD45RO T and CD20 B lymphocytes in rheumatoid arthritic subchondral bone: proposal for a two-compartment model of immune-mediated disease with implications for immunotherapeutic strategies.

In rheumatoid arthritis (RA) disease activity occurring as joint destruction of cartilage and bone is thought to be driven by inflammatory reactions which are initiated by exogenous microbial mechanisms and perpetuated by endogenous autoimmune mechanisms. According to the synovial model of RA, these reactions originate in the adjacent synovial tissues. The following set of observations is presented herein to suggest an alternate model involving subchondral bone.

Eccentric and concentric muscle performance in patients with spastic paresis secondary to motor neuron disease. A preliminary report.

This study investigated the potential value of eccentric (ECC) and concentric (CONC) isokinetic testing for quantifying motor deficit in patients with spastic paresis secondary to motor neuron disease. We hypothesized that, at a moderately fast (120 degrees s-1) angular velocity, spastic patients would demonstrate different ECC-CONC torque relationships from healthy controls or patients with non-spastic neuromuscular disorders. Eleven patients with motor neuron disease having clinical evidence of spasticity, and 11 disease-control patients (with non-spastic disorders, e.

Enoxaparin: the low-molecular-weight heparin for prevention of postoperative thromboembolic complications.

Objective: To introduce readers to a new low-molecular-weight heparin (LMWH) product, enoxaparin. The chemistry, pharmacology, pharmacodynamics, clinical efficacy in thromboembolic prophylaxis following surgery, and adverse effects are reviewed.

Data Sources: A MEDLINE search of the English-language literature was used to identify relevant literature.

Eccentric muscle performance of elbow and knee muscle groups in untrained men and women.

Maximal voluntary eccentric (ECC) and concentric (CON) capacity of knee and elbow muscle groups was investigated in healthy untrained men (N = 40) and women (N = 50), 21-67 yr of age. Purposes of the study were to describe torque-velocity and ECC-CON relationships, and to compare these relationships among muscle groups and between genders. Average torque was measured at angular velocities of 30 degrees and 120 degrees.

A comparison of photographic and transparency-based methods for measuring wound surface area.

Background And Purpose: The purposes of this study were to compare test-retest reliability of measurements obtained by the use of a photographic method and those obtained by the use of a transparency method and to compare wound surface area (WSA) measurements obtained by these two methods.

Subjects: Twenty inpatients (18 male, 2 female), aged 31 +/- 16 years (mean +/- SD), participated in the study.

Methods: Tracings of ulcer borders generated by the photographic and transparency methods were digitized to obtain WSA measurements.

Seated lumbar/pelvic alignment. A comparison between spinal cord-injured and noninjured groups.

It has been postulated that loss of voluntary trunk stability, combined with the posture imposed by the configuration of the wheelchair seat, biomechanically necessitates that a person with diminished trunk control assume an abnormal sitting posture. This posture is characterized by a long, "C"-shaped kyphotic thoracolumbar spine, an extended cervical spine, a flattened lumbar spine, and a posteriorly tilted pelvis. If lateral trunk deformities are present, trunk imbalance and pelvic deformities in the coronal (frontal) plane can exist.

Failure of centralization of the fibula for congenital longitudinal deficiency of the tibia.

Between 1962 and 1983, fourteen patients (twenty knees) had centralization of the fibula for congenital longitudinal deficiency: tibial, complete. Eleven of the twenty index procedures were performed on patients who were one year old or less. A progressive flexion deformity of the knee developed after all twenty index procedures.

Efficacy of high voltage pulsed current for healing of pressure ulcers in patients with spinal cord injury.

The purpose of this study was to assess the efficacy of high voltage pulsed direct current (HVPC) for healing of pressure ulcers in patients with spinal cord injury. Seventeen patients having pressure ulcers in the pelvic region were randomly assigned to either an HVPC group or a placebo HVPC group. Treatments were given for 1 hour a day for 20 consecutive days.

Measurement of pressure ulcer volume using dental impression materials: suggestion from the field.

Understanding of the healing rates of deep pressure ulcers may be enhanced in future studies by relating changes in wound volume to changes in WSA. In this report, a type of dental impression material, vinyl polysiloxane, was used to produce a model of the internal topography of a pressure ulcer. This model was used to obtain volumetric measurements of the wound cavity.

Effect of viscoelastic insoles on pain.

The purpose of this study was to assess the effect of viscoelastic shoe inserts on pain in nursing students. Students (N = 100) were randomly assigned to control and viscoelastic groups. The viscoelastic group used viscoelastic insoles in their work shoes for five weeks.

Compression-plate fixation in acute diaphyseal fractures of the radius and ulna.

At the Campbell Clinic and City of Memphis Hospital from 1960 to 1970, 244 patients (216 with closed and twenty-eight with open fractures) had 330 acute diaphyseal fractures of the radius and ulna which were treated with ASIF compression plates and followed for from four months to nine years. One hundred and twelve patients had fractures of both bones of the forearm; fifty, single fractures of the ulna; and eighty-two, single fractures of the radius. In all, 193 fractures of the radius and 137 fractures of the ulna were treated by compression plating.