Journal of Bone and Joint Surgery
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Sắp xếp:
NORIAN SRS CEMENT COMPARED WITH CONVENTIONAL FIXATION IN DISTAL RADIAL FRACTURES
Journal of Bone and Joint Surgery - Tập 85 Số 11 - Trang 2127-2137 - 2003
Intra-Articular Fractures of the Distal Aspect of the Radius
Journal of Bone and Joint Surgery - Tập 81 Số 8 - Trang 1093-1110 - 1999
Biomechanical and Histological Evaluation of a Calcium Phosphate Cement*
Journal of Bone and Joint Surgery - Tập 80 Số 8 - Trang 1112-24 - 1998
Radiocarpal Dislocations: Classification and Proposal for Treatment
Journal of Bone and Joint Surgery - Tập 83 Số 2 - Trang 212-218 - 2001
Fracture-dislocation of the radiocarpal joint
Journal of Bone and Joint Surgery - Tập 59 Số 2 - Trang 198-203 - 1977
The Use of Pedicle-Screw Internal Fixation for the Operative Treatment of Spinal Disorders*
Journal of Bone and Joint Surgery - Tập 82 Số 10 - Trang 1458-1476 - 2000
The Value of Mentorship in Orthopaedic Surgery Resident Education: The Residentsʼ Perspective
Journal of Bone and Joint Surgery - Tập 91 Số 4 - Trang 1017-1022 - 2009
Accuracy of 3-Dimensional Planning, Implant Templating, and Patient-Specific Instrumentation in Anatomic Total Shoulder Arthroplasty
Background:
Use of 3-dimensional (3D) computed tomography (CT) preoperative planning and patient-specific instrumentation has been demonstrated to improve the accuracy of glenoid implant placement in total shoulder arthroplasty (TSA). The purpose of this study was to compare the accuracy of glenoid implant placement in primary TSA among different types of instrumentation used with the 3D CT preoperative planning.
Methods:
One hundred and seventy-three patients with end-stage glenohumeral arthritis were enrolled in 3 prospective studies evaluating patient-specific instrumentation and 3D preoperative planning. All patients underwent preoperative 3D CT planning to determine optimal glenoid component and guide pin position based on surgeon preference. Patients were placed into 1 of 5 instrument groups used for intraoperative guide pin placement: (1) standard instrumentation, (2) standard instrumentation combined with use of a 3D glenoid bone model containing the guide pin, (3) use of the 3D glenoid bone model combined with single-use patient-specific instrumentation, (4) use of the 3D glenoid bone model combined with reusable patient-specific instrumentation, and (5) use of reusable patient-specific instrumentation with an adjustable, reusable base. Postoperatively, all patients underwent 3D CT to compare actual versus planned glenoid component position. Deviation from the plan (in terms of orientation and location) was compared across groups on the basis of absolute differences and outlier analysis. Univariable and multivariable comparisons were performed. As the initial analyses showed no significant differences in preoperative factors or in deviation from the plan between Groups 1 and 2 or between Groups 4 and 5 across studies, the final analysis was across 3 major treatment groups: standard instrumentation (Groups 1 and 2), single-use patient-specific instrumentation (Group 3), and reusable patient-specific instrumentation (Groups 4 and 5).
Results:
In nearly all comparisons, there were no significant differences in the deviation from the plan (absolute differences or outlier frequency) for glenoid implant orientation or location across the 3 major treatment groups.
Conclusions:
This study did not demonstrate that any type of patient-specific instrumentation resulted in consistent differences in accuracy of glenoid implant placement in primary TSA with 3D CT preoperative planning. Surgeons have multiple patient-specific instrumentation options available for improving accuracy of glenoid implant placement when compared with 2D imaging without patient-specific instrumentation.
Level of Evidence
Therapeutic Level II . See Instructions for Authors for a complete description of levels of evidence.
Journal of Bone and Joint Surgery - Tập 101 Số 5 - Trang 446-457 - 2019
Relationship Between Glenoid Component Shift and Osteolysis After Anatomic Total Shoulder Arthroplasty
Background:
The purpose of this study was to evaluate glenoid component position and radiolucency following anatomic total shoulder arthroplasty (TSA) using sequential 3-dimensional computed tomography (3D CT) analysis.
Methods:
In a series of 152 patients (42 Walch A1, 16 A2, 7 B1, 49 B2, 29 B3, 3 C1, 3 C2, and 3 D glenoids) undergoing anatomic TSA with a polyethylene glenoid component, sequential 3D CT analysis was performed preoperatively (CT1), early postoperatively (CT2), and at a minimum 2-year follow-up (CT3). Glenoid component shift was defined as a change in component version or inclination of ≥3° from CT2 to CT3. Glenoid component central anchor peg osteolysis (CPO) was assessed at CT3. Factors associated with glenoid component shift and CPO were evaluated.
Results:
Glenoid component shift occurred from CT2 to CT3 in 78 (51%) of the 152 patients. CPO was seen at CT3 in 19 (13%) of the 152 patients, including 15 (19%) of the 78 with component shift. Walch B2 glenoids with a standard component and glenoids with higher preoperative retroversion were associated with a higher rate of shift, but not of CPO. B3 glenoids with an augmented component and glenoids with greater preoperative joint-line medialization were associated with CPO, but not with shift. More glenoid component joint-line medialization from CT2 to CT3 was associated with higher rates of shift and CPO. A greater absolute change in glenoid component inclination from CT2 to CT3 and a combined absolute glenoid component version and inclination change from CT2 to CT3 were associated with CPO. Neither glenoid component shift nor CPO was associated with worse clinical outcomes.
Conclusions:
Postoperative 3D CT analysis demonstrated that glenoid component shift commonly occurs following anatomic TSA, with increased inclination the most common direction. Most (81%) of the patients with glenoid component shift did not develop CPO. Longer follow-up is needed to determine the relationships of glenoid component shift and CPO with loosening over time.
Level of Evidence:
Therapeutic Level IV . See Instructions for Authors for a complete description of levels of evidence.
Journal of Bone and Joint Surgery - Tập 103 Số 15 - Trang 1417-1430 - 2021
Effects of Acquired Glenoid Bone Defects on Surgical Technique and Clinical Outcomes in Reverse Shoulder Arthroplasty
Journal of Bone and Joint Surgery - Tập 92 Số 5 - Trang 1144-1154 - 2010
Tổng số: 491
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