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At least 1,225 records · Page 68Linked to original sources
PubMed1987

Porous-surfaced metallic implants for orthopedic applications.

The fixation of orthopedic implants in bone by tissue ingrowth presents a possible solution to the problem of long-term implant loosening. To achieve this objective, metallic implants formed with porous surface coatings have been developed. This article reviews the methods proposed for fabricating such implants. Some possible problems related to loss of mechanical properties due to the processing to form the porous surface zone are described. For some of the porous-surfaced implant systems, processes have been developed to avoid the occurrence of such changes. It is particularly important at this stage of the evaluation of porous-surfaced implants in clinical situations that manufacturers are fully cognizant of the effects of processing on mechanical properties of these devices.

Animals↗
PubMed1986

[Short-term prophylaxis in orthopedic and traumatologic surgery].

The rational and selective use of the perioperative antibiotic prophylaxis plays a decisive role in prevention of post-operative infections in orthopedic surgery and traumatology. The conceptual bases for the application of the Short-Term chemioprophylaxis are presented in accord to the most recent data reported in the literature.

Anti-Bacterial Agents↗
PubMed1986

Researches in orthopedic wound infection.

The roles of personnel, clean air, and the patient in the contamination of clean orthopedic wounds have been investigated over a three-year period. Personnel control showed striking decreases in operative infection rates. Wound cultures failed to show specific routes of infection. Microspheres were useful tracers for contamination of a clean air operating room and indicated that residual wound contamination occurred from surgical personnel or from the patient's skin.

Environmental Microbiology↗
PubMed1986

Office automation for the orthopedic surgeon.

What are the essential elements of office automation that can be directly applied to the practice of orthopedics? New technology, when implemented into a planned, logical system, can increase practice efficiency and productivity.

Ambulatory Care Information Systems↗
PubMed1986

Application of computer graphics in the design of custom orthopedic implants.

Implementation of newly developed computer modelling techniques and computer graphics displays and software have greatly aided the orthopedic design engineer and physician in creating a custom implant with good anatomic conformity in a short turnaround time. Further advances in computerized design and manufacturing will continue to simplify the development of custom prostheses and enlarge their niche in the joint replacement market.

Computer Graphics↗
PubMed1986

Orthopedic experience with methicillin-resistant Staphylococcus aureus during a hospital epidemic.

Thirty-eight orthopedic patients with proven methicillin-resistant Staphylococcus aureus (MRSA) infections were assessed as to the effectiveness of treatment. All patients were admitted between June 1981 and September 1983 and were among the 508 patients who had positive cultures for MRSA during that period. The average age of the patients was 32.5 years. Thirty-two patients had fractures. In 70% of the patients the injury was due to a motor vehicle accident. Sixty percent of the patients had Grade III open fractures with severe soft tissue injury or associated vascular injury. All patients were given antibiotics within 30 days of a positive culture, with 97% getting a first-generation cephalosporin. There were an average of 5.5 surgical procedures per patient (range, one to 16). Nine patients (24%) required amputation and eight (21%) lost joints either by excision or fusion. Only 14 patients (37%) healed without drainage. Four patients (10%) healed the original fracture or surgery with chronic drainage. There were three nonunions, two of which continue to drain. The antibiotic cost for Vancomycin alone increased 300%, from $2,000 in 1982 to approximately $680,000 in 1983. Methicillin-resistant in 1983. Methicillin-resistant S. aureus (MRSA) has significant epidemic potential. Infection with this organism carries a high-morbidity in order to control the organism. Any reported case of MRSA should be isolated quickly and thoroughly investigated epidemiologically in an attempt to prevent an epidemic. Vancomycin is the antibiotic of choice. Emphasis should be placed on the interruption of transmission of MRSA within and among hospitals. Serious consideration must be given to the long-term effects of prophylactic antibiotics.

Adolescent↗
PubMed1985

Pharmacokinetic data analysis of alfentanil after multiple injections and etomidate-infusion in patients undergoing orthopedic surgery.

The pharmacokinetics of Alfentanil, a new short acting analgesic, and Etomidate, a very short acting hypnotic compound, were studied in patients undergoing orthopedic surgery. Anesthesia was induced by bolus i.v. injection of Alfentanil and Etomidate, whereas the maintenance was performed by continuous infusion of Etomidate and repetitive i.v. injections of Alfentanil. The kinetics of the analgesic can be described by a two-compartment model; the elimination half-life has a mean value of 64.8 +/- 38.5 min. No cumulation of the drug was seen in spite of multiple injections. Concerning Etomidate it is not clear whether one or two compartments are needed. The mean elimination half-life is 29.4 +/- 6.2 min. The results suggest a possible shortening of the half-life of Etomidate in the presence of Alfentanil.

Adult↗
PubMed1986

Epidural morphine provides postoperative pain relief in peripheral vascular and orthopedic surgical patients: a dose-response study.

A randomized double-blind study compared the dose-response relationship of epidural morphine for postoperative pain relief in two groups of patients whose surgical procedures would result in either moderate (femoral-popliteal bypass) or severe (total knee replacement) postoperative pain. Preservative-free morphine sulphate in doses of 0, 2, 5, or 10 mg in a volume of 10 ml saline were administered via lumbar epidural catheters. The epidural morphine was administered 1 hr after the last dose of intraoperative local epidural anesthetic in an effort to achieve a pain-free postoperative course. A significant relationship existed between the dose of epidural morphine and both time to first required pain medication and 24-hr weighted pain score. Five mg epidural morphine provided significant improvement in postoperative analgesia compared with the control in both groups. Further enhancement of analgesia occurred with 10 mg; however, late respiratory depression, demonstrated by an increased resting PaCO2 10 hr after administration, was seen only with the 10-mg dose in both surgical groups. Minor complications such as nausea, vomiting, pruritus, and urinary retention were uncommon and did not appear to be related to dose. We found that 5 mg epidural morphine provided long-lasting postoperative analgesia without serious adverse effects after peripheral vascular and orthopedic surgery.

Adult↗
PubMed1979

Anemia in the orthopedic patient: a diagnostic approach.

Anemia is the most common hematologic abnormality in the orthopedic patient. The diagnostic work-up is relatively simple if a systematic routine for ordering laboratory test is employed. The approach presented here includes a series of alogarithms incorporating pertinent laboratory tests that allow for a presumptive diagnosis and subsequent confirmation of a particular disease process. Whether all or none of the confirmatory tests is carried out depends on the severity of the anemia as well as the clinical setting. Failure to confirm a diagnosis means that other pathways should be followed or that additional diagnostic possibilities should be considered. There has been no attempt to cover all diagnostic possibilities should be considered. There has been no attempt to cover all diagnostic possibilities but rather to demonstrate a general approach to laboratory utilization.

Anemia↗
PubMed1971

Orthopedic rehabilitation of the stroke patient.

Rehabilitation of hemiplegic patients begins with setting reasonable functional goals and a treatment plan to reach them. During the initial illness an effort is made to begin range of motion exercising and positioning to prevent contractures. Transfer from bed to chair is recommended as soon as the patient's general condition permits.Upper extremity function depends on sensory and motor function as well as visual and central cerebral impairment. Spastic symptomatic contracture of the shoulder must be prevented by adequate orthopedic management of any musculoskeletal problems such as arthritis or tendinitis and the initiation of an active exercise program. Surgical release of contractures is occasionally indicated in refractory cases. Elbow flexion and pronation flexion deformity of the forearm and hand have also required surgical release on occasion. The goal of lower extremity function is ambulation. A double upright short leg brace aids stability in gait. Long leg braces are not used but a cane may be necessary for balance assistance. Contractures must be prevented by an exercise program or surgically released.

Braces↗
PubMedDate not supplied

Ankylosing spondylitis and its variants. A review of recent developments for orthopedic surgeons.

Recent developments in genetic tissue typing have altered concepts of ankylosing spondylitis (AS) or variants of this spondylitic arthritis. It is now apparent that AS is separate and distinct from rheumatoid arthritis; and the term "rheumatoid" should be avoided except as it applies to the latter, usually characterized by rheumatoid factor or nodules and symmetrical arthritis of peripheral joints. Classical definitions of AS require X-ray evidence of sacroiliitis and/or restriction of chest expansion. Recent studies suggest that many patients, especially women, may have symptoms of AS without typical roentgenographic or clinical findings. Use of the HL-A B27 genetic test is useful for identifying AS patients. Radioisotope bone or joint scanning techniques further augment present diagnostic capabilities. Atypical AS may be a very common form of morbidity among patients with back pain in the United States. Since patients have a tendency to form osseous reankylosis after total hip replacement, it is especially important for orthopedic surgeons to identify incipient AS and related disorders. Inappropriate treatment or procedures may be avoided by use of these newer clinical tools in the evaluation of patients with chronic back or skeletal pain.

Anti-Inflammatory Agents↗
PubMed1984

Comparative study of ceftriaxone and cefuroxime for perioperative prophylaxis in orthopedic surgery.

The results of perioperative prophylaxis with either ceftriaxone or cefuroxime have been compared in a nonrandomized trial in 60 patients undergoing orthopedic surgery. A 2 g dose of ceftriaxone was given intravenously 15 minutes before surgery and repeated 24 hours after surgery in 29 patients. One patient with renal insufficiency received 1 g doses of ceftriaxone. The other 30 patients received a 1.5 g dose of cefuroxime given intravenously 15 minutes before surgery and repeated every 6 hours for 48 hours after surgery. In one of the 30 patients given cefuroxime, a postoperative infection due to Staph. aureus developed in association with a hematoma, which resolved after surgical debridement and drainage; treatment was continued with cefuroxime. No postoperative infection developed in any of the patients who received ceftriaxone. Both antibiotics were well tolerated locally and systemically.

Adult↗
PubMed1984

[Evaluation of the analgesic activity of a soluble precursor of aspirin in orthopedic surgery].

We carried out a randomized double-blind trial to evaluate the analgesic effect, rapidity of action and tolerance of calcium carbasalate relative to a placebo, given in a single dose of 1 gr. aspirin equivalent immediately after an orthopedic surgical procedure. Autoevaluation by the patient using a visual scale and overall evaluation of analgesic effectiveness by the patient and relatives showed that pain was significantly less with the active therapy whose tolerance was excellent.

Adolescent↗