Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ORTHOPEDICS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,405 records · Page 78Linked to original sources
PubMed1993

Use of erythropoietin to increase the volume of autologous blood donated by orthopedic patients.

For patients who donate blood for autologous use and undergo major orthopedic surgery, low basal hematocrit (Hct) is the major cause of allogeneic blood exposure. To determine whether recombinant human erythropoietin (rHuEPO) could increase autologous blood procurement and reduce allogeneic blood exposure, a prospective randomized study was conducted in 50 women undergoing total hip replacement who had basal Hct < 40 percent (0.40). Patients were randomly placed in three groups: those receiving placebo, those receiving 300 U of rHuEPO per kg, and those receiving 600 U of rHuEPO per kg every 3 to 4 days for 21 days. Oral iron (125-270 mg/day) was given; in the last 24 patients, 100 mg of iron saccharate was administered intravenously at each donation. At each visit, 350 mL of blood was collected if Hct was > or = 34 percent (0.34). Patients receiving rHuEPO donated a greater amount of blood for autologous use than did patients in the placebo group (4.5 +/- 1.1 vs. 2.8 +/- 0.6 units; p < 0.05) and received a significantly lower amount of allogeneic blood (1.2 +/- 1.4 vs. 0.4 +/- 0.8 units; p < 0.05). No difference between the effects of the two doses of rHuEPO was observed. Iron support was a critical factor in the efficacy of treatment. No untoward effects were observed. The rHuEPO emerged as a safe and effective treatment, with adequate iron support, by which to increase preoperative deposit of autologous blood and to reduce exposure to allogeneic blood for patients with low basal Hct.

Blood Transfusion, Autologous↗
PubMed1994

Use of recombinant human erythropoietin to assist autologous blood donation by anemic rheumatoid arthritis patients undergoing major orthopedic surgery.

BACKGROUND: In rheumatoid arthritis (RA) patients undergoing orthopedic surgery, anemia is the major factor in the use of allogeneic blood. STUDY DESIGN AND METHODS: To determine whether recombinant human erythropoietin (rHuEPO) could allow preoperative autologous blood procurement and reduce allogeneic blood exposure, 11 RA patients who were unable preoperatively to deposit blood for autologous use because of their anemia (baseline hematocrit < 34% [0.34]) and who were scheduled for primary total hip replacement or total knee replacement were treated intravenously with 300 U per kg of rHuEPO in combination with intravenous iron saccharate (100 mg), given twice weekly for 3 weeks. The transfusion treatment was compared with that in 12 control patients with comparable baseline hematologic values who underwent the same operation. RESULTS: Control patients could not preoperatively deposit any blood for autologous use, while all but one of the rHuEPO-treated patients deposited 2 or more units (mean, 2.6 +/- 0.6; range, 2-4) (p < 0.001). The control group received more allogeneic units (2.6 +/- 1.6 vs. 0.8 +/- 0.8) (p = 0.009). Moreover, 50 percent of the rHuEPO-treated patients, as compared with 8 percent of controls, completely avoided allogeneic transfusion. CONCLUSION: Recombinant human erythropoietin is safe and effective in stimulating erythropoiesis, allowing preoperative donation of blood for autologous use, and reducing exposure to allogeneic blood for RA patients who are unable preoperatively to deposit blood because of anemia.

Adult↗
PubMed1996

Effectiveness of very low doses of subcutaneous recombinant human erythropoietin in facilitating autologous blood donation before orthopedic surgery.

BACKGROUND: Clinical and pharmacokinetic data suggest that very low doses of subcutaneous recombinant human erythropoietin (rHuEPO) may be effective in a preoperative autologous blood deposit program. STUDY DESIGN AND METHODS: Fifty-two patients, scheduled for orthopedic surgery, were enrolled in a double-blind and placebo-controlled study. Patients were randomly assigned to the placebo group or to receive 30, 60, or 100 IU per kg of rHuEPO subcutaneously twice a week for 2 weeks before surgery. The dose of rHuEPO that was effective in facilitating the collection of 4 units of blood in the 2 weeks before surgery and that prevented a sharp decrease in hematocrit was determined. RESULTS: Only in patients receiving 100 IU per kg of rHuEPO did the outcome measurements differ significantly from those in the placebo group. With a higher (p < 0.01) cumulative increase in red cell volume during the study period (297 +/- 127 vs. 121 +/- 44 mL), 64 percent of those receiving 100 IU per kg of rHuEPO were able to donate 4 units of blood for autologous use, as compared with 23 percent of the placebo group (p < 0.05). Allogeneic transfusion was avoided, and the preoperative hematocrit and reticulocyte count were significantly higher in the patients receiving 100 IU per kg of rHuEPO (p < 0.05 and p < 0.01, respectively). CONCLUSION: Subcutaneously administered rHuEPO at a dose of 100 IU per kg twice a week for 2 weeks is effective in facilitating the collection of blood for autologous use and may improve the cost-benefit ratio of blood conservation interventions. Doses < or = 60 IU per kg are ineffective in facilitating such collections in this surgical setting.

Aged↗
PubMed1999

The effect of unmodified or prestorage white cell-reduced allogeneic red cell transfusions on the immune responsiveness in orthopedic surgery patients.

BACKGROUND: The immunomodulatory effects of allogeneic blood transfusions have been attributed to the white cells (WBCs) present in the cellular blood components transfused to patients. STUDY DESIGN AND METHODS: The effect of the transfusion of allogeneic red cells (RBCs) or allogeneic prestorage WBC-reduced RBCs (WBC-reduced RBCs) on host immune responsiveness was evaluated by measuring the lymphocyte subsets and the in-vitro cytokine production in response to phytohemagglutinin stimulation of WBCs of orthopedic surgery patients. Forty-seven patients undergoing hip replacement surgery were randomly assigned to receive allogeneic RBCs (n = 17) or WBC-reduced RBCs (n = 14; 99.95% WBC removal). Sixteen patients were not transfused. Patient blood samples taken before surgery and on Days 1 and 4 after surgery were tested for complete blood count, lymphocyte subset analysis, and measurement of cytokine levels. RESULTS: After surgery, the lymphocyte count was significantly decreased in patients transfused with > or = 3 units of allogeneic RBCs (2.0 +/- 0.5 vs. 1.3 +/- 0.3 x 10(9)/L; p = 0.017), but not in patients transfused with > or = 3 units of WBC-reduced RBCs (2.0 +/- 0.9 vs. 1.7 +/- 0.8 x 10(9)/L). Compared with preoperative levels, on Day 4 after surgery, patients transfused with > or = 3 units of allogeneic RBCs also had a decrease in the number of natural killer cells (0.07 +/- 0.05 vs. 0.04 +/- 0.03 x 10(9)/L; p = 0.018). Postoperatively, interleukin-2 was decreased in one patient who received WBC-reduced RBCs compared with that in four patients transfused with allogeneic RBCs (p = 0.32), and eight untransfused patients (p = 0.01). On Day 4, about 70 percent of patients transfused with allogeneic RBCs showed a 20-percent decrease in the interferon gamma level. CONCLUSION: Taken together, these data support the hypothesis that transfusion of > or = 3 units of allogeneic RBCs is associated with early postoperative lymphopenia in otherwise healthy individuals undergoing surgery. These findings were not observed in those individuals transfused with RBCs that had undergone prestorage WBC reduction.

Adult↗
PubMed2003

Orthopedic Surgery Transfusion Hemoglobin European Overview (OSTHEO) study: blood management in elective knee and hip arthroplasty in Europe.

BACKGROUND: The purpose of this study was to assess current practices in blood management in elective orthopedic surgery in Europe. STUDY DESIGN AND METHODS: For this 225-center prospective survey, data were collected on 3996 patients. Actual perioperative blood loss was compared to preoperative estimates. Differences in Hb levels and other outcome variables for patients receiving allogeneic versus autologous transfusions were evaluated. The probability of allogeneic transfusion based on selected predictor variables was estimated. RESULTS: A total of 2640 (67%) hip and 1305 (33%) knee arthroplasty patients were evaluated. Estimated blood loss (median, 750 mL) was significantly lower than computed blood loss (median, 1944 mL). A total of 2762 (69%) patients received transfusions, including 1393 (35%) autologous-only and 1024 (25%) allogeneic-only. The probability of allogeneic transfusion decreased with increasing baseline Hb, but differentially so for men and women. Transfusion triggers were Hb levels of 8.93 +/- 1.83 g per dL for allogeneic transfusions, and 21 percent of these occurred when the Hb level was greater than 10 g per dL. Autologous blood transfusion was associated with a significantly lower rate (1%) of wound infections than allogeneic blood transfusion (4.2%). CONCLUSION: Accurate assessment of preoperative Hb levels, better estimation of perioperative blood loss, efficient use of autologous blood, adherence to transfusion guidelines, and pharmacologic alternatives contribute to effective and comprehensive blood and anemia management.

Aged↗
PubMed2006

[The role of the maxillary incisors in the development of the base of the nose. Applications in dento-facial orthopedics].

The neonatal respiratory distress observed in the event of a solitary median maxillary central incisor compels us to reconsider some of the traditional concepts relative to the transverse growth of the nasal level of the face. The "container-contents" connections associating maxillary incisor odontogenesis with the development of the premaxillary and facial envelopes draw the attention to the significant geometrical and mechanical expression of this morphogenesis. They require attributing to the maxillary incisors an important motor role in this development. They lead to granting the ontogenetic bonds, between malocclusions and disturbed nasal breathing, the place they deserve, taking into account the morphological integration combining them. They eventually open a new therapeutic prospect: the optimization of the development of the growing face, with regard to the various tissue mechanics and physiologies, becoming the best guarantor for the prevention of relapse after dentofacial orthopedics.

Animals↗
PubMed2006

[Orthopedic activators for growth and treatment of Class II malocclusion].

Activators are functional jaw orthopedic appliances which provide various mandibular position, but always different from habitual positions. Mechanisms and modus operandi of activators explain therapeutic objectives of clinicians. When we analyse different determinants of modus operandi of activators (skeletal, muscular and articular), it is possible to classify these appliances in rigid monobloc appliances, composite or elastic activators and thrusting activators. Many prospective or retrospective clinical studies analyse dentoalveolar or skeletal effects of the activators.

Activator Appliances↗
PubMed2004

Pediatric orthopedic trauma: principles of management.

Musculoskeletal injuries in the pediatric population are unique and require a thorough evaluation by a trained specialist. Unlike adults, many of the injuries may be treated closed due to the amazing growth and remodeling potential of children. Special consideration should be taken in treating certain fracture patterns to prevent the long-term consequences of growth deformities and protect children from child abuse. It is the goal of this article to outline common orthopedic injuries in the pediatric population to facilitate proper care in the multidisciplinary evaluation and treatment of children.

Adolescent↗
PubMedDate not supplied

[FDG-PET for diagnosis and follow-up of inflammatory processes: initial results from the orthopedic viewpoint].

AIM: The diagnosis and the assessment of osteomyelitis and spondylodiscitis can be difficult. The aim of this study was to evaluate the usefulness of FGD-PET in the detection of inflammatory processes. METHOD: 23 orthopedic patients suspected of having peripheral osteomyelitis (n = 13) or spondylodiscitis (n = 10) were examined consecutively with FDG-PET. The FDG-PET scans were evaluated by the nuclear physicians in ignorance of the clinical diagnosis by visual interpretation, which was graded on a five-point scale (0 = no infection-4 = definitely infection). RESULTS: Of 23 patients, 15 had osteomyelitis (n = 8) or spondylodiscitis (n = 7). In these 15 cases, the FDG-PET was true-positive. The sensitivity was 100%. In the 8 cases without infection, the FDG-PET was in 5 cases true-negative and in 3 cases false-positive. Even with inlying metal implants, soft-tissue abscesses could be differentiated from the bony process. CONCLUSION: The FDG-PET is a very sensitive procedure for the diagnosis of osteomyelitis and spondylodiscitis and for screening of inflammation foci. A further advantage is the high spatial solution. The quantification of the inflammatory activity allowed a monitoring of the therapy.

Abscess↗
PubMed2000

Focus on muscle in orthopedic MRI.

Although much has been learned regarding the pathophysiology and imaging characteristics of orthopaedic muscle injuries, more is unknown and areas of controversy still exist. Consequently, there are two main goals of this article. The first is to address what is known regarding magnetic resonance imaging (MRI) of orthopedic muscle disorders, focusing on selected entities rather than an exhaustive review of the subject. The second is to address areas of current controversy. Our hope is that the discussion that follows will stimulate further interest and investigation.

Diagnosis, Differential↗
PubMed2001

Role of MR imaging in the evaluation of low back pain (orthopedic surgeon's view).

In this article, the role of magnetic resonance imaging in the evaluation of degenerative lumbar disorders causing low back pain and radicular symptoms is discussed from an orthopedic surgeon's point of view. Magnetic resonance imaging can represent not only morphological, but pathological changes of osteoligamentous and neural components of the lumbar spine.

Humans↗
PubMed2001

Proper use of MR imaging in internal derangement of the knee (orthopedic surgeon's view).

MR imaging of the knee is a highly accurate examination in terms of the detection of meniscal tears and cruciate ligament ruptures among internal derangement of the knee. The overall accuracy in more than 2000 published cases reached nearly as high as 90% in meniscal tears, and 94% in anterior cruciate ligament (ACL) and 99% in posterior cruciate ligament (PCL) ruptures. Furthermore, the negative predictive value of the knee MR imaging, the number of true negative examination results divided by the numbers of true negative plus false-negative examination results, reaches almost 100% because of its very low false-negative rate. Therefore, from the orthopedic surgeon's point of view, even though the medical cost becomes a great concern, MR imaging has prime importance in the diagnosis of the internal derangement of the knee.

Anterior Cruciate Ligament Injuries↗
PubMedDate not supplied

[Orthopedic considerations of trichorhinophalangeal syndrome type II].

INTRODUCTION: The trichorhinophalangeal syndrome type II or Langer-Giedion syndrome is regarded as a rare abnormity that is marked by a number of clinical characteristics beside multiple cartilaginous exostoses. RESULTS: The deviation of the fingers within the scope of the TRPS II that is often reported in literature can not be found in the case at issue of a now 14 year old boy. The course of disease was complicated due to consecutive axis deviation of two large joints of the lower extremities being determined by the syndrome. Due to the marked exostoses in the area of the growth plate of the left knee joint a valgus deformity developed there. It was corrected with means of a temporary clamping of the growth plate. With the increasing valgus deformity of the right ankle causing a calcaneovalgus foot deformity the osteochondroma located at the distal fibula was also removed and a temporary clamping of the growth plate was carried out at the right medial malleolus. From earliest childhood repeating cartilaginous exostoses both at the extremities and the trunk attracted attention. Also strongly developed are the facial distinguishing marks which determine the typical shape of the face. CONCLUSION: By the case of a now 14 year old boy with severe orthopedic complications considerations are made concerning therapeutic principles due to the TRPS II.

Adolescent↗
PubMed2002

Effect of mandibular orthopedic repositioning appliance on kinematic pattern in golf swing.

Experience has shown that repositioning the mandible may have an influence on the athletic performance. Many athletes with or without occlusal problems are now using mandibular orthopedic repositioning appliance (MORA) supposedly to optimize their performance. In golf, the players do not have any direct opponent and they have different clubs to reach various distances. Therefore, an automatic swing permits the uncertainty of the movement to be restricted. The aim of this study was to analyze if the use of the MORA could have an effect on the stability of the kinematic pattern in golf swing, connected to the capacity of the golfers to reproduce their swing from kinematic perspective. The measures of kinematic data have been established with the optoelectronic system VICON (Oxford's Metrix, Oxford, UK) with five cameras operating at 50 frames per second. Measurements of the speed of the ball at impact were obtained with a radar (Bridgestone HD.01, Science eye, USA). Six professional (current handicap ranging from 0 to 4) right-handed golfers participated in the study. Six MORA were made and adjusted to fit each player. Each golfer performed five swings without mouthpiece and five with the MORA. The results of this study show that there was no difference related to the MORA on kinematic pattern of the golf swing. Moreover, there were significant differences concerning the ball speed at the impact, among the two test conditions, with or without the appliance (p < 0.03). The percentage of variability indicates that the speed with MORA was more regular than the speed without the appliance.

Adolescent↗
PubMed2002

Prolonged prophylaxis in orthopedic surgery: insights from the United States.

The U.S. Hip and Knee Registry is a voluntary national registry of outcome data for hip and knee surgery. In total, 469 orthopedic surgeons from 325 hospitals reported data on 7677 patients who underwent total hip arthroplasty (THA) and 11,461 patients who underwent total knee arthroplasty (TKA). Data on patients enrolled between 1996 and 2000 indicate that 40% of THA patients and 42% of TKA patients received prophylaxis for a period of 8 to 21 days, including the in-hospital period. Prolonged prophylaxis for more than 21 days was used in 49% of THA patients and 44% of TKA patients. Moreover, year on year, data indicate that the percentage of patients who receive prophylaxis for longer than 21 days is gradually increasing. In 2000, 53% of THA patients and 47% of TKA patients received prophylaxis for longer than 21 days.

Aged↗
PubMed2006

[On uniform social medical evaluation of performance capacity in orthopedic rehabilitation].

The need for standardized and unified performance capacity assessment in orthopedic rehabilitation has led to the attempt to use an existing standardized procedure. Graduated disease features have been defined which are relevant for work and their effects on performance capacity been formulated as rules. In this way so-called disease-conditioned performance capacities are obtained which help to identify problems in carrying out various activities. These activities can be directly assessed using tests. Appropriate tests are listed in a table.

Disability Evaluation↗
PubMed1997

[Orthopedic hippotherapy in postoperative rehabilitation of lumbar intervertebral disk patients. A prospective, randomized therapy study].

In a prospectively randomized therapy study the influence of a new therapeutical approach, called "Orthopedic Horseback-Riding-Therapy (OHRT)", was evaluated on the postoperative rehabilitation after lumbal discectomie in 16 patients against an identical numbered control group. In comparison with the reference group the utilization of OHRT not only produced an improvement in the patients' self evaluation of their postoperative condition (McNab Score). Also a significant reduction of postoperative work disablement could be achieved. Compared with the reference group influences of previously detected negative psychic predictors (Hs and Hy scales of MMPI) could be reduced. Thus the OHRT is a serious therapy concept in postoperative treatment of patients with lumbal disc herniation.

Adult↗