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Collecting a comprehensive evidence base to monitor fracture rehabilitation: A case study

World Journal of Orthopedics 2013年第4期4卷 259-266页

作者： Stuart A Callary Dominic Thewlis Alex V Rowlands David M Findlay Lucian B Solomon Centre for Orthopaedic and Trauma Research The University of Adelaide Department of Orthopaedics and Trauma Royal Adelaide Hospital School of Health Sciences University of South Australia

AIM: To determine the feasibility and potential role of combining radiostereometric analysis(RSA), gait analysis and activity monitoring in the follow-up of fracture ***: Two patients with similar 41B3 tibial plateau fractures were treated by open reduction internal fixation augmented with impaction bone grafting and were instructed to partial weight bear to 10 kg for the first six postoperative weeks. Fracture reduction and fixation were assessed by postoperative computer tomographic(CT) scanning. Both patients had tantalum markers inserted intra-operatively to monitor their fracture stability during healing using RSA and differentially loaded RSA(DLRSA) at 6 and 12 wk postoperatively. Gait analyses were performed at 1, 2, 6, and 12 wk postoperatively. Activity monitors were worn for 4 wk between the 2 and 6 wk appointments. In addition to gait analysis, knee function was assessed using the patient reported Lysholm scores, and doctor reported knee range of motion and stability, at 6 and 12 wk ***: There were no complications. CT demonstrated that both fractures were reduced anatomically. Gait analysis indicated that Patient 1 bore weight to 60% of body weight at 2 wk postoperative and 100% at 6 wk. Patient 2 bore weight at 10% of body weight to 6 wk and had very low joint contact forces to that time. At 12 wk however, there was no difference between the gait patterns in the two patients. Patient 1 increased activities of moderate-vigorous intensity from 20 to 60 min/d between 2 and 6 postoperative weeks, whereas Patient 2 remained more stable at 20-30 min/d. The Lysholm scores were similar for both patients and did not improve between 6 and 12 wk postoperatively. DLRSA examination at 12 wk showed that both patients were comfortable to weight bear to 80 kg and under this weight the fractures displaced less than 0.4 mm. RSA measurements demonstrated over time fracture migrations of less than 2 mm in both cases. However, Patient 2, who

关键词： radiostereometric analysis Gait analysis Activity monitoring Rehabilitation protocols Lower

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Hip prosthetic loosening:A very personal review

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World Journal of Orthopedics 2021年第9期12卷 629-639页

作者： Bengt Mjöberg Department of Orthopedics Lund UniversityLund SE-22100Sweden

Hip prosthetic loosening is often difficult to detect at an early stage,and there has been uncertainty for a long time as to when the loosening occurs and thus to the basic *** comparing different diagnostic methods,we found that loosening is best defined as prosthetic migration and measured by radiostereometric *** evidence indicates that poor interlock,poor bone quality,and resorption of a necrotic bone bed may initiate loosening during or shortly after surgery;this forms the basis of the theory of early *** factors do affect the subsequent progression of loosening,which may increase subclinically during a long period of ***,the loosening may be detected on standard radiographs and may be interpreted as late loosening but should to be interpreted as late detection of *** theory of early loosening explains the rapid early migration,the development of periprosthetic osteolysis and granulomas,the causality between wear and loosening,and largely the epidemiology of clinical failure of hip *** discussed are definition of loosening,the pattern of early migration,the choice of migration threshold,the current understanding of loosening,a less exothermic bone cement,cemented taper-slip stems,a new exciting computed tomography-based technique for simpler implant migration studies,and research suggestions.

关键词： Hip prosthesis Prosthesis failure radiostereometric analysis Bone resorption Bone cements Radionuclide imaging

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Hip prosthetic loosening and periprosthetic osteolysis:A commentary

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World Journal of Orthopedics 2022年第6期13卷 574-577页

作者： Bengt Mjöberg Department of Orthopedics Lund UniversityLund SE-22100Sweden

Prosthetic loosening and periprosthetic osteolysis have been debated for decades,both in terms of the timing and nature of the triggering *** hypothesis of wear-particle-induced loosening states that wear particles cause a foreign-body response leading to periprosthetic osteolysis and ultimately to late prosthetic loosening,i.e.,that the osteolysis precedes the *** theory of early loosening,on the other hand,postulates that the loosening is already initiated during or shortly after surgery,i.e.,that the osteolysis is secondary to the *** commentary focuses on the causal relationship between prosthetic loosening and periprosthetic osteolysis.

关键词： Hip prosthesis radiostereometric analysis Prosthesis failure Osteoclasts Bone resorption Alarmins

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