Holckbass4124

Secondary outcome measures included a postoperative visual analogue scale (VAS) pain score, range-of-motion measures, and International Knee Documentation Committee scores. Demographic data were collected.

Thirty-three patients (89%) completed the study's 6-month follow-up, at which time the femoral ossification score was significantly greater in the aperture fixation group (p = 0.025). There was no substantial difference between the 2 groups with regard to any other outcome measure.

Performing Achilles tendon allograft ACL reconstruction with femoral aperture fixation results in greater femoral bone block incorporation at 6 months postoperatively compared with what is seen after suspensory fixation.

Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Over 1 million joint arthroplasties are performed annually in the United States. Ideally, as devices and surgical techniques improve, the number of revision arthroplasties relative to primary arthroplasties should decrease. To our knowledge, this is the first study to evaluate state-by-state disparities in the ratio of revision to primary knee arthroplasty (unicompartmental and total) and total hip arthroplasty (THA).

The National Inpatient Sample was used to identify patients who had undergone primary or revision knee arthroplasty or primary or revision THA from 2001 to 2011. Demographic characteristics, surgical rates, and revision ratios (the number of revision procedures divided by the number of primary procedures) were determined for the United States as a whole and by state.

During the study window, 47 states were sampled. For knee arthroplasty, 1,251,484 patients were identified 91% underwent primary procedures and 9% underwent revision procedures. Compared with the primary knee arthroplasty cohowhereas patients who had undergone revision had no significant age trend (p = 1.0000). Unlike for knee arthroplasty, the national THA revision ratio trended downward (0.24 evolved to 0.18, p = 0.0016), and there was a 2.1-fold variation in the revision ratio by state (revision ratio state range, 0.119 to 0.248).

This study found significant variability in state-by-state revision ratios. It also found that the national revision ratio stayed relatively steady for knee arthroplasty but was decreasing for THA, and that patients who had undergone revision knee arthroplasty were getting younger, whereas patients who had undergone revision THA were not. These discrepancies suggest divergent histories for primary knee arthroplasty and THA and warrant further detailed evaluation.

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Implant-related symptoms are the most common reason for reoperation after open reduction and internal fixation (ORIF) of midshaft clavicular fractures. Dual mini-fragment plate fixation is a relatively new solution that may decrease implant prominence while maintaining fixation strength and function. There are minimal published data comparing reoperation rates and clinical outcomes between single, superior-plate constructs and dual mini-fragment plate constructs in the fixation of midshaft clavicular fractures. We hypothesized that reducing plate size with the use of dual mini-fragment plating compared with standard, 3.5-mm, superior plating would minimize implant symptoms and the corresponding need for reoperation while still providing sufficient fixation to allow fracture-healing and return to function.

We retrospectively reviewed the cases of 44 consecutive patients who underwent ORIF of displaced midshaft clavicular fractures utilizing either a single, 3.5-mm, superior plate construct (21 patients) orr the treatment of displaced midshaft clavicular fractures was associated with a significantly lower rate of reoperation when compared with single, 3.5-mm, superior plate fixation.

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Over 20% of patients do not report clinically relevant pain relief or functional improvements after total knee arthroplasty (TKA). The aim of this study was to investigate the effect of demographics, pre-TKA knee-joint biomechanics, and postoperative changes in knee biomechanics on meaningful improvements in self-reported pain and function after TKA.

Forty-six patients underwent 3-dimensional gait analysis and completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire before and 1 year after TKA. Pepstatin A cost Response to treatment in terms of pain relief and functional improvement ("pain and function responders") was defined as improvements in WOMAC scores that met minimal clinically important difference thresholds in the pain and function domains. Differences between responder and non-responder demographics, severity of the osteoarthritis as seen radiographically, and knee kinematics and kinetics before TKA were explored using the t test and Mann-Whitney U test. Correlations antrated less reduction in frontal plane angles during gait after TKA had greater self-reported pain and function score improvements after standard TKA. Gait analysis may aid preoperative identification of kinematic subgroups associated with self-reported improvements after TKA, and provide evidence that may inform triaging, surgical planning, and expectation management strategies.

Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.The appropriate amount of iodine is critical for normal function of thyroid cells synthesizing thyroid hormones. Although normal thyroid cell lines such as rat PCCL3 and FRTL5 and human Nthy-ori 3-1 have been widely used for in vitro studies on physiological and pathophysiological effects of iodine on thyroid cells, we have recently pointed out the critical differences between FRTL5/PCCL3 cells and Nthy-ori 3-1 cells. Therefore, we here directly compared some of the cellular characteristics-iodine uptake, differentiated status, iodine-induced cytotoxicity, and iodine-regulation of autophagy-between PCCL3 and Nthy-ori 3-1 cells. PCCL3 cells express messenger RNAs for thyrotropin receptor and sodium/iodine symporter and incorporate iodine in a thyrotropin-dependent manner, whereas Nthy-ori 3-1 cells do not either. Nevertheless, both cells were comparably resistant to iodine cytotoxicity Only far excess iodine (5 × 10-2 M) killed 20% to 40% cells in 24 hours with perchlorate exhibiting no effect, suggesting this cytotoxic effect is due to extracellular iodine.