The ProDisc-C implant appears to be safe and effective for the treatment of SCDD. Patients with the implant retained motion at the involved segment and had a lower reoperation rate than those with an ACDF.
Background The contribution provided by the popliteus tendon in patients undergoing TKA is poorly defined. Some authors believe the popliteus tendon is essential to a well-functioning arthroplasty, while others do not believe it provides a critical function. Questions/purposes The purposes of this study were to (1) evaluate the effect of resecting the popliteus tendon on knee ligament balancing in extension and flexion intraoperatively during posterior stabilized TKA; and (2) evaluate the effect of resecting the popliteus tendon on load distribution on the tibial plateau as determined by an in vitro single limb stance model during TKA. Methods We randomized 18 patients scheduled for a TKA into two groups, A and B. Once component trials were in place, the senior surgeon removed himself from the operating table to allow for a blinded trial. The first assistant then cut the popliteus tendon in Group A patients but not in Group B patients. The senior surgeon then returned to the table to reevaluate the subjective balance of the ligamentous structures of the knee in both extension and in flexion. A parallel cadaveric study was also completed using a sophisticated instrumented tibial plateau sensor in three knees.
Study design: Prospective randomized controlled study.Introduction: Symptomatic cervical disc disease (SCDD) causing radiculopathy is a common diagnosis traditionally treated surgically with anterior cervical discectomy and fusion (ACDF).Objective: The purpose of this trial is to compare the safety and effi cacy of total disc arthroplasty (TDA) using the ProDisc-C (Synthes Spine Company, LP, West Chester, PA, USA) implant to ACDF in patients with single-level SCDD between C3 and C7.Methods: This study is a report of the single-site results from a trial of 13 sites in a multicenter trial. Patients for this study were enrolled and treated in accordance with the approved US Food and Drug Administration protocol, using a non-inferiority design. The trial used a prospective, randomized controlled methodology. Patients were randomized to either TDA using the ProDisc-C device or ACDF in a one-to-one method. All enrollees were evaluated preoperatively and postoperatively at 6 weeks, 3, 6, 12, 18, 24, 36, 48, 60, 72, and 84 months. Data was collected using the Visual Analog Scale (VAS) for neck and arm pain/intensity, and satisfaction. Neck Disability Index (NDI) and Short-Form 36 (SF-36) questionnaires were also completed. Adverse events were recorded.
The deaths of otherwise healthy patients that are attributable to contaminated allografts have heightened concerns about the screening, processing, and use of such tissues. We present one tertiary care institution's experience with musculoskeletal allografts and determine the frequency of postoperative Clostridium infection. We used an institutional microbiology database to identify all records of culture-confirmed Clostridium infection from January 1990 through July 2006. A comprehensive musculoskeletal database was cross-referenced to include all possible allograft samples surgically collected or implanted from January 1990 through July 2004 to determine the frequency of Clostridium infection associated with use of allograft musculoskeletal tissue. Musculoskeletal allografts were implanted in 16,314 patients during the study period. After a minimum follow-up of 2 years, no patient had development of a definite Clostridium infection that was attributable to the use of musculoskeletal allograft tissue. These outcomes can be achieved with established screening and processing techniques for donor tissue.
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