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Scientific Articles  |  April 16, 2014

Evidence-Based Orthopaedics  |  April 16, 2014
The Orthopaedic Forum  |  April 16, 2014
Figures  
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    Breakdown of the RC appropriateness ratings.

    Figure Description
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    3D reconstructions of preoperative CT imaging were performed with use of image analysis software (OrthoVis; Custom Orthopaedic Solutions, Cleveland, Ohio). Three anatomical landmarks were selected to define the plane of the scapular body: the center of the glenoid fossa, the inferior angle of the scapula, and the trigonum scapulae.

    Figure Description
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    The 2013 AOA-COA ABC fellows. Back row (left to right): Dr. Albert Yee, Dr. Matthew Provencher, Dr. Gregory J. Della Rocca, Dr. Ranjan Gupta, and Dr. Brian Wolf. Front row (left to right): Dr. Michelle Ghert and Dr. Jennifer Moriatis Wolf.

    Figure Description
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    Descriptive Kaplan-Meier curves showing the distribution of osteolysis at the proximal part of the humerus (red curve) and glenoid loosening and/or polyethylene wear in metal-backed glenoid components (blue curve). The two curves are almost parallel, suggesting that there is a relationship between the variables. There is a significant increase of glenoid loosening and osteolysis over time. The shaded areas for each curve indicate the 95% confidence interval.

    Figure Description
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    Flowchart for the literature search.

    Figure Description
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    A graphical plot showing the ROC curve for frozen section histology based on the total number of polymorphonuclear leukocytes in the five highest-density high-power fields. The optimal threshold value of 72% sensitivity and 0% false positive rate was for more than ten polymorphonuclear leukocytes in five high-power fields (black arrow).

    Figure Description
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    Schema summarizing the approaches that have been evaluated for augmentation of tendon-to-bone healing, including the use of osteoinductive growth factors, platelet-rich plasma, gene therapy, enveloping the grafts with periosteum, osteoconductive materials, cell-based therapies, biodegradable scaffolds, and biomimetic patches. Low-intensity pulsed ultrasound and extracorporeal shockwave treatment may affect tendon-to-bone healing by means of mechanical forces that stimulate biological cascades at the insertion site. Application of various loading methods and immobilization times influences the stress forces acting on the recently repaired tendon-to-bone attachment, which eventually may change the biological dynamics of the interface. Other approaches such as the use of coated sutures and interference screws aim to deliver biological factors while achieving mechanical stability by means of various fixators.

    Figure Description
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    CONSORT flow diagram. ROM = range of motion and PVAS = pain visual analog scale.

    Figure Description
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    A CONSORT diagram showing the grouping and flow of patients through the trial. WCB = Workers’ Compensation Board; MDI = multidirectional instability.

    Figure Description
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    Figs. 1-A, 1-B, and 1-C The surgical technique. Fig. 1-A The sternal tendon of the sternocleidomastoid (SCM) muscle is dissected from within the muscle (the cranial end is often indistinct). Fig. 1-B An oblique capsulotomy is performed with elevation of two capsular flaps. (*The dashed line represents the line of capsular incision.) A 3.5-mm tunnel is drilled in the medial end of the clavicle. The tendon is tubularized with a whip stitch. Fig 1-C The tendon is passed through an aperture in the inferomedial capsular flap, then through the tunnel (1), and folded back to be sutured to itself on the manubrium sterni (2). The capsule is closed with a superior-to-inferior slide. The hiatus in the sternocleidomastoid muscle is sutured together (3). SCM(C) = clavicular head of sternocleidomastoid muscle, SCM(S) = sternal head of the sternocleidomastoid muscle, CCL = costoclavicular ligament, C = sternoclavicular joint capsule, CF(S) = superior capsular flap of the anterior sternoclavicular joint capsule, CF(I) = inferior capsular flap of the anterior sternoclavicular joint capsule, S = manubrium sterni, and R = first rib.

    Figure Description
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