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Musculoskeletal Surgery

A Kornuijt, D Das, T Sijbesma, L de Vries, W van der Weegen
INTRODUCTION: The etiology of the stiff knee after total knee arthroplasty (TKA) is largely unknown, although excessive scar tissue due to arthrofibrosis is an important reason for a limited range of motion (ROM) after this procedure. Persistent limited ROM after TKA results in poor patient-reported outcomes and is increasingly becoming a more prominent reason for TKA revision surgery. METHODS: A narrative review of current literature on manipulation under anesthesia (MUA) after TKA analyzing etiology and risk factors for stiffness after TKA, effectiveness of MUA and what is known about rehabilitation after MUA...
March 15, 2018: Musculoskeletal Surgery
S G Walter, T Stadler, T S Thomas, W Thomas
BACKGROUND: To introduce a (semi-)quantitative surgical score for the classification of rotator cuff tears. MATERIAL AND METHODS: A total of 146 consecutive patients underwent rotator cuff repair and were assessed using the previously defined Advanced Rotator Cuff Tear Score (ARoCuS) criteria: muscle tendon, size, tissue quality, pattern as well as mobilization of the tear. The data set was split into a training (125 patients) and a testing set (21 patients). The training data set fitted a nonlinear predictive model of the tear score based on the ARoCuS criteria, while the testing data served as control...
March 2, 2018: Musculoskeletal Surgery
A Tecame, M Ferrari, B Violante, G Calafiore, R Papalia, P Adravanti
PURPOSE: This study is aimed to investigate the effects of the choice of femoral and tibial components on several mechanical outputs that might be associated with total knee replacement surgery outcomes using a validated computational model: the Kansas knee simulator. METHODS: Two models from the same range of implants were taken into account: Model 1, the femoral component fitted the femoral epiphysis, with physiological positioning of the articulating surface using a 10-mm-thick tibial component, and in Model 2, the femoral component was 4 mm smaller than in Model 1, and a 14-mm-thick tibial component was used with a similar tibial resection and the tibio-femoral joint line was 4 mm more proximal to compensate the increased posterior bone resection and maintain proper soft-tissue tension in flexion...
February 5, 2018: Musculoskeletal Surgery
S P Mohanty, M Pai Kanhangad, S N Bhat, S Chawla
PURPOSE: To assess the pedicle morphology in the lower thoracic and lumbar spine in an Indian population and to determine the causes of pedicle wall violation by pedicle screws. METHODS: Computerised tomographic scans of 135 consecutive patients with thoracolumbar and lumbar spine fractures were prospectively analysed to determine the pedicle morphology. The transverse pedicle angle, pedicle diameter and screw path length at 527 uninjured levels were measured. Post-operative CT scans of 117 patients were analysed to determine the accuracy of 468 pedicle screws at 234 vertebrae...
February 3, 2018: Musculoskeletal Surgery
S Caravelli, M Mosca, S Massimi, C Pungetti, A Russo, M Fuiano, G Catanese, S Zaffagnini
Hallux rigidus, Latin for Stiff Toe, is characterized by an osteoarthritic degeneration of the articular surfaces of the first metatarsophalangeal joint. The aim of this literature narrative overview is to summarize and expose the great amount of management concepts and information, including the well-codified operative procedures and the more up to date knowledge about non-operative and surgical treatment of hallux rigidus. This may provide current information for physicians, medschool attendants and researchers...
February 1, 2018: Musculoskeletal Surgery
A J Rush, P D Patel, S Shemesh, T K Subhawong, J Pretell-Mazzini
A systematic review of the cases documented in the literature regarding Pleomorphic hyalinizing angiectatic tumor of soft parts (PHAT) was performed in order to identify (1) location on presentation (2) surgical treatment modality (3) recurrence rate (4) any associations between location, age, histology, surgery type on recurrence. A systematic review of medical literature listed on PubMed was conducted identifying any prior case report and/or case series of diagnosed PHAT, with no exclusion based on language or time...
February 1, 2018: Musculoskeletal Surgery
C Iorio, R M Lanzetti, D Lupariello, A Vadalà, M Fabbri, A Ciompi, A Ferretti, A De Carli
PURPOSE: Some authors consider preservation of the subscapularis tendon as one of the most important elements for a successful long-term outcome in patients operated on with open capsulorrhaphy for recurrent anterior shoulder dislocation. The purpose of this study was to evaluate whether vertical tenotomy of the subscapularis tendon might affect internal rotation strength recovery in patients operated on with open capsulorrhaphy for recurrent anterior shoulder dislocation. METHODS: Ninety-six patients were retrospectively followed up at a mean of 72...
January 31, 2018: Musculoskeletal Surgery
A Leti Acciaro, F Pilla, C Faldini, R Adani
INTRODUCTION: Carpal tunnel syndrome (CTS) in children represents a complex challenge for the hand surgeon because of its rarity, poor patient cooperation, frequently associated malformation syndromes and mental retard, atypical symptoms and nuanced and poor sensitivity of instrumental tests. The most frequently associated causes with the CTS in children are rare congenital malformations and diseases, requiring an overall assessment of the young patient and a high degree of suspicion for the potentially associated canalicular syndrome...
December 21, 2017: Musculoskeletal Surgery
G Porcellini, A Combi, G Merolla, B Bordini, S Stea, G Zanoli, P Paladini
BACKGROUND: Implant registries have proved valuable in assessing the outcomes of arthroplasty procedures. Moreover, by identifying lesser quality implants they have indirectly improved the quality of care. The registry of prosthetic shoulder implants was established in 2008. METHODS: It records information on all types of primary and revision arthroplasty procedures involving the glenohumeral joint, including reverse and total arthroplasty, hemiarthroplasty, resurfacing, removal, and any other surgical procedures that are required to manage these patients...
December 4, 2017: Musculoskeletal Surgery
F Pegreffi, A Pellegrini, P Paladini, G Merolla, G Belli, P U Velarde, G Porcellini
PURPOSE: The reverse shoulder prosthesis (RSP) was developed to relieve pain and improve functional outcomes in patients with glenohumeral arthritis and deficiency of the rotator cuff. Even if clinical and functional outcomes regarding the use of the RSP were reported by literature, data concerning progressive deltoid adaptation to this non-anatomic implant are still missing. The purpose of our study was to correlate clinical and functional outcomes with deltoid fibers activity and muscle fatigability in patients with reverse shoulder prosthesis at 2 years follow-up...
December 2017: Musculoskeletal Surgery
A Maresca, P Sangiovanni, S Cerbasi, R Politano, R Fantasia, M Commessatti, R Pascarella
AIM: The aim of this study was to evaluate nonunion causes of surgically treated humeral shaft fractures in two different trauma centers. METHODS: A total of 327 cases of humeral shaft fractures were treated in 11 years in two trauma centers. We retrospectively reviewed in detail some factors in order to understand the reasons for nonunion: (1) fracture type, according to the AO classification, (2) grade of open fracture, according to Gustilo-Anderson, (3) timing, (4) reduction and (5) fixation...
December 2017: Musculoskeletal Surgery
R Finkelstein, O Eluk, T Mashiach, D Levin, B Peskin, G Nierenberg, S Karkabi, M Soudri
In the original article, one of the co-author's family name has been published incorrectly.
December 2017: Musculoskeletal Surgery
A Marinelli, E Guerra, A Ritali, M Cavallo, R Rotini
Radial head prostheses (RHP) have been developed to decrease the complications rate following a radial head resection surgery. The aim of the RHP is to replicate the physiological radiocapitellar tracking, reproducing the mechanical function of the native radial head: to stabilize the elbow and to shear the forces passing through the elbow along with the other stabilizers. The currently used RHP models try to achieve this target with three different prosthesis' strategies: (a) loose fit stem, (b) bipolar radial head or (c) anatomical radial head...
December 2017: Musculoskeletal Surgery
E Carità, A Donadelli, L Cugola, P Perazzini
BACKGROUND/PURPOSE: Radial head replacement is frequently used in treatment of radial head fractures or sequela. Impossibility to restore a correct anatomy, acute elbow traumatic instability and failure of osteosynthesis hardware are the most common indications. The authors describe their case studies and results on the implantation of various radial head prostheses. MATERIALS: Between June 2005 and June 2016, 28 radial head prostheses were implanted in the same number of patients with an average follow-up of 49 months (6-104)...
December 2017: Musculoskeletal Surgery
S Carbone, C Razzano, P Albino, R Mezzoprete
PURPOSE: To select in a 2-year survey of proximal humerus fractures accessing the emergency department, a population of osteoporotic stable impacted fractures and to randomize them into two groups, one with an immediate intensive mobilization program and the other with an immediate conventional mobilization program. METHODS: In emergency department, patients with clinical signs of shoulder girdle fracture were submitted to standard X-ray examination and CT scan...
December 2017: Musculoskeletal Surgery
M Conti, R Garofalo, A Castagna, G Massazza, E Ceccarelli
PURPOSE: We evaluate the ability of in-season competitive athletes to return to competition after an anterior shoulder instability treated conservatively with a new dynamic brace combined with a specific rehabilitation program. METHODS: Twenty soccer players affected by traumatic anterior shoulder dislocation have been enrolled in the "Footballer In Season Fast Rehab" project during 2 consecutive football seasons. We excluded patients affected by rotator cuff tears and the bony defect over 25%...
December 2017: Musculoskeletal Surgery
A Sard, E Dutto, R Rotini, S Vanni, S Pastorelli, B Battiston
BACKGROUND: The medial collateral ligament (MCL) is one of the primary elbows stabilizers. It is composed of an anterior bundle (AB), a posterior bundle (PB) and a transverse bundle. In elbow dislocations, until today MCL reconstruction has addressed the AB only. The purpose of this paper is to understand the biomechanical role of the PB of the MCL and to propose a new surgical technique for the simultaneous reconstruction of the anterior and posterior bundles, preventing the risk of recurrent posterior dislocation or posteromedial rotational instability (PMRI)...
December 2017: Musculoskeletal Surgery
P Arrigoni, D Cucchi, A Menon, P Randelli
PURPOSE: The presence of intra-articular findings that may complement the extra-articular pathology in lateral epicondilytis has been suggested, and a role for minor instability of the elbow as part of the causative process of this disease has been postulated. This study was designed to describe two new clinical tests, aimed at detecting intra-articular pathology in patients affected by recalcitrant lateral epicondylitis and investigate their diagnostic performance. METHODS: Ten patients suffering of atraumatic lateral elbow pain unresponsive to conservative treatment were considered in this study...
December 2017: Musculoskeletal Surgery
R Lanzone, S Carbone, P Albino, J-B Cassio, P Métais
PURPOSE: The objective of this study is to evaluate the clinical and radiological results of reverse shoulder arthroplasty (RSA) with glenoid plating in a consecutive series of patients affected by cuff tear glenohumeral arthropathy with glenoid retroversion >15°. We hypothesized that autologous humeral head graft may be better stabilized between the baseplate and the native glenoid surface with the use of a glenoid plate. METHODS: Twenty consecutive patients affected by cuff tear arthropathy with glenoid retroversion >15° (B2 or C according to Walch classification) were enrolled in this study...
December 2017: Musculoskeletal Surgery
A Vadalà, R M Lanzetti, A De Carli, D Lupariello, M Guzzini, D Desideri, A Ferretti
PURPOSE: The purpose of this study was to correlate the bone block graft position, its dimension, its reabsorption and its integration with clinical outcome in patients operated on for recurrent anterior shoulder instability. METHODS: Twenty-four patients affected by recurrent anterior shoulder dislocation and operated on using the Latarjet procedure were enrolled in this study. At 6 and 24 months, patients were evaluated with the following scales: ROWE, WOSI, Oxford instability score, UCLA, DASH and Constant score...
December 2017: Musculoskeletal Surgery
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