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Michele Vasso, Katia Corona, Giuseppe Toro, Marco Rossini, Alfredo Schiavone Panni
Medial patellofemoral ligament (MPFL) represents the main restraint against lateral patellar displacement. The MPFL insertion at the patella is up to 30 mm wide and is located along the upper half of the medial patellar rim. The femoral insertion of the MPFL is approximately 10 mm distal to the apex of the adductor tubercle and 16 mm proximal to the medial epicondyle. Since most of the patients suffer from MPFL rupture just after the first patellar dislocation, MPFL reconstruction results necessarily in all cases of chronic objective patellar instability to reestablish the primary passive patellofemoral stabilizer...
December 2017: Joints
Francesco Leonardi, Alessandra Zorzan, Augusto Palermo, Luigi Molfetta
Chronic dislocation of the knee is a rare condition due to a diagnostic mistake during emergency assessment. Usually, dislocation obliges the surgeon to carry out a broad assessment, with vascular and neurological examination, and a thorough assessment of joint injuries. The immediate and stable closed reduction can resolve neurovascular compression. The most serious late sequela is joint instability with impairment of ambulation and patient's autonomy. Treatment of neglected knee dislocation is surgical, that is, arthrodesis or arthroplasty, the latter representing the treatment of choice...
December 2017: Joints
Augusto Dagnino, Nicola Ursino, Carlo A M Ripamonti, Carlo E Fiorentini, Michele Scelsi, Riccardo D'Ambrosi, Nicola M Portinaro
Congenital insensitivity to pain with anhidrosis (CIPA) is an extremely rare disorder characterized by autonomic and sensory nerves malfunction with insensitivity to both deep and superficial painful stimuli, inability to sweat and produce tears, and mild to moderate mental retardation with self-mutilating behavior. Related consequences of inveterate musculoskeletal injuries represent a major issue for these patients, since pain cannot act as a protection mechanism. For the same reason, the patients are at risk during postoperative rehabilitation, which should be taken into account when selecting an orthopaedic implant...
December 2017: Joints
Armando Macera, Francesca Teodonno, Christian Carulli, Alberto Frances Borrego, Massimo Innocenti
Tarsal coalitions have an incidence of 2% and are often underdiagnosed. These are considered to be one of the causes of chronic ankle and foot pain. Among all tarsal coalitions, the talonavicular type represents a rare and uncommon condition. The purpose of this article was to present the case of a 35-year-old male patient with a bilateral talonavicular coalition treated conservatively. A review of the literature was also performed to understand the management of this rare condition.
December 2017: Joints
Gabriele Pisanu, Federica Rosso, Corrado Bertolo, Federico Dettoni, Davide Blonna, Davide Edoardo Bonasia, Roberto Rossi
Patellofemoral osteoarthritis (PFOA) can be associated with anterior knee pain, stiffness, and functional impairment. Some authors report that PFOA affects approximately 9% of patients older than 40 years with a greater prevalence in females. Etiology of PFOA is multifactorial and is related to the presence of abnormal stresses at the PF joint due to knee- and patient-related factors. The need for a joint preserving treatment by isolated replacement of the injured compartment of the knee led to the development of PF arthroplasty (PFA)...
December 2017: Joints
Francesco Di Caprio, Renato Meringolo, Maria Adiletta Navarra, Massimiliano Mosca, Lorenzo Ponziani
Knee osteonecrosis is a severe disease rapidly leading to end-stage osteoarthritis, which was classified into three categories: spontaneous, secondary, and postarthroscopy. To understand postarthroscopy osteonecrosis of the knee, all the three types of knee osteonecrosis have to be deepened. This article reviewed spontaneous and secondary osteonecroses of the knee, with special focus upon postarthroscopy osteonecrosis, which is a rare form, affecting patients operated for arthroscopic knee surgery, most commonly for meniscectomy...
December 2017: Joints
G Solarino, C Piconi, V De Santis, A Piazzolla, B Moretti
Total knee arthroplasty (TKA) is a well-established surgical procedure in the late stages of knee osteoarthritis. Nevertheless, this procedure is associated with a percentage of unsatisfactory results and biomechanical failures, with aseptic loosening being the most common cause of revision. Beside these problems, cutaneous and systemic hypersensitivity reactions to metals have arisen as an increasing concern after joint arthroplasties, even if allergies against implant materials are still a quite rare and not well-known problem...
December 2017: Joints
Davide Cucchi, Antongiulio Marmotti, Silvana De Giorgi, Alberto Costa, Rocco D'Apolito, Marco Conca, Alessandro Russo, Maristella F Saccomanno, Laura de Girolamo
Shoulder stiffness is a condition of painful restriction of the glenohumeral range of motion. Numerous risk factors for primary and postoperative shoulder stiffness have been described. This article summarizes the known aspects of the pathophysiology of shoulder stiffness, with special attention to elements of molecular biology and genetics, which could influence the risk of developing shoulder stiffness. Furthermore, the role of hormonal and metabolic factors, medical disorders, drugs, and of other published risk factors for primary and postoperative shoulder stiffness is reviewed and discussed...
December 2017: Joints
Federico Giuseppe Usuelli, Riccardo D'Ambrosi, Luigi Manzi, Cristian Indino, Jorge Hugo Villafañe, Pedro Berjano
Objective  The purpose of the study is to evaluate the clinical results and return to sports in patients undergoing reconstruction of the Achilles tendon after minimally invasive reconstruction with semitendinosus tendon graft transfer. Methods  Eight patients underwent surgical reconstruction with a minimally invasive technique and tendon graft augmentation with ipsilateral semitendinosus tendon for chronic Achilles tendon rupture (more than 30 days after the injury and a gap of >6 cm). Patients were evaluated at a minimum follow-up of 24 months after the surgery through the American Orthopaedic Foot and Ankle Society (AOFAS), the Achilles Tendon Total Rupture Scores (ATRS), the Endurance test, the calf circumference of the operated limb, and the contralateral and the eventual return to sports activity performed before the trauma...
December 2017: Joints
Giacomo Stefani, Valerio Mattiuzzo, Greta Prestini
Purpose  The aim of this study was to evaluate the efficacy of revision total knee arthroplasty (TKA) with cementless metaphyseal sleeves without stems either in the femoral or tibial side or in both. Methods  In this retrospective study, 51 patients (51 knees) operated in the period 2010 to 2015 met the above-mentioned criteria and were invited to a medical examination including X-rays. Forty-six were available for the study. Mean follow-up was 37 months. Knee Society score (KSS) (objective knee score), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and range of motion (ROM) were used as outcome scores and compared with baseline values...
December 2017: Joints
Riccardo Di Miceli, Carlotta Bustos Marambio, Alessandro Zati, Roberta Monesi, Maria Grazia Benedetti
Purpose  The aim of this study was to assess the effect of knee bracing and timing of full weight bearing after anterior cruciate ligament reconstruction (ACLR) on functional outcomes at mid-term follow-up. Methods  We performed a retrospective study on 41 patients with ACLR. Patients were divided in two groups: ACLR group, who received isolated ACL reconstruction and ACLR-OI group who received ACL reconstruction and adjunctive surgery. Information about age at surgery, bracing, full or progressive weight bearing permission after surgery were collected for the two groups...
December 2017: Joints
Michele Losco, Filippo Familiari, Francesco Giron, Rocco Papalia
Purpose  The purpose of this study is to provide basic information on the availability and current use of cadaver laboratories in the education of orthopaedic residents and trainees and to determine the interest for the implementation of this type of training. Methods  All Orthopaedic residents and trainees who attended a cadaver laboratory organized by SIGASCOT (Italian Society of the Knee, Arthroscopy, Sports Traumatology, Cartilage and Orthopaedic Technology) between 2013 and 2016 were asked to complete a survey on the availability and current use of cadaver laboratories in the education of Orthopaedic residents and trainees...
December 2017: Joints
Giuseppe Milano
No abstract text is available yet for this article.
December 2017: Joints
Dirk-Jonas Danneberg
Osgood-Schlatter Disease (OSD) is a painful, growth-related overuse condition of the tibial tuberosity, leading to inflammation of the patellar ligament at the tibial tuberosity. It primarily affects young adolescents, athletic population, and usually, resolves with age or skeletal maturity. Therapy is usually conservative, with surgery indicated in a minority of cases. For patients with treatment-resistant or refractory OSD, an alternative is the application of autologous platelet concentrate. Here, we describe two cases in which autologous-conditioned plasma therapy was used to treat OSD, and present the treatment protocol developed in our clinic...
September 2017: Joints
Massimo Berruto, Paolo Ferrua, Daniele Tradati, Francesco Uboldi, Eva Usellini, Bruno Michele Marelli
Medial patellofemoral ligament (MPFL) reconstruction has a key role in patellofemoral instability surgery. Many surgical techniques have been described so far using different types of grafts (autologous, heterologous, or synthetic) and fixation techniques. The hereby described technique for MPFL reconstruction relies on the use of a biosynthetic graft (LARS Arc Sur Tille, France). Fixation is obtained by means of suture anchors on the patellar side and a resorbable interference screw on the femoral side locating the insertion point according to Schottle et al...
September 2017: Joints
Roberto Simonetta, Michela Florio, Filippo Familiari, Giorgio Gasparini, Michele Attilio Rosa
Pigmented villonodular synovitis (PVNS) is a rare, benign, proliferative neoplastic condition affecting synovial-lined anatomic spaces. PVNS is characterized by hypertrophy of a synovial membrane by villous, nodular, and villonodular proliferation, with pigmentation secondary to hemosiderin deposition. The two forms of PVNS that have been described are diffuse (DPVNS) and localized (LPVNS). The knee is the most commonly involved anatomic location, followed by hip, ankle, shoulder, and elbow. Diagnosis of PVNS is not always obvious clinically...
September 2017: Joints
Francesco M Uboldi, Silvia Limonta, Paolo Ferrua, Andrea Manunta, Antonio Pellegrini
Tuberculosis (TB) is currently in resurgence due to immigration from endemic areas. Skeletal TB frequently mimics more common etiologies and can be difficult to diagnose. A case of TB knee arthritis in a young woman with painful and swelling knee is reported here. Arthrotomy was performed and inflamed synovial tissue was found, with multiple rice bodies in the eroded lateral femoral condyle. The patient was treated with an antituberculosis polytherapy and at 1-year follow-up, she reported relief from pain and swelling...
September 2017: Joints
Francesco Ranuccio, Filippo Familiari, Giuseppe Tedesco, Francesco La Camera, Giorgio Gasparini
Purpose  Notchplasty is a complementary surgical procedure often performed during anterior cruciate ligament reconstruction (ACLR) with the aim to widen the intercondylar notch and to avoid graft impingement. The aim of this review was to analyze the current literature evidence concerning the effects of notchplasty on clinical outcome after primary ACLR. Methods  Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, PubMed, and MEDLINE were used to search English language studies, from January 1990 to July 2015, concerning the effects of the notchplasty on ACLR, using the following keywords: "ACL" OR "anterior cruciate ligament" OR "ACL reconstruction" OR "anterior cruciate ligament reconstruction" AND "notch" OR "notchplasty" OR "intercondylar notch"...
September 2017: Joints
Mattia Fortina, Simone Mangano, Serafino Carta, Christian Carulli
Purpose  This study aims to analyze the risk factors and type of injuries occurring in Taekwondo athletes participating in a national competition. Methods  Out of the 127 competitors, 18 athletes got injured during a Taekwondo championship who were analyzed for the following parameters: modality of training; age, weight; belt color; and the type of injury. Results  Around 89% of the injuries were due to bruising and were found mainly on the lower limbs (61%) during the elimination rounds and during the first match of the day...
September 2017: Joints
P Antinolfi, R Crisitiani, F Manfreda, S Bruè, V Sarakatsianos, G Placella, M Bartoli, A Caraffa
Purpose  The aim of this prospective study was to compare and correlate clinical, MRI, and arthroscopic findings in cases of suspected meniscal tears. Using arthroscopic findings as the gold standard, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of clinical investigation and MRI were evaluated to determine if is possible, after a careful examination, to bypass MRI and perform directly arthroscopy in suspected cases. Methods  A total of 80 patients with a history of knee trauma, preoperative RX, and MRI underwent arthroscopy over an 8-month period at our department...
September 2017: Joints
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