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https://www.readbyqxmd.com/read/29149741/the-isolated-posterior-malleolar-fracture-and-syndesmotic-instability-a-case-report-and-review-of-the-literature
#1
Diederik P J Smeeing, Roderick M Houwert, Moyo C Kruyt, Falco Hietbrink
INTRODUCTION: Ankle fractures are among the most common type of fractures in the lower extremity. A posterior malleolar fracture is frequently part of a more complex ankle fracture and only in rare cases it occurs as isolated injury. Posterior malleolar fractures often occur with associated injuries, such as a Maisonneuve fracture or with bi- or trimalleolar ligamentous injuries. Knowledge about these associated injuries is essential to prevent missed diagnoses. The aim of this article is to describe the isolated posterior malleolar fracture, the possible associated injuries, the diagnostic work-up and therapeutic consequences...
November 13, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29147744/consistency-in-patient-reported-outcome-measures-after-total-knee-arthroplasty-using-patient-specific-instrumentation-a-5-year-follow-up-of-200-consecutive-cases
#2
Daphne A L Schoenmakers, Martijn G M Schotanus, Bert Boonen, Nanne P Kort
PURPOSE: The purpose of this study was to evaluate the 5-year follow-up results of the first 200 total knee arthroplasties (TKA) performed by one high-volume surgeon, using patient-specific information (PSI). To date, there has been no other research into the mid-term follow-up of TKA performed using PSI. MATERIALS AND METHODS: A total of 184 consecutive patients (200 TKA) were evaluated. Outcome measures included implant survival rate, adverse events, and the following patient-reported outcome measures (PROMs); Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oxford Knee Score (OKS), Pain Visual Analogue Score (VAS) and EuroQol-5D Score (EQ-5D)...
November 17, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29145966/outcome-evaluation-of-staged-treatment-for-bicondylar-tibial-plateau-fractures
#3
Vincenzo Giordano, Ney Pecegueiro do Amaral, Hilton A Koch, Rodrigo Pires E Albuquerque, Felipe Serrão de Souza, José Félix Dos Santos Neto
BACKGROUND: The universal accepted strategy for treating high-energy tibial plateau fractures remains a topic of ongoing debate. The challenge for the practicing orthopaedic trauma surgeon is to provide anatomical articular fracture reduction, with successfully managing the complex soft-tissue injury that is commonly present at patient admission. The primary aim of the actual study was to evaluate the results of a staged protocol for the treatment of high-energy bicondylar tibial plateau fractures...
October 2017: Injury
https://www.readbyqxmd.com/read/29143300/effect-of-restraining-the-base-of-support-on-the-other-biomechanical-features-in-patients-with-cerebellar-ataxia
#4
C Conte, Mariano Serrao, L Cuius, A Ranavolo, S Conforto, F Pierelli, L Padua
This study aimed to analyze the biomechanical consequences of reducing the base of support in patients with ataxia. Specifically, we evaluated the spatio-temporal parameters, upper- and lower-body kinematics, muscle co-activation, and energy recovery and expenditure. The gaits of 13 patients were recorded using a motion analysis system in unperturbed and perturbed walking conditions. In the latter condition, patients had to walk using the same step width and speed of healthy controls. The perturbed walking condition featured reduced gait speed, step length, hip and knee range of motion, and energy recovery and increased double support duration, gait variability, trunk oscillation, and ankle joint muscle co-activation...
November 15, 2017: Cerebellum
https://www.readbyqxmd.com/read/29138919/low-re-rupture-rate-with-bptb-autograft-and-semitendinosus-gracilis-autograft-with-preserved-insertions-in-acl-reconstruction-surgery-in-sports-persons
#5
Ravi Gupta, Munish Sood, Anubhav Malhotra, Gladson David Masih, Anil Kapoor, Mukta Raghav, Mehar Dhillon
PURPOSE: To compare the results of bone-patellar tendon-bone graft (BPTB), semitendinosus-gracilis graft with preserved insertions (STGPI) and semitendinosus-gracilis-free graft (STGF) in terms of graft failure, objective mechanical stability, functional outcome, and return to sports in elite and recreational sports persons. It was hypothesized that the STGPI graft provided superior outcome as compared to the other two grafts. METHODS: Two hundred and forty-nine elite and recreational players who underwent ACL reconstruction surgery, with BPTB graft (N = 80), STGPI graft (N = 85), and STGF graft (N = 84) with a minimum follow-up of 2 years, were assessed using clinical tests, knee arthrometer (KT 1000™), single-leg hop test, Lysholm knee score, Tegner's activity scale, and return to sports...
November 14, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29132386/primary-single-suture-anchor-re-fixation-of-anterior-cruciate-ligament-proximal-avulsion-tears-leads-to-good-functional-mid-term-results-a-preliminary-study-in-12-patients
#6
Christof Hoffmann, Jan Friederichs, Christian von Rüden, Christian Schaller, Volker Bühren, Christoph Moessmer
BACKGROUND: Current studies demonstrate encouraging short-term results after primary anterior cruciate ligament (ACL) suture anchor repair. However, earlier studies reported deterioration of knee function at 5-year follow-up following good clinical short-term recovery. Therefore, the aim of this study was to evaluate clinical long-term results after primary ACL repair at a minimum 5-year follow-up. METHODS: In a retrospective study, 13 patients were included between 2009 and 2012...
November 13, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29128875/allowing-one-quadrant-of-patellar-lateral-translation-during-medial-patellofemoral-ligament-reconstruction-successfully-limits-maltracking-without-overconstraining-the-patella
#7
John J Elias, Kerwyn C Jones, Molly K Lalonde, Joseph N Gabra, S Cyrus Rezvanifar, Andrew J Cosgarea
PURPOSE: Graft tensioning during medial patellofemoral ligament (MPFL) reconstruction typically allows for lateral patellar translation within the trochlear groove. Computational simulation was performed to relate the allowed patellar translation to patellofemoral kinematics and contact pressures. METHODS: Multibody dynamic simulation models were developed to represent nine knees with patellar instability. Dual limb squatting was simulated representing the pre-operative condition and simulated MPFL reconstruction...
November 11, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29125074/-a-soccer-player-with-an-unstable-knee
#8
D Janssen, B Koc, E Jansen
A 19-year-old soccer player presented with instability of his left knee after a rotation trauma. Congenital absence of the anterior cruciate ligament was suspected because of leg length discrepancy and specific MRI findings. He regained stability after an anterior cruciate reconstruction.
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29124285/kinematics-and-arthrokinematics-in-the-chronic-acl-deficient-knee-are-altered-even-in-the-absence-of-instability-symptoms
#9
Chen Yang, Yasutaka Tashiro, Andrew Lynch, Freddie Fu, William Anderst
PURPOSE: To analyze the in vivo kinematics and arthrokinematics of chronic ACL-deficient (ACL-D) and unaffected contralateral knees during level walking and downhill running using dynamic biplane radiography. It was hypothesized that ACL-D knees would demonstrate increased anterior translation and internal rotation, and that ACL-deficiency would alter the tibiofemoral contact paths in comparison to the unaffected contralateral side. METHODS: Eight participants with unilateral chronic ACL-D without instability symptoms were recruited...
November 9, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29122124/anatomical-and-radiological-evaluation-of-less-invasive-stabilisation-system-liss-in-correlation-with-knee-lateral-collateral-ligament-insertion
#10
Florian Freimoser, Stephan Grechenig, Anna Ofenhitzer, Bore Bakota, Mario Staresinic, Christian G Pfeifer
INTRODUCTION: The Less Invasive Stabilisation System (LISS) is an angle-stable plate that enables treatment of distal femoral comminuted and periprosthetic fracture. As it is placed through a minimally-invasive lateral approach, lateral knee pain is a commonly described symptom after its application. This study investigates knee lateral collateral ligament (LCL) iatrogenic injury during LISS plate fixation. A cadaver study was performed and a retrospective radiological investigation with the analysis of its clinical application was conducted to evaluate possible knee LCL damage...
November 2017: Injury
https://www.readbyqxmd.com/read/29121680/effects-of-drop-height-and-surface-instability-on-jump-performance-and-knee-kinematics
#11
Melanie Lesinski, Olaf Prieske, Rainer Beurskens, David Behm, Urs Granacher
The purpose of this study was to examine the combined effects of drop-height and surface condition on drop jump (DJ) performance and knee joint kinematics. DJ performance, sagittal and frontal plane knee joint kinematics were measured in jump experienced young male and female adults during DJs on stable, unstable and highly unstable surfaces using different drop-heights (20, 40, 60 cm). Findings revealed impaired DJ performance (Δ5-16%; p<0.05; 1.43≤d≤2.82), reduced knee valgus motion (Δ33-52%; p<0...
November 9, 2017: International Journal of Sports Medicine
https://www.readbyqxmd.com/read/29119285/lateral-femoral-notch-depth-is-not-associated-with-increased-rotatory-instability-in-acl-injured-knees-a-quantitative-pivot-shift-analysis
#12
Ajay C Kanakamedala, Jeremy M Burnham, Thomas R Pfeiffer, Elmar Herbst, Marcin Kowalczuk, Adam Popchak, James Irrgang, Freddie H Fu, Volker Musahl
PURPOSE: A deep lateral femoral notch (LFN) on lateral radiographs is indicative of ACL injury. Prior studies have suggested that a deep LFN may also be a sign of persistent rotatory instability and a concomitant lateral meniscus tear. Therefore, the purpose of this study was to evaluate the relationship between LFN depth and both quantitative measures of rotatory knee instability and the incidence of lateral meniscus tears. It was hypothesized that greater LFN depth would be correlated with increased rotatory instability, quantified by lateral compartment translation and tibial acceleration during a quantitative pivot shift test, and incidence of lateral meniscus tears...
November 8, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29110366/energy-dissipation-differs-between-females-with-and-without-chronic-ankle-instability
#13
Ryan S McCann, Masafumi Terada, Kyle B Kosik, Phillip A Gribble
Chronic ankle instability (CAI) is associated with altered energy dissipation patterns, but comparisons to lateral ankle sprain (LAS) copers have not been explored. The purpose of this study was to examine differences in relative sagittal plane energy dissipation during a single-leg landing between female CAI and LAS coper participants. We separated 33 females (23.6±4.6yrs, 164.3±6.2cm, 69.4±13.7kg) into CAI (n=17) and LAS coper (n=16) groups. Participants completed five single-leg landings followed by a 5-second stabilization...
November 7, 2017: Scandinavian Journal of Medicine & Science in Sports
https://www.readbyqxmd.com/read/29102017/editorial-commentary-measuring-coronal-mal-alignment-for-patients-with-patellar-instability-tibial-tubercle-to-trochlear-groove-versus-tibial-tubercle-to-posterior-cruciate-ligament-distance
#14
EDITORIAL
Andrew J Cosgarea
Excessive lateralization of the tibial tuberosity is one of the anatomic factors that contribute to lateral patellar instability, which we usually correct surgically with tibial tuberosity osteotomy. Traditionally, coronal alignment was determined clinically by measuring the Q angle, which has proven to be unreliable. Radiographic measurements of coronal alignment made using computed tomography and magnetic resonance imaging are more reliable and have become the standard for determining the need for corrective tibial tuberosity osteotomy...
November 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29101982/acr-appropriateness-criteria-%C3%A2-imaging-after%C3%A2-total%C3%A2-knee-arthroplasty
#15
Mary G Hochman, Yulia V Melenevsky, Darlene F Metter, Catherine C Roberts, Jenny T Bencardino, R Carter Cassidy, Michael G Fox, Mark J Kransdorf, Douglas N Mintz, Nehal A Shah, Kirstin M Small, Stacy E Smith, Kathy M Tynus, Barbara N Weissman
Total knee arthroplasty (TKA) is the most commonly performed joint replacement procedure in the United States and annual demand for primary TKA is expected to grow by 673% by 2030. The first part provides an overview of imaging modalities (radiographs, CT, MRI, ultrasound, and various nuclear medicine studies) and discusses their usefulness in the imaging evaluation of TKA. The second part focuses on evidence-based imaging and imaging-guided intervention algorithms for the workup of TKA and its complications, including routine follow-up, component wear, periprosthetic infection, aseptic loosening, granulomas/osteolysis, conventional and rotational instability, periprosthetic fracture, patellar complications, and a variety of periprosthetic soft tissue abnormalities...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29100777/anisometry-of-medial-patellofemoral-ligament-reconstruction-in-the-setting-of-increased-tibial-tubercle-trochlear-groove-distance-and-patella-alta
#16
Lauren H Redler, Kathleen N Meyers, Jacqueline M Brady, Elizabeth R Dennis, Joseph T Nguyen, Beth E Shubin Stein
PURPOSE: To assess the impact elevated tibial tubercle-trochlear groove (TT-TG) distance and patella height, as measured by the Caton-Deschamps Index (CDI), have on the isometry of a reconstructed medial patellofemoral ligament (MPFL). METHODS: Nine fresh-frozen cadaveric knees were placed on a custom testing fixture, with a fixed femur and a mobile tibia. A suture fixed to the MPFL origin on the patella and free to move at the Schöttle point on the femur represented a reconstructed MPFL...
October 31, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29100468/treatment-of-knee-osteochondritis-dissecans-with-a-cell-free-biomimetic-osteochondral-scaffold-clinical-and-imaging-findings-at-midterm-follow-up
#17
Francesco Perdisa, Elizaveta Kon, Andrea Sessa, Luca Andriolo, Maurizio Busacca, Maurilio Marcacci, Giuseppe Filardo
BACKGROUND: Osteochondritis dissecans (OCD) is a developmental condition of subchondral bone that may result in secondary separation and instability of the overlying articular cartilage, which in turn may lead to degeneration of the overall joint and early osteoarthritis. Biphasic scaffolds have been developed to address defects of the entire osteochondral unit by reproducing the different biological and functional requirements and guiding the growth of both bone and cartilage. PURPOSE: To evaluate midterm clinical and imaging results after cell-free osteochondral scaffold implantation for the treatment of knee OCD...
November 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29092986/the-analysis-of-synovial-fluid-in-total-knee-arthroplasties-with-flexion-instability
#18
N M Hernandez, M J Taunton, K I Perry, K C Mara, A D Hanssen, M P Abdel
AIMS: Patients with flexion instability after total knee arthroplasty (TKA) often present with a recurrent effusion, which may be a haemarthrosis. While the radiographic factors contributing to flexion instability have been elucidated, the clinical diagnosis remains challenging. Our aim, in this study, was to determine the mean white cell count and differential profile in pre-operative aspirations of synovial fluid in a consecutive series of patients undergoing revision TKA for flexion instability...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092985/fixation-and-clinical-outcome-of-uncemented-peri-apatite-coated-versus-cemented-total-knee-arthroplasty-five-year-follow-up-of-a-randomised-controlled-trial-using-radiostereometric-analysis-rsa
#19
K T van Hamersveld, P J Marang-van de Mheen, R Tsonaka, E R Valstar, S Toksvig-Larsen
AIMS: The optimal method of tibial component fixation remains uncertain in total knee arthroplasty (TKA). Hydroxyapatite coatings have been applied to improve bone ingrowth in uncemented designs, but may only coat the directly accessible surface. As peri-apatite (PA) is solution deposited, this may increase the coverage of the implant surface and thereby fixation. We assessed the tibial component fixation of uncemented PA-coated TKAs versus cemented TKAs. PATIENTS AND METHODS: Patients were randomised to PA-coated or cemented TKAs...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29083227/variation-in-the-medial-patellofemoral-ligament-origin-in-the-skeletally-immature-knee-an-anatomic-study
#20
Kevin G Shea, W Duncan Martinson, Peter C Cannamela, Connor G Richmond, Peter D Fabricant, Allen F Anderson, John D Polousky, Theodore J Ganley
BACKGROUND: The medial patellofemoral ligament (MPFL) is frequently reconstructed to treat recurrent patellar instability. The femoral origin of the MPFL is well described in adults but not in the skeletally immature knee. PURPOSE: To identify a radiographic landmark for the femoral MPFL attachment in the skeletally immature knee and study its relationship to the distal femoral physis. STUDY DESIGN: Descriptive laboratory study. METHODS: Thirty-six cadaveric specimens between 2 and 11 years old were dissected and examined (29 male and 7 female)...
October 1, 2017: American Journal of Sports Medicine
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