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https://www.readbyqxmd.com/read/29888637/rehabilitation-variability-following-medial-patellofemoral-ligament-reconstruction
#1
Harry M Lightsey, Margaret L Wright, David P Trofa, Charles A Popkin, Lauren H Redler
BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction is an increasingly utilized surgical option for recurrent patellar instability. Recent studies have highlighted the potential benefits of accelerated functional rehabilitation; however, no validated MPFL rehabilitation guidelines currently exist. OBJECTIVE: To assess the variability of MPFL reconstruction rehabilitation protocols published online by academic orthopaedic programs. METHODS: Online MPFL rehabilitation protocols from U...
June 9, 2018: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/29881695/suture-augmentation-an-alternative-to-reconstruction-for-incomplete-posterior-cruciate-ligament-injuries-in-the-multiple-ligament-injured-knee
#2
Nicholas A Trasolini, George F Rick Hatch
Treatment of posterior cruciate ligament injuries remains controversial, particularly in the case of partial or incomplete tears in the context of a multiple ligament-injured knee. Suture augmentation, or internal bracing, has been shown in other ligament and tendon repairs or reconstructions to provide stable biomechanics and facilitate early return to activity. In the knee, suture augmentation has previously been used for the treatment of medial collateral ligament tears and in the support of anterior cruciate ligament reconstructions...
March 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29871003/-standards-in-rehabilitation-following-anterior-cruciate-ligament-reconstruction-in-the-german-speaking-world
#3
Christina Valle, Anja Hirschmüller, Marcus Schmitt-Sody, Bernhard Haller, Matthias Keller, Wolfgang Schoch, Helmut Hoffman, Philipp Minzlaff
INTRODUCTION:  Rehabilitation protocols following anterior cruciate ligament (ACL) reconstruction often differ among orthopaedic surgeons. The primary aim of this study was to investigate which follow-up treatment is recommended by "AGA instructors" certified by the German-speaking Association for Arthroscopic and Open Joint Surgery (AGA). The secondary aim was to compare these findings with the current literature. MATERIAL AND METHODS:  A structured anonymous online survey was performed with "AGA instructors" specialised in knee or ACL surgery...
June 2018: Sportverletzung Sportschaden: Organ der Gesellschaft Für Orthopädisch-Traumatologische Sportmedizin
https://www.readbyqxmd.com/read/29858655/implant-preloading-in-extension-reduces-spring-length-change-in-dynamic-intraligamentary-stabilization-a-biomechanical-study-on-passive-kinematics-of-the-knee
#4
Janosch Häberli, Benjamin Voumard, Clemens Kösters, Daniel Delfosse, Philipp Henle, Stefan Eggli, Philippe Zysset
PURPOSE: Dynamic intraligamentary stabilization (DIS) is a primary repair technique for acute anterior cruciate ligament (ACL) tears. For internal bracing of the sutured ACL, a metal spring with 8 mm maximum length change is preloaded with 60-80 N and fixed to a high-strength polyethylene braid. The bulky tibial hardware results in bone loss and may cause local discomfort with the necessity of hardware removal. The technique has been previously investigated biomechanically; however, the amount of spring shortening during movement of the knee joint is unknown...
June 1, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29847145/operative-repair-of-medial-patellofemoral-ligament-injury-versus-knee-brace-in-children-with-an-acute-first-time-traumatic-patellar-dislocation-a-randomized-controlled-trial
#5
Marie Askenberger, Eva Bengtsson Moström, Wilhelmina Ekström, Elizabeth A Arendt, Anna Hellsten, Christina Mikkelsen, Per-Mats Janarv
BACKGROUND: A lateral patellar dislocation (LPD) is the most common traumatic knee injury with hemarthrosis in children. The redislocation rate is high. Varying operative and nonoperative treatments have been advocated with no consensus on the best treatment. PURPOSE: (1) To evaluate if arthroscopic-assisted repair of the medial patellofemoral ligament (MPFL) in patients with an acute first-time traumatic LPD would reduce the recurrence rate and offer better objective/subjective knee function compared with a knee brace without repair...
May 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29805102/the-effectiveness-of-medial-femoral-epicondyle-up-sliding-osteotomy-to-correct-severe-valgus-deformity-in-primary-total-knee-arthroplasty
#6
Ping Mou, Yi Zeng, Jing Yang, Hang Zhong, Shi-Jiu Yin, Rui-Bo Li
BACKGROUND: While many surgical techniques can achieve neutral limb alignment and soft tissue balance in severe valgus deformity during total knee arthroplasty (TKA), few published reports concern medial femoral epicondyle up-sliding osteotomy. METHODS: A prospective investigation was conducted of patients with severe valgus deformities who underwent medial femoral epicondyle up-sliding osteotomy. Clinical measurements, radiological evaluation, and complication data were recorded...
May 3, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29791699/a-comparative-effectiveness-study-for-non-operative-treatment-methods-for-knee-osteoarthritis
#7
Frank R Kolisek, Charles Jaggard, Anton Khlopas, Assem A Sultan, Nipun Sodhi, Michael A Mont
A number of non-operative treatment options are commonly prescribed for patients presenting with degenerative osteoarthritis of the knee, where surgery is not yet recommended. However, there is a paucity of studies evaluating the comparative effectiveness of these treatment options to best inform both patients and providers. This study examined the comparative effectiveness of a home exercise program versus bracing or a combination of the two (brace-only, exercise-only, and brace and exercise cohorts) on the following: 1) objective functional measures (quadriceps muscle strength, Self-Paced Walk Test [SPWT], and Timed "Up & Go" [TUG] Test); 2) subjective functional measures (Lower Extremity Function Scale [LEFS] and Health Survey [VR-12] outcomes); 3) pain using Visual Analog Scale [VAS-10]; 4) patient metrics (patient treatment preference, perceptions, and compliance); and 5) progression to total knee arthroplasty (TKA) over a 12-week period...
June 1, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29753125/adaptation-of-kinematic-synergy-and-postural-control-to-mechanical-ankle-constraint-on-an-unsteady-stance-surface
#8
Yi-Ying Tsai, Gwo-Ching Chang, Ing-Shiou Hwang
Joint constraint interferes with the coordinative structure in joint movements used to optimize postural stability. This study aimed to investigate changes in postural synergy when the ankle joints were bilaterally braced during a stabilometer stance. Twenty-four young adults stood on a stabilometer plate while wearing a pair of ankle-foot orthoses, which were either unlocked or locked to restrict ankle motion (the ankle constraint (AC) and non-constraint (NC) conditions). Although ankle constraint did not significantly affect the dynamics of the stabilometer movements, the size and regularity of the first principal component (PC1), which explained more than 80% of the variance of joint movements in the lower limb, were increased...
May 9, 2018: Human Movement Science
https://www.readbyqxmd.com/read/29724537/confirmation-bias-affects-user-perception-of-knee-braces
#9
Brittany Balsamo, Mark D Geil, Rebecca Ellis, Jianhua Wu
Technological advances in orthopedic devices such as prostheses and orthoses are intended to improve function but may also result in increased complexity and expense. Consequently, accurate determination of effectiveness is important. When devices with advanced technology are used, it is possible that confirmation bias - the tendency for a user to actually experience what he or she expects to experience - will influence outcomes. This study assessed confirmation bias in 18 healthy young adults walking in knee braces...
April 25, 2018: Journal of Biomechanics
https://www.readbyqxmd.com/read/29709723/the-effect-of-functional-bracing-on-the-arthrokinematics-of-anterior-cruciate-ligament-injured-knees-during-lunge-exercise
#10
Maryam Jalali, Farzam Farahmand, Fateme Esfandiarpour, Seyed Ali Golestanha, Mohammad Akbar, Amirhosein Eskandari, Seyed Ebrahim Mousavi
BACKGROUND: Functional knee braces are extensively used for partially and completely torn anterior cruciate ligament (ACL) patients and those who have undergone ACL graft reconstruction, in order to support the healing ACL, improve the joint's functional stability, and restore the normal joint kinematics. RESEARCH QUESTION: Does wearing braces alter the arthrokinematics of the ACL deficient knees during lung exercise? METHODS: For ten male unilateral ACL deficient subjects, 3D knee models were reconstructed from CT images, acquired in rest position...
June 2018: Gait & Posture
https://www.readbyqxmd.com/read/29688959/arthroscopic-management-of-tibial-spine-avulsion-fractures-principles-and-techniques
#11
Eric J Strauss, Daniel James Kaplan, Maxwell E Weinberg, Jonathan Egol, Laith M Jazrawi
Tibial spine fractures are uncommon injuries affecting the insertion of the anterior cruciate ligament on the tibia. They typically occur in skeletally immature patients aged 8 to 14 years and result from hyperextension of the knee with a valgus or rotational force. Diagnosis is based on history, physical examination, and standard radiographs. The use of MRI can identify entrapped soft tissue that may prevent reduction. Open or arthroscopic repair is indicated in patients with partially displaced fractures (>5 mm) with one third to one half of the avulsed fragment elevated, in patients who have undergone unsuccessful nonsurgical reduction and long leg casting or bracing, and in patients with completely displaced fractures...
May 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29665579/correction-measurements-agreement-between-low-cost-and-high-level-handheld-3d-scanners-to-scan-the-knee-for-designing-a-3d-printed-knee-brace
#12
Yoann Dessery, Jari Pallari
[This corrects the article DOI: 10.1371/journal.pone.0190585.].
2018: PloS One
https://www.readbyqxmd.com/read/29662789/pie-crusting-technique-is-effective-and-safe-to-release-superficial-medial-collateral-ligament-for-total-knee-arthroplasty
#13
Xuan He, Hong Cai, Ke Zhang
Background: Pie-crusting technique is a damage-control soft tissue balance skill of total knee arthroplasty (TKA). The outcome of this technique to release lateral soft tissue is reasonable. A limited number of studies have focused on medial collateral ligament release with pie-crusting technique in the past years because of concerns about its efficacy and safety. Method: All cases underwent superficial medial collateral ligament (SMCL) release with either pie-crusting technique or traditional technique (39 knees in each group) between January 1, 2014 and August 31, 2015...
April 2018: Journal of Orthopaedic Translation
https://www.readbyqxmd.com/read/29644038/calcific-tendonitis-of-the-quadriceps-tendon
#14
S A Webb, M A Hopper, J Chitnavis
A 61-year-old woman presented with chronic anterior pain and stiffness in the distal left thigh. Examination revealed swelling and tenderness immediately proximal to the patella. Radiographs showed opacities in the distal anterior thigh whilst MRI identified enlargement of the distal quadriceps tendon with splayed fibres separated by solid conglomerates. Dystrophic calcification of the quadriceps tendon was diagnosed. Blood tests revealed no systemic abnormalities in calcium handling. Arthroscopy of the left knee identified calcific deposits in the supra-patella pouch with surrounding synovitis...
April 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29593820/prophylaxis-of-medial-compartment-gonarthrosis-in-varus-knee-current-state-of-knowledge
#15
Anna Fryzowicz, Lechosław B Dworak, Paweł Koczewski
The progression of gonarthrosis results in reduction of physical activity. One of the factors that increase the risk of osteoarthrosis may be joint overload related to the malalignment of the mechanical axis of the lower extremity. The medial compartment (MC) of the knee is particularly susceptible to overload due to the external knee adduction moment (EKAM). Varus knee malalignment contributes to increased EKAM and thus results in increased MC loading. The purpose of this study is to present methods described in current literature aimed at reducing the disproportion in the distribution of loads on articular surfaces of medial and lateral knee compartments in people with varus knee malalignment...
March 2018: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/29584491/active-muscle-response-contributes-to-increased-injury-risk-of-lower-extremity-in-occupant-knee-airbag-interaction
#16
Bingbing Nie, Deepak Sathyanarayan, Xin Ye, Jeff R Crandall, Matthew B Panzer
OBJECTIVE: Recent field data analysis has demonstrated that knee airbags (KABs) can reduce occupant femur and pelvis injuries but may be insufficient to decrease leg injuries in motor vehicle crashes. An enhanced understanding of the associated injury mechanisms requires accurate assessment of physiological-based occupant parameters, some of which are difficult or impossible to obtain from experiments. This study sought to explore how active muscle response can influence the injury risk of lower extremities during KAB deployment using computational biomechanical analysis...
February 28, 2018: Traffic Injury Prevention
https://www.readbyqxmd.com/read/29543576/effectiveness-of-valgus-offloading-knee-braces-in-the-treatment-of-medial-compartment-knee-osteoarthritis-a-systematic-review
#17
Chetan Gohal, Ajaykumar Shanmugaraj, Patrick Tate, Nolan S Horner, Asheesh Bedi, Anthony Adili, Moin Khan
CONTEXT: Knee osteoarthritis affects 9.3 million adults over age 45 years in the United States. There is significant disability associated with this condition. Given the potential complications and the significant cost to the health care system with the dramatic increase in total knee arthroplasties performed for this condition, assessment of the efficacy of nonoperative modalities, such as offloading knee braces, is essential as part of optimizing nonoperative treatment for this condition...
March 1, 2018: Sports Health
https://www.readbyqxmd.com/read/29535572/exploring-the-metabolic-and-perceptual-correlates-of-self-selected-walking-speed-under-constrained-and-un-constrained-conditions
#18
David T Godsiff, Shelly Coe, Charlotte Elsworth-Edelsten, Johnny Collett, Ken Howells, Martyn Morris, Helen Dawes
Mechanisms underpinning self-selected walking speed (SSWS) are poorly understood. The present study investigated the extent to which SSWS is related to metabolism, energy cost, and/or perceptual parameters during both normal and artificially constrained walking. Fourteen participants with no pathology affecting gait were tested under standard conditions. Subjects walked on a motorized treadmill at speeds derived from their SSWS as a continuous protocol. RPE scores (CR10) and expired air to calculate energy cost (J...
March 2018: Journal of Sports Science & Medicine
https://www.readbyqxmd.com/read/29526856/a-wearable-resistive-robot-facilitates-locomotor-adaptations-during-gait
#19
Edward P Washabaugh, Chandramouli Krishnan
BACKGROUND: Robotic-resisted treadmill walking is a form of task-specific training that has been used to improve gait function in individuals with neurological injury, such as stroke, spinal cord injury, or cerebral palsy. Traditionally, these devices use active elements (e.g., motors or actuators) to provide resistance during walking, making them bulky, expensive, and less suitable for overground or in-home rehabilitation. We recently developed a low-cost, wearable robotic brace that generates resistive torques across the knee joint using a simple magnetic brake...
2018: Restorative Neurology and Neuroscience
https://www.readbyqxmd.com/read/29511700/variability-of-united-states-online-rehabilitation-protocols-for-proximal-hamstring-tendon-repair
#20
Harry M Lightsey, David E Kantrowitz, Hasani W Swindell, David P Trofa, Christopher S Ahmad, T Sean Lynch
Background: The optimal postoperative rehabilitation protocol following repair of complete proximal hamstring tendon ruptures is the subject of ongoing investigation, with a need for more standardized regimens and evidence-based modalities. Purpose: To assess the variability across proximal hamstring tendon repair rehabilitation protocols published online by United States (US) orthopaedic teaching programs. Study Design: Cross-sectional study...
February 2018: Orthopaedic Journal of Sports Medicine
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