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Knee trauma

E Archer Danielle, Reza Mafi, Pouya Mafi, Wasim Khan
BACKGROUND: Knee joint trauma may result in damage of the intra-articular ligaments, with rupture of the anterior cruciate ligament (ACL) a common and troublesome injury due to poor capabilities for spontaneous regeneration. Autograft and allograft surgical reconstructions are the mainstay of treatment, but have associated risks of failure, therefore tissue-engineering techniques aiming to regenerate the native ACL are being researched as a potential alternative treatment. OBJECTIVES: This article aims to review the current evidence produced by ex vivo and in vivo studies investigating biomaterial scaffolding and mesenchymal stem cell (MSC) techniques in orthopaedic tissue engineering of ACL injuries...
August 8, 2018: Current Stem Cell Research & Therapy
Robert J Stewart, David C Landy, Ravand S Khazai, Jospeh B Cohen, Sherwin S Ho, Douglas R Dirschl
OBJECTIVE: To describe associations between mechanism of injury energy level and neurovascular injury (NVI) following knee dislocation (KD) using a large representative sample of trauma patients, and to examine risk factors within these groups. DESIGN: Retrospective cohort study. SETTING: Trauma centers participating in the American College of Surgeons National Trauma Data Bank PARTICIPANTS:: Adult KD patients without lower extremity fracture...
July 30, 2018: Journal of Orthopaedic Trauma
Jonathan D Gillig, Russell D Goode, Brian Campfield, Julia R Crim, Brett D Crist
OBJECTIVES: To address the safety of obtaining magnetic resonance imaging (MRI) in patients with temporary knee-spanning external fixators placed for tibial plateau fractures. DESIGN: IRB approved retrospective review SETTING:: Level 1 trauma center PATIENTS/PARTICIPANTS:: Records were reviewed on patients with knee-spanning external fixators applied during staged management of tibial plateau fractures from 2009-2015 and who also had an MRI performed. MAIN OUTCOME MEASUREMENTS: complications associated with the MRI; secondary outcomes were pain scores, narcotic requirements, and fracture healing...
July 16, 2018: Journal of Orthopaedic Trauma
Antonios N Gargalionis, Lina S Malakou, Christos Adamopoulos, Christina Piperi, Irini Theochari, Marjan Nokhbehsaim, James Deschner, Georgios Kokkalis, Penelope Korkolopoulou, Evangelia Papadavid, Athanasios G Papavassiliou, Efthimia K Basdra
Psoriatic plaques tend to localize to the knees and elbows, areas that are particularly subject to mechanical stress resulting from bending and friction. Moreover, plaques often develop at sites of mechanical trauma or injury (Koebner phenomenon). Nevertheless, mechanotransduction has never been linked to psoriasis. Polycystins (polycystin-1, PC1; polycystin-2, PC2) are mechanosensitive molecules that function as key regulators of cellular mechanosensitivity and mechanotransduction. The aim of this in vitro study was to investigate the role of polycystins in the development of psoriasis...
August 2, 2018: Biochimica et Biophysica Acta
Areg Grigorian, Samuel E Wilson, Nii-Kabu Kabutey, Roy M Fujitani, Christian de Virgilio, Sebastian Schubl, Viktor Gabriel, Samuel Chen, Victor Joe, Jeffry Nahmias
BACKGROUND: Popliteal arterial injury (PAI) is the second most common infrainguinal arterial injury after femoral artery injury with an incidence < 0.2%. A 2003 analysis of the National Trauma Data Bank (NTDB) reported a below the knee amputation (BKA) rate of 7.1% in patients with PAI as well as higher risk in those with an associated fracture or nerve injury. Given advances in vascular surgical techniques, improved multidisciplinary care and expeditious diagnosis with computed tomography angiography, we hypothesized the national rate of BKA in patients with PAI has decreased and sought to identify risk factors for BKA in patients with PAI...
July 24, 2018: Annals of Vascular Surgery
Michele Zukauskas de Andrade Gomes, Carlos Eduardo Pinfildi
BACKGROUND: The activities carried out by soldiers in the army involve great physical demands and require intense trainings to perform combat-specific tasks. Musculoskeletal injury is a potential threat to the health and physical integrity of the soldier. This study aimed to evaluate the prevalence of lower limb musculoskeletal injuries among soldiers and to propose a training protocol to prevent the most frequent injuries. METHODS: This observational (cross-sectional) study recruited a sample of 103 soldiers who required medical attention, from a total 202 new battalion soldiers...
July 27, 2018: Military Medical Research
Derrick M Knapik, Kathryn B Metcalf, James E Voos
Background: Isolated tearing and avulsions of the distal biceps femoris sustained during sporting activities are uncommon. Purpose: To systematically review the literature to identify distal biceps femoris tears and avulsions experienced during sporting activities to determine injury prevalence, sporting activities/mechanisms, management, and time to return to sport. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was conducted investigating studies published between January 1970 and December 2017 that reported on athletes sustaining tears and avulsions of the distal biceps femoris during sporting activity...
July 2018: Orthopaedic Journal of Sports Medicine
Andreas Baranowski, Ludwig Schlemmer, Katharina Förster, Stefan G Mattyasovszky, Ulrike Ritz, Daniel Wagner, Pol M Rommens, Alexander Hofmann
BACKGROUND: Animal models of posttraumatic joint stiffness (PTJS) are helpful in understanding underlying mechanisms, which is important for developing specific treatments and prophylactic therapies. Existing rat models of PTJS in the knee failed to show that the created contracture does not resolve through subsequent remobilization. Our objective was to establish a rat model of persisting PTJS of the knee and compare it to existing models. METHODS: Thirty skeletally immature male Sprague Dawley rats underwent surgical intervention with knee hyperextension, extracartilaginous femoral condyle defect, and Kirschner (K)-wire transfixation for 4 weeks with the knee joint in 146...
July 25, 2018: Journal of Orthopaedic Surgery and Research
Nynke M Swart, Kim van Oudenaarde, Sita Ma Bierma-Zeinstra, Hans Jl Bloem, Wilbert B van den Hout, Paul R Algra, Patrick Je Bindels, Bart W Koes, Rob Ghh Nelissen, Jan An Verhaar, Monique Reijnierse, Pim Aj Luijsterburg
OBJECTIVE: To determine whether referral to MRI by the general practitioner (GP) is non-inferior to usual care (no access to MRI by GPs) in patients with traumatic knee complaints regarding knee-related daily function. METHODS: This was a multicentre, non-inferiority randomised controlled trial with 1-year follow-up. GPs invited eligible patients during or after their consultation. Eligible patients (18-45 years) consulted a GP with knee complaints due to a trauma during the previous 6 months...
July 24, 2018: British Journal of Sports Medicine
Eric D Schadler, Bernhard Ortel, Stephanie L Mehlis
Psoriasis is a chronic, systemic, inflammatory disease that affects approximately 7.5 million people in the United States. The disease results in significant suffering, morbidity, and economic impact. Psoriasis is considered a multifaceted disease with a strong genetic component. Genetic data has revealed the presence of particular risk alleles found in patients with psoriasis. Triggers of the disease have been elucidated and include factors such as trauma, obesity, infection, stress, and medications. At its core, psoriasis is a result of a dysfunctional immune response with T-cells at the center of immunogenesis...
July 20, 2018: Disease-a-month: DM
Jack Daoud, Dany Aouad, Youssef Hassan, Georges El Rassi
Background: Pigmented villonodular synovitis is a rare pathology causing hyperplasia of the synovium. It mostly affects young populations and most commonly the knee joint. It rarely affects the posterior compartment of the knee as the case presented in this study. Open surgery is usually used to treat this condition; however, in our case it was excised arthroscopically despite the anatomical challenges of the posterior knee compartment. Case Presentation: This case presents a female patient with a complaint of posterior-region pain of her left knee post direct trauma post fall...
2018: Case Reports in Orthopedics
Cecilie Mullerup Kiel, Kim Lyngby Mikkelsen, Michael Rindom Krogsgaard
BACKGROUND: Tibial plateau fractures (TPFs) are sometimes overlooked in the emergency room (ER). Using a national register covering 18 years we aimed to find out why and to evaluate if use of a specific radiographic decision rule, Pittsburgh Knee Rules (PKRs), could have reduced the number of overlooked TPFs. METHODS: Medical records for 137 patients, prospectively registered during 18 years by the Danish Patient Compensation Association (DPCA) (a national register), were studied...
July 21, 2018: BMC Musculoskeletal Disorders
Fatma Eti Aslan, Sennur Kula Şahin, Selda Secginli, Semra Bülbüloğlu
OBJECTIVES: The aim of this study was to investigate patient satisfaction with nursing practices regarding postoperative pain management. METHODS: A systematic review of the literature published between 2005 and 2015 was conducted, comprising a search of 7 databases: ScienceDirect, Turkish Medline, PsycINFO, Ovid, Prequest, Google Scholar, and the ULAKBIM Turkish Medical Database. Five articles were identified as eligible for review. The methodological quality of the studies was assessed using the Turkish version of the Joanna Briggs Institute-Meta Analysis of Statistics Assessment and Review Instrument (JBI -MAStARI) Critical Appraisal Checklist...
July 2018: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
David S Kauvar, Diane Miller, Thomas J Walters
BACKGROUND: The effect of battlefield extremity tourniquet (TK) use on limb salvage and long-term complications following vascular repair is unknown. This study explores the influence of TK use on limb outcomes in military lower extremity arterial injury. METHODS: The study database includes cases of lower extremity vascular injury from 2004-2012 with data recorded until discharge from military service. We analyzed all limbs with at least one named arterial injury from the femoral to the tibial level...
July 17, 2018: Journal of Trauma and Acute Care Surgery
Christer Aasheim, Håvard Stavenes, Stig Haugsbø Andersson, Lars Engbretsen, Benjamin Clarsen
Aim: To record overuse injuries among male junior handball players throughout a handball season. Design: Prospective cohort study. Methods: Ten Norwegian junior male handball teams (145 players aged 16-18 years) were followed for one 10-month season. All players were sent the Oslo Sports Trauma Research Center Overuse Injury Questionaire every second week to record overuse injuries located in the shoulder, elbow, lower back and knee. The relative burden of overuse injuries was calculated in each anatomical area represented, defined as the proportion of the total cumulative severity score...
2018: BMJ Open Sport & Exercise Medicine
Marcus Hofbauer, Francesco Soldati, Pavol Szomolanyi, Siegfried Trattnig, Francesca Bartolucci, Freddie Fu, Matteo Denti
PURPOSE: In this prospective, double-center cohort study, we aim to assess how the anterior cruciate ligament (ACL) signal intensity on magnetic resonance imaging (MRI) potentially varies between a group of patients with anatomic ACL reconstruction using autogenous hamstring grafts 6 months postoperatively and a healthy ACL control group, and how MRI-based graft signal intensity is related to knee laxity. METHODS: Sixty-two consecutive patients who underwent ACL reconstruction using quadrupled hamstring tendon autograft were prospectively invited to participate in this study, and they were evaluated with MRI after 6 months of follow-up...
July 14, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Christopher M McAndrew, William M Ricci, Anna N Miller, Matthew C Avery
Semiextended positioning can improve the surgeon's ability to obtain, maintain, and fluoroscopically evaluate a fracture reduction when performing fixation with an intramedullary nail, especially in fractures at the proximal and distal ends. Furthermore, this position allows for evaluation of instrument placement, including the start point, without moving the fluoroscopic unit into extremes of angulation or compromising the quality of the beam orientation. The intraarticular suprapatellar approach has been described as a soft tissue approach to maintain the leg in a position that would not complicate management of these fractures, especially those in the proximal third of the tibia...
August 2018: Journal of Orthopaedic Trauma
Gokhan Ozkocak, Guzin Cakir Kandemirli, Suheda Ozcakir
Introduction Heterotopic ossification is the formation of lamellar bone in periarticular soft tissue that can be seen in paralysed patients or following trauma. It can cause significant burden to already debilitated patients. Case presentation A 12-year-old boy with paraplegia due to neuromyelitis optica presented with progressive right knee pain and swelling. There was no history of trauma to the knee. Anteroposterior radiograph of femur at the initial presentation showed a supracondylar femur fracture for which casting was performed...
January 1, 2018: Scottish Medical Journal
Bogdan Kovcan, Janez Vodicar, Jožef Šimenko, Mateja Videmšek, Primož Pori, Hadžiž Vedran
Introduction: Injury registration is an important first step of the musculoskeletal injury (MSI) prevention process that helps establish the magnitude of the problem and focus prevention on the body parts that are most frequently injured. However, an injury definition used in that process may influence the reported prevalence of MSI, causing some injuries to be under-reported which in turn alters the prevention efforts. The primary goal of our study was to identify the 10-year prevalence of MSI in members of the Slovenian Armed Forces (SAF), to help plan and implement preventive measures for the reduction of MSI...
July 3, 2018: Military Medicine
Andreas Hupperich, G M Salzmann, P Niemeyer, M Feucht, H Eberbach, N P Südkamp, J Kühle
INTRODUCTION: The purpose of this study is to identify patient, meniscus rupture and surgical characteristics that influence the outcome and clinical healing following operative repair of bucket handle tears. METHODS: Between 02/2006 and 10/2012, a total of 38 patients (14 women, 24 men) with bucket handle tears underwent surgical meniscus repair. There were 27 isolated repairs and 11 with concomitant anterior cruciate ligament (ACL) replacement. Patients were analyzed on an average of 44...
June 29, 2018: Archives of Orthopaedic and Trauma Surgery
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