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Knee trauma

Kun Xiao, Chun Chen, Jie Yang, Di Yang, Jiong Liu
We treated a 15-year-old female patient with fracture of the post-lateral femoral condyle and the bone shifted in front of the knee. Considering that the traditional surgical approach has the shortcomings of significant trauma and poor prognosis, we designed an arthroscopic procedure, which achieved satisfactory short-term efficacy, effectively reduced and fixed the fractures, avoided damage to vascular nerves, and maximally reduced the trauma caused by surgery itself.
October 4, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Benjamin K Potter, Robert G Sheu, Daniel Stinner, John Fergason, Joseph R Hsu, Kevin Kuhn, Johnny G Owens, Jessica Rivera, Scott B Shawen, Jason M Wilken, Jennifer DeSanto, Yanjie Huang, Daniel O Scharfstein, Ellen J MacKenzie
BACKGROUND: The Intrepid Dynamic Exoskeletal Orthosis (IDEO) is a custom energy-storing carbon fiber ankle-foot orthosis developed for lower-extremity trauma patients. Studies conducted at the military treatment facility where the IDEO was developed demonstrated benefits of the IDEO when used with the Return to Run Physical Therapy (RTR PT) program. The current study was designed to determine if results could be replicated at other military treatment facilities and to examine whether early performance gains in patient-reported functional outcomes remained at 12 months...
October 17, 2018: Journal of Bone and Joint Surgery. American Volume
Katrin Brodbeck, Stefanie Kern, Sylvia Schick, Arnd Steinbrück, Michael Schwerer, Birgit Bayer, Katja Anslinger, Steffen Peldschus
INTRODUCTION: Cell-free DNA (cfDNA) elevations were remarked in the blood of trauma patients. Published increases refer to comparative values of a healthy control group, ignoring thereby inter- and intra-individual differences under normal conditions. The aim of this study was to quantify cfDNA in patients in the time course of a planned orthopedic surgery, which constitutes the advantage of obtaining individual pre- and post-trauma values for each patient. By this approach, a basis should be established for the potential future application of cfDNA as biomarker for the detection of mild injuries related to volunteer experiments in forensic biomechanics...
October 16, 2018: International Journal of Legal Medicine
Manoshi Bhowmik-Stoker, Laura Scholl, Anton Khlopas, Assem A Sultan, Nipun Sodhi, Joseph T Moskal, Michael A Mont, Steven M Teeny
BACKGROUND: Preoperative templating of total knee arthroplasty (TKA) components can help in choosing appropriate implant size prior to surgery. While long limb radiographs have been shown to be beneficial in assessing alignment, disease state, and previous pathology or trauma, their accuracy for size prediction has not been proven. In an attempt to improve templating precision, surgeons have looked to develop other predictive models for component size determination utilizing patient characteristics...
October 16, 2018: Surgical Technology International
Christopher W Bunt, Christopher E Jonas, Jennifer G Chang
Knee pain affects approximately 25% of adults, and its prevalence has increased almost 65% over the past 20 years, accounting for nearly 4 million primary care visits annually. Initial evaluation should emphasize excluding urgent causes while considering the need for referral. Key aspects of the patient history include age; location, onset, duration, and quality of pain; associated mechanical or systemic symptoms; history of swelling; description of precipitating trauma; and pertinent medical or surgical history...
November 1, 2018: American Family Physician
Prabath C A M Lodewijks, Diyar Delawi, Thomas L Bollen, Gawein R Dijkhuis, Nienke Wolterbeek, Jacco A C Zijl
PURPOSE: To describe the validity and inter- and intra-observer reliability of the lateral femoral notch sign (LFNS) as measured on conventional radiographs for diagnosing acute anterior cruciate ligament (ACL) injury. METHODS: Patients (≤ 45 years) with a traumatic knee injury who underwent knee arthroscopy and had preoperative radiographs were retrospectively screened for this case-control study. Included patients were assigned to the ACL injury group (n = 65) or the control group (n = 53) based on the arthroscopic findings...
October 13, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Alexander Barié, Michael Köpf, Ayham Jaber, Babak Moradi, Holger Schmitt, Jürgen Huber, Nikolaus Alexander Streich
BACKGROUND: The use of a quadriceps tendon-patellar bone (QTPB) autograft provides an alternative procedure in primary reconstruction of the anterior cruciate ligament (ACL). Using the press-fit technique for femoral fixation and knotting over a bone bridge as well as additional spongiosa filling for tibial fixation can completely eliminate the need for fixation implants. The objective of this study was to evaluate the long-term clinical, functional and radiological results of this operating method...
October 12, 2018: BMC Musculoskeletal Disorders
Raja Bhaskara Rajasekaran, Dheenadhayalan Jayaramaraju, Hari Venkataramani, Devendra Agraharam, Raja Sabapathy Shanmuganathan, Rajasekaran Shanmuganathan
Reconstruction of large defects following trauma in the distal femur are a surgical challenge. These cases usually require multiple procedures and are associated with poor functional outcomes. We managed a post-traumatic distal femur defect of 16 cm using the modified Capanna's technique - combination of a vascularised free fibula and an allograft - and achieved a successful union at 6 months and also a good functional outcome with knee flexion of 100°. The patient received a vascularised free fibula which was pegged into an allograft which was sculptured to bridge the defect...
October 2018: Trauma Case Reports
Liyun Wang, Xi Xiang, Yuanjiao Tang, Yujia Yang, Li Qiu
Background: High frequency ultrasound is often used to measure the thickness of fluid in peripheral joints and bursae of healthy asymptomatic populations. Two major steps critical to this procedure are obtaining the detection rates and analyzing the relevant factors. Methods: Healthy Chinese adult volunteers with no history of arthritis, past trauma or surgery and joint pain were enrolled in this study. Ultrasonography was performed on the bilateral shoulders, elbows, wrists, metacarpophalangeal joints (MCP) 1-5, proximal interphalangeal joints (PIP) 1-5, distal interphalangeal joints (DIP) 2-5, suprapatellar knees, ankles, metatarsophalangeal joints (MTP) 1-5, subacromial and subdeltoid bursae, deep infrapatellar bursae, retrocalcaneal bursae and long biceps tendons in B mode...
September 2018: Quantitative Imaging in Medicine and Surgery
John Koo, Gregory D Deans
Bacteria of the Burkholderia cepacia complex have rarely been reported to cause septic arthritis. Cases have been reported in patients who were immunocompromised, at extremes of age or who had history of steroid injection or penetrating trauma. A 67-year-old man with a history of opioid use disorder, osteoarthritis, and gout but no known immunocompromise was admitted to hospital with pain and swelling of his right knee. Cultures of synovial fluid and urine grew Burkholderia cepacia complex. Microscopy of synovial fluid also identified intracellular calcium pyrophosphate crystals...
2018: Case Reports in Infectious Diseases
Ingrid Arevalo-Rodriguez, Edgar Muñoz, Diana Buitrago-Garcia, Solange Nuñez-González, Nadia Montero-Oleas, Vanessa Garzón, Hector Pardo-Hernandez, Xavier Bonfill
Few Orthopaedics and Traumatology journals from Latin America and Spain are indexed in major databases; controlled clinical trials published in these journals cannot be exhaustively retrieved using electronic literature searches. We aimed to identify, describe and assess the quality of controlled clinical trials published in Orthopaedics and Traumatology journals from Latin America and Spain through handsearching and evidence mapping methods. We identified controlled clinical trials published in eligible Orthopaedics/Traumatology journals in Spanish until July 2017 by handsearching...
2018: SAGE Open Medicine
M Křivohlávek, J Šrám, J Pazour, M Kloub
PURPOSE OF THE STUDY The locked nailing of diaphyseal fractures of the tibia currently represents a method of choice for treating the closed diaphyseal fractures, some of the tibial metaphyseal fractures and open tibial diaphyseal fractures classified as grade I and II according to Gustilo-Anderson (GA) classification. The suprapatellar (SP) approach is an alternative technique of insertion of the nail in semi-extension of the lower extremity with easier reduction, namely of multiple fractures and proximal diaphyseal fractures of the tibia in particular...
2018: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Roger Erivan, Thibault Chaput, Guillaume Villatte, Matthieu Ollivier, Stéphane Descamps, Stéphane Boisgard
BACKGROUND: Current trends in patient management include decreasing hospital stay lengths and reductions in available material and human resources. A shortening of hospital stays in university hospitals has been documented over the last decade. However, to our knowledge, no study has assessed possible relationships linking shorter stays to staffing levels or complication rates. The objectives of this study were: 1) to assess changes in case volume in a university orthopaedics and trauma surgery department between 2006 and 2016, 2) and to look for correlations linking these changes to staffing levels and the rates of significant complications, including the number of hip dislocations after total hip arthroplasty (THA) and the number of infections and complications resulting in malpractice litigation after hip, knee, or shoulder arthroplasty...
October 2, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Sebastian M Dettmer, Uwe Schweigkofler, Reinhard Hoffmann
Ruptures of the extensor mechanism of the knee joint are rare but disabling injuries. Injuries occur on the basis of degeneration or acute trauma. The understanding of anatomy and biomechanical function plays an essential role for choosing the right diagnostic methods and initiating successful treatment. Besides clinical examination ultrasound is a cost efficient primary diagnostic measure. Additional MRI can be beneficial for partial tears or chronic ruptures. Non-operative treatment is suitable for minor partial ruptures with sustained function...
October 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
Markus Rupp, Lydia Anastasopoulou, Elke Wintermeyer, Deeksha Malhaan, Thaqif El Khassawna, Christian Heiss
Predatory publishing is a major threat to contemporary publishing, as it offers 'to unaware scientist's', a quick open-access publication against fees without peer-review procedures.. Lack of peer-review leads to unethical practices, as plagiarism, publication of unscientific falsified data, and even unsafe clinical practices. As these journals threaten the credibility of academic publishing, significant work has been done from many scientific teams, in the last years, in establishing discriminating criteria between predatory and legitimate publishing...
October 4, 2018: International Orthopaedics
Akihiro Nakamura, Yoga Raja Rampersaud, Sayaka Nakamura, Anirudh Sharma, Fanxing Zeng, Evgeny Rossomacha, Shabana Amanda Ali, Roman Krawetz, Nigil Haroon, Anthony V Perruccio, Nizar N Mahomed, Rajiv Gandhi, Jason S Rockel, Mohit Kapoor
OBJECTIVES: We recently identified microRNA-181a-5p (miR-181a-5p) as a critical mediator involved in the destruction of lumbar facet joint (FJ) cartilage. In this study, we tested if locked nucleic acid (LNA) miR-181a-5p antisense oligonucleotides (ASO) could be used as a therapeutic to limit articular cartilage degeneration. METHODS: We used a variety of experimental models consisting of both human samples and animal models of FJ and knee osteoarthritis (OA) to test the effects of LNA-miR-181a-5p ASO on articular cartilage degeneration...
October 4, 2018: Annals of the Rheumatic Diseases
Christoph J Laux, Erika J Ulbrich, Gustav Andreisek, Magda Marcon, Michael A Fischer, Tarun Mehra, Bernhard D Ciritsis
BACKGROUND: The optimal positioning of anterior cruciate ligament graft is still controversially discussed. We therefore wanted to determine the tunnel-to-joint (TJA), tunnel-to-shaft (TSA), and graft-tunnel divergence angles which would provide the best outcome, determined by the KOOS (Knee Injury and Osteoarthritis Outcome Score). This study evaluated the clinical influence of graft orientation as measured with the KOOS questionnaire in patients with anterior cruciate ligament reconstruction with bone-patellar tendon-bone autografts...
October 3, 2018: Journal of Orthopaedic Surgery and Research
Julian Mehl, A Otto, L Willinger, A Hapfelmeier, A B Imhoff, P Niemeyer, P Angele, W Zinser, G Spahn, A Schmitt
PURPOSE: The purpose of this study was to utilize data from the German Cartilage Registry (KnorpelRegister DGOU) to examine the hypothesis that degenerative cartilage defects of the patellofemoral joint are associated with more severe clinical symptoms compared to trauma-related defects. METHODS: All patients with isolated focal cartilage defects of the patellofemoral joint registered in the German Cartilage Registry until May 2017 were included in the study. Patients with previous surgery of the ipsilateral knee were excluded...
October 3, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
João Bourbon de Albuquerque Ii, Ferris Pfeiffer, James P Stannard, James L Cook, Mauricio Kfuri
Posterior cruciate ligament (PCL) injuries are generally associated with high-energy trauma. There are many controversies regarding optimal surgical technique in regard to graft selection and fixation methods. The recently described onlay technique allows for direct fixation of a hamstring autograft to the posterior aspect of the tibia with cancellous screw and spiked washer, while protecting the neurovascular structures and avoiding the so-called "killer turn." The objective of this study was to compare immediate postimplantation biomechanics of unicortical versus bicortical tibial fixation of onlay PCL grafts...
October 3, 2018: Journal of Knee Surgery
David N Kugelman, Abdullah M Qatu, Eric J Strauss, Sanjit R Konda, Kenneth A Egol
OBJECTIVES: What patient characteristics and injury factors predict decreased knee range of motion (ROM) after operative management of tibial plateau fractures? DESIGN: Prospective cohort study. SETTING: Academic medical center. PATIENTS: Over 11 years, tibial plateau fractures at a single academic institution were prospectively followed. A total of 266 patients were included in this study. INTERVENTION: Surgical repair of tibial plateau fractures and secondary interventions due to arthrofibrosis...
November 2018: Journal of Orthopaedic Trauma
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