Knee trauma

BACKGROUND: Identification of cortical loci for lower limb movements for stroke rehabilitation is crucial for better rehabilitation outcomes via noninvasive brain stimulation by targeting the fine-grained cortical loci of the movements. However, identification of the cortical loci for lower limb movements using functional MRI (fMRI) is challenging due to head motion and difficulty in isolating different types of movement. Therefore, we developed a custom-made MR-compatible footplate and leg cushion to identify the cortical loci for lower limb movements and conducted multivariate analysis on the fMRI data...

PURPOSE: Investigate efficacy of reduced compression bandage for the control of pain after total knee arthroplasty. PATIENTS & METHODS: Prospective, single-centre, randomised controlled trial involving data for 56 out of 94 consented patients; 29 standard care versus 27 Andoflex TLC Calamine Lite. Comparison of standard care (non-compression bandage applied for up to one day) versus Andoflex TLC Calamine Lite (25-30 mmHg) two-layer compression bandage worn for five days...

INTRODUCTION: The rate of revision TKA and thus the use of hinged implants (HI) steadily rises. Aseptic loosening lies on the top of the failure patterns. However, no evidence exists until now based on national scale high-caseloads that analyzes the impact of cemented HI stem-design on aseptic survival rates. METHODS: Data on aseptic HI-revisions with full-cemented tibia-stems were conducted from the German Arthroplasty Registry. Cases were divided in primary HI (PHI) and HI used in revision operations (RHI)...

A prevalent condition that is frequently linked to joint trauma is joint hyper-laxity. The knee joint is one of the most complex and injury-prone joints in sports. The most commonly injured is the anterior cruciate ligament (ACL). The case presented below is of a 24-year-old athlete with a past history of many sports-related injuries who is now presented with a complete tear of the ACL with hyper-laxity as a risk factor. The patient has a Beighton score of six out of nine without any other symptoms, which is suggestive of benign hyper-laxity of the joints and not hyper-laxity syndrome...

BACKGROUND: Recent adult studies have demonstrated that decreased posterior tibial slope angle (PTSA) may be a risk factor for posterior cruciate ligament (PCL) injury. However, there is no study investigating this phenomenon in a pediatric population. Understanding risk factors for PCL injuries among a pediatric population is important given the recent rise in athletic competition/specialization and sports-related injuries. HYPOTHESIS/PURPOSE: The purpose of this study was to compare PTSA between pediatric patients sustaining a primary PCL tear compared with age- and sex-matched controls...

Introduction Artificial intelligence (AI) models using large language models (LLMs) and non-specific domains have gained attention for their innovative information processing. As AI advances, it's essential to regularly evaluate these tools' competency to maintain high standards, prevent errors or biases, and avoid flawed reasoning or misinformation that could harm patients or spread inaccuracies. Our study aimed to determine the performance of Chat Generative Pre-trained Transformer (ChatGPT) by OpenAI and Google BARD (BARD) in orthopedic surgery, assess performance based on question types, contrast performance between different AIs and compare AI performance to orthopedic residents...

INTRODUCTION: Following total knee arthroplasty (TKA), there is a significant decline in periprosthetic bone mineral density (BMD), potentially resulting in complications such as prosthetic loosening, periprosthetic fracture, and influencing the postoperative recovery. The objective of this study was to summarize the factors influencing periprosthetic BMD in TKA from existing studies. METHODS: A comprehensive systematic search was performed in 4 databases: Pubmed, Embase, Web of Science, and Cochrane Library...

INTRODUCTION: While total knee arthroplasty (TKA) is typically implemented in patients > 65 years old, young patients may need to undergo TKA for pain relief and functional improvement. Current data are limited by older cohorts and short-term survival rates. This study aimed to examine a large sample size of patients with degenerative and inflammatory conditions who underwent primary TKA at a young (≤ 40) age to identify predictors of reoperation, as well 15-year survivorship...

INTRODUCTION: Popliteal pterygium syndrome is a rare congenital disorder characterized by orofacial, cutaneous, musculoskeletal, and genital anomalies. The popliteal pterygium (PP) affects ambulation due to severe knee flexion contracture and equinovarus deformities. Surgical treatment aims to correct these deformities while preserving limb sensibility. However, due to its rarity, surgical guidelines are lacking. MATERIALS AND METHODS: A meta-analysis according to PRISMA guidelines was conducted to summarize and compare surgical methods for PP...

BACKGROUND: Traumatic knee injuries are challenging to diagnose accurately through radiography and to a lesser extent, through CT, with fractures sometimes overlooked. Ancillary signs like joint effusion or lipo-hemarthrosis are indicative of fractures, suggesting the need for further imaging. Artificial Intelligence (AI) can automate image analysis, improving diagnostic accuracy and help prioritizing clinically important X-ray or CT studies. OBJECTIVE: To develop and evaluate an AI algorithm for detecting effusion of any kind in knee X-rays and selected CT images and distinguishing between simple effusion and lipo-hemarthrosis indicative of intra-articular fractures...

Osteoarthritis (OA) commonly affects the knee and hip joints and accounts for 19.3% of disability-adjusted life years and years lived with disability worldwide (Refs , ). Early management is important in order to avoid disability uphold quality of life (Ref. ). However, a lack of awareness of subclinical and early symptomatic stages of OA often hampers early management (Ref. ). Moreover, late diagnosis of OA among those with severe disease, at a stage when OA management becomes more complicated is common (Refs , , , )...

A middle-aged female patient with a tibial plateau fracture combined with an avulsion of the tibial eminence was treated with a combination of medial plate fixation for the plateau and an arthroscopic aided nonabsorbable suture of the eminence. Our technique for tibial eminence avulsion fractures has no interference with tibial plateau osteosynthesis materials and has proven, once again, to have good results in the treatment of combined and complex injuries of the knee.

Tears of the posterior cruciate ligament (PCL) are rare, and avulsion fracture of the tibial attachment of the posterior cruciate ligament is even rarer. These injuries usually occur in accidents such as car crashes, causing acute pain, swelling as well as total functional impotence of the knee. Studies on the incidence of these injuries show variable results, but there appears to be an upward trend. The surgical management of PCL avulsion fracture is not clearly established, although arthroscopic techniques are becoming more popular due to their potential benefits...

BACKGROUND: The pendulum test is a quantitative method used to assess knee extensor spasticity in humans with spinal cord injury (SCI). Yet, the clinical implementation of this method remains limited. The goal of our study was to develop an objective and portable system to assess knee extensor spasticity during the pendulum test using inertial measurement units (IMU). METHODS: Spasticity was quantified by measuring the first swing angle (FSA) using a 3-dimensional optical tracking system (with external markers over the iliotibial band, lateral knee epicondyle, and lateral malleolus) and two wireless IMUs (positioned over the iliotibial band and mid-part of the lower leg) as well as a clinical exam (Modified Ashworth Scale, MAS)...

PURPOSE: To perform a systematic review evaluating clinical outcomes in patients undergoing medial ulnar collateral ligament reconstruction (MUCLR) with soft tissue allograft. METHODS: A systematic review of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The primary outcomes evaluated were patient-reported outcome scores, return to play (RTP) rates, incidence of postoperative complications, and rates of graft rupture or mechanical failure...

BACKGROUND: Patients' postoperative quality of recovery (QOR) is an important outcome measurement and predicting and preventing impaired quality of recovery is essential. In this study, we aimed to investigate if patients Sense of Coherence (SOC) could be a potential predictor and screening instrument for impaired quality of recovery. We hypothesized that patients' SOC is positively related to their QOR. MATERIAL AND METHODS: The study was performed as a descriptive single-center prospective cohort study...

BACKGROUND: Our purpose was to evaluate whether the time of intervention and the type of meniscus surgery (repair vs. partial meniscectomy) play a role in managing anterior cruciate ligament (ACL) reconstructions with concurrent meniscus pathologies. METHODS: We performed a prospective cohort study which differentiated between early and late ACL reconstructions with a cut-off at 3 months. Patients were re-evaluated after 2 years. RESULTS: Thirty-nine patients received an operation between 2-12 weeks after the injury, and thirty patients received the surgery between 13-28 weeks after trauma...

Patella fractures usually occur as a result of direct trauma to the anterior knee joint, indirect injury as a result of eccentric muscle contraction, or rapid knee flexion against a contracted quadriceps muscle. The patella functions as part of the extensor mechanism of the knee, where large forces are transmitted, and its subcutaneous nature has made treatment of patella fractures a challenge. In this review article, we evaluate how the management of these fractures has evolved over time and the advantages associated with the various treatment techniques...

Background : Distal lower extremity reconstruction is challenging. This study aims to propose a protocol for the treatment of traumatic soft tissue defects. The key concept is to combine the surgical armamentarium of the reconstructive surgeon with the advantages provided by hyperbaric oxygen therapy. Methods : This retrospective study analyzed data of 57 patients affected with unilateral or bilateral lower extremity trauma distal to the knee and involving soft tissues with no indication of immediate reconstruction between 2010 and 2021...

BACKGROUND: Schatzker type VI tibia fractures are usually associated with infection and surgical wound-related problems. Circular external fixation (CEF) has been shown to minimize such complications. METHODS: We pose a retrospective study of patients with Schatzker type VI fractures treated with CEF. RESULTS: Twenty-two (22) patients were included (11M/11F) with a mean age of 60.1 ± 14.9 years. According to the AO/OTA classification, two fractures (9...