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Knee Flexion

Henrik C Bäcker, Adrian J Yenchak, David P Trofa, J Turner Vosseller
The goal of treatment after Achilles tendon rupture (ATR) is to restore appropriate tension to the tendon, so that normal baseline strength and functional soft-tissue length can be achieved. The assessment of plantarflexion strength has shown widespread variability. The purpose of this study is to document variations in strength assessment after the treatment of ATR in the literature. A comprehensive literature review was performed. In total, 2758 articles were found on Achilles tendon rupture and Achilles tendon strength measurement...
December 17, 2018: Foot & Ankle Specialist
Davide Mondin, Julian A Owen, Massimo Negro, Giuseppe D'Antona
Modifiable risk factors for hamstring injury include lack of strength, fatigue and muscle strength asymmetry. Assessing lower body strength in the field is problematic as "gold standard assessment" are expensive, non-portable and assessment is time-consuming. Therefore, the objective of this study was to examine the validity and reliability of an adapted aneroid sphygmomanometer test of hamstring and quadricep strength. In 14 active males (age 23.1 ± 2.5 years; height 180.9 ± 8.2 cm; weight 88.4 ± 8...
2018: Frontiers in Physiology
Jae S You, Anne R Wright, Ian Hasegawa, Brandon Kobayashi, Matthew Kawahara, Jordan Wang, Cass K Nakasone
BACKGROUND: Tibial osseous defects can present a serious challenge in primary total knee arthroplasty. We describe a technique of using porous tantalum cones along with primary arthroplasty implants to address large tibial osseous defects in primary total knee arthroplasty and present the short-term results. METHODS: We present 17 cases (15 patients) in which primary total knee implants and porous tantalum cones were used to address large tibial bony defects. Clinical results were evaluated using Knee Society Scores, pre- and postoperative knee range of motion, and serial radiographs...
December 13, 2018: Knee
M C Fennema, R A Bloomfield, B A Lanting, T B Birmingham, M G Teeter
BACKGROUND: As assessment with inertial-measurement-units (IMUs) increases in research and in clinics, it is important to be aware of the repeatability of these sensors. The objectives of this experiment were to evaluate the measurement repeatability of IMU joint angles using a repeatable robot controller and an anthropomorphic leg phantom and to determine effects of joint speed and sensor positioning on the angles collected by these sensors. Comparisons to an electro-goniometer and three-dimensional (3D) motion capture cameras were also completed...
December 13, 2018: Knee
Jacopo A Vitale, Giuseppe Banfi, Ennio Belli, Francesco Negrini, Antonio La Torre
BACKGROUND: Isolated patellar tendon rupture (PTR) is the final stage of a long-standing tendon chronic degeneration. PTR requires immediate repair in order to avoid important muscle retraction and tendon fibrosis. The aim was to describe the effects of a rehabilitation protocol after chronic-degenerative PTR on subjective functional outcomes, knee range of motion (ROM), size, and strength in a professional football player. CASE REPORT: A 26-years-old football player who experienced RPT after a 3-year history of proximal patellar tendinopathy...
December 14, 2018: European Journal of Physical and Rehabilitation Medicine
Cornelia Lützner, Anne Postler, Franziska Beyer, Stephan Kirschner, Jörg Lützner
PURPOSE: Constant efforts have been made to improve prosthesis design in total knee arthroplasty (TKA), but a significant number of patients remain dissatisfied postoperatively. Besides poor improvement in pain or function, poor fulfillment of patients expectations were identified as contributing factors. Purpose of the study was to assess fulfillment of patients' expectations and satisfaction with TKA 5 years after surgery. METHODS: A total of 103 patients from a prospective randomised study of a high-flexion or standard TKA implant were investigated 5 years after surgery and patient-reported outcomes (PRO), fulfillment of expectations and satisfaction with the result of the surgery were obtained...
December 13, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Olivia J Bono, Christopher W Olcott, Robert Carangelo, James P Jamison, Russell G Tigges, Carl T Talmo, James V Bono
While femoral intramedullary alignment has been found to be the most accurate and reproducible method for proper femoral component orientation in total knee arthroplasty, certain situations preclude the use of intramedullary alignment, such as ipsilateral long-stem total hip arthroplasty, femoral shaft deformity (congenital or post-traumatic), capacious femoral canal, and retained hardware. These cases require alternative alignment guides, that is, extramedullary alignment. The purpose of this study was to determine the accuracy of intramedullary alignment in reproducing the femoral anatomic axis...
December 13, 2018: Journal of Knee Surgery
Devon L Albert, Stephanie M Beeman, Andrew R Kemper
OBJECTIVE: The objective of this research was to compare the kinetics and predicted injury risks of the Hybrid III (HIII) and Test device for Human Occupant Restraint (THOR)-M necks during full-scale frontal sled tests under 3 safety restraint conditions: knee bolster (KB), knee bolster and steering wheel airbag (KB/SWAB), and knee bolster airbag and steering wheel airbag (KBAB/SWAB). METHODS: Twelve sled tests were performed for the HIII and THOR-M, and 8 matched sled tests were performed using postmortem human surrogates (PMHSs)...
December 13, 2018: Traffic Injury Prevention
Malte Bellmann, Thomas Maximilian Köhler, Thomas Schmalz
Safety-relevant gait situations (walking on stairs and slopes, walking backwards, walking with small steps, simulated perturbations of swing phase extension) were investigated in a motion analysis laboratory with six unilateral transfemoral amputees using two different microprocessor-controlled prosthetic knee joints (Rheo Knee XC, C-Leg). A randomized crossover design was chosen. The study results imply that the performance and safety potential of a microprocessor-controlled knee joint can be associated with the individual control algorithms and the technological concepts that are implemented to generate motion resistances for controlling flexion and extension movements...
December 12, 2018: Biomedizinische Technik. Biomedical Engineering
Yvonne van Zaanen, Rutger C I van Geenen, Thijs M J Pahlplatz, Arthur J Kievit, Marco J M Hoozemans, Eric W P Bakker, Leendert Blankevoort, Matthias U Schafroth, Daniel Haverkamp, Ton M J S Vervest, Dirk H P W Das, Walter van der Weegen, Vanessa A Scholtes, Monique H W Frings-Dresen, P Paul F M Kuijer
Purpose Three out of ten patients do not return to work after total knee arthroplasty (TKA). Patient expectations are suggested to play a key role. What are patients' expectations regarding the ability to perform work-related knee-demanding activities 6 months after TKA compared to their preoperative status? Methods A multi-center cross-sectional study was performed among 292 working patients listed for TKA. The Work Osteoarthritis or joint-Replacement Questionnaire (WORQ, range 0-100, minimal important difference 13) was used to assess the preoperatively experienced and expected ability to perform work-related knee-demanding activities 6 months postoperatively...
December 11, 2018: Journal of Occupational Rehabilitation
V Schütte, A Schmidt-Hebbel, A B Imhoff, A Achtnich
OBJECTIVE: Transosseous augmentation of patellar sleeve fractures (PSF) with suture tape in young athletes. INDICATIONS: Acute avulsions of the proximal or distal patellar pol with clinical relevant deficit of knee extension. CONTRAINDICATIONS: Local infections, severe soft tissue damage (relative contraindication), fractures of the patella or tibial tuberosity. SURGICAL TECHNIQUE: Direct longitudinal anterior approach to the patella...
December 11, 2018: Operative Orthopädie und Traumatologie
Dana Guy-Cherry, Ahmad Alanazi, Lauren Miller, Darrin Staloch, Alexis Ortiz-Rodriguez
The aim was to determine which three landing styles - stiff (ST), self-selected (SS), or soft (SF) - exhibit safer landing mechanics and greater jumping performance. Thirty participants (age: 26.5±5.1 years; height: 171.0±8.8 cm; weight: 69.7±10.1 kg) performed five trials of three randomized drop jump (40 cm) landing styles including SF (~60° knee flexion), ST (knees as straight as possible), and SS. Knee flexion and valgus angles and kinetics were measured. An electromyography system measured muscle activity of the gluteus maximus, quadriceps, hamstrings, tibialis anterior, and gastrocnemius...
April 2018: Sports medicine international open
W A M van Lieshout, C D Martijn, B T J van Ginneken, R J van Heerwaarden
INTRODUCTION: Medial closing wedge high tibial osteotomy (CWHTO) for valgus deformity correction was first described by Coventry whom performed an additional reefing of the medial collateral ligament (MCL) to prevent instability postoperative. In our clinic the additional reefing procedure has never been performed and instability has not been reported routinely by patients. Using instrumented laxity testing, pre- and postoperative valgus and varus knee laxity can be measured objectively...
December 10, 2018: Journal of Experimental Orthopaedics
Filippo Migliorini, Markus Tingart, Marc Niewiera, Björn Rath, Jörg Eschweiler
PURPOSE: In the last couple of years, a significant amount of studies comparing the UKA and TKA for unicompartmental knee osteoarthritis have been published. However, there is a lack of recent meta-analysis comparing the two implants. Since the number of performed UKAs is currently increasing and the indications are obsolete, it becomes important to update current evidences and outcomes. With these premises, a meta-analysis of clinical trials comparing UKA versus TKA was conducted. METHODS: In October 2018, the following databases were accessed: Cochrane Systematic Reviews, Scopus, PubMed and Google Scholar...
December 7, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Hiroshi Watanabe, Tokifumi Majima, Kenji Takahashi, Norishige Iizawa, Yasushi Oshima, Shinro Takai
PURPOSE: Flexion-type Salter-Harris (SH) II fractures of the proximal tibia, also described as Watson-Jones (WJ) IV fractures, are rare injuries reported among adolescent athletes who are close to skeletal maturity and remain elusive. Due to this classification disagreement, the various treatments range from nonoperative to operative types, and no previous studies have explained the mechanisms of injury or the source of the fracture forces. This retrospective matched case-control study aimed to identify radiological factors that are associated with the fracture forces and to elucidate the mechanisms of these injuries...
December 10, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Christian Baumgart, Wouter Welling, Matthias W Hoppe, Jürgen Freiwald, Alli Gokeler
Background: Strength deficits, muscle imbalances, and quadriceps inhibition are common after the surgical reconstruction of the anterior cruciate ligament (ACL), even after the patient's returned-to-sport. Typically, asymmetries between the operated and non-operated leg as well as the hamstring/quadriceps (HQ) ratio are calculated using maximum isokinetic torque values. Moreover, the knee flexion angles, which correspond to the measured torque values, were not considered. Therefore, the aim of the study was to evaluate the usage of an angle-specific approach for the analysis of isokinetic data in patients after an ACL-reconstruction...
2018: BMC Sports Science, Medicine and Rehabilitation
Konrad Malinowski, Adrian Góralczyk, Krzysztof Hermanowicz, Robert F LaPrade, Rafał Więcek, Marcin E Domżalski
Knee flexion contracture is a clinically important complication that can be observed after trauma, after knee surgery, or as a result of osteoarthritis. When it is left untreated, knee shearing forces increase not only in the affected joint but also in the contralateral knee, leading to mechanical overload in both limbs. Conservative management is a first-line treatment option for extension deficits, but when it fails, surgical treatment is necessary. Open as well as arthroscopic techniques focus mainly on an anterior arthrolysis and a posterior capsular release...
November 2018: Arthroscopy Techniques
Mitchell I Kennedy, Nicholas N DePhillipo, Jorge Chahla, Christopher Armstrong, Connor G Ziegler, Patrick S Buckley, Andrew S Bernhardson, Robert F LaPrade
A snapping biceps tendon is an infrequently seen and commonly misdiagnosed pathology, leaving patients with persistent symptoms that can be debilitating. Patients will present with a visible, audible, and/or painful snap over the lateral aspect of their knee when performing squats, sitting in low seats, or participating in activities with deep knee flexion. A thorough knowledge of the anatomy is essential for surgical treatment of this pathology, which is caused by a detachment of the direct arms of the long and short heads of the biceps femoris off the fibular styloid...
November 2018: Arthroscopy Techniques
Brett G Brazier, Stephen A Sudekum, Paul M DeVito, Julie A Dodds
Popliteal cysts, often referred to as Baker's cysts, are a common occurrence in the adult knee. Although controversy exists as to the exact indications for treatment, these structures can cause extreme discomfort and morbidity, including pain from rupture and symptoms from neurovascular compromise. Prior to the development of the arthroscope, open treatment of popliteal cysts was not uncommon. Complications such as poor wound healing, cyst recurrence, and knee flexion contractures were reported after such treatment...
November 2018: Arthroscopy Techniques
Trevor J Shelton, Stephen M Howell, Maury L Hull
BACKGROUND: Four mechanical alignment force targets are used to predict early patient-reported outcomes and/or to indicate a balanced TKA. For surgeons who use kinematic alignment, there are no reported force targets. To date the usefulness of these mechanical alignment force targets with kinematic alignment has not been reported nor has a specific force target for kinematic alignment been identified. QUESTIONS/PURPOSES: (1) Does hitting one of four mechanical alignment force targets proposed by Gustke, Jacobs, Meere, and Menghini determine whether a patient with a kinematically aligned TKA had better patient-reported Oxford Knee and WOMAC scores at 6 months? (2) Can a new force target be identified for kinematic alignment that determines whether the patient had a good/excellent Oxford Knee Score of ≥ 34 points (48 best, 0 worst)? METHODS: Between July 2017 and November 2017, we performed 148 consecutive primary TKAs of which all were treated with kinematic alignment using 10 caliper measurements and verification checks...
December 7, 2018: Clinical Orthopaedics and related Research
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