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https://www.readbyqxmd.com/read/27926681/influence-of-immediate-and-delayed-lower-limb-amputation-compared-with-lower-limb-salvage-on-functional-and-mental-health-outcomes-post-rehabilitation-in-the-u-k-military
#1
Peter Ladlow, Rhodri Phillip, Russell Coppack, John Etherington, James Bilzon, M Polly McGuigan, Alexander N Bennett
BACKGROUND: Medical practitioners face difficult decisions over whether to amputate or to salvage a lower limb that has undergone trauma. To our knowledge, there has been little evidence reporting the impact of different surgical decisions on functional and mental health outcomes following intensive rehabilitation that might inform decision-making. METHODS: This study is a retrospective, independent-group comparison of rehabilitation outcomes from a U.K. military complex trauma rehabilitation center...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27921146/bone-loss-at-the-distal-femur-and-proximal-tibia-in-persons-with-spinal-cord-injury-imaging-approaches-risk-of-fracture-and-potential-treatment-options
#2
REVIEW
C M Cirnigliaro, M J Myslinski, M F La Fountaine, S C Kirshblum, G F Forrest, W A Bauman
Persons with spinal cord injury (SCI) undergo immediate unloading of the skeleton and, as a result, have severe bone loss below the level of lesion associated with increased risk of long-bone fractures. The pattern of bone loss in individuals with SCI differs from other forms of secondary osteoporosis because the skeleton above the level of lesion remains unaffected, while marked bone loss occurs in the regions of neurological impairment. Striking demineralization of the trabecular epiphyses of the distal femur (supracondylar) and proximal tibia occurs, with the knee region being highly vulnerable to fracture because many accidents occur while sitting in a wheelchair, making the knee region the first point of contact to any applied force...
December 5, 2016: Osteoporosis International
https://www.readbyqxmd.com/read/27917705/efficacy-of-argane-oil-on-metabolic-syndrome-in-a-moroccan-knee-osteoarthritis-population
#3
Jamila Essouiri, Fatima Ezzahra Abourazzak, Faiza Lazrak, Adil Najdi, Nadia Benaicha, Taoufik Harzy, Mourad Errasfa
Five medical conditions characterizes metabolic syndrome: abdominal obesity, elevated blood pressure, elevated fasting plasma glucose, high serum triglycerides, and low high-density lipoproteins cholesterol. When a patient has three of the five above parameters, he is called to have metabolic syndrome, and these conditions represents a key element in cardiovascular diseases. On the other hand, knee osteoarthritis is a degenerative disease which was shown to be affected by some of the parameters of metabolic syndrome...
December 4, 2016: Current Rheumatology Reviews
https://www.readbyqxmd.com/read/27913269/the-structure-organisation-and-perioperative-management-of-ambulatory-surgery-and-anaesthesia-in-france-methodology-of-the-sfar-opera-study
#4
Pierre Albaladejo, Frédéric Aubrun, Charles-Marc Samama, Laurent Jouffroy, Marc Beaussier, Dan Benhamou, Pauline Romegoux, Kristina Skaare, Jean Luc Bosson, Claude Ecoffey
The organization of health care establishments and perioperative care are essential for ensuring the quality of care and safety of patients undergoing outpatient surgery. In order to correctly inventory these organizations and practices, in 2013-2014, the French Society of Anaesthesia and Intensive Care organized an extensive practical survey in French ambulatory surgery units entitled the "OPERA" study (Organisation PERiopératoire de l'anesthésie en chirurgie Ambulatoire). From among all of the ambulatory surgery centres listed by the Agences Régionales de Santé [Regional Health Agencies, France], 206 public and private centres were randomly selected...
November 29, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27911477/vascularized-appendicular-lymph-node-transfer-for-treatment-of-extremity-lymphedema-a-case-report
#5
Pedro Ciudad, Oscar J Manrique, Shivprasad Date, Wei-Ling Chang, Fabio Nicoli, Stamatis Sapountzis, Hsu-Tang Cheng, Agko Mouchammed, Hung-Chi Chen
Vascularized lymph node transfer has demonstrated promising results for the treatment of extremity lymphedema. In an attempt to find the ideal donor site, several vascularized lymph nodes have been described. Each has a common goal of decreasing morbidity and avoiding iatrogenic lymphedema while obtaining good clinical results. Herein, we present the preliminary clinical outcomes of an intra-abdominal lymph node flap option based on the appendicular artery and vein used for the treatment of extremity lymphedema...
December 2, 2016: Microsurgery
https://www.readbyqxmd.com/read/27909207/below-knee-amputation-failure-and-poor-functional-outcomes-are-higher-than-predicted-in-contemporary-practice
#6
Jesse A Columbo, Brian W Nolan, Ryland S Stucke, Eva M Rzucidlo, Karen L Walker, Richard J Powell, Bjoern D Suckow, David H Stone
OBJECTIVE: The perceived functional benefit of below-knee amputation (BKA) must be carefully weighed against the need for potential reinterventions. This study sought to examine the contemporary clinical and functional outcomes of patients undergoing BKA in the endovascular era. METHODS: All patients who underwent BKA from January 2008 to December 2014 at a single tertiary medical center were retrospectively reviewed. Demographics, comorbidities, ambulation status, and transcutaneous oximetry (TcPO2) values were recorded...
November 30, 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27900305/microfracture-versus-microfracture-and-platelet-rich-plasma-arthroscopic-treatment-of-knee-chondral-lesions-a-two-year-follow-up-study
#7
Annalisa Mancò, Remo Goderecci, Anna Rughetti, Silvana DE Giorgi, Stefano Necozione, Alfredo Bernardi, Vittorio Calvisi
PURPOSE: the aim of this study was to describe and compare the clinical results obtained in patients affected by chondral lesions of the knee submitted to an arthroscopic treatment with the microfracture technique or microfracture + intraoperative autologous platelet-rich plasma (PRP) injection. METHODS: a prospective observational study was performed in patients affected by chondral lesions of the knee (classed as grade III-IV according to Outer-bridge's classification) and early osteoarthritis (classed as grade 1-2 according to the Kellgren-Lawrence classification)...
July 2016: Joints
https://www.readbyqxmd.com/read/27897156/quantitative-evaluation-of-the-mechanical-risks-caused-by-focal-cartilage-defects-in-the-knee
#8
Mikko S Venäläinen, Mika E Mononen, Jari Salo, Lasse P Räsänen, Jukka S Jurvelin, Juha Töyräs, Tuomas Virén, Rami K Korhonen
Focal cartilage lesions can proceed to severe osteoarthritis or remain unaltered even for years. A method to identify high risk defects would be of utmost importance to guide clinical decision making and to identify the patients that are at the highest risk for the onset and progression of osteoarthritis. Based on cone beam computed tomography arthrography, we present a novel computational model for evaluating changes in local mechanical responses around cartilage defects. Our model, based on data obtained from a human knee in vivo, demonstrated that the most substantial alterations around the defect, as compared to the intact tissue, were observed in minimum principal (compressive) strains and shear strains...
November 29, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27886244/reconstructing-networks-from-profit-sequences-in-evolutionary-games-via-a-multiobjective-optimization-approach-with-lasso-initialization
#9
Kai Wu, Jing Liu, Shuai Wang
Evolutionary games (EG) model a common type of interactions in various complex, networked, natural and social systems. Given such a system with only profit sequences being available, reconstructing the interacting structure of EG networks is fundamental to understand and control its collective dynamics. Existing approaches used to handle this problem, such as the lasso, a convex optimization method, need a user-defined constant to control the tradeoff between the natural sparsity of networks and measurement error (the difference between observed data and simulated data)...
November 25, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27882808/no-degeneration-found-in-focal-cartilage-defects-evaluated-with-dgemric-at-12-year-follow-up
#10
Cathrine Nørstad Engen, Sverre Løken, Asbjørn Årøen, Charles Ho, Lars Engebretsen
Background and purpose - The natural history of focal cartilage defects (FCDs) is still unresolved, as is the long-term cartilage quality after cartilage surgery. It has been suggested that delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) is a biomarker of early OA. We aimed to quantitatively evaluate the articular cartilage in knees with FCDs, 12 years after arthroscopic diagnosis. Patients and methods - We included 21 patients from a cohort of patients with knee pain who underwent arthroscopy in 1999...
November 24, 2016: Acta Orthopaedica
https://www.readbyqxmd.com/read/27881381/two-year-outcomes-of-a-randomized-trial-investigating-a-6-week-return-to-full-weightbearing-after-matrix-induced-autologous-chondrocyte-implantation
#11
Jay R Ebert, Peter K Edwards, Michael Fallon, Timothy R Ackland, Gregory C Janes, David J Wood
BACKGROUND: Matrix-induced autologous chondrocyte implantation (MACI) has demonstrated encouraging outcomes in treating patients with knee cartilage defects. Postoperatively, the time required to attain full weightbearing (WB) remains conservative. HYPOTHESIS: We hypothesized that patients would have no significant clinical or radiological differences or graft complications after an 8-week or 6-week return to full WB after MACI. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1...
November 23, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27880969/the-prevalence-of-cruciate-ligament-and-meniscus-knee-injury-in-young-adults-and-associations-with-gender-body-mass-index-and-height-a-large-cross-sectional-study
#12
Ran Thein, Oded Hershkovich, Barak Gordon, Gideon Burstein, Shay Tenebaum, Estela Derazne, Dorit Tzur, Ari Shamis, Arnon Afek, Yitshak Kreiss
Anterior cruciate ligament and meniscal injuries are associated with secondary osteoarthrosis which may lead to functional impairment and economic burden. The prevalence of knee injury has not been studied in depth. Our purpose was to report the prevalence of knee ligament and meniscal injuries and their associations with gender, body mass index (BMI), and height in young adults and to characterize individuals with meniscal injuries who gained full recovery. A cross-sectional, population-based study was conducted...
November 23, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27878340/anatomical-risk-evaluation-of-iatrogenic-injury-to-the-infrapatellar-branch-of-the-saphenous-nerve-during-medial-meniscus-arthroscopic-surgery
#13
Guillaume Koch, Agathe Kling, Nitin Ramamurthy, Faramarz Edalat, Roberto Luigi Cazzato, Jean-Luc Kahn, Julien Garnon, Philippe Clavert
PURPOSE: To determine the relationship of the medial meniscus with the infrapatellar branches of the saphenous nerve, the primary goal is to define and characterize different risk areas for these nerves during medial meniscus surgery. METHODS: After dissecting 20 embalmed cadaver knees, we defined 7 readily identifiable anatomical landmarks. For each knee, we recorded 2 morphological criteria and 16 measurements. RESULTS: The most common anatomical course is a main trunk that is 8 mm anterior to the tuberculum adductorium and 60 mm posterior to the midpoint of the medial patellar margin...
November 22, 2016: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/27876283/importance-of-trabecular-anisotropy-in-finite-element-predictions-of-patellar-strain-after-total-knee-arthroplasty
#14
A Latypova, D P Pioletti, A Terrier
Patellar fracture and anterior knee pain remain major complications after Total Knee Arthroplasty (TKA). Patient-specific finite element (FE) models should help improve understanding of these complications through estimation of joint and bone mechanics. However, sensitivity of predictions on modeling techniques and approaches is not fully investigated. In particular, the importance of patellar bone anisotropy, usually omitted in FE models, on strain prediction is still unknown. The objective of this study was thus to estimate the influence of modeling patellar trabecular anisotropy on prediction of patellar strain in TKA models...
November 18, 2016: Medical Engineering & Physics
https://www.readbyqxmd.com/read/27867137/minimally-invasive-internal-fixation-of-distal-femur-fractures
#15
REVIEW
Guy Piétu, Mathieu Ehlinger
Fractures of the distal femur remain a daunting challenge. Since 1970, operative treatment has been recommended. Unfortunately it is fraught with complications, and techniques have been developed to limit incidence of non-union, infection and stiffness. A soft-tissue friendly approach is the key point, with minimally invasive surgery as the ultimate goal: its biological and anatomical advantages have; been demonstrated, but clinical studies have been less convincing, being based on historical series. At present, retrograde nailing and minimally invasive percutaneous plate osteosynthesis (ideally by locking plate) are the two main techniques...
November 17, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27866971/snapping-knee-caused-by-the-thickening-of-the-medial-hamstrings
#16
B de la Hera Cremades, L Escribano Rueda, A Lara Rubio
We report a case of symptomatic subluxation of the semitendinosus and gracilis over the medial condyle of the tibia caused by the thickening of its tendons. Snapping was reproduced on active extension. Clinical examination and, above all, dynamic ultrasound were the key for the diagnosis because other imaging tests were normal. Due to failure of conservative treatment with physiotherapy and infiltrations, surgery was undertaken, involving desinsertion and excision of distal 8cm segment of the semitendinosus and gracilis tendons...
November 17, 2016: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/27861523/knee-moment-angle-characteristics-and-semitendinosus-muscle-morphology-in-children-with-spastic-paresis-selected-for-medial-hamstring-lengthening
#17
Helga Haberfehlner, Richard T Jaspers, Erich Rutz, Jules G Becher, Jaap Harlaar, Johannes A van der Sluijs, Melinda M Witbreuk, Jacqueline Romkes, Marie Freslier, Reinald Brunner, Huub Maas, Annemieke I Buizer
To increase knee range of motion and improve gait in children with spastic paresis (SP), the semitendinosus muscle (ST) amongst other hamstring muscles is frequently lengthened by surgery, but with variable success. Little is known about how the pre-surgical mechanical and morphological characteristics of ST muscle differ between children with SP and typically developing children (TD). The aims of this study were to assess (1) how knee moment-angle characteristics and ST morphology in children with SP selected for medial hamstring lengthening differ from TD children, as well as (2) how knee moment-angle characteristics and ST morphology are related...
2016: PloS One
https://www.readbyqxmd.com/read/27852532/are-physiotherapists-adhering-to-quality-indicators-for-the-management-of-knee-osteoarthritis-an-observational-study
#18
David Spitaels, Rosella Hermens, Dieter Van Assche, Sabine Verschueren, Frank Luyten, Patrik Vankrunkelsven
BACKGROUND: Osteoarthritis (OA) is a common musculoskeletal condition that often leads to pain, stiffness and disability. Physiotherapy plays an important role in the management of knee OA, however we hypothesize discordance between physiotherapists' practice and existing guideline recommendations. OBJECTIVES: This study aimed to measure physiotherapists' guideline adherence for knee OA. Additionally, determinants for guideline adherence at the professional and organizational level were explored, to find clues for improvement...
October 26, 2016: Manual Therapy
https://www.readbyqxmd.com/read/27846241/sprint-start-kinetics-of-amputee-and-non-amputee-sprinters
#19
Steffen Willwacher, Volker Herrmann, Kai Heinrich, Johannes Funken, Gerda Strutzenberger, Jan-Peter Goldmann, Björn Braunstein, Adam Brazil, Gareth Irwin, Wolfgang Potthast, Gert-Peter Brüggemann
The purpose of this study was to explore the relationship between the forces applied to the starting blocks and the start performances (SPs) of amputee sprinters (ASs) and non-amputee sprinters (NASs). SPs of 154 male and female NASs (100-m personal records [PRs], 9.58-14.00 s) and 7 male ASs (3 unilateral above knee, 3 unilateral below knee, 1 bilateral below knee; 100 m PRs, 11.70-12.70 s) with running specific prostheses (RSPs) were analysed during full-effort sprint starts using instrumented starting blocks that measured the applied forces in 3D...
2016: PloS One
https://www.readbyqxmd.com/read/27836800/sex-and-age-dependence-of-region-and-layer-specific-knee-cartilage-composition-spin-spin-relaxation-time-in-healthy-reference-subjects
#20
Wolfgang Wirth, Susanne Maschek, Felix Eckstein
Compositional measures of articular cartilage are accessible in vivo by magnetic resonance imaging (MRI) based relaxometry and cartilage spin-spin transverse relaxation time (T2) has been related to tissue hydration, collagen content and orientation, and mechanical (functional) properties of articular cartilage. The objective of the current study was therefore to evaluate subregional variation, and sex- and age-differences, in laminar (deep and superficial) femorotibial cartilage T2 relaxation time in healthy adults...
November 9, 2016: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
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