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https://www.readbyqxmd.com/read/28431865/statin-use-and-other-factors-associated-with-mortality-after-major-lower-extremity-amputation
#1
Charles DeCarlo, Larry Scher, Saadat Shariff, John Phair, Evan Lipsitz, Karan Garg
OBJECTIVE: Above-knee amputations (AKAs) and below-knee amputations (BKAs) are associated with high postoperative mortality rates. In this study, we examined factors associated with 30-day, 90-day, and 1-year mortality in patients who underwent a major lower extremity amputation. METHODS: We queried a prospectively collected institutional database for all patients who underwent AKA or BKA with primary or secondary closure, during a 5-year period, between November 2009 and November 2014...
April 18, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28422865/crystalglobulinemia-manifesting-as-chronic-arthralgia-and-acute-limb-ischemia-a-clinical-case-report
#2
Nobuya Abe, Tomoko Tomita, Miyuki Bohgaki, Hideki Kasahara, Takao Koike
RATIONALE: Crystalglobulinemia is a rare disease caused by monoclonal immunoglobulins, characterized by irreversible crystallization on refrigeration. It causes systemic symptoms including purpura, arthralgia, and vessel occlusive conditions to be exacerbated by exposure to cold. We report a patient with crystalglobulinemia associated with monoclonal gammopathy of undetermined significance (MGUS) manifesting as chronic arthralgia and recurrent acute arterial occlusion. PRESENTING CONCERNS: A 61-year-old man, who had been diagnosed with MGUS and who had arthralgia of unknown origin, presented with recurrent acute limb ischemia after surgical thromboembolectomy...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28421308/an-intelligent-remote-monitoring-system-for-total-knee-arthroplasty-patients
#3
Yunus Msayib, Patrick Gaydecki, Michael Callaghan, Nicola Dale, Sheheera Ismail
For the first six weeks following total knee arthroplasty (TKA), a patient will attend an outpatient clinic typically seen twice weekly. Here, an exercise regime is performed and improvement assessed using a hand held goniometer that measures the maximum angle of knee flexion, an important metric of progress. Additionally a series of daily exercises is performed at home, recorded in a diary. This protocol has problems. Patients must attend the hospital with assistance since they are not permitted to drive for six weeks following the procedure; appointments are sometimes missed; there are occasionally not enough physiotherapy appointment available; furthermore, it is difficult to be sure that patients are compliant with their exercises at home...
June 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28418577/prospective-assessment-of-sleep-quality-before-and-after-primary-total-joint-replacement
#4
Blaine T Manning, Sean M Kearns, Daniel D Bohl, Tori Edmiston, Scott M Sporer, Brett R Levine
Sleep disruption is a common, yet rarely addressed, complaint among patients who have undergone total joint arthroplasty (TJA). This study assessed sleep quality before and after primary TJA. A total of 105 patients who underwent primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) prospectively completed questionnaires during the preoperative, early postoperative, and late postoperative periods. The survey included the Epworth Sleepiness Scale, current sleeping habits, and patient perspectives of sleep quality and duration...
April 18, 2017: Orthopedics
https://www.readbyqxmd.com/read/28403726/gastrocnemius-recession-a-cadaveric-study-of-surgical-safety-and-effectiveness
#5
Eva M Hoefnagels, Stephen M Belkoff, Bart A Swierstra
Background and purpose - Many methods of gastrocnemius lengthening have been described, with different surgical challenges, outcomes, and risks to the sural nerve. Our aims were (1) to locate the gastrocnemius muscular-tendinous junction in relation to the mid-length of the fibula (from here on designated the mid-fibula), (2) to compare the dorsiflexion achieved with dorsal recession or ventral recession, and (3) to determine the risk of injury to the sural nerve during gastrocnemius recession. Methods - In 10 pairs of fresh-frozen adult cadaveric lower extremities transected above the knee, we measured dorsiflexion, performed dorsal or ventral gastrocnemius recession at the mid-fibula, and then measured the increase in dorsiflexion and fasciotomy gap...
April 13, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28400218/outcomes-of-the-japanese-multicenter-viabahn-trial-of-endovascular-stent-grafting-for-superficial-femoral-artery-lesions
#6
Takao Ohki, Kimihiko Kichikawa, Hiroyoshi Yokoi, Masaaki Uematsu, Terutoshi Yamaoka, Koji Maeda, Yuji Kanaoka
OBJECTIVE: The objective of this study was to assess 1-year safety, efficacy, and invasiveness outcomes of endovascular stent grafting of symptomatic long lesions (≥10 cm) in the superficial femoral artery (SFA) as a substitute for above-knee open bypass surgery. METHODS: This prospective, multicenter (15 hospitals) study assessed heparin-coated stent grafts for the treatment of long SFA lesions in Japanese subjects with peripheral arterial disease. Inclusion criteria were Rutherford category 2 to 5 symptoms (grade 5 without active infection), ankle-brachial index ≤0...
April 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28390911/critical-limb-ischemia-secondary-to-antiphospholipid-syndrome-in-a-pediatric-patient-case-report-and-review
#7
Andrew J Soo Hoo, Joseph M White, Paul W White
A pediatric patient with critical limb ischemia secondary to antiphospholipid syndrome (APS) is reported. A 14-year-old male underwent extensive evaluation for worsening right lower extremity pain and ulcerative lesions of his right foot. He was discovered to have proximal occlusion of the superficial femoral artery (SFA), the distal popliteal artery, the anterior tibial artery at the mid-calf, and the posterior tibial artery at the ankle. Laboratory analysis revealed a diagnosis of APS, and he underwent a common femoral artery to above-knee-popliteal artery bypass with reversed greater saphenous graft...
April 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28366438/measuring-joint-kinematics-of-treadmill-walking-and-running-comparison-between-an-inertial-sensor-based-system-and-a-camera-based-system
#8
Corina Nüesch, Elena Roos, Geert Pagenstert, Annegret Mündermann
Inertial sensor systems are becoming increasingly popular for gait analysis because their use is simple and time efficient. This study aimed to compare joint kinematics measured by the inertial sensor system RehaGait® with those of an optoelectronic system (Vicon®) for treadmill walking and running. Additionally, the test re-test repeatability of kinematic waveforms and discrete parameters for the RehaGait® was investigated. Twenty healthy runners participated in this study. Inertial sensors and reflective markers (PlugIn Gait) were attached according to respective guidelines...
March 21, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28361432/prediction-of-intraoperative-blood-loss-during-total-knee-arthroplasty-in-hcv-and-hcv-patients-with-hemophilia-a
#9
E S Shurkhina, T Yu Polyanskaya, V Yu Zorenko, V M Nesterenko
We examined HCV+ and HCV- hemophilia A patients with knee arthropathy and hematocrit above 38.5%. The mean density of erythrocytes was studied by the phthalate method, intraoperative blood loss was assessed gravimetrically. The volume of blood loss in HCV+ patients with manifest adhesive process and chronic synovitis varied from 300 to 1900 ml, in patients with moderate adhesive process from 400 to 1500 ml. The volume of blood loss in HCV- patients was 300-800 ml. A positive correlation between the blood loss volume and mean density of erythrocytes was detected...
March 31, 2017: Bulletin of Experimental Biology and Medicine
https://www.readbyqxmd.com/read/28359275/leg-pain-location-and-neurological-signs-relate-to-outcomes-in-primary-care-patients-with-low-back-pain
#10
Lisbeth Hartvigsen, Lise Hestbaek, Charlotte Lebouef-Yde, Werner Vach, Alice Kongsted
BACKGROUND: Low back pain (LBP) patients with related leg pain and signs of nerve root involvement are considered to have a worse prognosis than patients with LBP alone. However, it is unclear whether leg pain location above or below the knee and the presence of neurological signs are important in primary care patients. The objectives of this study were to explore whether the four Quebec Task Force categories (QTFC) based on the location of pain and on neurological signs have different characteristics at the time of care seeking, whether these QTFC are associated with outcome, and if so whether there is an obvious ranking of the four QTFC on the severity of outcomes...
March 31, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28358184/the-role-of-drug-coated-balloons-in-in-stent-restenosis
#11
Martin Andrassy, Sultan Celik, Joachim Andrassy, Michael K Lichtenberg, Marianne Brodmann
INTRODUCTION: Despite a constantly expanding spectrum of therapeutic options for lower limb artery disease, there is not yet a well-defined consensus on the specific type of endovascular treatment that is best suited. Clinical data on patients with femoropopliteal disease treated with drug-coated balloons have not been elaborated sufficiently, especially in the case of in-stent restenosis (ISR). EVIDENCE ACQUISITION: For this review a systematic research of the medical databases (http://www...
March 28, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28348796/diagnostic-difficulty-identifying-apophysomyces-trapeziformis-septic-arthritis-in-a-patient-with-multiple-myeloma
#12
J Bradford Bertumen, Wiley A Schell, Maria Joyce, Christopher Alley, Christopher W Woods
INTRODUCTION: Mucormycosis is a rare fungal infection, but can cause substantial morbidity and mortality in both immunocompromised and immunocompetent patients. Apophysomyces is a mucormycetes species ubiquitous in nature, particularly in soil, decaying wood and other organic matter. Apophysomyces is known to cause cutaneous fungal infections, particularly after penetrating trauma. Septic arthritis is a rare clinical manifestation. CASE PRESENTATION: We describe a case of Apophysomyces trapeziformis causing septic arthritis of the knee of a patient with multiple myeloma...
December 2016: JMM Case Reports
https://www.readbyqxmd.com/read/28345409/osteoarthritis-in-football
#13
Gian M Salzmann, Stefan Preiss, Marcy Zenobi-Wong, Laurent P Harder, Dirk Maier, Jirí Dvorák
Football is currently the most popular sporting activity in the world. Multiple reports have shown that a high incidence of osteoarthritis is found in football players. Evidence clearly shows that traumatic injury significantly predisposes players for such pathophysiology. Injuries are frequent in amateur as well as professional football players, with knee and ankle accounting for the most severe injuries. Many professional athletes lose playing time due to injuries and many are forced into early retirement...
April 2017: Cartilage
https://www.readbyqxmd.com/read/28344755/effect-of-topical-application-of-nigella-sativa-oil-and-oral-acetaminophen-on-pain-in-elderly-with-knee-osteoarthritis-a-crossover-clinical-trial
#14
Akram Kooshki, Reza Forouzan, Mohammad Hassan Rakhshani, Maryam Mohammadi
BACKGROUND: Limited evidence supports Nigella sativa's role as an effective complementary and alternative medicine and the anti-inflammatory effects of Nigella sativa on patients with allergic rhinitis. OBJECTIVE: The aim of this study was to investigate the effect of topical application of Nigella sativa oil and oral acetaminophen on pain in the elderly with knee osteoarthritis residing in a parents' home in Sabzevar. METHODS: This study is done as a crossover clinical trial...
November 2016: Electronic Physician
https://www.readbyqxmd.com/read/28341493/procalcitonin-as-a-biomarker-for-predicting-amputation-level-in-lower-extremity-infections
#15
Matthew M Reiner, Wissam E Khoury, Michael B Canales, Richard A Chmielewski, Kartick Patel, Mark C Razzante, Coleman O Cloughtery, Douglas Y Rowland
Inflammatory markers are essential tools in the decision-making process for lower extremity infections. When coupled with objective findings, clinicians can more accurately diagnose and treat these entities. Typically, markers such as the white blood cell count, erythrocyte sedimentation rate, and C-reactive protein are used to initially assess these patients or monitor the progression of medical or surgical therapy. Procalcitonin is a newer inflammatory marker that is specific for an infectious process. Originally, procalcitonin was used to monitor antibiotic therapy and sepsis for patients in the intensive care setting, but it has now been expanded to other facets of medicine...
March 21, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28337656/what-factors-are-associated-with-femoral-component-internal-rotation-in-tka-using-the-gap-balancing-technique
#16
Seung-Yup Lee, Hong-Chul Lim, Ki-Mo Jang, Ji-Hoon Bae
BACKGROUND: When using the gap-balancing technique for TKA, excessive medial release and varus proximal tibial resection can be associated with internal rotation of the femoral component. Previous studies have evaluated the causes of femoral component rotational alignment with a separate factor analysis using unadjusted statistical methods, which might result in treatment effects being attributed to confounding variables. QUESTIONS/PURPOSES: (1) What pre- and intraoperative factors are associated with internal rotation of the femoral component in TKA using the gap balancing technique? (2) To what degree does femoral component rotation as defined by the navigation system differ from rotation as measured by postoperative CT? METHODS: Three hundred seventy-seven knees that underwent computer-assisted primary TKA attributable to degenerative osteoarthritis with varus or mild valgus alignment in which medial soft tissue release was performed, and those with preoperative radiographs including preoperative CT between October 2007 and June 2014 were included in the study...
March 23, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28296659/modified-ponseti-technique-for-management-of-neglected-clubfeet
#17
Anil Mehtani, Jatin Prakash, Vipul Vijay, Nishikant Kumar, Abhinav Sinha
Achieving adequate dorsiflexion in neglected clubfoot cases remains challenging. On a close observation of the Ponseti method, we have now made certain modifications from the standard Ponseti protocol. This has helped us improve functional results, as well as reduce the number of casts in this walking-age group. From March 2011 onward, we managed 62 neglected clubfeet in 41 patients with the modified protocol. All these patients were treated with serial weekly above-knee casts. The feet were assessed by Dimeglio and Pirani scorings, which were done every week...
March 14, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28294398/functional-properties-of-native-and-tissue-engineered-cartilage-toward-understanding-the-pathogenesis-of-chondral-lesions-at-the-knee-a-bovine-cadaveric-study
#18
Nikolaos K Paschos, Nikita Lim, Jerry C Hu, Kyriacos A Athanasiou
Chondral lesions frequently occur in different topographic locations of the knee. This study evaluated the functional properties among the articulating surfaces of the tibiofemoral and patellofemoral joints, and whether neo-cartilage engineered using chondrocytes from different knee locations would reflect these differences. The biomechanical properties of bovine cartilage isolated from eight locations within the tibiofemoral (medial and lateral condyle, medial and lateral tibial plateau) and patellofemoral joints (medial and lateral trochlea, medial and lateral patella) were examined...
March 10, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28291452/slack-reducing-band-improves-combat-application-tourniquet-pressure-profile-and-hemorrhage-control-rate
#19
Dean Nachman, Avi Benov, Amiram Shovali, Yavnai Nirit, Roy Nadler, Yitzhak Avraham, Elon Glassberg
BACKGROUND: The Combat Application Tourniquet (CAT) is the tourniquet of choice in the Israeli defense forces. Applying the device loosely before windlass twisting is a main pitfall in CAT application. This study objective is to assess the effectiveness of a novel design modification of the CAT, aiming to prevent loose applications, by minimizing the slack. METHODS: Using the HapMed leg tourniquet trainer, an above the knee traumatic amputation was simulated. Active duty combatants and Special Forces basic medics were randomly assigned to apply the modified (n = 67) or conventional CAT (n = 65) once...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28288331/within-assessor-reliability-and-minimal-detectable-change-of-gait-kinematics-in-a-young-obese-demographic
#20
Brian Horsak, Barbara Pobatschnig, Arnold Baca, Susanne Greber-Platzer, Alexandra Kreissl, Stefan Nehrer, Barbara Wondrasch, Richard Crevenna, Mohammad Keilani, Andreas Kranzl
INTRODUCTION: Three-dimensional gait analysis (3DGA) in obese populations is a difficult task due to a great amount of subcutaneous fat. This makes it more challenging to identify anatomical landmarks, thus leading to inconsistent marker placement. Therefore, the purpose of this study was to investigate the test-retest reliability for kinematic measurements of obese children and adolescents. METHODS: Nine males and two females with an age-based BMI above the 97th percentile (age: 14...
March 2, 2017: Gait & Posture
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