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Dario Graceffa, Claudio Bonifati, Viviana Lora, Pier Luigi Saraceni, Catia De Felice, Maria Sole Chimenti, Roberto Perricone, Aldo Morrone
BACKGROUND: The inflammatory involvement of the enthesis in the course of psoriasis is accompanied by structural abnormalities detectable by ultrasound. The most common of these abnormalities is the thickening of the tendon at the insertion site. AIMS: The aim of the present study was to compare the thickness of entheses of patients with psoriatic arthritis, only skin psoriasis, and healthy controls. METHODS: A cross-sectional study was conducted in a cohort of patients affected with either only skin psoriasis or psoriatic arthritis as well as in a control group...
March 16, 2018: Indian Journal of Dermatology, Venereology and Leprology
Sergio Barroso Rosa, Zaid Bahho, Kenji Doma, Kaushik Hazratwala, Peter McEwen, Varaguna Manoharan, Brent Matthews, Matthew Wilkinson
INTRODUCTION: Patella alta (PA) is one of the primary correctable risk factors for patellofemoral instability (PFI). Both an accurate diagnosis of PA and a clinically relevant target for correction are necessary for optimal treatment. An ideal test for PA should relate the position of the patella to the femur rather than tibia, should do so with the quadriceps contracted and the patellar tendon under tension and should have good sensitivity and specificity. None of the currently used radiographic tests PA meet these criteria, most of which are based on the position of the patella relative to the tibia with diagnostic cutoffs based on 2 standard deviations from the mean rather than optimal sensitivity and specificity...
March 15, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
John J Elias, Kerwyn C Jones, S Cyrus Rezvanifar, Joseph N Gabra, Melanie A Morscher, Andrew J Cosgarea
BACKGROUND: Continued patellar instability can occur following medial patellofemoral ligament (MPFL) reconstruction. Computational simulation of function was used to investigate the influence of the lateral position of the tibial tuberosity, trochlear dysplasia and patella alta on lateral patellar tracking following MPFL reconstruction. METHODS: Multibody dynamic simulation models were developed to represent nine knees being treated for recurrent patellar instability...
March 12, 2018: Knee
Regina Wing Shan Sit, Keith Kwok Wai Chan, Benjamin Hon Kei Yip, Daisy Dexing Zhang, Kenneth Dean Reeves, Ying Ho Chan, Vincent Chi Ho Chung, Samuel Yeung Shan Wong
INTRODUCTION: Knee osteoarthritis (KOA) is a common, disabling and costly medical condition. The patellofemoral joint is a critical source of pain in individuals with KOA, and coexistence of patellofemoral osteoarthritis (PFOA) and tibiofemoral osteoarthritis (TFOA) is sometimes observed. The identification of subgroups with PFOA and customised interventions to correct underlying pathomechanics is beneficial for individuals with KOA. This study aims to evaluate whether a clinic-based patella mobilisation therapy (PMT) leads to significant improvement in pain, physical function and quality of life of individuals with KOA...
March 14, 2018: BMJ Open
Sophia M Schermerhorn, Paul J Auchincloss, Kyle Kraft, Kenneth J Nelson, Jeremy C Pamplin
Review the management of a patient with acute patella fracture supported by telemedical consultation. Clinical Context: Regionally Aligned Forces (RAF) supporting US Army Africa/Southern European Task Force (USARAF/ SETAF) in Africa Command area of responsibility. Care was provided by a Role I facility on the compound. Organic Expertise: Three 68W combat medics; one Special Operations Combat Medic (SOCM). Closest Medical Support: Organic battalion physician assistant (PA) located in the United States; USARAF PA located in a European country; French Role II located in nearby West African country; telemedical consults via e-mail, phone, or videoteleconsultation...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Seung Hoo Lee, Min Bom Kim, Jae Ang Sim, Do Hwan Han
We report our surgical method used to treat type C distal femur fractures accompanied by patella fractures whereby we approach the articular surface of the femur through the already-fractured patella. We treated 10 patients with type C3 distal femur and patella fractures between May 2013 and April 2015. Because the patella was fractured in all cases, we could approach the articular surface of the distal femur through the transverse gap between the retracted patellar fracture fragments, "transpatellar approach...
February 6, 2018: Journal of Knee Surgery
Idil Kurut Aysin, Ayhan Askin, Berna Dirim Mete, Ece Guvendi, Murat Aysin, Hikmet Kocyigit
Objective: The study aimed to investigate whether there is any association of anterior knee pain and knee function with chondromalacia stage and patellofemoral alignment in patients with anterior knee pain for over a month and with chondromalacia patellae (CMP) detected by magnetic resonance imaging (MRI). Materials and Methods: We reviewed the medical records of 38 patients who underwent a knee MRI examination and were diagnosed with chondromalacia based on the MRI...
February 2018: Eurasian Journal of Medicine
Philip P Roessler, Dieter C Wirtz, Max J Friedrich
OBJECTIVE: Successful treatment of knee joint disease requires an accurate diagnosis. In addition to a differentiated history, clinical examination is the most important component in the diagnosis of knee joint diseases. METHOD: The present video explains the common provocation and functional tests that are used in the basic clinical examination of the knee joint. In addition to general inspection and palpation, the focus here is on the individual region's patella, menisci, cruciate ligaments and collateral ligaments...
March 12, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
Jamie S McPhee, James Cameron, Thomas Maden-Wilkinson, Mathew Piasecki, Moi Hoon Yap, David A Jones, Hans Degens
The contributions of fibre atrophy, fibre loss, in situ specific force and voluntary activation to weakness in sarcopenia remain unclear. To investigate, forty older (20 women; age 72±4yrs) and 31 younger adults (15 women, age 22±3yrs) completed measurements. The knee extensor maximal voluntary torque (MVC) was measured as well as voluntary activation, patella tendon moment arm length, muscle volume and fascicle architecture to estimate in situ specific force. Fibre cross-sectional area (FCSA), fibre numbers and connective tissue contents were also estimated from vastus lateralis biopsies...
February 26, 2018: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Christopher J Vertullo, Stephen E Graves, Yi Peng, Peter L Lewis
Background and purpose - Recent direct comparative reports suggest that hybrid fixation may have a similar or superior outcome to cemented fixation in total knee replacement (TKR); however, a paucity of long-term data exists. To minimize the confounders of a direct comparison, we performed an instrumental variable analysis examining the revision rate of 2 cohorts of patients based on their surgeon's preference for cemented or hybrid fixation. Methods - Registry data were obtained from 1999 until 2015 for 2 cohorts of patients who received minimally stabilized TKR, defined as those treated by high-volume hybrid fixation preferring surgeons, designated routinely hybrid (RH), and those treated by high-volume cemented fixation preferring surgeons, designated routinely cemented (RC)...
March 12, 2018: Acta Orthopaedica
James Watson, Robert M Barker-Davies, Alexander N Bennett, Daniel T P Fong, Patrick C Wheeler, Mark Lewis, Craig Ranson
Objective: Several lower limb tendinopathy treatment modalities involve identification of pathological paratendinous or intratendinous neovascularisation to target proposed co-location of painful neoneuralisation. The ability to reliably locate and assess the degree of neovascularity is therefore clinically important. The Modified Ohberg Score (MOS) is frequently used to determine degree of neovascularity, but reliability has yet to be established among Sport and Exercise Medicine (SEM) consultants...
2018: BMJ Open Sport & Exercise Medicine
Michael Carl, Yajun Ma, Jiang Du
PURPOSE: Off-resonance saturation (ORS) is a tool which can be used in ultrashort echo time (UTE) magnetic resonance imaging to selectively reduce short T2 signals. When these ORS prepared UTE images are subtracted from a non-suppressed UTE acquisition, the short T2 signals are highlighted. The aim of this paper is to develop a theoretical ORS model and optimize short T2 contrast. THEORY: Using a theoretical model the sequence parameters such as saturation flip angle and off-resonance frequency were optimized to maximize short T2 contrast...
March 8, 2018: Magnetic Resonance Imaging
Hyeon-Ki Jeong, Maziyar Baran Pouyan, Daniel C Whittingslow, Venu Ganti, Omer T Inan
In this paper, we investigate the effects of increasing mechanical stress on the knee joints by recording knee acoustical emissions and analyze them using an unsupervised graph mining algorithm. We placed miniature contact microphones on four different locations: on the lateral and medial sides of the patella and superficial to the lateral and medial meniscus. We extracted audio features in both time and frequency domains from the acoustical signals and calculated the graph community factor (GCF): an index of heterogeneity (variation) in the sounds due to different loading conditions enforced on the knee...
March 2018: IEEE Transactions on Neural Systems and Rehabilitation Engineering
Nili Steinberg, Myriam Stern, Shay Tenenbaum, Alexander Blankstein, Aviva Zeev, Itzhak Siev-Ner
This study aimed at evaluating whether the prevalence of knee injuries and morphological features are different among pre-and-post menarche dancers; Sixty-seven pre-and-post menarche dancers were screened for anthropometric parameters; knee laxity; patella femoral pain syndrome (PFPS), pathologies and anatomical structure of the knees. Both groups showed a high and similar prevalence of PFPS. The post-menarche dancers produced a significantly higher rate of Tanner stages 3-4 (p = .010), greater weight (p < ...
March 8, 2018: Research in Sports Medicine
Georg Siebenbürger, Christian Zeckey, Julian Fürmetz, Wolfgang Böcker, Tobias Helfen
PURPOSE: Joint dislocations occur frequently in prehospital settings. The medical specialities of emergency physicians are heterogeneous. Decision making and the success rates of reduction attempt can vary greatly. The aim of this prospective multicentre study was to identify the factors most crucial for achieving successful prehospital reduction. METHODS: Study was conducted from 05/2012-05/2015 investigating cases of shoulder, patella and ankle joint dislocations in 16 emergency physician rescue stations...
March 7, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
I N Aboobacker, A Krishnakumar, S Narayanan, B Hafeeque, J C Gopinathan, F Aziz
Nail-Patella syndrome (NPS) is an inherited disease with characteristic nail, limb, and renal anomalies. While almost all patients manifest classical skeletal and nail abnormalities, renal involvement is seen in only 40% of patients. Asymptomatic proteinuria is the most common renal presentation. Although a substantial number of patients can progress to nephrotic range proteinuria, development of end-stage kidney disease is rare. Pathological abnormalities are appreciable only by electron microscopy. Our patient who had not been diagnosed with NPS previously presented with new-onset proteinuria during the second trimester of her first pregnancy...
January 2018: Indian Journal of Nephrology
Rana Muhammad Kamran Shabbir, Gökhan Nalbant, Nafees Ahmad, Sajid Malik, Aslıhan Tolun
BACKGROUND: Carbohydrate sulfotransferase 11 (CHST11) is a membrane protein of Golgi that catalyses the transfer of sulfate to position 4 of the N-acetylgalactosamine residues of chondroitin. Chondroitin sulfate is the predominant proteoglycan in cartilage, and its sulfation is important in the developing growth plate of cartilage. A homozygous deletion encompassing part of the gene and the embedded miRNA MIR3922 had been detected in a woman with hand/foot malformation and malignant lymphoproliferative disease...
March 7, 2018: Journal of Medical Genetics
Perry Jaymes Evangelista, Nathan Lenz, Scott Laster, Neil P Sheth, Ran Schwarzkopf
Despite the overall successful outcomes following primary total knee arthroplasty (TKA) and the concept that a well-balanced TKA yields a more successful result, concerns still remain in the reported literature regarding the patellofemoral joint. Diminished outcomes have been associated with poorly balanced or placed patella implants. The effect of different techniques to achieve flexion-extension balance and the use of posterior stabilized (PS) versus cruciate retaining (CR) implant designs on patellofemoral balancing has not been previously studied...
March 7, 2018: Journal of Knee Surgery
Masoud Parish, Haleh Farzin
Muscular dystrophies are considered to be a series of neuromuscular diseases with genetic causes and are characterized by progressive muscle weakness and degeneration of the skeletal muscle. The case of an adult man with Becker dystrophy referred for repair of the patella tendon tearing and patella fracture is described. He underwent successful surgery using total intravenous anesthesia without any complications.
2018: International Medical Case Reports Journal
Raashad Hasan, Wiqqas Jamil
The medial patellofemoral ligament (MPFL) is a key soft tissue stabilizer of the medial patella, with deficiency proven to be a key contributor to patellar dislocation. Reconstruction of this ligament has become a widely employed procedure in managing patients with recurrent patellar dislocation, and is also gaining popularity in the setting of primary dislocation. A wide variety of techniques have been described, differing in the type of graft used, sites for fixation and fixation technique. A number of complications have also been reported in the literature, including post-operative stiffness, apprehension, patellar fracture and recurrence of instability and dislocation...
February 2018: Journal of Surgical Case Reports
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