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https://www.readbyqxmd.com/read/28723917/evidence-base-and-practice-variation-in-acute-care-processes-for-knee-and-hip-arthroplasty-surgeries
#1
Marcel Mayer, Justine Naylor, Ian Harris, Helen Badge, Sam Adie, Kathryn Mills, Joseph Descallar
BACKGROUND: Lack of evidence contributes to unnecessary variation in treatment costs and outcomes. This study aimed to identify from interventions historically used for total knee or hip arthroplasty (TKA, THA): i) if routine use is supported by high-level evidence; ii) whether surgeon use aligns with the evidence. METHODS: Part 1: Systematic search of electronic library databases for systematic reviews and practice guidelines concerning seven acute-care interventions...
2017: PloS One
https://www.readbyqxmd.com/read/28718946/evidence-for-plical-support-of-the-patella
#2
Robert M Geraghty, Michelle Spear
There is a consensus that there is no overt anterior joint capsule in the knee. However, other anterior structures act in lieu of a joint capsule: the quadriceps tendon and patellar retinacular fibres. In the absence of a capsule, the synovium forms the suprapatellar pouch. Other synovial structures, the plicae, are more controversial. They are often described as embryonic remnants with no function, despite surrounding the patella. We aimed to identify plical anatomy and histology on cadaveric dissection and to examine their embryology using the human virtual embryo website...
July 18, 2017: Journal of Anatomy
https://www.readbyqxmd.com/read/28717624/ipsilateral-hamstring-tendon-graft-reconstruction-for-chronic-patellar-tendon-ruptures-surgical-technique
#3
Nicola Maffulli, Angelo Del Buono, Francesco Oliva
BACKGROUND: Patellar tendon chronic ruptures are more debated to manage that acute injuries as the patella tends to retract proximally (after 2 weeks), and surrounding soft tissues may make the repair more complicate. PURPOSE: We propose a novel technique in which the patellar tendon is reconstructed using ipsilateral hamstring tendons. This surgical procedure implies to drill a single tunnel through the patella and another through the tibia to reduce the risk of bony breakage...
January 2017: Muscles, Ligaments and Tendons Journal
https://www.readbyqxmd.com/read/28717616/topical-polidocanol-application-in-combination-with-static-stretching-in-tendinopathies-a-prospective-pilot-study
#4
Matthias Gatz, Simone Schrading, Timm Dirrichs, Marcel Betsch, Markus Tingart, Björn Rath, Christiane Kuhl, Valentin Quack
BACKGROUND: Highly operator-based injection therapy with vasosclerosing and anesthetic polidocanol is used for tendinopathies. This pilot-study evaluates the topical application of polidocanol gel. METHODS: Prospective case series. 39 patients with tendinopathies (14 Achilles, 14 patella, 11 wrist extensors) with a symptom duration > 6 months were included. Polidocanol and static stretching were the therapy in the first 2 weeks, while static stretching was continuously performed for 6 months...
January 2017: Muscles, Ligaments and Tendons Journal
https://www.readbyqxmd.com/read/28717066/a-heart-shaped-sleeve-simplifies-intramedullary-tibial-nail-insertion-when-using-the-suprapatellar-approach
#5
Kosuke Tajima, Chikako Shimizu, Soichiro Ohno, Yusho Nishida, Kazuhiko Udagawa, Junichi Sasaki
The suprapatellar approach for intramedullary tibial nailing has become widely accepted over the past decade. A round sleeve is passed beneath the patella to protect the surface of the patellofemoral joint (PFJ). However, the round sleeve cannot be easily stabilized in the PFJ because it does not conform to the shape of the patellar apex. Consequently, we produced a heart-shaped sleeve to simplify the insertion of the entry sleeve during the suprapatellar approach. Using the new sleeve, the following procedure is used: (1) make a longitudinal 4 cm skin incision proximal to the patella to reach the PFJ, (2) insert the guide pin manually to the ventral edge of the tibial plateau, (3) insert the cannulated trocar along the guide pin, (4) insert the heart-shaped sleeve along the cannulated trocar, (5) remove the cannulated trocar, (6) ream the entry point through the heart-shaped sleeve...
July 15, 2017: Keio Journal of Medicine
https://www.readbyqxmd.com/read/28713612/in-vivo-magnetic-resonance-imaging-morphometry-of-the-patella-bone-in-south-indian-population
#6
Reshma Muhamed, Vasudha V Saralaya, B V Murlimanju, Ganesh Kumar Chettiar
Racial differences exist in the dimensions of structures and the commercially available prostheses are designed based on the Caucasians. In this context, the goal of the present investigation was to determine the gender wise measurements of patella bone in South Indians. The present study included axial magnetic resonance images of the knee joint from 140 South Indian adults (70 males, 70 females; aged between 20-70 years). The angle, width, thickness, lateral facet width, facet thickness, ratio of the lateral facet, the relative thickness and ratio of facet thickness were measured in the patella by using the digital ruler...
June 2017: Anatomy & Cell Biology
https://www.readbyqxmd.com/read/28711951/optimizing-patellar-positioning-during-total-knee-arthroplasty-an-anatomical-and-clinical-study
#7
Chahine Assi, Nadim Kheir, Camille Samaha, Mary Deeb, Kaissar Yammine
INTRODUCTION: Optimal positioning of the patellar component is crucial for the success of a total knee arthroplasty (TKA). Usually, the patellar component is placed empirically over the presumed centre of the patellar cut. Medialization of the prosthetic patella has been recommended; however, no evidence-based guidelines have been reported. MATERIAL AND METHOD: This anatomical study aims to quantify a pre-defined optimal location for positioning of the patellar component with regard to the centre of the patellar cut...
July 15, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28711819/differentiation-potential-of-synoviocytes-derived-from-joints-with-cranial-cruciate-ligament-rupture-and-medial-patella-luxation-in-dogs
#8
H M Suranji Wijekoon, Kazuhide Toyota, Sangho Kim, Jing Fang, Eugene C Bwalya, Kenji Hosoya, Masahiro Okumura
The objective of this study was to assess the differentiation capability of synoviocytes derived from dogs with inflammatory joint conditions. Cranial cruciate ligament ruptured (CCLr) (n=12) and medial patella luxated (MPL) (n=10) knee joints of the dogs were used to collect the synovial membrane (SM). Synoviocytes were enzymatically released from the SM and analyzed by flow cytometry for specific cellular markers (CD44 and CD90) of mesenchymal stem cells (MSCs), while doing histopathology from another part of SM sections...
July 9, 2017: Research in Veterinary Science
https://www.readbyqxmd.com/read/28707311/dynamic-contrast-enhanced-mri-of-the-patellar-bone-how-to-quantify-perfusion
#9
Dirk H J Poot, Rianne A van der Heijden, Marienke van Middelkoop, Edwin H G Oei, Stefan Klein
PURPOSE: To identify the optimal combination of pharmacokinetic model and arterial input function (AIF) for quantitative analysis of blood perfusion in the patellar bone using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). MATERIALS AND METHODS: This method design study used a random subset of five control subjects from an Institutional Review Board (IRB)-approved case-control study into patellofemoral pain, scanned on a 3T MR system with a contrast-enhanced time-resolved imaging of contrast kinetics (TRICKS) sequence...
July 14, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28706827/surgical-technique-for-arthroscopic-resection-of-painful-bipartite-patella
#10
Thais D Vieira, Mathieu Thaunat, Adnan Saithna, Olivier Carnesecchi, Eric Choudja, Maxime Cavalier, Jose Roberto Benites Vendrame, Andrew Charles Ockuly, Bertrand Sonnery-Cottet
Bipartite patella (BP) is uncommon and is usually an incidental finding. Painful BP occurs rarely and is usually associated with post-traumatic anterior knee pain. When nonoperative treatment fails, fragment resection is indicated. A systematic review shows a potentially increased risk of complications with open surgery. The purpose of this Technical Note is to demonstrate a simple arthroscopic technique for treating painful BP through resection of the bone fragment.
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706804/tibial-tuberosity-transfer-in-combination-with-medial-patellofemoral-ligament-reconstruction-surgical-technique
#11
Damian Clark, Katie Walmsley, Peter Schranz, Vipul Mandalia
The stability of the patellofemoral joint relies on the tenuous interplay of soft tissue and bony factors. Anatomic risk factors for instability include a shallow trochlea, an abnormally lateral tibial tubercle position, patella alta, hypermobility, or a secondary injury to the medial patellofemoral ligament (MPFL). There is an increasing interest in restoring normal anatomy to achieve stability, and at times more than 1 abnormality exists. This article describes the technique for combining a tibial tuberosity transfer and an MPFL reconstruction...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28705123/surgery-of-patellar-fractures-using-a-medial-parapatellar-approach
#12
Yong-Cheol Yoon, Jae-Ang Sim, Jin-Hun Hong
PURPOSE: The general surgical approach for patellar fractures has a significant weakness, in that the articular facet is invisible because the fixation is performed using radiation amplifiers after exposing the fracture site through vertical or transverse dissection on the anterior patella. We report excellent outcomes in the surgical treatment of patellar fractures, using a medial parapatellar approach. METHODS: This study evaluated 20 patients who underwent surgery between August 2008 and April 2014 to correct patellar fractures with comminution or with displacement of the articular facet of ≥2 mm and who had ≥1 year of follow-up...
May 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28702749/evaluation-of-different-surgical-methods-in-treating-recurrent-patella-dislocation-after-three-dimensional-reconstruction
#13
Hao Du, Xiao-Xiao Tian, Fa-Qi Guo, Xiang-Ming Li, Tao-Tao Ji, Bin Li, Tong-Sen Li
PURPOSE: Recurrent patella dislocation (RPD) is the most common complication of patellar instability. The effects of different surgical techniques on the outcome of RPD treatments remain unclear. This study was conducted to compare the effects of three surgical techniques in treating RPD by three-dimensional (3D) reconstruction from computed tomography (CT) scans. METHODS: Sixty-eight patients with RPD and no previous surgical treatments who attended our hospital between October 2010 and 2013 were enrolled and randomly assigned into three groups: (1) medial patellofemoral ligament (MPFL) reconstruction and medial patellar retinaculum (MPR) plication group; (2) lateral patellar retinaculum (LPR) release and MPR plication group; and (3) MPFL reconstruction and LPR release group...
July 12, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28697081/suture-repair-of-a-pole-patella-fracture
#14
Stephanie Swensen, Nina Fisher, Abiola Atanda, Kenneth A Egol
PURPOSE: Operative fixation of displaced patella fractures is considered to be standard of care. However, patients with inferior pole patella fractures have limited options in terms of fixation. This video demonstrates the repair of an inferior pole patella fracture using nonabsorbable suture fixation. METHODS: Suture repair of patella fractures is a clinically acceptable technique, yielding similar functional results to patella fractures treated with K-wires or cannulated screws while reducing the rates of removal of hardware after fixation...
August 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28697080/plate-osteosynthesis-of-patella-fractures-a-video-case-report
#15
Matthew Siljander, Alexander D Vara, Denise M Koueiter, Sapan Gandhi, Meghan Quigley, Brett Wiater, Patrick Wiater
Operative management of patella fractures continues to be associated with poor outcomes and high reoperation rates. Traditionally, tension band fixation has been used for more simple fracture patterns; however, fixation remains a challenge particularly for comminuted fractures. More recently, various types of plate fixation have been used and reported in the literature. Earlier mobilization after plate osteosynthesis of patella fractures is possible because of a more robust construct, with the potential for decreased knee stiffness and improved functional outcomes...
August 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28697071/orif-patella-fracture-with-a-tension-band-construct
#16
Laura Blum, Mark Hake
Patellar fractures can occur as a result of direct or indirect injuries. Indirect injury is more common and occurs when the patella fails in tension when the force exerted by the extensor mechanism exceeds that of the bone. Common mechanism of indirect injury is rapid knee flexion with fully contracted quadriceps muscle. Treatment with a tension band construct is indicated for transverse patella fractures without significant comminution. This can be performed with 18-gauge wire and either 2 parallel, longitudinally oriented cannulated screws or 2 Kirschner wires...
August 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28696495/robotic-arm-assisted-total-knee-arthroplasty-demonstrated-soft-tissue-protection
#17
Anton Khlopas, Morad Chughtai, Emily L Hampp, Laura Y Scholl, Michael Prieto, Ta-Cheng Chang, Abdullah Abbasi, Manoshi Bhowmik-Stoker, Jason Otto, David J Jacofsky, Michael A Mont
INTRODUCTION: While total knee arthroplasty (TKA) procedures have demonstrated clinical success, occasionally intraoperative complications can occur. Collateral or posterior cruciate ligament injury, instability, extensor mechanism disruption, and tibiofemoral or patellofemoral dislocation are among a few of the intraoperatively driven adverse events prevalently ranked by The Knee Society. Robotic-arm assisted TKA (RATKA) provides a surgeon the ability to three-dimensionally plan a TKA and use intraoperative visual, auditory, and tactile feedback to ensure that only the desired bone cuts are made...
July 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28694244/tumor-matrix-stiffness-promotes-metastatic-cancer-cell-interaction-with-the-endothelium
#18
Steven E Reid, Emily J Kay, Lisa J Neilson, Anne-Theres Henze, Jens Serneels, Ewan J McGhee, Sandeep Dhayade, Colin Nixon, John Bg Mackey, Alice Santi, Karthic Swaminathan, Dimitris Athineos, Vasileios Papalazarou, Francesca Patella, Álvaro Román-Fernández, Yasmin ElMaghloob, Juan Ramon Hernandez-Fernaud, Ralf H Adams, Shehab Ismail, David M Bryant, Manuel Salmeron-Sanchez, Laura M Machesky, Leo M Carlin, Karen Blyth, Massimiliano Mazzone, Sara Zanivan
Tumor progression alters the composition and physical properties of the extracellular matrix. Particularly, increased matrix stiffness has profound effects on tumor growth and metastasis. While endothelial cells are key players in cancer progression, the influence of tumor stiffness on the endothelium and the impact on metastasis is unknown. Through quantitative mass spectrometry, we find that the matricellular protein CCN1/CYR61 is highly regulated by stiffness in endothelial cells. We show that stiffness-induced CCN1 activates β-catenin nuclear translocation and signaling and that this contributes to upregulate N-cadherin levels on the surface of the endothelium, in vitro This facilitates N-cadherin-dependent cancer cell-endothelium interaction...
July 10, 2017: EMBO Journal
https://www.readbyqxmd.com/read/28693590/patella-morphological-alteration-after-patella-instability-in-growing-rabbits
#19
Jinghui Niu, Qi Qi, Yingzhen Niu, Conglei Dong, Zhenyue Dong, Peng Cui, Fei Wang
BACKGROUND: The shape of the patella has been considered to be a predisposing factor resulting in patellar instability, but the effects of abnormal patella position during its development are unclear. The present study evaluated patellar morphological changes after patella instability and evaluated the influence of patellar instability on the patella shape. METHODS: Twenty rabbits that were 2 months old were included in the study. The left knee of each rabbit, defined as the experimental group (N = 20 knees/group), underwent a medial soft tissue restraint release...
July 11, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28691409/comparison-of-titanium-cable-tension-band-and-nickel-titanium-patella-concentrator-for-patella-fractures
#20
Quan-Ming Zhao, Xiao-Feng Gu, Li Cheng, De-Hong Feng
BACKGROUND: Patellar fractures account for approximately 1% of all fractures.Due to the patella's importance as regards the extensor mechanism, efforts should to be made to preserve the patella.Several operative treatment methods have been introduced for patella fractures. OBJECTIVES: This study aims to compare the clinical effect of a titanium cable tension band and nickel-titanium (NiTi) patella concentrator (NT-PC) in treating patella fractures. MATERIAL AND METHODS: Thirty-nine patients with patella fractures were enrolled in this retrospective study...
June 27, 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
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