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https://www.readbyqxmd.com/read/28424860/influence-of-tibial-hybrid-fixation-on-graft-tension-and-stability-in-acl-double-bundle-reconstruction
#1
B H Drews, A Seitz, J Huth, G Bauer, A Ignatius, L Dürselen
PURPOSE: Initial graft tension in anterior cruciate ligament (ACL) reconstruction affects stability and tension loss at follow-up. This study investigated the influence of hybrid tibial fixation in 3-tunnel double-bundle ACL reconstruction on initial graft tension and tension change and stability under anterior and combined rotatory loads. METHODS: Eleven fresh-frozen cadaveric knees were reconstructed with an ACL double bundle using a 3-tunnel technique. Grafts were tightened to 80 N in 60° (AM bundle) and 15° (PL bundle) of flexion...
April 19, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28421261/-positive-and-negative-predictors-of-long-term-results-after-an-osteotomy-around-the-knee-joint
#2
S Hinterwimmer
A frequently asked question in the context of any surgical procedure, including an osteotomy around the knee joint, is "which parameters are in favor of a therapeutic success in this special case?" If the analysis of the leg geometry is in favor of an osteotomy, then the patient must be assessed further, taking into account the joint status and patient's condition. Positive outcome predictors for long-term success of an osteotomy around the knee, especially for a valgus osteotomy at the tibia are a tibial bone varus angle (TBVA) > 3-5°, knee joint range of motion > 100° flexion, male sex, and a BMI < 30...
April 18, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28417183/patella-height-is-not-altered-by-descending-medial-open-wedge-high-tibial-osteotomy-hto-compared-to-ascending-hto
#3
Matthias Krause, Tobias Claus Drenck, Alexander Korthaus, Achim Preiss, Karl-Heinz Frosch, Ralph Akoto
PURPOSE: The primary purpose of the study was to gain insight into geometric changes of the patellar height (PH) and posterior tibial slope (PTS) after a biplanar ascending medial open-wedge high tibial osteotomy (HTO) compared to biplanar descending medial open-wedge HTO in patients with genu varum. METHODS: Sixty-four patients (mean age 45.2 ± 8.7 years, females n = 24, males n = 40) with varus malalignment and medial gonarthrosis were retrospectively studied...
April 17, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28413139/evaluation-of-extensor-mechanism-in-revision-knee-arthroplasty
#4
Vadym Zhamilov, Vasfi Karatosun, Serpil Kalkan, Bayram Unver, Izge Gunal
BACKGROUND: The success of revision total knee arthroplasty depends on adequate exposure that does not produce complications. The purpose of this study was to compare the results of revision total knee arthroplasty between V-Y quadricepsplasty (QP) and quadriceps snip (QS) approaches. METHODS: In the study, 92 knees with follow-up of 12-108 months which were operated by using QP (55) and QS (37) were evaluated retrospectively. Measurements were taken by using universal transparent goniometer, also varus valgus deformities, knee flexion angles, instability, Hospital for Special Surgery and Lower Extremity Functional Scale scores, functional condition of the knee and activity levels of the patients were evaluated cross-sectionally...
March 22, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28400204/computed-navigated-total-knee-arthroplasty-compared-to-computed-tomography-scans
#5
Ron Batash, Guy Rubin, Alexander Lerner, Hussein Shehade, Nimrod Rozen, David E Rothem
BACKGROUND: Successful total knee arthroplasty (TKA) includes accurate alignment. Controversy remains as to whether computer-navigated TKA improves the overall result and clinical outcome. Our aim is to compare the limb alignment and prosthesis positioning according to the pre- and postoperative computed tomography (CT) scans with the data collected from the navigation system. METHODS: We compared the pre- and postoperative limb alignments and prosthesis alignment provided by the Orthopilot navigation system, Aesculap®, with CT scans measured by the Traumacad® software of 70 TKAs...
April 8, 2017: Knee
https://www.readbyqxmd.com/read/28396931/does-low-constraint-mobile-bearing-knee-prosthesis-give-satisfactory-results-for-severe-coronal-deformities-a-five-to-twelve-year-follow-up-study
#6
Jaroslaw Czekaj, Camdon Fary, Thierry Gaillard, Sebastien Lustig
PURPOSE: Severe varus and valgus knee deformities traditionally are replaced with constrained implants, with a number of disadvantages. We present our results in this challenging group using a low constraint deep-dish mobile bearing implant design. METHODS: One hundred fifty-four patients (170 arthroplasties) who underwent primary TKA using a deep-dish, mobile bearing posterior-stabilized implant for severe varus (HKA < 170°) or valgus (HKA > 190°) deformity between 2004 and 2009 were evaluated at a mean of 6...
April 11, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28395419/-individual-difference-of-coronal-bowing-of-femur-and-its-influence-on-the-lower-limbs-alignment-after-the-total-knee-arthroplasty
#7
W Wu, W S Guo, L M Cheng, Z H Liu, Q D Zhang, N F Zhang
Objective: To disclose the correlation between the femur bowing angle(FBA) and vulgas correction angle(VCA), anlysys its influence on the total knee arthroplasty and the lower limbs alignment. Methods: From Janurary 2013 to December 2015, 699 patients who had received total knee arthroplasty(TKA)were collected in the Department of Joint Surgery, China-Japan Friendship. The FBA, VCA, offset of the proximal femur, the lengh of the femur, the neck shaft angle of the femur of the eligible cases from the long leg X-ray were measured...
April 4, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28394040/pain-related-unscheduled-contact-with-healthcare-services-after-outpatient-surgery
#8
L D Brix, K T Bjørnholdt, T M Thillemann, L Nikolajsen
This prospective, observational study explored the need for pain-related unscheduled contact with healthcare services after outpatient surgery. We hypothesised that 10% of outpatients would have pain-related unscheduled contact with healthcare services, and that the incidence would differ depending on the type of surgical procedure. In total, 905 patients who had undergone one of five common outpatient surgical procedures (knee or shoulder arthroscopy, surgical correction of hallux valgus, laparoscopic cholecystectomy or laparoscopic gynaecological procedures) completed an electronic questionnaire one week and eight weeks after surgery...
April 10, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28390890/impact-of-soft-tissue-imbalance-on-knee-flexion-angle-after-posterior-stabilized-total-knee-arthroplasty
#9
Sachiyuki Tsukada, Tomoko Fujii, Motohiro Wakui
BACKGROUND: This study was performed to assess the impact of soft tissue imbalance on the knee flexion angle 2 years after posterior stabilized total knee arthroplasty (TKA). METHODS: A total of 329 consecutive varus knees were included to assess the association of knee flexion angle 2 years after TKA with preoperative, intraoperative, and postoperative variables. All intraoperative soft tissue measurements were performed by a single surgeon under spinal anesthesia in a standardized manner including the subvastus approach, reduced patella, and without use of a pneumonic tourniquet...
March 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28386499/total-knee-arthroplasty-in-severe-valgus-osteoarthritis-excellent-early-results-in-a-90-year-old-patient-with-a-valgus-deformity-of-47%C3%A2
#10
Petros Ismailidis, Rolf Kernen, Sebastian Andreas Mueller
Grade III valgus deformity (tibiofemoral alignment > 20°) is present in only 0.5% of patients receiving total knee arthroplasty. Furthermore, cases with a valgus deformity exceeding 40° are even rarer. Since they mostly affect elderly, polymorbid patients, successful outcome means a great challenge. We report on a case of a 90-year-old patient with a valgus deformity of 47°. The patient was preoperatively restricted to a wheel chair, unable to walk, and only able to stand for a few seconds. The maximal knee flexion was 100°, and there was an extension deficit of 15°...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28378234/core-curriculum-case-illustration-stieda-fracture-avulsion-fracture-of-the-medial-femoral-condyle
#11
Shaimaa Abdelhassib Fadl, Jeffrey D Robinson
This is the 30th installment of a series that will highlight one case per publication issue from the bank of cases available online as part of the American Society of Emergency Radiology (ASER) educational resources. Our goal is to generate more interest in and use of our online materials. To view more cases online please visit the ASER Core Curriculum and Recommendations for Study online at: http://www.erad.org/page/CCIP_TOC . A Stieda fracture is an avulsion injury from the medial femoral condyle of the origin of the medial collateral ligament...
April 4, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28367688/first-metatarsophalangeal-contact-properties-following-proximal-opening-wedge-and-scarf-osteotomies-for-hallux-valgus-correction-a-biomechanical-study
#12
Cameron Kia, Ryu Yoshida, Mark Cote, Jessica DiVenere, Lauren E Geaney
BACKGROUND: Proximal opening wedge osteotomy (POWO) is an established procedure for moderate to severe hallux valgus. A common concern of this procedure is that it results in lengthening of the first metatarsal, which could cause increased intra-articular pressure of the first metatarsophalangeal joint (MTP) and may ultimately lead to arthritis because of these altered mechanics. The purpose of this study was to use a cadaveric model to compare intra-articular pressures and articulating contact properties of the MTP joint following either scarf osteotomy or POWO...
April 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28365070/clinical-outcome-of-primary-medial-collateral-ligament-posteromedial-corner-repair-with-or-without-staged-anterior-cruciate-ligament-reconstruction
#13
Vivek Pandey, Vikrant Khanna, Sandesh Madi, Anshul Tripathi, Kiran Acharya
INTRODUCTION: Medial collateral ligament (MCL) is a prime valgus stabilizer of the knee, and MCL tears are currently managed conservatively. However, posteromedial corner (PMC) injury along with MCL tear is not same as isolated MCL tear and the former is more serious injury and requires operative attention. However, literature is scarce about the management and outcome of PMC-MCL tear alongside anterior cruciate ligament (ACL) tear. The purpose of this study is to report the clinical outcome of primary repair of MCL and PMC with or without staged ACL reconstruction...
March 22, 2017: Injury
https://www.readbyqxmd.com/read/28364964/leaving-residual-varus-alignment-after-total-knee-arthroplasty-does-not-improve-patient-outcomes
#14
R Michael Meneghini, Tanner W Grant, Marshall K Ishmael, Mary Ziemba-Davis
BACKGROUND: Recent popularity of kinematic alignment and constitutional varus has caused some surgeons to leave varus limbs in residual varus after total knee arthroplasty (TKA). This study assessed whether if patients left in residual varus have improved outcomes compared with those fully corrected to neutral alignment. METHODS: A retrospective review of 361 consecutive primary TKAs was performed. Anatomic tibiofemoral alignment was measured and knees were categorized as neutral, varus, or valgus...
March 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28351371/unicompartmental-knee-arthroplasty-is-it-superior-to-high-tibial-osteotomy-in-treating-unicompartmental-osteoarthritis-a-meta-analysis-and-systemic-review
#15
Marcel Budhi Santoso, Lidong Wu
BACKGROUND: Debate remains whether high tibial osteotomy (HTO) or unicompartmental knee arthroplasty (UKA) is more beneficial for the treatment of unicompartmental knee osteoarthritis. The purpose of this study was to compare the functional results, knee scores, activity levels, and complications between the two procedures. METHODS: We performed a systematic review of published literature from August 1982 through January 2017. Fifteen papers reporting three prospective randomized trials were subjected to a meta-analysis...
March 28, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28347597/does-standing-limb-alignment-after-total-knee-arthroplasty-predict-dynamic-alignment-and-knee-loading-during-gait
#16
Charles Rivière, Matthieu Ollivier, Damien Girerd, Jean Noël Argenson, Sébastien Parratte
BACKGROUND: A principle of TKA is to achieve a neutral standing coronal alignment of the limb (HKA angle) to reduce risks of implant loosening, reduce polyethylene wear, and optimize patellar tracking. Several long-term studies have questioned this because the relationship between alignment and implant survivorship is weaker than previously reported. We hypothesize that standing HKA poorly predicts implant failure because it does not predict dynamic HKA, dynamic adduction moment, and loading of the knee during gait...
March 24, 2017: Knee
https://www.readbyqxmd.com/read/28342722/the-effects-of-graft-size-and-insertion-site-location-during-anterior-cruciate-ligament-reconstruction-on-intercondylar-notch-impingement
#17
Alexander D Orsi, Paul K Canavan, Askhan Vaziri, Ruben Goebel, Onaly A Kapasi, Hamid Nayeb-Hashemi
BACKGROUND: Intercondylar notch impingement is detrimental to the anterior cruciate ligament (ACL). Notchplasty is a preventative remodeling procedure performed on the intercondylar notch during ACL reconstruction (ACLR). This study investigates how ACL graft geometry and both tibial and femoral insertion site location may affect ACL-intercondylar notch interactions post ACLR. A range of ACL graft sizes are reported during ACLR, from six millimeters to 11mm in diameter. Variability of three millimeters in ACL insertion site location is reported during ACLR...
March 22, 2017: Knee
https://www.readbyqxmd.com/read/28339815/relationships-between-standing-frontal-plane-knee-alignment-and-dynamic-knee-joint-loading-during-walking-and-jogging-in-youth-who-are-obese
#18
Matthew S Briggs, Sharon Bout-Tabaku, Michael P McNally, Ajit M W Chaudhari, Thomas M Best, Laura C Schmitt
Background: Youth who are obese have high risk of poor knee health and cartilage damage. Understanding factors which may affect knee health in youth who are obese is critical for preservation of knee integrity and function. Objective: Compare standing frontal plane knee alignment and knee loading patterns between youth who are obese and healthy-weight and determine the association between knee alignment and knee loading patterns during walking and jogging. Design: Cross sectional matched-pair...
February 28, 2017: Physical Therapy
https://www.readbyqxmd.com/read/28337656/what-factors-are-associated-with-femoral-component-internal-rotation-in-tka-using-the-gap-balancing-technique
#19
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/28336150/effects-of-foot-rotation-positions-on-knee-valgus-during-single-leg-drop-landing-implications-for-acl-injury-risk-reduction
#20
P S P Teng, P W Kong, K F Leong
BACKGROUND: Non-contact anterior cruciate ligament (ACL) injuries commonly occur when athletes land in high risk positions such as knee valgus. The position of the foot at landing may influence the transmission of forces from the ankle to the knee. Using an experimental approach to manipulate foot rotation positions, this study aimed to provide new insights on how knee valgus during single-leg landing may be influenced by foot positions. METHODS: Eleven male recreational basketball players performed single-leg drop landings from a 30-cm high platform in three foot rotation positions (toe-in, toe-forward and toe-out) at initial contact...
March 20, 2017: Knee
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