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https://www.readbyqxmd.com/read/28918784/-treatment-of-patellar-instability
#1
Martin Lind, Peter Faunø, Ole Gade Sørensen, Bjarne Mygind-Klavsen
First-time patellar luxation appears typically in teenagers and young adults below the age of 16 years, with a prevalence of 45/100,000/year. This luxation is treated with brief limited mobility in a bandage, and with a complementary physiotherapy if the mobility is influenced afterwards. Risk factors for patellar instability are patellofemoral dysplasia, hyperlaxity, patella alta and valgus malalignment in the knee joint. In case of repeated luxation the treatment is surgical, i.e. reconstruction of the medial patellofemoral ligament recreating the medial patella-stabilizing structures...
September 18, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28915961/short-stem-total-hip-arthroplasty-potential-explanations-for-persistent-post-surgical-thigh-pain
#2
Isabel A C Baert, Enrique Lluch, Francis Van Glabbeek, Rudy Nuyts, Salim Rufai, Joanna Tuynman, Filip Struyf, Mira Meeus
Short stem uncemented femoral implants were developed with the aim of preserving proximal bone stock for future revisions, improving biomechanical reconstruction, aiding insertion through smaller incisions and potentially decreasing or limiting the incidence of thigh pain. Despite all the advantages of short stem designs, it remains unclear whether they are able to limit post-surgical thigh pain. In patients with short stem hip arthroplasty and persistent thigh pain, it is of the utmost importance to understand the potential etiologies of this chronic pain for selecting the appropriate treatment strategy...
September 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28906304/comparison-of-expert-opinion-majority-rule-and-a-clinical-prediction-rule-to-estimate-distal-radius-malalignment
#3
Toni Luokkala, Tapio Flinkkilä, Juha Paloneva, Teemu V Karjalaine
OBJECTIVES: To investigate the ability of individual surgeons (expert opinion [EO]) to predict distal radius fracture healing above a threshold malalignment compared with the majority prediction of the group of surgeons ("majority rule," [MR]) and a statistically derived clinical prediction formula (Edinburgh wrist calculator [EWC]). DESIGN: Comparative diagnostic study from prospectively collected data of consecutive patients. SETTING: Two academic level 1 and one academic level 2 trauma centers...
September 11, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28904636/the-orthopaedic-management-of-lower-limb-deformity-in-hypophosphataemic-rickets
#4
A Horn, J Wright, D Bockenhauer, W Van't Hoff, D M Eastwood
BACKGROUND: Many patients with X-linked hypophosphataemic rickets (X-LHPR) demonstrate significant lower limb deformity despite optimal medical management. This study evaluates the use of guided growth by means of hemi-epiphysiodesis to address coronal plane deformity in the skeletally immature child. METHODS: Since 2005, 24 patients with X-LHPR have been referred to our orthopaedic unit for evaluation. All patients had standardised long leg radiographs that were analysed sequentially before and after surgery if any was performed...
August 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28903017/is-a-high-tibial-osteotomy-hto-superior-to-non-surgical-treatment-in-patients-with-varus-malaligned-medial-knee-osteoarthritis-oa-a%C3%A2-propensity-matched-study-using-2-randomized-controlled-trial-rct-datasets
#5
M V van Outeren, J H Waarsing, R W Brouwer, J A N Verhaar, M Reijman, S M A Bierma-Zeinstra
OBJECTIVE: No randomized controlled trial (RCT) has compared the high tibial osteotomy (HTO) with non-surgical treatment in patients with medial knee osteoarthritis (OA) and varus malalignment. The aim was to compare the effectiveness of an unloader brace treatment or a usual care program to the HTO regarding pain severity and knee function. DESIGN: Surgical treatment (HTO) to two non-surgical options was compared by combining the data of two RCTs. One RCT (n = 117) compared an unloader brace to usual care treatment; the other RCT (n = 92) compared closing to opening wedge HTO...
September 10, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28888572/risk-factors-of-lunate-collapse-in-kienb%C3%A3-ck-disease
#6
Wouter F van Leeuwen, Matthew A Tarabochia, Arnold H Schuurman, Neal Chen, David Ring
PURPOSE: Not all patients with Kienböck disease progress to collapse of the lunate and carpal malalignment, but it is difficult to determine which patients are at risk. We aimed to identify demographic or anatomical factors associated with more advanced stages of Kienböck disease. METHODS: We included all 195 eligible patients with Kienböck disease and available preoperative posteroanterior and lateral radiographs. We compared the mean age, sex distribution, mean ulnar variance, radial height, radial (ulnarward) inclination, palmar tilt, anteroposterior distance, and lunate type among the different Lichtman stages of Kienböck disease and performed ordinal logistic regression analysis...
September 6, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28888229/changes-in-ankle-joint-motion-after-supramalleolar-osteotomy-a-cadaveric-model
#7
Hak Jun Kim, Eui Dong Yeo, Im Joo Rhyu, Soon-Hyuck Lee, Yeon Soo Lee, Young Koo Lee
BACKGROUND: Malalignment of the ankle joint has been found after trauma, by neurological disorders, genetic predisposition and other unidentified factors, and results in asymmetrical joint loading. For a medial open wedge supramalleolar osteotomy(SMO), there are some debates as to whether concurrent fibular osteotomy should be performed. We assessed the changes in motion of ankle joint and plantar pressure after supramalleolar osteotomy without fibular osteotomy. METHODS: Ten lower leg specimens below the knee were prepared from fresh-frozen human cadavers...
September 9, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28885967/outcomes-of-medializing-tibial-tubercle-osteotomy-with-medial-reefing-and-vastus-medialis-obliquus-advancement-coupled-with-lateral-retinacular-z-lengthening-for-recurrent-patellar-instability
#8
Patrick Morrissey, Daniel Christensen, Trevor Tompane, Jared Wolfe, Lance LeClere
PURPOSE: Patella-femoral dislocations, although rare, can result in functionally limiting symptoms and limited return to prior activity levels. The purpose of this study is to report outcomes of a three-in-one patellar realignment surgery for treatment of recurrent patellar instability in a young, active duty military population. METHODS: We conducted a retrospective chart review of all patients who underwent our senior author's three-in-one patellar realignment surgery for recurrent patellar instability in the setting of underlying anatomic malalignment...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28885128/sagittal-alignment-and-complications-following-lumbar-3-column-osteotomy-does-the-level-of-resection-matter
#9
Emmanuelle Ferrero, Barthelemy Liabaud, Jensen K Henry, Christopher P Ames, Khaled Kebaish, Gregory M Mundis, Richard Hostin, Munish C Gupta, Oheneba Boachie-Adjei, Justin S Smith, Robert A Hart, Ibrahim Obeid, Bassel G Diebo, Frank J Schwab, Virginie Lafage
OBJECTIVE Three-column osteotomy (3CO) is a demanding technique that is performed to correct sagittal spinal malalignment. However, the impact of the 3CO level on pelvic or truncal sagittal correction remains unclear. In this study, the authors assessed the impact of 3CO level and postoperative apex of lumbar lordosis on sagittal alignment correction, complications, and revisions. METHODS In this retrospective study of a multicenter spinal deformity database, radiographic data were analyzed at baseline and at 1- and 2-year follow-up to quantify spinopelvic alignment, apex of lordosis, and resection angle...
September 8, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28885125/risk-factor-analysis-of-kyphotic-malalignment-after-cervical-intramedullary-tumor-resection-in-adults
#10
Satoshi Nori, Akio Iwanami, Akimasa Yasuda, Narihito Nagoshi, Nobuyuki Fujita, Tomohiro Hikata, Mitsuru Yagi, Takashi Tsuji, Kota Watanabe, Suketaka Momoshima, Morio Matsumoto, Masaya Nakamura, Ken Ishii
OBJECTIVE A number of studies have reported that surgery for cervical intramedullary tumors via the posterior approach can result in postoperative sagittal malalignment of the cervical spine; however, the risk factors remain unclear. The purpose of this study was to investigate the changes in cervical spinal alignment after surgery for cervical intramedullary tumors in adults and to elucidate the risk factors for cervical spinal sagittal misalignment. METHODS Data for the period from April 2001 to December 2011 for all adults who had undergone surgery for cervical intramedullary spinal cord tumors at a single institution were retrospectively analyzed to determine the postoperative changes in cervical spine alignment...
September 8, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28883689/lateral-column-lengthening-for-adolescent-idiopathic-pes-planovalgus-deformity-systematic-review
#11
REVIEW
Sanjay Kumar, S V Sonanis
Pes planovalgus is the commonest foot deformity in children and presents with wide range of severity and symptoms. Surgery is mostly indicated for significant malalignment, resistant to non-surgical management. Lateral column lengthening is considered an appealing option as does not involve arthrodesis and allows for further growth and foot development. METHODS: We conducted a systematic review on lateral column lengthening for pes planovalgus deformity in line with PRISMA-P Checklist...
December 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28882753/knee-internal-contact-force-in-a-varus-malaligned-phenotype-in-knee-osteoarthritis-koa
#12
A Dell'Isola, S L Smith, M S Andersen, M Steultjens
PURPOSE: Multiple phenotypes characterized by different disease mechanisms have been hypothesized to explain the large variability in the knee osteoarthritis (KOA) population. The purpose of this study was: to estimate and compare the medial and lateral knee compression forces (CF) during gait of three subgroups of KOA subjects characterized by different alignment and cartilage disruption patterns. METHODS: A secondary data analysis was conducted on a sample of 39 KOA subjects and 18 controls (C) recruited for a previous study...
September 4, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28882525/multi-level-posterior-foraminotomy-with-laminoplasty-versus-laminoplasty-alone-for-cervical-spondylotic-myelopathy-with-radiculopathy-a-comparative-study
#13
Dong-Ho Lee, Jae Hwan Cho, Chang Ju Hwang, Choon Sung Lee, Chunghwan Kim, Jung-Ki Ha
BACKGROUND CONTEXT: Conventional laminoplasty is useful for expanding a stenotic spinal canal. However, it has limited use for the decompression of accompanying neural foraminal stenosis. As such, an additional posterior foraminotomy could be simultaneously applied, although this procedure carries a risk of segmental kyphosis and instability. PURPOSE: The aim was to elucidate the long-term surgical outcomes of additional posterior foraminotomy with a laminoplasty for cervical spondylotic myelopathy (CSM) with radiculopathy...
September 4, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28877328/procedural-sedation-with-ketamine-versus-propofol-for-closed-reduction-of-pediatric-both-bone-forearm-fractures
#14
Todd Morrison, Chris Carender, Brendan Kilbane, Raymond W Liu
Effective treatment of pediatric both bone forearm fractures consists of timely restoration of anatomic alignment with manipulation and immobilization, often accomplished with the aid of procedural sedation in the emergency department setting. The current lack of consensus regarding a safe and optimal regimen may result in inadequate sedation, compromised quality of reduction, or patient harm. The current study was conducted to answer the following questions for pediatric both bone forearm fractures treated with closed reduction with either ketamine or propofol procedural sedation: (1) Is there a difference in the rate of unacceptable alignment 4 weeks after reduction? (2) Is there a difference in the rates of major sedation-related complications? Medical records, data on procedural sedation, and radiographs of 74 skeletally immature patients with diaphyseal or distal metaphyseal both bone forearm fractures treated with manipulation were reviewed (ketamine sedation, 26; propofol sedation, 48)...
September 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28874195/malalignment-and-malposition-of-quadriceps-sparing-approach-in-primary-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#15
REVIEW
Fu-Zhen Yuan, Shao-Jie Wang, Zhu-Xing Zhou, Jia-Kuo Yu, Dong Jiang
BACKGROUND: Quadriceps-sparing (QS) approach is considered to be the most minimally invasive surgery for total knee arthroplasty (TKA). We perform this meta-analysis to evaluate whether malalignment and malposition are more biased towards the QS approach compared to the traditional medial parapatellar (MP) approach, which is still controversial. METHODS: According to the PRISMA guidelines, a comprehensive search was conducted in the databases of PubMed, the Cochrane library, and Embase...
September 6, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28869390/approach-to-interpret-images-produced-by-new-generations-of-multi-detector-computed-tomography-scanners-in-post-operative-spine
#16
Rania Zeitoun, Manar Hussein
OBJECTIVE: To reach a practical approach to interpret MDCT findings in post-opartive spine cases and to change the false belief of CT failure in the setting of instruments secondary to related artifacts. METHODS: We performed observational retrospective analysis of premier, early and late MDCT scans in 68 post-operative spine patients, with emphasis on instruments related complications and osseous fusion status. We used a grading system for assessment of osseous fusion in 35 patients and we further analyzed the findings in failure of fusion, grade (D)...
September 4, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28867056/arthroscopic-ankle-arthrodesis-an-update
#17
REVIEW
Jason A Piraino, Michael S Lee
Arthroscopic ankle arthrodesis provides an alternative to open techniques. Advancements in arthroscopic techniques and instrumentation have made the procedure easier to perform. Arthroscopic ankle arthrodesis has demonstrated faster rates of union, fewer complications, reduced postoperative pain, and shorter hospital stays. Sound surgical techniques, particularly with regard to joint preparation, are critical for success. Comorbidities such as increased body mass index, history of smoking, malalignment, and posttraumatic arthritis should be considered when contemplating arthroscopic ankle arthrodesis...
October 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28867052/supramalleolar-osteotomies
#18
REVIEW
Varun Chopra, Paul Stone, Alan Ng
Distal tibial malalignment can result from posttraumatic malunion, physeal disturbances, congenital or metabolic diseases, and degenerative arthritis. Malalignment leads to an altered load distribution across the joint leading to early ankle joint arthritis. If a substantial part of the joint is salvageable, ankle fusion or joint replacement is not always the best option. Realignment of the distal tibia with a joint-sparing supramalleolar osteotomy is a valuable procedure in correcting deformity at the distal tibia...
October 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28865583/a-prospective-24-months-follow-up-of-a-three-component-press-fit-prosthesis-for-hallux-rigidus
#19
S Wassink, B J Burger, N P Saragas, J Asunción Márquez, L Trtik, J Harlaar
BACKGROUND: The aim of this study was to evaluate the results following total first metatarsophalangeal (FMTP) joint replacement arthroplasty using a modular three component press fit prosthesis at two year follow up. METHODS: All patient data was collected in a prospective way in four study centres. Both preoperative and postoperative evaluation consisted of an assessment using the AOFAS-HMI score, visual analogue scale for pain, evaluation of the range of motion and patient satisfaction scores...
September 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28852341/age-differences-in-the-prevalence-of-isolated-medial-and-lateral-meniscal-tears-in-surgically-treated-patients
#20
T J Ridley, Mark A McCarthy, Matthew J Bollier, Brian R Wolf, Annunziato Amendola
PURPOSE: To compare the prevalence of isolated lateral and medial meniscal tears in different aged populations. METHODS: A five-year retrospective review for meniscal procedures performed on a total of 782 patients. Each chart was reviewed to document the prevalence of medial or lateral meniscal injuries. Inclusion criteria were patients found to have documented evidence of meniscal tear, either lateral or medial, without any concomitant injuries and/or any other procedures performed...
2017: Iowa Orthopaedic Journal
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