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https://www.readbyqxmd.com/read/28437494/patellofemoral-pain-an-enigma-explained-by-homeostasis-and-common-sense
#1
William R Post, Scott F Dye
We present a rational, scientific, low-risk approach to patellofemoral pain (anterior knee pain) based on an understanding of tissue homeostasis. Loss of tissue homeostasis from overload and/or injury produces pain. Bone overload and synovial inflammation are common sources of such pain. Chondromalacia and malalignment are findings that almost always do not need to be "corrected" to relieve pain. Patience and persistence in nonoperative care results in consistent success. Surgery should be rare and done only after extensive nonoperative management and in the setting of clearly defined pathology...
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28431578/is-the-effectiveness-of-patellofemoral-bracing-modified-by-patellofemoral-alignment-and-trochlear-morphology
#2
Xi Zhang, Jillian P Eyles, Joanna Makovey, Matthew J Williams, David J Hunter
BACKGROUND: This study was performed to determine if the effectiveness of patellofemoral bracing as a treatment for patellofemoral osteoarthritis is influenced by patellofemoral joint alignment and trochlear morphology. We hypothesized that those with more extreme patellar malalignment would benefit more from bracing. METHODS: Thirty-eight patients who had received bracing as part of a comprehensive treatment plan for patellofemoral osteoarthritis were selected for this study...
April 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28421261/-positive-and-negative-predictors-of-long-term-results-after-an-osteotomy-around-the-knee-joint
#3
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/28419292/design-and-testing-of-2-novel-scores-that-predict-global-sagittal-alignment-utilizing-cervical-or-lumbar-plain-radiographs
#4
Ezequiel Goldschmidt, Federico Angriman, Bruno Ferreyro, Nitin Agarwal, James Zhou, Katherine Chen, Zachary J Tempel, Peter C Gerszten, Adam S Kanter, David O Okonkwo, Peter Passias, Justin Scheer, Themistocles Protopsaltis, Virginie Lafage, Renaud Lafage, Frank Schwab, Shay Bess, Chris Ames, Justin S Smith, Douglas Burton, D Kojo Hamilton
BACKGROUND: Global sagittal deformity is an established cause of disability. However, measurements of sagittal alignment are often ignored when patients present with symptoms localizing to the cervical or lumbar spine. OBJECTIVE: To develop scoring scales to predict the risk of sagittal malalignment in patients with only cervical or lumbar spine radiographs. METHODS: A retrospective review of a prospectively maintained multicenter adult spinal deformity database was performed...
April 17, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28417183/patella-height-is-not-altered-by-descending-medial-open-wedge-high-tibial-osteotomy-hto-compared-to-ascending-hto
#5
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/28411443/assessment-of-stability-during-gait-in-patients-with-spinal-deformity-a-preliminary-analysis-using-the-dynamic-stability-margin
#6
Anne-Laure Simon, Vipul Lugade, Kathie Bernhardt, A Noelle Larson, Kenton Kaufman
Daily living activities are dynamic, requiring spinal motion through space. Current assessment of spinal deformities is based on static measurements from full-spine standing radiographs. Tools to assess dynamic stability during gait might be useful to enhance the standard evaluation. The aim of this study was to evaluate gait dynamic imbalance in patients with spinal deformity using the dynamic stability margin (DSM). Twelve normal subjects and 17 patients with spinal deformity were prospectively recruited...
April 5, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28406876/cartilage-restoration-techniques-for-the-patellofemoral-joint
#7
Robert H Brophy, Robert D Wojahn, Joseph D Lamplot
Symptomatic osteochondral lesions of the patellofemoral joint are clinically challenging to manage because of the limited healing potential of articular cartilage; the complex morphology of the patellofemoral joint; the heterogeneity of the articular surface between patients; and high stresses across the joint, which can be altered by malalignment, tilt, or maltracking. Indications for surgery include traumatic lesions, osteochondritis dissecans, and high-grade chondromalacia in association with persistent pain despite a course of nonsurgical management...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28406175/nkx2-5-and-sarcospan-genetically-interact-in-the-development-of-the-muscular-ventricular-septum-of-the-heart
#8
Adam A Panzer, Suk D Regmi, DePorres Cormier, Megan T Danzo, Iuan-Bor D Chen, Julia B Winston, Alayna K Hutchinson, Diana Salm, Claire E Schulkey, Rebecca S Cochran, David B Wilson, Patrick Y Jay
The muscular ventricular septum separates the flow of oxygenated and de-oxygenated blood in air-breathing vertebrates. Defects within it, termed muscular ventricular septal defects (VSDs), are common, yet less is known about how they arise than rarer heart defects. Mutations of the cardiac transcription factor NKX2-5 cause cardiac malformations, including muscular VSDs. We describe here a genetic interaction between Nkx2-5 and Sarcospan (Sspn) that affects the risk of muscular VSD in mice. Sspn encodes a protein in the dystrophin-glycoprotein complex...
April 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28405221/assessment-of-the-restriction-of-arm-elevation-after-intramedullary-fixation-for-proximal-humeral-fractures
#9
Hiroaki Inui, Katsuya Nobuhara
BACKGROUND: Nail protrusion is suspected as a reason for the restriction of arm elevation after antegrade nailing of proximal humeral fractures, although assessment of the restriction of the glenohumeral joint during arm elevation has been insufficient. METHODS: In this retrospective study, 30 shoulders with proximal humeral fractures in 29 cases were treated with Polarus short nails (Acumed, Beaverton, OR, USA). At a mean final follow-up of 14 months, clinical outcomes, bony union, alignment including retroversion of the head and entry points of the nails were evaluated...
April 2017: Shoulder & Elbow
https://www.readbyqxmd.com/read/28402458/the-influence-of-pelvic-incidence-and-lumbar-lordosis-mismatch-on-development-of-symptomatic-adjacent-level-disease-following-single-level-transforaminal-lumbar-interbody-fusion
#10
Zachary J Tempel, Gurpreet S Gandhoke, Bryan D Bolinger, Nicolas K Khattar, Philip V Parry, Yue-Fang Chang, David O Okonkwo, Adam S Kanter
BACKGROUND: Annual incidence of symptomatic adjacent level disease (ALD) following lumbar fusion surgery ranges from 0.6% to 3.9% per year. Sagittal malalignment may contribute to the development of ALD. OBJECTIVE: To describe the relationship between pelvic incidence-lumbar lordosis (PI-LL) mismatch and the development of symptomatic ALD requiring revision surgery following single-level transforaminal lumbar interbody fusion for degenerative lumbar spondylosis and/or low-grade spondylolisthesis...
April 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28392214/the-role-of-social-comparison-in-social-judgments-of-dental-appearance-an-experimental-study
#11
Ghada H Al-Kharboush, Koula Asimakopoulou, AlJazi H AlJabaa, J Tim Newton
OBJECTIVE: The objective of this study was to examine the influence of social comparison on social judgments of dental malalignment in a sample of females. METHOD: In a Repeated measures design, N=218 female participants of which N=128 were orthodontic patients (mean age 31.4) and N=90 controls (mean age 26.1) rated their satisfaction with their facial appearance after viewing stereotypically beautiful images of faces (experimental condition) or houses (neutral condition)...
April 6, 2017: Journal of Dentistry
https://www.readbyqxmd.com/read/28392088/single-stage-treatment-of-osteomyelitis-for-digital-salvage-by-using-an-antibiotic-eluting-methylmethacrylate-joint-spanning-spacer
#12
REVIEW
Victoria L Aimé, John T Kidwell, Leland H Webb
Osteomyelitis of the digit is a challenging problem that can result in amputation. We describe 13 cases of osteomyelitis involving bones of the hand managed with a novel technique. We reviewed records of 12 patients (13 digits) who had joint-spanning, antibiotic-eluting (tobramycin or vancomycin), methylmethacrylate spacers placed as definitive, single-stage treatment for digital osteomyelitis. The primary outcome was digit salvage. Secondary outcomes were infection eradication (no recurrence at 3 months) and spacer removal...
April 6, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28365069/quality-of-life-and-prognostic-factors-after-intra-articular-tibial-pilon-fracture
#13
Jorge De-Las-Heras-Romero, Ana M Lledo-Alvarez, Alejandro Lizaur-Utrilla, Fernando A Lopez-Prats
BACKGROUND: Intra-articular tibial plafond fractures are a challenge for the surgeon with generally poor functional outcomes. The purpose was to assess the impact of this injury on patient quality of life (QOL), as well as analyzed the predictor factors. METHODS: Retrospective study of 47 patients with mean age of 44.4 (range 18-79) years. Patients were also invited for new clinical and radiological assessments. QOL was evaluated by the Short Form-36 questionnaire and compared to the standard in the age-matched general population...
March 22, 2017: Injury
https://www.readbyqxmd.com/read/28364351/-prevention-of-lateral-cortex-fractures-in-open-wedge-high-tibial-osteotomies-the-anteroposterior-drill-hole-approach
#14
G Reyle, O Lorbach, A Diffo Kaze, A Hoffmann, D Pape
BACKGROUND: In osteotomies with larger correction angles, the capacity for elastic deformation is frequently exceeded, resulting in plastic deformation and fracture of the opposite cortex, which may lead to subsequent loss of correction. An anteroposterior drill hole at the apex of the horizontal osteotomy (= hinge) is supposed to increase the capacity of the bony hinge for elastic deformation and ideally to prevent fractures of the opposite cortex. MATERIALS AND METHODS: A high tibial osteotomy (HTO) using standard surgical technique was performed in 20 each of Synbones, Sawbones, and human cadaver tibial specimens...
March 31, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28361192/-malalignment-of-the-first-ray-clinical-and-radiological-diagnostics
#15
M Walther
Clinical and radiological examination of the foot are mandatory before surgical correction of the forefoot. The clinical examination includes leg axis, position of the hind foot, deformity of the first ray as well as skin conditions, pulse status and possible sensitive deficits. A shortening of the gastrocnemius muscle can be identified using the Silfverskiöld test. Discomfort in the midfoot can indicate pathologies of the tarsometatarsal joint and the same applies for osteophyte infiltration around the Lisfranc joint line, whereby the second tarsometatarsal joint often shows more advanced degenerative arthritis than the first tarsometatarsal joint...
March 30, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28356631/associations-of-knee-muscle-force-bone-malalignment-and-knee-joint-laxity-with-osteoarthritis-in-elderly-people
#16
Kazumasa Nakagawa, Misako Maeda
[Purpose] From the viewpoint of prevention of knee osteoarthritis, the aim of this study was to verify how muscle strength and joint laxity are related to knee osteoarthritis. [Subjects and Methods] The study subjects consisted of 90 community-dwelling elderly people aged more than 60 years (22 males, 68 females). Femorotibial angle alignment, knee joint laxity, knee extensors and flexor muscle strengths were measured in all subjects. In addition, the subjects were divided into four groups based on the presence of laxity and knee joint deformation, and the muscle strength values were compared...
March 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28331961/-corrective-osteotomies-for-posttraumatic-elbow-deformities
#17
J Nowotny, F Thielemann, A Biewener, K D Schaser
OBJECTIVES: Correcion of elbow joint deformities that usually develop secondary to direct or indirect trauma of the arm or elbow with subsequent inadequate healing and consecutive axial/rotational malalignment and may be associated with cosmetic or functional deficits of the arm. INDICATIONS: Relevant malalignment of the arm axis with corresponding cosmetic or functional deficits for the patient. CONTRAINDICATIONS: Pre-existing degenerative and chronic inflammatory changes...
March 22, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28322717/lengthening-and-deformity-correction-about-the-knee-using-a-magnetic-internal-lengthening-nail
#18
Austin T Fragomen, S Robert Rozbruch
INTRODUCTION: The introduction of the internal lengthening nail (ILN) has changed the treatment of complex malalignment and shortening about the knee. Acute correction of the deformity and gradual lengthening through this osteotomy site has greatly simplified postoperative recovery. This manuscript is a review of the techniques that are currently being used in surgery. METHODS: The article is broken into two sections: distal femur osteotomy and tibia osteotomy. Each is addressed separately since they have different personalities...
2017: SICOT-J
https://www.readbyqxmd.com/read/28306639/defining-the-role-of-the-lower-limbs-in-compensating-for-sagittal-malalignment
#19
Renaud Lafage, Barthelemy Liabaud, Bassel G Diebo, Jonathan H Oren, Shaleen Vira, Sébastien Pesenti, Themistocles S Protopsaltis, Thomas J Errico, Frank J Schwab, Virginie Lafage
STUDY DESIGN: Retrospective review OBJECTIVE.: Investigate the role of lower limbs compensation with progressive sagittal malalignment SUMMARY OF BACKGROUND DATA.: While lower limb compensatory mechanisms are an established response to progressive sagittal malalignment, their specific role and potential impact on surgical planning has not been evaluated. METHODS: Single center retrospective review of full body xrays was performed in patients >20 yrs. Parameters were measured with dedicated software...
March 16, 2017: Spine
https://www.readbyqxmd.com/read/28298946/tissue-doppler-imaging-in-the-evaluation-of-abdominal-aortic-pulsatility-a-useful-tool-for-the-neonatologist
#20
Enrico Valerio, Alessandra Grison, Anna Capretta, Rosanna Golin, Paola Ferrarese, Massimo Bellettato
Sonographic cardiac evaluation of newborns with suspected aortic coarctation (AoC) should tend to demonstrate a good phasic and pulsatile flow and the absence of pressure gradient along a normally conformed aortic arch from the modified left parasternal and suprasternal echocardiographic views; these findings, however, may not necessarily rule out a more distal coarctation in the descending aorta. For this reason, the sonographic exam of newborns with suspected AoC should always include a Doppler evaluation of abdominal aortic blood flow from the subcostal view...
March 2017: Journal of Ultrasound
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