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Norachart Sirisreetreerux, Babar Shafiq, Greg M Osgood, Erik A Hasenboehler
OBJECTIVES: To determine the location of distal medial neurovascular structures, identifying a medial "safe zone" for minimally invasive plate osteosynthesis to treat displaced femoral condylar fractures. METHODS: Eleven uninjured lower-half torsos were dissected on the bilateral medial lower thigh. A longitudinal incision was made at the midsagittal plane of the medial thigh starting 1 cm proximal to the knee joint and extending to the proximal one-third of the femur...
November 2016: Journal of Orthopaedic Trauma
Eisuke Nomura, Hisatada Hiraoka, Hiroya Sakai
We report two cases of the spontaneous recurrent hemarthrosis of the knee. In these cases lateral meniscus was severely torn and a small tubular soft tissue with pulsation was identified on the synovium in the posterolateral corner during arthroscopic surgery of the knee joint. Gentle grasping of this tissue by forceps led to pulsating bleeding, which stopped by electrocoagulation. This soft tissue was considered a source of bleeding, since no recurrence of hemarthrosis was observed for more than four years after surgery...
2016: Case Reports in Orthopedics
David Schanbacher, Michelle Poliak-Tunis, Michael J Suer
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Salima Qudsi-Sinclair, Enrique Borrás-Rubio, Juan F Abellan-Guillén, María Luz Padilla Del Rey, Guadalupe Ruiz-Merino
BACKGROUND: Knee osteoarthritis is a disease that affects a third of the population over 65 years of age, and it is increasingly becoming a motive for consultation and a source of pain and disability. The gold standard surgical treatment is a total knee arthroplasty; however, 15% to 30% of patients who have undergone surgery continue to experience pain and functional limitation. METHODS: A double-blind, randomized clinical study compared neurolysis using traditional radiofrequency (RF) to local anesthetic and corticosteroid block of the superolateral, superomedial, and inferomedial branches of the knee genicular nerves in patients who had total knee arthroplasty but still experience pain...
September 19, 2016: Pain Practice: the Official Journal of World Institute of Pain
Michael E Farrell, Genaro Gutierrez, Mehul J Desai
This case presentation demonstrates radiographic evidence of lesions created following cooled radiofrequency (cRF) neurotomy of the knee. A 67-year-old man presented with chronic left knee osteoarthritis, pain, and disability. After a failed trial of conservative treatments, the patient underwent diagnostic genicular nerve blocks and subsequent cRF neurotomy, of the left knee. Shortly after cRF, magnetic resonance imaging (MRI) of the left knee was performed. On MRI, lesions created by cRF ablation were identified...
September 14, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Andrei Zbuchea
This article presents the case of a 53 years old patient, with ulcerated and infected dermatofibrosarcoma, extended on the anterolateral side of the left knee. The postexcisional defect, exposing patella, was covered through a regional cutaneous flap of the distal third of the thigh, upper lateral genicular artery-based, measuring 20/10 cm, together with expanded free skin split grafts, applied in proximal third of the leg and distal third of the left thigh. Surgical stages and favorable postoperative evolution are exposed...
July 2016: Chirurgia
M Tremp, A Haumer, R Wettstein, Y X Zhang, P Honigmann, D J Schaefer, D F Kalbermatten
In this report, we present two cases of the bony reconstruction with the medial trochlea (MFT) flap including a skin island that was used to monitor the perfusion of flap in the postoperative period. Between March 2013 and April 2015, we performed surgery on two patients who suffered from scaphoid and talus non-union after trauma and initial treatment by osteosynthesis. A skin island (1 cm × 1 cm and 3 cm × 1 cm, respectively) was included with the osseous flap (1.6 cm × 1 cm × 1 cm and 2 cm × 3 cm × 2 cm, respectively) to assess the perfusion of the flap...
August 29, 2016: Microsurgery
Farzad Borumandi, James P Higgins, Heinz Buerger, Anna Vasilyeva, Memmet Emre Benlidayi, Leman Sencar, Alexander Gaggl
In arterialized venous flaps (AVFs) the venous network is used to revascularize the flap. While the feasibility of AVFs in soft tissues has been reported there is no study on osseous AVFs. In this study we aim to assess the flap survival of osseous AVFs in a pig model. Medial femoral condyle flaps were elevated in 18 pigs. Three groups were created: AVF (n = 6), conventional arterial flap (cAF, n = 6) and bone graft (BG, n = 6). The AVFs were created by anastomosis of genicular artery with one vena comitans while leaving one efferent vein for drainage...
2016: Scientific Reports
Andrew P Murdoch, Sam N Greenaway, Laura J Owen, Alan Danielski
OBJECTIVES: To confirm the anatomic location of the cranial cutaneous branch of the saphenous artery (CCSA), delineate the angiosome of the CCSA, and provide guidelines for clinical use of an axial pattern flap based on the CCSA. STUDY DESIGN: Anatomic study. ANIMALS: Greyhound cadavers (n=10). METHODS: Shortly after euthanasia, the CCSA was identified and isolated in each hindlimb. Methylene blue and radiographic perfusion studies were performed...
October 2016: Veterinary Surgery: VS
Sinem Sarı, Osman N Aydın, Yasemin Turan, Pınar Özlülerden, Ufuk Efe, İmran Kurt Ömürlü
OBJECTIVES: To compare the efficacy of intra-articular injection and radiofrequency (RF) neurotomy of genicular nerves in patients with chronic knee osteoarthritis (OA) pain. METHODS: Seventy-three patients with knee OA were included in the study. Patients were randomly assigned to Group IA (intra-articular 2.5 mL of bupivacaine, 2.5 mg of morphine and 1 mL of betamethasone, 6 mL of fluid injection) or Group RF (RF neurotomy of the genicular nerves). The outcome measures included a pain scale (visual analog scale, VAS) and Western Ontario and McMaster Universities (WOMAC) Index of Osteoarthritis...
August 12, 2016: International Journal of Rheumatic Diseases
Norachart Sirisreetreerux, Babar Shafiq, Greg M Osgood, Erik A Hasenboehler
OBJECTIVES: To determine the location of distal medial neurovascular structures, identifying a medial "safe zone" for minimally invasive plate osteosynthesis to treat displaced femoral condylar fractures. METHODS: Eleven uninjured lower-half torsos were dissected on the bilateral medial lower thigh. A longitudinal incision was made at the midsagittal plane of the medial thigh starting 1 cm proximal to the knee joint and extending to the proximal one-third of the femur...
July 21, 2016: Journal of Orthopaedic Trauma
Serdar Kesikburun, Evren Yaşar, Ayça Uran, Emre Adigüzel, Bilge Yilmaz
BACKGROUND: Genicular nerve ablation with radiofrequency (RF) has recently emerged as a promising treatment in the management of osteoarthritis related knee pain. To date, genicular nerve injections have been performed under fluoroscopic guidance. OBJECTIVE: To evaluate the effect of ultrasound-guided genicular nerve pulsed RF treatment on chronic knee pain and function in patients with knee osteoarthritis. STUDY DESIGN: Single-arm prospective study...
July 2016: Pain Physician
Soo Yeon Kim, Phuong Uyen Le, Boleslav Kosharskyy, Alan D Kaye, Naum Shaparin, Sherry A Downie
Genicular nerve radiofrequency ablation (RFA) has recently gained popularity as an intervention for chronic knee pain in patients who have failed other conservative or surgical treatments. Long-term efficacy and adverse events are still largely unknown. Under fluoroscopic guidance, thermal RFA targets the lateral superior, medial superior, and medial inferior genicular nerves, which run in close proximity to the genicular arteries that play a crucial role in supplying the distal femur, knee joint, meniscus, and patella...
July 2016: Pain Physician
Rakhi G Sutaria, Se Won Lee, Soo Yeon Kim, Ruth Howe, Sherry A Downie
BACKGROUND: The lateral retincular nerve (LRN) is a branch of the superior lateral genicular nerve (SLGN) and is believed to contribute to anterolateral knee pain. However, the precise anatomical pathway of the LRN has not been demonstrated as it relates to the performance of targeted nerve block procedures. OBJECTIVE: To describe the anatomical landmarks for localization of the lateral reticular nerve in order to facilitate diagnostic and therapeutic nerve blocks in the treatment of chronic anterolateral knee pain...
June 23, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Mark W Denny, Felicia A King
Flexibility is key to survival for seaweeds exposed to the extreme hydrodynamic environment of wave-washed rocky shores. This poses a problem for coralline algae, whose calcified cell walls make them rigid. Through the course of evolution, erect coralline algae have solved this problem by incorporating joints (genicula) into their morphology, allowing their fronds to be as flexible as those of uncalcified seaweeds. To provide the flexibility required by this structural innovation, the joint material of Calliarthron cheilosporioides, a representative articulated coralline alga, relies on an extraordinary tissue that is stronger, more extensible and more fatigue resistant than the tissue of other algal fronds...
June 15, 2016: Journal of Experimental Biology
Daryousch Parvizi, Anna Vasilyeva, Paul Wurzer, Alexandru Tuca, Patricia Lebo, Raimund Winter, Robert P Clayton, Thomas Rappl, Michael V Schintler, Lars-P Kamolz, Heinz K Buerger
BACKGROUND: The perforators of the free lateral femoral condyle flap have yet to be adequately described in humans. Therefore, the authors investigated the perforator vessels of the lateral femoral condyle flap in an anatomical study and discussed potential clinical applications with a particular interest in its indication with vascularized bone and/or iliotibial band for tendon repair surgery. METHODS: The authors dissected thighs of 28 cadavers to evaluate the anatomical properties of perforator vessels that branch from the superior lateral genicular artery and supply bone, cartilage, subcutaneous tissue, and the iliotibial band of the lateral femoral condyle...
June 2016: Plastic and Reconstructive Surgery
Sinem Sarı, Osman Nuri Aydın, Yasemin Turan, Selda Şen, Pınar Özlülerden, İmran Kurt Ömürlü, Ferdi Gulastı
This study aimed to perform genicular nerve RF neurotomy using two different imaging methods, fluoroscopy and ultrasound, and to compare the clinical effects and reliability of the two methods. Fifty patients with osteoarthritis were included in this study. Patients were randomly allocated into group 1 (fluoroscopy imaging) and group 2 (ultrasound imaging). Outcomes were measured using a pain scale (visual analog scale; VAS) and the Western Ontario and McMaster Universities (WOMAC) Index of Osteoarthritis. The application time in the ultrasound group (20...
May 3, 2016: Journal of Clinical Monitoring and Computing
Matteo Guzzini, Cosma Calderaro, Marco Guidi, Carolina Civitenga, Germano Ferri, Andrea Ferretti
Introduction. The vascularized corticoperiosteal flap is harvested from the medial femoral condyle and it is nourished by the articular branch of the descending genicular artery and the superomedial genicular artery. This flap is usually harvested as a free flap for the reconstruction of bone defects at forearm, distal radius, carpus, hand, and recently at lower limb too. Case Report. A 50-year-old Caucasian man referred to our department for hypertrophic nonunion of the distal femur, refractory to the conservative treatments...
2016: Case Reports in Orthopedics
Shan Zhu, Yuanbo Liu, Shengji Yu, Mengqing Zang, Zhenguo Zhao, Libin Xu, Xinxin Zhang, Bo Chen, Qiang Ding
OBJECTIVE: To explore the feasibility and technical essentials of soft tissue defect reconstruction following malignant tumor removal of limbs using perforator propeller flaps. METHODS: Between July 2008 and July 2015, 19 patients with malignant limb tumor underwent defect reconstruction following tumor removal using the perforator propeller flaps. There were 13 males and 6 females with an average age of 53.4 years (range, 20-82 years). The disease duration ranged from 1 to 420 months (mean, 82 months)...
January 2016: Chinese Journal of Reparative and Reconstructive Surgery
David Burckett-St Laurant, Philip Peng, Laura Girón Arango, Ahtsham U Niazi, Vincent W S Chan, Anne Agur, Anahi Perlas
BACKGROUND AND OBJECTIVES: Adductor canal block contributes to analgesia after total knee arthroplasty. However, controversy exists regarding the target nerves and the ideal site of local anesthetic administration. The aim of this cadaveric study was to identify the trajectory of all nerves that course in the adductor canal from their origin to their termination and describe their relative contributions to the innervation of the knee joint. METHODS: After research ethics board approval, 20 cadaveric lower limbs were examined using standard dissection technique...
May 2016: Regional Anesthesia and Pain Medicine
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