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https://www.readbyqxmd.com/read/28065868/clinical-impact-of-positive-propionibacterium-acnes-cultures-in-orthopedic-surgery
#1
Valery Lavergne, Michel Malo, Cinzia Gaudelli, Michelle Laprade, Stéphane Leduc, Pierre Laflamme, Dominique M Rouleau
BACKGROUND: The clinical significance of a positive culture to Propionibacterium acnes in orthopedic specimens remains unclear, whether about its role as a contaminant or a pathogen, or its impact as a coinfectant. Therefore we performed a retrospective study to provide a more accurate description of the clinical impact of P.acnes in an orthopedic population aiming to determine: 1) if there is a clinical difference between P.acnes infection and contamination? 2) if there is a clinical difference between P...
January 5, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28063761/comparison-of-radiographs-and-computed-tomography-for-the-screening-of-anterior-inferior-iliac-spine-impingement
#2
Broc R Schindler, Melanie B Venderley, Jacob D Mikula, Jorge Chahla, Grant J Dornan, Travis Lee Turnbull, Robert F LaPrade, Marc J Philippon
PURPOSE: To compare radiographic and 3-dimensional (3D) computed tomography (CT) imaging modalities for the screening of anterior inferior iliac spine (AIIS) impingement by establishing imaging measurement related to the AIIS. METHODS: Anteroposterior and false-profile radiographs and 3D CT scans were obtained on 10 human cadaveric pelvises. On the anteroposterior view for each methodology, 2 measurements were calculated: distance to the most lateral AIIS from the 12 o'clock position on the acetabular rim, and the angle between the lateral AIIS and the sagittal plane...
January 4, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28043749/an-anatomic-analysis-of-mid-anterior-and-anterolateral-approaches-for-hip-arthrocentesis-a%C3%A2-male-cadaveric-study
#3
Jacob D Mikula, Jason M Schon, Chase S Dean, Jorge Chahla, Renato Locks, Alex W Brady, Robert F LaPrade, Marc J Philippon
PURPOSE: To determine the accuracy and safety of non-image-guided modified mid-anterior and anterolateral approaches to the hip joint for arthrocentesis. METHODS: Six pairs (n = 12) of human cadaveric hemipelvises underwent methylene blue hip injections through either a mid-anterior or an anterolateral approach. The distance from the mid-anterior approach to the lateral femoral cutaneous nerve (LFCN) was measured. Needle orientation was defined by a combination of 2 angles, calculated by the computer software analysis of digitized points...
December 30, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28012152/erratum-to-bone-marrow-aspirate-concentrate-for-the-treatment-of-osteochondral-lesions-of-the-talus-a-systematic-review-of-outcomes
#4
Jorge Chahla, Mark E Cinque, Jason M Schon, Daniel J Liechti, Lauren M Matheny, Robert F LaPrade, Thomas O Clanton
No abstract text is available yet for this article.
December 2016: Journal of Experimental Orthopaedics
https://www.readbyqxmd.com/read/27999730/post-operative-rehabilitation-of-grade-iii-medial-collateral-ligament-injuries-evidence-based-rehabilitation-and-return-to-play
#5
Catherine A Logan, Luke T O'Brien, Robert F LaPrade
: The medial collateral ligament is the most commonly injured ligament of the knee, with injury generally sustained in the athletic population as a result of valgus contact with or without tibial external rotation. The capacity of the medial collateral ligament to heal has been demonstrated in both laboratory and clinical studies; however, complete ruptures heal less consistently and may result in persistent instability. When operative intervention is deemed necessary, anatomical medial knee reconstruction is recommended...
December 2016: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/27920331/3d-model-analysis-of-ankle-flexion-on-anatomic-reduction-of-a-syndesmotic-injury
#6
Jason M Schon, Jacob D Mikula, Jonathon D Backus, Melanie B Venderley, Grant J Dornan, Robert F LaPrade, Thomas O Clanton
BACKGROUND: The effect of ankle positioning during suture-button fixation for syndesmosis repair on range of motion (ROM) and anatomic reduction has yet to be investigated. The purpose of this cadaveric study was to compare the effects of 3 different ankle positions during suture-button repair on volumetric reduction of the syndesmosis, fibular displacement, and ROM of the ankle using 3-dimensional computed tomography (CT) analysis. The null hypothesis was that ankle position during fixation would not affect syndesmotic volume restoration, fibular displacement, or ROM...
December 5, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27919916/posterior-meniscal-root-repairs-outcomes-of-an-anatomic-transtibial-pull-out-technique
#7
Robert F LaPrade, Lauren M Matheny, Samuel G Moulton, Evan W James, Chase S Dean
BACKGROUND: Outcomes after transtibial pull-out repair for posterior meniscal root tears remain underreported, and factors that may affect outcomes are unknown. PURPOSE/HYPOTHESIS: The purpose of this study was to compare patient-centered outcomes after transtibial pull-out repair for posterior root tears in patients <50 and ≥50 years of age. We hypothesized that improvement in function and activity level at minimum 2-year follow-up would be similar among patients <50 years of age compared with patients ≥50 years and among patients undergoing medial versus lateral root repairs...
December 5, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27872126/multiple-ligament-reconstruction-femoral-tunnels-intertunnel-relationships-and-guidelines-to-avoid-convergence
#8
Gilbert Moatshe, Alex W Brady, Erik L Slette, Jorge Chahla, Travis Lee Turnbull, Lars Engebretsen, Robert F LaPrade
BACKGROUND: Knee dislocations often require multiple concurrent ligament reconstructions, which involve creating several tunnels in the distal femur. Therefore, the risk of tunnel convergence is increased because of the limited bone volume within the distal aspect of the femur. PURPOSE: To assess the risk of tunnel convergence and determine the optimal reconstruction tunnel orientations for multiple ligament reconstructions in the femur. STUDY DESIGN: Descriptive laboratory study...
November 21, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27871653/surgical-management-and-treatment-of-the-anterior-cruciate-ligament-posterolateral-corner-injured-knee
#9
REVIEW
Nicholas I Kennedy, Christopher M LaPrade, Robert F LaPrade
Posterolateral knee injuries occur more commonly than in the past. These injuries most commonly occur concurrent with cruciate ligament tears. The main stabilizers of the posterolateral knee are the fibular collateral ligament, the popliteus tendon, and the popliteofibular ligament. These static stabilizers function to prevent increased varus, external rotation, and coupled posterolateral rotation of the knee. The most important clinical tests to diagnose posterolateral knee injuries are the varus stress test, posterolateral drawer, and dial tests...
January 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27813021/bone-marrow-aspirate-concentrate-for-the-treatment-of-osteochondral-lesions-of-the-talus-a-systematic-review-of-outcomes
#10
REVIEW
Jorge Chahla, Mark E Cinque, Jason M Shon, Daniel J Liechti, Lauren M Matheny, Robert F LaPrade, Thomas O Clanton
BACKGROUND: The goal of this perform a systematic review on the outcomes of bone marrow aspirate concentrate (BMAC) for the treatment of chondral defects and osteoarthritis (OA) of the talus. RESULTS: The systematic search performed identified 47 studies after duplicates were removed. After inclusion criteria were applied four studies were considered for insightful analysis for the treatment of focal chondral defects in the foot and ankle with the use of BMAC. Three studies were retrospective and one study was prospective in nature...
December 2016: Journal of Experimental Orthopaedics
https://www.readbyqxmd.com/read/27733556/a-3-d-ct-analysis-of-screw-and-suture-button-fixation-of-the-syndesmosis
#11
Jason M Schon, Brady T Williams, Melanie B Venderley, Grant J Dornan, Jonathon D Backus, Travis Lee Turnbull, Robert F LaPrade, Thomas O Clanton
BACKGROUND: Historically, syndesmosis injuries have been repaired with screw fixation; however, some suggest that suture-button constructs may provide a more accurate anatomic and physiologic reduction. The purpose of this study was to compare changes in the volume of the syndesmotic space following screw or suture-button fixation using a preinjury and postoperative 3-D computed tomography (CT) model. The null hypothesis was that no difference would be observed among repair techniques...
October 12, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27729320/overlap-between-anterior-cruciate-ligament-and-anterolateral-meniscal-root-insertions-a-scanning-electron-microscopy-study
#12
Brett D Steineman, Samuel G Moulton, Tammy L Haut Donahue, Cristián A Fontboté, Christopher M LaPrade, Tyler R Cram, Chase S Dean, Robert F LaPrade
BACKGROUND: The anterolateral meniscal root (ALMR) has been reported to intricately insert underneath the tibial insertion of the anterior cruciate ligament (ACL). Previous studies have begun to evaluate the relationship between the insertion areas and the risk of iatrogenic injuries; however, the overlap of the insertions has yet to be quantified in the sagittal and coronal planes. PURPOSE: To investigate the insertions of the human tibial ACL and ALMR using scanning electron microscopy (SEM) and to quantify the overlap of the ALMR insertion in the coronal and sagittal planes...
October 11, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27709059/medial-opening-wedge-proximal-tibial-osteotomy
#13
Jorge Chahla, Chase S Dean, Justin J Mitchell, Gilbert Moatshe, Raphael Serra Cruz, Robert F LaPrade
Genu varus malalignment can lead to medial compartment overload and progression of ipsilateral compartment osteoarthritis. To slow this process, a medial opening wedge proximal tibial osteotomy (PTO) can be performed. This type of PTO is indicated in patients with genu varus malalignment and isolated medial compartment osteoarthritis of the knee, prior to or concurrent with medial compartment cartilage procedures or meniscal transplants, chronic posterolateral corner deficiency, or chronic anterior cruciate ligament deficiency...
August 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27709054/medial-meniscus-radial-tear-a-transtibial-2-tunnel-technique
#14
Marco Nitri, Jorge Chahla, David Civitarese, Sanjeev Bhatia, Samuel G Moulton, Christopher M LaPrade, Robert F LaPrade
Complete radial tears of the medial meniscus significantly decrease the meniscal tissue's ability to dissipate tibiofemoral loads and have been described as functionally similar to a total meniscectomy, predisposing patients to early osteoarthritis. At present, no consensus exists regarding the optimal surgical treatment of a radial meniscal tear. Current repair techniques have led to a reportedly high rate of incomplete healing or healing of the meniscus in a nonanatomic, gapped position, which compromises its ability to withstand hoop stresses...
August 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27709040/varus-producing-lateral-distal-femoral-opening-wedge-osteotomy
#15
Justin J Mitchell, Chase S Dean, Jorge Chahla, Gilbert Moatshe, Tyler R Cram, Robert F LaPrade
Valgus knee alignment in excess of physiological valgus leads to excessive loading of the lateral compartment, which can potentially increase the risk of osteoarthritis and can place the medial knee structures at risk of chronic attenuation. Varus-producing distal femoral osteotomies have been proposed for correction of valgus malalignment, to relieve tension on medial-sided structures, as well as to off-load the lateral compartment. Understanding that symptomatic valgus deformity of the knee represents a complex problem that is magnified in the setting of lateral compartment arthritis or medial ligamentous incompetence, we present our preferred technique for a varus-producing distal femoral osteotomy using plate osteosynthesis and cancellous bone allograft...
August 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27697189/editorial-commentary-limited-data-shows-how-little-we-know
#16
Justin J Mitchell, Jorge Chahla, Robert F LaPrade
Lateral compartment osteoarthritis of the knee can be a challenging problem to address in the younger, active population. The challenge is compounded by limited treatment options and high patient expectations, with patients often desiring a return to impact high intensity activity. Distal femoral osteotomy has been reported to be one potential treatment option; however, a highly heterogeneous literature exists for both opening and closing wedge distal femoral osteotomies for the treatment of isolated lateral compartment osteoarthritis with valgus malalignment...
October 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27683660/filamentation-protects-candida-albicans-from-amphotericin-b-induced-programmed-cell-death-via-a-mechanism-involving-the-yeast-metacaspase-mca1
#17
David J Laprade, Melissa S Brown, Morgan L McCarthy, James J Ritch, Nicanor Austriaco
The budding yeast Candida albicans is one of the most significant fungal pathogens worldwide. It proliferates in two distinct cell types: blastopores and filaments. Only cells that are able to transform from one cell type into the other are virulent in mouse disease models. Programmed cell death is a controlled form of cell suicide that occurs when C. albicans cells are exposed to fungicidal drugs like amphotericin B and caspofungin, and to other stressful conditions. We now provide evidence that suggests that programmed cell death is cell-type specific in yeast: Filamentous C...
July 2016: Microbial Cell
https://www.readbyqxmd.com/read/27681857/biomechanical-analysis-of-the-individual-ligament-contributions-to-syndesmotic-stability
#18
Thomas O Clanton, Brady T Williams, Jonathon D Backus, Grant J Dornan, Daniel J Liechti, Scott R Whitlow, Adriana J Saroki, Travis Lee Turnbull, Robert F LaPrade
BACKGROUND: Biomechanical data and contributions to ankle joint stability have been previously reported for the individual distal tibiofibular ligaments. These results have not yet been validated based on recent anatomic descriptions or using current biomechanical testing devices. METHODS: Eight matched-pair, lower leg specimens were tested using a dynamic, biaxial testing machine. The proximal tibiofibular joint and the medial and lateral ankle ligaments were left intact...
January 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/27672016/biomechanical-comparison-of-3-current-ankle-syndesmosis-repair-techniques
#19
Thomas O Clanton, Scott R Whitlow, Brady T Williams, Daniel J Liechti, Jonathon D Backus, Grant J Dornan, Adriana J Saroki, Travis Lee Turnbull, Robert F LaPrade
BACKGROUND: Significant debate exists regarding optimal repair for unstable syndesmosis injuries. Techniques range from screw fixation, suture-button fixation, or a combination of the two. In this study, 3 common repairs were compared using a simulated weightbearing protocol with internal and external rotation of the foot. METHODS: Twenty-four lower leg specimens with mean age 54 years (range, 38-68 years) were used for testing. Following creation of a complete syndesmotic injury (AITFL, ITFL, PITFL, interosseous membrane), specimens were repaired using 1 of 3 randomly assigned techniques: (1) one 3...
September 25, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27659939/hip-capsular-closure-a-biomechanical-analysis-of-failure-torque
#20
Jorge Chahla, Jacob D Mikula, Jason M Schon, Chase S Dean, Kimi D Dahl, Travis J Menge, Eduardo Soares, Travis Lee Turnbull, Robert F LaPrade, Marc J Philippon
BACKGROUND: Hip capsulotomy is routinely performed during arthroscopic surgery to achieve adequate exposure of the joint. Iatrogenic instability can result after hip arthroscopic surgery because of capsular insufficiency, which can be avoided with effective closure of the hip capsule. There is currently no consensus in the literature regarding the optimal quantity of sutures upon capsular closure to achieve maximal stability postoperatively. PURPOSE/HYPOTHESIS: The purpose of this study was to determine the failure torques of 1-, 2-, and 3-suture constructs for hip capsular closure to resist external rotation and extension after standard anterosuperior interportal capsulotomy (12 to 3 o'clock)...
September 22, 2016: American Journal of Sports Medicine
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