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Limb length discrepancy

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https://www.readbyqxmd.com/read/28803814/revision-total-hip-arthroplasty-with-a-monoblock-splined-tapered-grit-blasted-titanium-stem
#1
Michael D Hellman, Sean M Kearns, Daniel D Bohl, Bryan D Haughom, Brett R Levine
BACKGROUND: In revision total hip arthroplasty (THA), proximal femoral bone loss creates a challenge of achieving adequate stem fixation. The purpose of this study was to examine the outcomes of a monoblock, splined, tapered femoral stem in revision THA. METHODS: Outcomes of revision THA using a nonmodular, splined, tapered femoral stem from a single surgeon were reviewed. With a minimum of 2-year follow-up, there were 68 cases (67 patients). Paprosky classification was 3A or greater in 85% of the cases...
July 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28803367/the-role-of-agonist-and-antagonist-muscles-in-explaining-isometric-knee-extension-torque-variation-with-hip-joint-angle
#2
Theodoros M Bampouras, Neil D Reeves, Vasilios Baltzopoulos, Constantinos N Maganaris
PURPOSE: The biarticular rectus femoris (RF), operating on the ascending limb of the force-length curve, produces more force at longer lengths. However, experimental studies consistently report higher knee extension torque when supine (longer RF length) compared to seated (shorter RF length). Incomplete activation in the supine position has been proposed as the reason for this discrepancy, but differences in antagonistic co-activation could also be responsible due to altered hamstrings length...
August 12, 2017: European Journal of Applied Physiology
https://www.readbyqxmd.com/read/28793888/does-structural-leg-length-discrepancy-affect-postural-control-preliminary-study
#3
Małgorzata Eliks, Wioleta Ostiak-Tomaszewska, Przemysław Lisiński, Paweł Koczewski
BACKGROUND: Leg-length inequality results in an altered position of the spine and pelvis. Previous studies on the influence of leg asymmetry on postural control have been inconclusive. The purpose of this paper was to investigate the effect of structural leg-length discrepancy (LLD) on the control of posture. METHODS: We studied 38 individuals (19 patients with structural LLD, 19 healthy subjects). The examination included measurement of the length of the lower limbs and weight distribution as well as a static posturography...
August 9, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28767173/prevalence-presentation-and-treatment-of-lower-limb-pathologies-in-juvenile-idiopathic-arthritis-a-narrative-review
#4
REVIEW
Antoni Fellas, Fiona Hawke, Derek Santos, Andrea Coda
Juvenile idiopathic arthritis is a chronic, autoimmune, inflammatory joint disease. It is the most common arthritis in children and adolescents. This paper reviews the presentation and treatment of lower limb pathologies in juvenile idiopathic arthritis from an allied health perspective. Common lower limb pathologies include: synovitis causing swelling, tenderness and pain; persistent inflammation leading to flexion contractures; limb length discrepancies; muscle atrophy; enthesopathies such as plantar fasciitis and Achilles tendonitis; and tenosynovitis...
August 2, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28756873/accordion-technique-combined-with-minimally-invasive-percutaneous-decortication-for-the-treatment-of-bone-non-union
#5
Qun Zhang, Wei Zhang, Zhuo Zhang, Peifu Tang, Lihai Zhang, Hua Chen
BACKGROUND: A variety of approaches have been used to treat oligotrophic or atrophic non-union. Conventional methods are often associated with great operative trauma, increased blood loss, a risk of re-infection, higher medical costs, and complications at the donor site. This study aimed to assess the clinical efficacy of the accordion technique combined with Minimally Invasive Percutaneous Decortication (MIPD) for these types of bone non-union. METHODS: From January 2010 to December 2015, 20 patients with long bone aseptic non-unions of the lower extremities without bone defects who were treated with the accordion technique combined with MIPD...
July 12, 2017: Injury
https://www.readbyqxmd.com/read/28714636/-corrective-surgery-for-lower-limb-length-discrepancy-and-malalignment-in-paediatric-orthopaedics
#6
Dimitri Ceroni, Raimonda Valaikaite, Catherine Grumetz, Odile Desvachez, Sophie Pusateri, Pierre Dunand, Vasiliki Spyropoulou, Eleftheria Samara
Lower limb length discrepancy and malalignment in paediatric orthopaedics constitute a set of acquired or malformative structural pathologies. These anomalies, which may alter statics of lower limbs, are susceptible to engender an asymmetry of mechanical constraints' distribution across joints, and thus to promote the onset of arthritic phenomenons. The purpose of this review's article is to define the limits of tolerance of the various malformations and describe the innovative techniques available in order to correct them...
February 15, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28706382/cementless-acetabular-component-with-or-without-upward-placement-in-dysplasia-hip-early-results-from-a-prospective-randomised-study
#7
Zhiqi Zhang, Peihui Wu, Zhiyu Huang, Baoxi Yu, Hong Sun, Ming Fu, Yan Kang, Weiming Liao
BACKGROUND: Total hip arthroplasty (THA) in developmental dysplasia of hip (DDH) is difficult for the abnormal acetabulum. The purpose of this study was to evaluate the difference of anatomic and upward placement of acetabular component during early stage. METHODS: From April 2014 through June 2015, forty DDH patients (Crowe I to III, 42 hips) were prospectively randomized to either anatomic or upward group. Patient recorded diaries were collected. Radiographs were reviewed...
September 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28704303/gain-of-length-loss-of-strength-alteration-in-muscle-strength-after-femoral-leg-lengthening-in-young-patients-a-prospective-longitudinal-observational-study
#8
Andreas H Krieg, Sebastian Gehmert, Olivia L Neeser, Xaver Kaelin, Bernhard M Speth
This study aimed to determine the alteration in maximum isokinetic torque in patients after intramedullary femoral leg lengthening. Thirty patients with a median leg-length discrepancy of 3.0 cm underwent femoral limb lengthening with an intramedullary motorized device. Maximum isokinetic, concentric torque of the extensors, and flexors of the knee was measured before (n=30) and 2 years after surgery (n=21). Postoperatively, a significant difference remained for the maximum isokinetic torque of the extensors (22%) between the lengthened and the normal leg, which might have been caused by muscle response to the distraction procedure itself in the form of higher stiffness, less immediate displacement, and inconsistent force relaxation properties...
July 12, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28704298/titanium-mesh-cage-as-an-alternative-reconstruction-method-for-epiphyseal-sparing-tumour-resections-in-children
#9
Mehmet Ayvaz, Senol Bekmez, Altug Yucekul, Musa U Mermerkaya, A Mazhar Tokgozoglu
In this study, we introduced an alternative reconstruction option for epiphysis-sparing tumour resection in children. Eight patients with a malignant tumour in the diaphysis or metaphysis-diaphysis junction of a long bone underwent epiphysis-sparing intercalary resection. Reconstruction was performed using a titanium mesh cage filled with impacted cancellous bone allograft and autograft. A plate and screws were used to supplement the fixation. At the last follow-up, union was achieved in seven patients. Limb-length discrepancy occurred in three patients...
July 12, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28692359/prevention-of-limb-length-discrepancy-in-total-hip-arthroplasty
#10
Babar Kayani, Jurek Pietrzak, Fahad S Hossain, Sujith Konan, Fares S Haddad
Total hip arthroplasty is a highly effective and cost-efficient procedure but postoperative limb length discrepancy is a common source of patient dissatisfaction and litigation. This article provides a systematic, stepwise approach for identifying and proactively managing risk factors associated with limb length discrepancy following total hip arthroplasty. This review explores preoperative history taking, clinical examination, radiological templating, implant positioning, soft tissue balancing, and intraoperative surgical techniques for minimizing leg length discrepancy while maintaining stability and restoring mechanical function following total hip arthroplasty...
July 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28690469/ankle-reconstruction-in-fibular-hemimelia-new-approach
#11
Hany Hefny, ElHussein M Elmoatasem, Mahmoud Mahran, Tamer Fayyad, Mohamed A Elgebeily, Ahmed Mansour, Mamdouh Hefny
BACKGROUND: Fibular hemimelia is a congenital disorder that is characterized by the absence of the fibula that could be either partial or complete. Successful management aims to restore normal weight bearing and normal limb length. The introduction of the Ilizarov method of limb lengthening has provided an attractive alternative to amputation. During lengthening, the tight posterolateral soft-tissue structures, the thick fibrous fibular band, and the shortened Achilles tendon become tighter and transfer a valgus force to the talus and calcaneus, further aggravating the deformity...
July 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28674737/systematic-review-of-the-outcome-of-total-hip-arthroplasty-in-patients-with-sequelae-of-legg-calv%C3%A3-perthes-disease
#12
Sammy A Hanna, Khaled M Sarraf, Manoj Ramachandran, Pramod Achan
BACKGROUND: Total hip arthroplasty (THA) in patients with sequelae of Legg-Calvé-Perthes disease (LCP) is technically demanding because of the disease related deformities occuring in the proximal femur and/or the multiplanar deformities secondary to corrective osteotomies in childhood. Little is known about the long-term outcome of the procedure in this challenging group of patients. METHODS: We carried out a systematic review of the literature to determine the functional outcome, complications and revision rate of THA in patients with sequelae of LCP disease...
August 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28639009/chipping-and-lengthening-over-nailing-technique-for-femoral-shaft-nonunion-with-shortening
#13
Gen Sasaki, Yoshinobu Watanabe, Motoyuki Takaki, Youichi Yasui, Wataru Miyamoto, Hirotaka Kawano, Takashi Matsushita
PURPOSE: Chipping and lengthening over nailing (CLON) technique was developed to treat femoral shaft nonunion with shortening more than 10 mm. The purpose of the current retrospective case series was to clarify the effectiveness of the CLON technique on the femoral shaft nonunion following intramedullary nailing. METHODS: Clinical and radiological outcomes in the patients receiving operative treatment for femoral shaft nonunion between August 2012 and December 2016 were retrospectively reviewed using the Refractory Fracture Data Registry at the authors' institution...
June 21, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28622842/two-stage-knee-arthrodesis-with-a-modular-intramedullary-nail-due-to-septic-failure-of-revision-total-knee-arthroplasty-with-extensor-mechanism-deficiency
#14
Max J Friedrich, Jan Schmolders, Matthias D Wimmer, Andreas C Strauss, Milena M Ploeger, Dieter C Wirtz, Sascha Gravius, Thomas M Randau
BACKGROUND: Periprosthetic joint infection is a serious complication and reconstruction after failed revision total knee arthroplasty with significant bone loss and compromised soft-tissues can be challenging. Objective of this study was to assess clinical and functional results, implant survival and infection recurrence rates in patients treated with two-stage arthrodesis after failed revision TKA with extensor mechanism deficiencies due to PJI, and to identify the factors that affect outcomes after surgery...
June 13, 2017: Knee
https://www.readbyqxmd.com/read/28601180/musculoskeletal-traumatic-injuries-in-children-characteristic-imaging-findings-and-mimickers
#15
REVIEW
Victor M Ho-Fung, Matthew A Zapala, Edward Y Lee
Musculoskeletal traumatic injuries in children demonstrate characteristic imaging findings. The physis is the most susceptible structure to traumatic injury. The periosteum in children plays a key role in rapid bone healing and stability. The main complications of fractures in children are premature physeal closure, potential limb length discrepancy, and angular deformities. Understanding the normal bone growth, healing, and complications of pediatric fractures is crucial for appropriate imaging diagnosis. This article discusses currently available imaging modalities with up-to-date techniques, underlying mechanisms, and characteristic imaging findings of musculoskeletal traumatic injuries and mimickers encountered in daily clinical practice...
July 2017: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/28600975/relationship-and-significance-of-gait-deviations-associated-with-limb-length-discrepancy-a-systematic-review
#16
REVIEW
Sam Khamis, Eli Carmeli
Controversy still exists as to the clinical significance of leg length discrepancy (LLD) in spite of the fact that further evidence has been emerging regarding the relationship between several clinical conditions and LLD. The objectives of our study were to review the available research with regard to LLD as a cause of clinically significant gait deviations, to determine if there is a relationship between the magnitude of LLD and the presence of gait deviations and to identify the most common gait deviations associated with LLD...
May 31, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28578843/total-hip-arthroplasty-in-patients-with-multifactorial-perceived-limb-length-discrepancy
#17
Amgad M Haleem, Kevin F Wiley, Raul Kuchinad, S Robert Rozbruch
BACKGROUND: Patients with advanced hip arthritis can present with multifactorial limb length discrepancies (LLDs) owing to bony shortening from growth arrest, proximal hip migration, soft-tissue contractures, and pelvic obliquity. The patient perceives an LLD that is a combination of true LLD and apparent LLD. METHODS: We retrospectively reviewed 7 cases with multifactorial mean perceived LLD of 7.7 cm (range, 3.6-11 cm) that underwent primary total hip arthroplasty and auxiliary soft-tissue procedures...
April 27, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28567217/comparison-of-surgical-parameters-and-results-between-curved-varus-osteotomy-and-rotational-osteotomy-for-osteonecrosis-of-the-femoral-head
#18
Young-Kyun Lee, Chan Ho Park, Yong-Chan Ha, Do-Yeon Kim, Sung-Hwa Lyu, Kyung-Hoi Koo
BACKGROUND: Various osteotomies have been introduced to treat osteonecrosis of the femoral head. The purpose of this study was to compare surgical parameters, postoperative limb length discrepancy, and minimum 5-year clinical and radiological results between transtrochanteric curved varus osteotomy (TCVO) and transtrochanteric rotational osteotomy (TRO) for osteonecrosis of the femoral head. METHODS: From 2004 to 2009, 103 consecutive TROs (97 patients) followed by 72 consecutive TCVOs (64 patients) were performed for the treatment of osteonecrosis of the femoral head...
June 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28567150/cortical-fenestration-for-megaprosthesis-stem-revision
#19
Vincent Y Ng, Philip Louie, Stephanie Punt, Ernest U Conrad Iii
BACKGROUND: The most common modes of failure for megaprostheses are aseptic loosening followed by periprosthetic infection and stem fracture. Surgical technique for bone and implant exposure is controversial and may influence the success of revision and the need for additional future revisions. The purpose of this study was to evaluate the effectiveness of cortical fenestration for megaprosthesis revision, particularly for stem fracture. METHODS: From 1985-2014, 196 adult and pediatric patients underwent limb salvage with a distal femoral or proximal tibial megaprosthesis (109 cemented, 87 pressfit)...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28562492/congenital-pseudarthrosis-of-the-tibia-in-children-should-we-defer-surgery-until-3-years-old
#20
Yaoxi Liu, Haibo Mei, Guanghui Zhu, Kun Liu, Jiangyan Wu, Jin Tang, Rongguo He
Currently, the timing of surgery for congenital pseudarthrosis of the tibia (CPT) remains controversial. The aim of this study was to investigate the results of treatment of pseudarthrosis of the tibia in children younger than 3 years of age. A retrospective study was carried out to explore the relationship between postoperative complications and the age of surgery in children with CPT. The analysis was carried out on 42 patients with Crawford type IV CPT treated with a combined surgical technique between 2008 and 2012...
May 30, 2017: Journal of Pediatric Orthopedics. Part B
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