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Malalignement test

Michael E Steinhaus, Alexander S McLawhorn, Shawn S Richardson, Patrick Maher, David J Mayman
BACKGROUND: Proper alignment of total knee arthroplasty (TKA) is essential for TKA function and may reduce the risk of aseptic failure. Technologies that prevent malalignment may reduce the risk of revision surgery. QUESTIONS/PURPOSES: The purpose of this study was to compare two competing TKA systems that purport improved alignment: patient-specific instrumentation (PSI), and a handheld portable navigation device (NAV). METHODS: After IRB approval, 49 consecutive PSI TKAs (40 patients) were matched based on preoperative characteristics to 49 NAV TKAs (40 patients) performed by a single surgeon...
October 2016: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Hülya Kurtul Yildiz, Elif Evrim Ekin
PURPOSE: The medial patellofemoral ligament (MPFLL)/lateral patellar retinaculum (LPR) ratio were assessed in knees as a means to detect patellar malalignment. We also aimed to evaluate the prevalence of the various types of trochlear dysplasia in patients with patellar malalignment. MATERIALS AND METHODS: After approval of our institutional ethics committee, we conducted a retrospective study that included 450 consecutive patients to evaluate them for the presence of patellar malalignment...
2016: SpringerPlus
Abhishek Abhishek, Michael Doherty
Calcium pyrophosphate crystal deposition (CPPD) associates with ageing, osteoarthritis (OA), uncommon metabolic diseases, mutations and polymorphisms in the ankylosis human gene (ANKH). CPPD is frequently polyarticular, occurs due to a generalised articular predisposition, and the association between CPPD and OA is joint specific, for example CPPD associates with knee OA, but not with hip OA. Other recently identified associations include knee malalignment (knee CC), low cortical BMD and soft-tissue calcification...
July 2016: Clinical and Experimental Rheumatology
Ryuhei Katsui, Norihiro Samoto, Akira Taniguchi, Manabu Akahane, Shinji Isomoto, Kazuya Sugimoto, Yasuhito Tanaka
BACKGROUND: Although the tangential sesamoid view is used to visualize the sesamoid position relative to the first metatarsal head, correctly evaluating patients with severe varus of the first metatarsal is difficult. Computed tomography (CT) can be helpful due to its cross-sectional images in any plane. The purposes of this study were to evaluate the alignment of the tibial sesamoid and investigate the relationship between malalignment and degenerative change in the sesamoid metatarsal joint (SMJ) using simulated weight-bearing CT imaging in patients with hallux valgus...
August 16, 2016: Foot & Ankle International
Bum-Sik Lee, Seong-Il Bin, Jong-Min Kim, Won-Kyeong Kim, Jae Hyan Kim
BACKGROUND: Little is known about clinical outcomes after revision meniscal allograft transplantation (RMAT), and there are no studies on magnetic resonance imaging (MRI) evaluations during the early remodeling period. HYPOTHESIS: The objective imaging results, as determined by MRI evaluation, would be inferior to those of published data on primary meniscal allograft transplantations (MATs), although short-term clinical improvement would be achieved after RMAT. STUDY DESIGN: Case series; Level of evidence, 4...
July 25, 2016: American Journal of Sports Medicine
Carlo Camathias, Katrin Studer, Ata Kiapour, Erich Rutz, Patrick Vavken
BACKGROUND: The essential static patellar stabilizer is a normal-shaped trochlear groove. A dysplastic groove destabilizes the patella. Trochleoplasty approaches this underlying condition and reshapes the trochlea. However, studies have reported on trochleoplasty for revision cases or as accompanied by other interventions. The effect of trochleoplasty alone remains unexplained. PURPOSE: To introduce trochleoplasty as a stand-alone treatment for recurrent patellar dislocation and to compare its pre- to postoperative functional and clinical variables...
July 19, 2016: American Journal of Sports Medicine
I Obeid, L Boissière, C Yilgor, D Larrieu, F Pellisé, A Alanay, E Acaroglu, F J Perez-Grueso, F Kleinstück, J M Vital, A Bourghli
PURPOSE: Regarding the close interaction between the spinal alignment and the pelvis orientation, no parameter is routinely used to describe and to evaluate the global spinopelvic balance, taking into account simultaneously the spinal part and the pelvic part of the global alignment. We described the global tilt (GT) that could analyze malalignment considering the spine and the pelvis simultaneously. From a geometrical point of view, the global tilt is the sum of the pelvic tilt (PT) and the C7 vertical tilt (angular value of sagittal vertical axis)...
June 20, 2016: European Spine Journal
Jason W Stoneback, Patrick M Carry, Katherine Flynn, Zhaoxing Pan, Ernest L Sink, Nancy H Miller
BACKGROUND: To evaluate lower extremity strength and alignment among children who underwent submuscular plating (SMP). METHODS: Subjects who underwent SMP for a length unstable femoral fracture returned for isokinetic strength testing ≥2 years after surgery. Extensor and flexor strength deficits (percent difference) between the operative and nonoperative limbs were evaluated. Radiographic measurements of mechanical alignment [anatomic lateral distal femoral angle (aLDFA)] and qualitative measurements (The Pediatric Outcomes Data Collection Instrument, PODCI) were obtained from all subjects...
June 2, 2016: Journal of Pediatric Orthopedics
Roberta Ramonda, Marta Favero, Stefania Vio, Carmelo Lacognata, Paola Frallonardo, Elisa Belluzzi, Carla Campana, Mariagrazia Lorenzin, Augusta Ortolan, Federico Angelini, Antonio Piccoli, Francesca Oliviero, Leonardo Punzi
This study aimed to apply the recently proposed Oslo hand osteoarthritis magnetic resonance imaging (MRI) scoring system to evaluate MRI findings in a cohort of patients affected by long-standing erosive hand osteoarthritis (EHOA). Eleven female EHOA patients (median 59 [interquartile range 62-52] years, disease duration 9.5 [interquartile range 13-3.75] years) underwent MRI (1.5 T) of the dominant hand, and synovitis, bone marrow lesions (BMLs), joint space narrowing, osteophytes, cysts, malalignment, and erosions were scored using the Oslo scoring system...
August 2016: Clinical Rheumatology
Soo-Hyun Kim, Sang-Ho Ahn, Gil-Su Jung, Jin-Hyun Kim, Yun-Woo Cho
[Purpose] The biomechanical effects of foot orthoses on malalignment syndrome have not been fully clarified. This experimental investigation was conducted to evaluate the effects of orthoses on the gait patterns of patients with malalignment syndrome. [Subjects and Methods] Ten patients with malalignment syndrome were recruited. For each participant, kinematic and kinetic data were collected under three test conditions: walking barefoot, walking with flat insoles in shoes, and walking with a biomechanical foot orthosis (BFO) in shoes...
April 2016: Journal of Physical Therapy Science
Mitsuru Yagi, Shinjiro Kaneko, Yoshiyuki Yato, Takashi Asazuma, Masafumi Machida
PURPOSE: Pedicle subtraction osteotomy (PSO) is widely used to treat severe fixed sagittal imbalance. However, the effect of PSO on balance has not been fully documented. The aim of this study was to assess dynamic walking balance after PSO to treat fixed sagittal imbalance. METHODS: Gait and balance were assessed in 15 consecutive adult female patients who had been treated by PSO for a fixed sagittal imbalance and compare patients' preop and postop dynamic walking balance with that of 15 age- and gender-matched healthy volunteers (HV)...
August 2016: European Spine Journal
Guan-Yang Song, Xin Liu, Hui Zhang, Qian-Qian Wang, Jin Zhang, Yue Li, Hua Feng
BACKGROUND: A special type of meniscal lesion involving the peripheral attachment of the posterior horn of the medial meniscus (PHMM), termed ramp lesion, is commonly associated with anterior cruciate ligament (ACL) injury. However, no study has investigated its anatomic risk factors. Recently, increased meniscal slope has been identified as an independent anatomic risk factor for noncontact ACL injury. HYPOTHESIS: Increased medial meniscal slope (MMS) as measured on magnetic resonance imaging (MRI) will correlate with greater risk of concomitant ramp lesion in noncontact ACL injury...
August 2016: American Journal of Sports Medicine
S R Small, R D Rogge, R A Malinzak, E M Reyes, P L Cook, K A Farley, M A Ritter
OBJECTIVES: Initial stability of tibial trays is crucial for long-term success of total knee arthroplasty (TKA) in both primary and revision settings. Rotating platform (RP) designs reduce torque transfer at the tibiofemoral interface. We asked if this reduced torque transfer in RP designs resulted in subsequently reduced micromotion at the cemented fixation interface between the prosthesis component and the adjacent bone. METHODS: Composite tibias were implanted with fixed and RP primary and revision tibial trays and biomechanically tested under up to 2...
April 2016: Bone & Joint Research
M W Zhao, H Tian, L Zeng, B G Li, F L Zhang, L Y Li
OBJECTIVE: To evaluate the efficiency of the tibial coronal alignment after total knee arthroplasty with the extramedullary cutting system guided by the tibial tubercle and anterior tibial tendon, and to discuss the potential risk factors for the postoperative malalignment. METHODS: A retrospective study of 212 primary unilateral TKA surgeries (in 188 patients) in our hospital between June to December in 2014 had been analysed. All the cases were performed by one surgical group...
April 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Jamal McClendon, Randall B Graham, Patrick A Sugrue, Timothy R Smith, Sara E Thompson, Tyler R Koski
OBJECTIVE: To report the cranial center of mass (CCOM) progression in surgically treated patients for adult spinal deformity (ASD). The C7 plumb line/sagittal vertical axis (SVA) has important relationships with patient-reported outcomes; however, this has not yet been defined for CCOM. METHODS: Patients with consecutive ASD who were undergoing surgery greater than 5 levels of fusion between 2007 and 2012 and had radiographic, clinical, and outcomes data spanning ≥2 years were analyzed, retrospectively...
July 2016: World Neurosurgery
Juan Gómez-Hoyos, RobRoy L Martin, Ricardo Schröder, Ian James Palmer, Hal David Martin
PURPOSE: To establish the accuracy of the long-stride walking (LSW) and ischiofemoral impingement (IFI) tests for diagnosing IFI in patients whose primary symptom is posterior hip pain. METHODS: Confirmed IFI cases and cases in which IFI had been ruled out were identified considering imaging, injections, and endoscopic assessment, combined with pain relief and negative IFI-specific tests after treatment. Demographic data, duration of symptoms, pain location, ischiofemoral space, quadratus femoris space, quadratus femoris edema, surgical findings, and visual analog scale score for pain before and after treatment were computed for all patients included in this study...
July 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Benjamin R Rastetter, Samantha J Wright, Sabina Gheduzzi, Anthony W Miles, Sally E Clift
Revision total knee replacement is a challenging surgical procedure typically associated with significant loss of bone stock in the proximal tibia. To increase the fixation stability, extended stems are frequently used for the tibial component in revision surgery. The design of the tibial stem influences the load transfer from tibial component to the surrounding bone and is cited as a possible cause for the clinically reported pain in the location of the stem-end. This study aimed to analyse the strain distribution of a fully cemented revision tibial component with a validated finite element model...
June 2016: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
Bhaveen H Kapadia, Jeffrey Jai Cherian, Roland Starr, Morad Chughtai, Michael A Mont, Steven F Harwin, Anil Bhave
More than 20 million individuals in the United States are affected by knee osteoarthritis (OA), which can lead to altered biomechanics and excessive joint loading. The use of an unloader pneumatic brace with extension assist has been proposed as a nonoperative treatment modality that may improve gait mechanics and correct knee malalignment. We assessed the following parameters in patients who have knee OA treated with and without a brace: (1) changes in temporospatial parameters in gait; (2) knee range of motion, knee extension at heel strike, and foot placement; (3) knee joint moments and impulse; and (4) changes in dynamic stiffness and rate of change of knee flexion during midstance to terminal stance...
April 2016: Journal of Knee Surgery
Jeffrey D Seybold, John T Campbell, Clifford L Jeng, Kelly W Short, Mark S Myerson
BACKGROUND: Concomitant tears of the peroneus longus and brevis tendons are rare injuries, with literature limited to case reports and small patient series. Only 1 recent study directly compared the results of single-stage lateral deep flexor transfer, and no previous series objectively evaluated power and balance following transfer. The purpose of this study was to evaluate clinical outcomes, patient satisfaction, and objective power and balance data following single-stage flexor hallucis longus (FHL) and flexor digitorum longus (FDL) tendon transfers for treatment of concomitant peroneus longus and brevis tears...
June 2016: Foot & Ankle International
Harvi F Hart, Natalie J Collins, David C Ackland, Sallie M Cowan, Michael A Hunt, Kay M Crossley
BACKGROUND: Lateral knee osteoarthritis is notably common after anterior cruciate ligament reconstruction (ACLR). While valgus bracing has been investigated as an intervention for medial knee osteoarthritis (OA), little is known about the effectiveness of varus bracing for lateral knee OA after ACLR. PURPOSE: To determine the immediate effects of a varus unloader knee brace on gait biomechanics in people with lateral knee OA and valgus malalignment after ACLR. STUDY DESIGN: Controlled laboratory study...
April 2016: American Journal of Sports Medicine
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