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T K Kim, Mark Phillips, Mohit Bhandari, John Watson, Rajesh Malhotra
BACKGROUND: Most TKA prostheses are designed based on the anatomy of white patients. Individual studies have identified key anthropometric differences between the knees of the white population and other major ethnic groups, yet there is limited understanding of what these findings may indicate if analyzed collectively. QUESTION/PURPOSE: What are the differences in morphologic features of the distal femur and proximal tibia among and within various ethnicities? METHODS: A systematic review of the PubMed database and a hand-search of article bibliographies identified 235 potentially eligible English-language studies...
October 4, 2016: Clinical Orthopaedics and related Research
P Pinsornsak, K Naratrikun, S Kanitnate, T Sangkomkamhang
OBJECTIVES: The purpose of this study was to compare the joint space width between one-leg and both-legs standing radiographs in order to diagnose a primary osteoarthritis of the knee. METHODS: Digital radiographs of 100 medial osteoarthritic knees in 50 patients were performed. The patients had undergone one-leg standing anteroposterior (AP) views by standing on the affected leg while a both-legs standing AP view was undertaken while standing on both legs. The severity of the osteoarthritis was evaluated using the joint space width and Kellgren-Lawrence (KL) radiographic classification...
September 2016: Bone & Joint Research
Dimitris Dimitriou, Tsung-Yuan Tsai, Kwan Kyu Park, Ali Hosseini, Young-Min Kwon, Harry E Rubash, Guoan Li
An equal knee joint height during flexion and extension is of critical importance in optimizing soft-tissue balancing following total knee arthroplasty (TKA). However, there is a paucity of data regarding the in-vivo knee joint height behavior. This study evaluated in-vivo heights and anterior-posterior (AP) translations of the medial and lateral femoral condyles before and after a cruciate-retaining (CR)-TKA using two flexion axes: surgical transepicondylar axis (sTEA) and geometric center axis (GCA). Eleven osteoarthritis (OA) knee patients were studied during a weight-bearing single leg lunge, using a validated dual fluoroscopic imaging system (DFIS) based tracking technique...
June 14, 2016: Journal of Biomechanics
Sally Arno, Christopher P Bell, Michael J Alaia, Brian C Singh, Laith M Jazrawi, Peter S Walker, Ankit Bansal, Garret Garofolo, Orrin H Sherman
BACKGROUND: Considerable debate remains over which anterior cruciate ligament (ACL) reconstruction technique can best restore knee stability. Traditionally, femoral tunnel drilling has been done through a previously drilled tibial tunnel; however, potential nonanatomic tunnel placement can produce a vertical graft, which although it would restore sagittal stability, it would not control rotational stability. To address this, some suggest that the femoral tunnel be created independently of the tibial tunnel through the use of an anteromedial (AM) portal, but whether this results in a more anatomic footprint or in stability comparable to that of the intact contralateral knee still remains controversial...
July 2016: Clinical Orthopaedics and related Research
Lorenz Büchler, Dorina Regli, Dimitrios Stergios Evangelopoulos, Kathrin Bieri, Sufian S Ahmad, Anna Krismer, Thorsten Muller, Sandro Kohl
BACKGROUND: Recently, a new technique, dynamic intraligamentary stabilization (DIS) was introduced for the acute repair of ACL ruptures. The purpose of this study was to report the functional recovery for patients undergoing acute anterior cruciate ligament (ACL) repair alongside DIS. METHODS: Forty five patients sustaining acute ACL rupture and treated with DIS repair were retrospectively evaluated. Limb symmetry index of the hop test as well as knee function by means of range of motion, knee swelling, pain and maximum strength were evaluated...
June 2016: Knee
Lindsay V Slater, Joseph M Hart
Bilateral squats are frequently used exercises in sport performance programs. Lower extremity muscle activation may change based on knee alignment during the performance of the exercise. The purpose of this study was to compare lower extremity muscle activation patterns during different squat techniques. 28 healthy, uninjured subjects (19F, 9M, 21.5 ± 3 yrs, 170 ± 8.4cm, 65.7 ± 11.8kg) volunteered. EMG electrodes were placed on the vastus lateralis, vastus medialis, rectus femoris, biceps femoris, and the gastrocnemius of the dominant leg...
January 19, 2016: Journal of Strength and Conditioning Research
Koji Murakami, Satoshi Hamai, Ken Okazaki, Satoru Ikebe, Takeshi Shimoto, Daisuke Hara, Hideki Mizu-uchi, Hidehiko Higaki, Yukihide Iwamoto
PURPOSE: Participation in specific activities requires complex ranges of knee movements and activity-dependent kinematics. The purpose of this study was to investigate dynamic knee kinematics during squat and golf swing using image-matching techniques. METHODS: Five healthy males performed squats and golf swings under periodic X-ray images at 10 frames per second. We analyzed the in vivo three-dimensional kinematic parameters of subjects' knees, namely the tibiofemoral flexion angle, anteroposterior (AP) translation, and internal-external rotation, using serial X-ray images and computed tomography-derived, digitally reconstructed radiographs...
March 2016: Knee
Song-Jie Ji, Yi-Xin Zhou, Xu Jiang, Zhi-Yuan Cheng, Guang-Zhi Wang, Hui Ding, Ming-Lei Yang, Zhong-Lin Zhu
BACKGROUND: Joint line (JL) is a very important factor for total knee arthroplasty (TKA) to restore. The objective of this study was to evaluate the early clinical and kinematic results of TKAs with posterior-stabilized (PS) or cruciate retaining (CR) implants in which the JL was elevated postoperatively. METHODS: Data were collected from patients who underwent TKA in our department between April 2011 and April 2014. The patients were divided into two groups based on the prosthesis they received (PS or CR)...
November 5, 2015: Chinese Medical Journal
Stefan Brunner, Patrick Vavken, Robert Kilger, Julia Vavken, Erich Rutz, Reinald Brunner, Carlo Camathias
PURPOSE: To evaluate efficacy and safety of extraphyseal tibial eminence avulsion fracture repair with absorbable sutures and a distal bone bridge fixation in comparison to previously described technique with non-absorbable sutures and distal screw fixation. METHODS: In a physeal-sparing technique, tibial eminence fractures (n = 25; McKeever type II/III n = 11/14) were either treated in group A (n = 15, follow-up 28.1 months) using an absorbable suture fixed over a bone bridge or in group B (n = 10, follow-up 47...
March 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Biagio Zampogna, Sebastiano Vasta, Annunziato Amendola, Bastian Uribe-Echevarria Marbach, Yubo Gao, Rocco Papalia, Vincenzo Denaro
BACKGROUND: High tibial osteotomy (HTO) is a well-established and commonly utilized technique in medial knee osteoarthritis secondary to varus malalignment. Accurate measurement of the preoperative limb alignment, and the amount of correction required are essential when planning limb realignment surgery. The hip-knee-ankle angle (HKA) measured on a full length weightbearing (FLWB) X-ray in the standing position is considered the gold standard, since it allows for reliable and accurate measurement of the mechanical axis of the whole lower extremity...
2015: Iowa Orthopaedic Journal
Davide Edoardo Bonasia, Andrea D'Amelio, Pietro Pellegrino, Federica Rosso, Roberto Rossi
Although the importance of the anterolateral stabilizing structures of the knee in the setting of anterior cruciate ligament (ACL) injuries has been recognized since many years, most of orthopedic surgeons do not take into consideration the anterolateral structures when performing an ACL reconstruction. Anatomic single or double bundle ACL reconstruction will improve knee stability, but a small subset of patients may experience some residual anteroposterior and rotational instability. For this reason, some researchers have turned again towards the anterolateral aspect of the knee and specifically the anterolateral ligament...
June 3, 2015: Orthopedic Reviews
Lianxin Wang, Lin Lin, Yong Feng, Tiago Lazzaretti Fernandes, Peter Asnis, Ali Hosseini, Guoan Li
BACKGROUND: Clinical outcome studies showed a high incidence of knee osteoarthritis after anterior cruciate ligament reconstruction. Abnormal joint kinematics and loading conditions were assumed as risking factors. However, little is known on cartilage contact forces after the surgery. METHODS: A validated computational model was used to simulate anatomic and transtibial single-bundle anterior cruciate ligament reconstructions. Two graft fixation angles (0° and 30°) were simulated for each reconstruction...
December 2015: Clinical Biomechanics
Yasuo Niki, Katsuya Nagai, Kengo Harato, Yasunori Suda, Masaya Nakamura, Morio Matsumoto
PURPOSE: Bone tunnel creation techniques influence the 3-dimensional (3D) position of bone tunnels and graft-bending angle in anterior cruciate ligament (ACL) reconstruction. This study assessed graft-bending angle and 3D characteristics of femoral bone tunnels and compared them between outside-in (OI) and transportal (TP) techniques. METHODS: Participants comprised 64 patients who underwent anatomic double-bundle ACL reconstruction, allocated to OI and TP groups (n = 32 each)...
August 21, 2015: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
V Madonna, D Screpis, V Condello, G Piovan, A Russo, M Guerriero, C Zorzi
PURPOSE: In the last year, we have performed a new technique for combined medial collateral ligament (MCL) and posterior oblique ligament (POL) reconstruction in chronic setting of anterior cruciate ligament and MCL complex deficiency. Autogenous semitendinosus tendon with the tibial attachment preserved has been used for the medial/posteromedial compartment reconstruction. We describe the operative technique. METHODS: Between January and December 2014, 12 consecutive patients with multiligamentous injuries underwent concomitant MCL/POL using a novel technique...
October 2015: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Takumi Ino, Yasumitsu Ohkoshi, Tatsunori Maeda, Kensaku Kawakami, Shoji Suzuki, Harukazu Tohyama
[Purpose] The purpose of this study was to determine the normal range of the side-to-side difference in three dimensional knee kinematics measured by the point cluster technique (PCT). [Subjects] The subjects were twenty-one healthy normal volunteers without knee pain or an episode of injury to the legs. [Methods] The subjects were tested bilaterally at a self-selected normal walking speed and six degrees of freedom knee kinematics were measured using the PCT, and the 95% confidence intervals of the average side-to-side differences in flexion-extension (FE), adduction-abduction (AA), internal-external (IE) rotation, and anterior-posterior (AP), medial-lateral (ML), superior-inferior (SI) translation in each stage of the gait cycle were determined...
June 2015: Journal of Physical Therapy Science
Manfred Nelitz, Jens Dreyhaupt, Sean Robert March Williams, Daniel Dornacher
PURPOSE: Severly increased femoral anteversion is an important risk factor for patellofemoral instability. Recurrent dislocations cause a traumatic disruption of the medial patellofemoral ligament. Therefore a procedure that combines femoral derotation osteotomy and patellofemoral ligament reconstruction should be considered for patients with severely increased femoral anteversion. The aim of the study was to evaluate the subjective and objective outcomes after combined femoral derotation osteotomy and anatomical reconstruction of the MPFL...
December 2015: International Orthopaedics
Michael Osti, Alessa Krawinkel, Michael Ostermann, Thomas Hoffelner, Karl Peter Benedetto
BACKGROUND: Anatomic graft tunnel placement is recommended in anterior cruciate ligament (ACL) reconstruction to restore knee joint stability and function. Transtibial (TT), anteromedial portal (AMP), and outside-in (OI) retrograde drilling surgical techniques have been described for tibial and femoral bone tunnel preparation. PURPOSE/HYPOTHESIS: The purpose of this study was to evaluate the bone tunnel parameters and compare the ability of 3 different surgical techniques to achieve placement of the ACL femoral and tibial bone tunnels at the center of the native ACL femoral and tibial attachment sites...
September 2015: American Journal of Sports Medicine
S Brady, R Kaufman
PURPOSE: To develop an automated pediatric dose reporting quality assurance (QA) tool for digital radiography (DR) using DICOM metadata. METHODS: Patient examination and demographical information were gathered from metadata analysis of DICOM header data. Average patient thicknesses were measured for head, chest, abdomen, knees, and hands using volumetric images from CT. Patient entrance skin air KERMA (ESAK) was calculated by first looking up examination technique factors taken from DICOM header metadata (i...
June 2015: Medical Physics
Pierre Imbert, Claudio Belvedere, Alberto Leardini
PURPOSE: Quantifying the effects of anterior cruciate ligament (ACL) deficiency on knee joint laxity is fundamental for understanding the outcomes of its reconstruction techniques. The general aim of this study was to determine intra-operatively the main modifications in knee laxity before and after standard isolated intra-articular and additional extra-articular anterolateral reinforcement. Our main hypothesis was that laxity abnormalities, particularly axial rotation, can still result from these ACL reconstruction techniques...
June 3, 2015: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Paul Dearden, Kathryn Lowery, Kevin Sherman, Vishy Mahadevan, Hemant Sharma
Proximal tibio-fibular joint is routinely stabilised during leg lengthening, peri-articular fractures and deformity corrections of tibia. Potential injury to the common peroneal nerve at the level of the fibula head/neck junction during wire insertion is a recognised complication. Previous studies have mapped the course of the common peroneal nerve and its branches at the level of the fibular head, and guidelines are published regarding placement of proximal tibial wires. This study aims to relate the course of the common peroneal nerve to the placement of a lateral insertion fibula head transfixion wire...
August 2015: Strategies in Trauma and Limb Reconstruction
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