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Knee injuries

Tony Lin-Wei Chen, Duo Wai-Chi Wong, Zhi Xu, Qitao Tan, Yan Wang, Ameersing Luximon, Ming Zhang
Flip-flops may change walking gait pattern, increase muscle activity and joint loading, and predispose wearers to foot problems, despite that quantitative evidence is scarce. The purpose of this study was to examine the lower limb muscle co-contraction and joint contact force in flip-flops gait, and compare with those of barefoot and sports shoes walking. Ten healthy males were instructed to perform over-ground walking at self-selected speed under three footwear conditions: 1) barefoot, 2) sports shoes, and 3) thong-type flip-flops...
2018: PloS One
Allicia Imada, Nathaniel Nelms, David Halsey, Michael Blankstein
Background: Following total knee and hip arthroplasty, patient progress can be assessed with patient-reported outcome measures (PROMs) and performance-based outcome measures (PBOMs). The American Joint Replacement Registry 2016 guide recommends collecting several measures, including Patient Reported Outcome Measure Information System Global, Knee Injury and Osteoarthritis Outcome Score Jr, and Hip Injury and Osteoarthritis Outcome Score Jr. This study aimed to assess the current and anticipated use of PROMs and PBOMs by New England physical therapists...
March 2018: Arthroplasty Today
Majd Tarabichi, Abtin Alvand, Noam Shohat, Karan Goswami, Javad Parvizi
A 62-year-old man who had undergone a primary knee arthroplasty 3 years earlier, presented to the emergency department with an infected prosthesis. He underwent prosthesis resection. All cultures failed to identify the infecting organism. Analysis of the intraoperative samples by next-generation sequencing revealed Streptococcus canis (an organism that resides in the oral cavity of dogs). It was later discovered that the patient had sustained a dog scratch injury several days earlier. The patient reports that his dog had licked the scratch...
March 2018: Arthroplasty Today
Levi Reina Fernandes, Herve Ouanezar, Adnan Saithna, Bertrand Sonnery-Cottet
The Segond fracture (SF) is considered pathognomonic of an anterior cruciate ligament (ACL) tear. However, the anatomy of the soft-tissue attachments responsible for the avulsion of SFs has been a cause of controversy. A 31-year-old male patient presented with an injury to his right knee that resulted in ACL tear and a SF. Open SF fixation and arthroscopic ACL reconstruction were performed. The anatomical dissection demonstrated that the avulsion of SFs had occurred because of the tibial attachment of the anterolateral ligament (ALL) with an intact Iliotibial band...
March 20, 2018: BMJ Case Reports
Salil Sidharthan Karipott, Bradley D Nelson, Robert E Guldberg, Keat Ghee Ong
Implantable wireless sensors have been used for real-time monitoring of chemicals and physical conditions of bones, tendons and muscles to diagnose and study orthopedic diseases and injuries. Due to the importance of these sensors in orthopedic care, a critical review, which not only analyzes the underlying technologies but also their clinical implementations and challenges, will provide a landscape view on their current state and their future clinical role. Areas covered: By conducting an extensive literature search and following the leaders of orthopedic implantable wireless sensors, this review covers the battery-powered and battery-free wireless implantable sensor technologies, and describes their implementation for hips, knees, spine, and shoulder stress/strain monitoring...
March 21, 2018: Expert Review of Medical Devices
Andrew G Geeslin, Jorge Chahla, Gilbert Moatshe, Kyle J Muckenhirn, Bradley M Kruckeberg, Alex W Brady, Ashley Coggins, Grant J Dornan, Alan M Getgood, Jonathan A Godin, Robert F LaPrade
BACKGROUND: The individual kinematic roles of the anterolateral ligament (ALL) and the distal iliotibial band Kaplan fibers in the setting of anterior cruciate ligament (ACL) deficiency require further clarification. This will improve understanding of their potential contribution to residual anterolateral rotational laxity after ACL reconstruction and may influence selection of an anterolateral extra-articular reconstruction technique, which is currently a matter of debate. Hypothesis/Purpose: To compare the role of the ALL and the Kaplan fibers in stabilizing the knee against tibial internal rotation, anterior tibial translation, and the pivot shift in ACL-deficient knees...
March 1, 2018: American Journal of Sports Medicine
Audrey R C Elias, Kari J Harris, Paul C LaStayo, Ryan L Mizner
BACKGROUND: Limited knee flexion and increased muscle co-contraction during jump landing are believed to diminish outcomes after anterior cruciate ligament (ACL) reconstruction. The efficacy of jump training to improve patients' mechanical and neuromuscular deficits is understudied. HYPOTHESIS: Jump training will improve functional, mechanical, and neuromuscular outcomes and higher repetition training augmented by body weight support will result in better retention of gains...
March 1, 2018: American Journal of Sports Medicine
Ping Yao, Peng Li, Jun-Jian Jiang, Hong-Ye Li
Scar hyperplasia at the suture site is an important reason for hindering the repair effect of peripheral nerve injury anastomosis. To address this issue, two repair methods are often used. Biological agents are used to block nerve sutures and the surrounding tissue to achieve physical anti-adhesion effects. Another agent is glucocorticosteroid, which can prevent scar growth by inhibiting inflammation. However, the overall effect of promoting regeneration of the injured nerve is not satisfactory. In this regard, we envision that these two methods can be combined and lead to shared understanding for achieving improved nerve repair...
February 2018: Neural Regeneration Research
Yale A Fillingham, Brian Darrith, Jess H Lonner, Chris Culvern, Meredith Crizer, Craig J Della Valle
BACKGROUND: The purpose of this randomized clinical trial was to compare formal outpatient physical therapy (PT) and unsupervised home exercises after unicompartmental knee arthroplasty (UKA). METHODS: Fifty-two patients were randomized to 6 weeks of outpatient PT or an unsupervised home exercise program after UKA. The primary outcome was change in range of motion at 6 weeks with secondary outcomes including total arc of motion, Knee Society Score, Knee Injury and Osteoarthritis Outcome Score Jr, Lower Extremity Functional Scale, and Veterans Rands-12 score...
February 21, 2018: Journal of Arthroplasty
Pinar Yilgor Huri, Seren Hamsici, Emre Ergene, Gazi Huri, Mahmut Nedim Doral
Infrapatellar fat pad is a densely vascularized and innervated extrasynovial tissue that fills the anterior knee compartment. It plays a role in knee biomechanics as well as constitutes a source of stem cells for regeneration after knee injury. Infrapatellar fat pad-derived stem cells (IPFP-ASCs) possess enhanced and age-independent differentiation capacity as compared to other stem cells, which makes them a very promising candidate in stem cell-based regenerative therapy. The aims of this review are to outline the latest advances and potential trends in using IPFP-ASCs and to emphasize the advantages over other sources of stem cells for applications in orthopedic surgery...
March 19, 2018: Knee Surgery & related Research
Jill Alexander, Jim Richards, Obed Attah, Sam Cheema, Joanna Snook, Chloe Wisdell, Karen May, James Selfe
Delayed effects of a 20-min crushed ice application on knee joint position sense assessed by a functional task during a re-warming period. INTRODUCTION: The effect of cryotherapy on joint positioning presents conflicting debates as to whether individuals are at an increased risk of injury when returning to play following cryotherapy application at the lower limb. OBJECTIVES: The aim of this study was to investigate whether a 20 min application of crushed ice at the knee affects knee joint kinematics immediately post and up to 20 mins post ice removal, during a small knee bend...
March 6, 2018: Gait & Posture
Matthew D LaPrade, Samantha L Kallenbach, Zachary S Aman, Gilbert Moatshe, Hunter W Storaci, Travis Lee Turnbull, Elizabeth A Arendt, Jorge Chahla, Robert F LaPrade
BACKGROUND: Quantification of the biomechanical properties of each individual medial patellar ligament will facilitate an understanding of injury patterns and enhance anatomic reconstruction techniques by improving the selection of grafts possessing appropriate biomechanical properties for each ligament. PURPOSE: To determine the ultimate failure load, stiffness, and mechanism of failure of the medial patellofemoral ligament (MPFL), medial patellotibial ligament (MPTL), and medial patellomeniscal ligament (MPML) to assist with selection of graft tissue for anatomic reconstructions...
March 1, 2018: American Journal of Sports Medicine
Stefan Plesser, Mohammad Keilani, Gyoergy Vekszler, Timothy Hasenoehrl, Stefano Palma, Martin Reschl, Richard Crevenna, Stefan Hajdu, Harald Kurt Widhalm
Biomechanical studies have shown the use of suture anchors (SA) to be superior to the traditional transosseous sutures (TS) in the repair of quadriceps tendon rupture (QTR). This study aimed to analyze and compare the functional outcomes of patients treated for quadriceps tendon ruptures using suture anchors or transosseous sutures. Patients having undergone suture anchor repair or transosseous suture repair for quadriceps tendon rupture between 2010 and 2015 at one of the two participating hospitals were included...
2018: PloS One
Hanne Heszlein-Lossius, Yahya Al-Borno, Samar Shaqoura, Nashwa Skaik, Lasse Melvær Giil, Mads Gilbert
BACKGROUND: During four separate Israeli military attacks on Gaza (2006, 2009, 2012, and 2014), about 4000 Palestinians were killed and more than 17 000 injured (412 killed and 1264 injured in 2006; 1383 killed and more than 5300 injured in 2009; 130 killed and 1399 injured in 2012; and 2251 killed and 11 231 injured in 2014). An unknown number of people had traumatic amputations of one or more extremities. Use of unmanned Israeli drones for surveillance and armed attacks on Gaza was evident, but exact figures on numbers of drone strikes on Gaza are not available...
February 21, 2018: Lancet
Marie E Boo, J Craig Garrison, Joseph P Hannon, Kalyssa M Creed, Shiho Goto, Angellyn N Grondin, James M Bothwell
Background: Female patients are more likely to suffer a second anterior cruciate ligament (ACL) injury after ACL reconstruction (ACLR) and return to sport (RTS) compared with healthy female controls. Few studies have examined the energy absorption contribution (EAC) that could lead to this subsequent injury. Hypothesis: The ACLR group would demonstrate an altered EAC between joints (hip, knee, and ankle) but no difference in quadriceps, hip abduction, or hip external rotation (ER) strength at the time of RTS...
March 2018: Orthopaedic Journal of Sports Medicine
Tetsuro Ushio, Ken Okazaki, Hideki Mizu-Uchi, Satoshi Hamai, Yukio Akasaki, Yasuharu Nakashima
Background: An anterior cruciate ligament (ACL) reconstruction has become more common and the surgical morbidity has decreased, it has been performed not only in younger people to play sports but also middle-aged people, with satisfactory results. Therefore, some patients might have comorbidities for which they take medicines. Especially the medicines, such as systemic steroids, might influence the reconstructed ligament strength and durability. Case report: A 49-year-old woman who was taking oral steroids for autoimmune hepatitis suffered a spontaneous ACL injury...
January 2018: Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology
Joseph T Gamboa, Edward C Shin, Neil P Pathare, Patrick J McGahan, James L Chen
Anterior cruciate ligament (ACL) tears are an unfortunate and devastating injury in the athletic patient. Surgical reconstruction of the ACL with a taut graft construct is necessary to restore knee stability and help expedite the patient's return to an active lifestyle. Arthroscopy-assisted ACL reconstruction can be a technically involved procedure, where strong fixation limits graft motion to allow sufficient healing within the tibial and femoral tunnels at the bone-tendon interfaces. Loss of tension in a graft can cause symptomatic anterior or rotatory instability and potential retear of the ACL graft...
February 2018: Arthroscopy Techniques
Kadir Buyukdogan, Michael S Laidlaw, Mark D Miller
The management of multiligament knee injury is a complex process starting with the adequate identification of the injury. A detailed physical and radiographic examination with a thorough understanding of knee anatomy is crucial to assess all damaged structures: anterior cruciate ligament, posterior cruciate ligament, posteromedial corner including the medial collateral ligament, and posterolateral corner including the lateral collateral ligament. Several surgical techniques have been developed throughout the years to adequately address these ligament insufficiencies...
February 2018: Arthroscopy Techniques
Etienne Cavaignac, Gregoire Laumond, Nicolas Reina, Karine Wytrykowski, Jérôme Murgier, Marie Faruch, Philippe Chiron
Ultrasonography (US) is a nonirradiating, low-cost, real-time imaging modality that has very good spatial resolution. US can be used to view the anterolateral ligament (ALL) and injuries to the ALL. Several authors have sought to analyze the anterolateral aspect of the knee using US with varying luck. All of them analyzed the ALL statically only. The goal of this Technical Note is to describe in detail the technique that we use to analyze the anterolateral aspect of the knee in patients with an anterior cruciate ligament tear...
January 2018: Arthroscopy Techniques
Britt Elin Øiestad, Inger Holm, May Arna Risberg
OBJECTIVES: To examine the associations between return to pivoting sport following ACL reconstruction (ACLR) and knee osteoarthritis (OA), and self-reported knee symptoms, function and quality of life after 15 years. METHODS: Study sample included 258 participants with ACLR 15 years previously. Return to pivoting sport (handball, soccer and basketball) data were collected by interviews, and symptomatic OA was defined as Kellgren and Lawrence grade ≥2 plus almost daily knee pain in the last month...
March 17, 2018: British Journal of Sports Medicine
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