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https://www.readbyqxmd.com/read/29663125/arthroscopic-transtibial-pcl-reconstruction-surgical-technique-and-clinical-outcomes
#1
REVIEW
Jessica Shin, Travis G Maak
PURPOSE OF REVIEW: Posterior cruciate ligament (PCL) injuries are relatively uncommon injuries. As such, there is a dearth of high-quality studies in the literature examining the operative management of PCL injuries and a lack of clear consensus on what the optimal method should be. The goal of this review was to conduct a comprehensive evaluation of recent literature and provide an evidence-based algorithm to optimize surgical decision-making and outcomes for PCL reconstruction. RECENT FINDINGS: Recent literature confirms that transtibial PCL reconstruction is a reliable and reproducible method to manage PCL injuries and results in satisfactory patient outcomes...
April 16, 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29653108/validation-of-the-narrowing-beam-walking-test-in-lower-limb-prosthesis-users
#2
Andrew Sawers, Brian Hafner
OBJECTIVE: To evaluate the content, construct, and discriminant validity of the Narrowing Beam Walking Test (NBWT), a performance-based balance test for lower limb prosthesis users. DESIGN: Cross-sectional study. SETTING: Research laboratory and prosthetics clinic. PARTICIPANTS: Forty unilateral transtibial and transfemoral prosthesis users. INTERVENTION: Not applicable. MAIN OUTCOME MEASURE(S): Content validity was examined by quantifying the percentage of participants receiving maximum or minimum scores (i...
April 10, 2018: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29623812/the-efficacy-of-the-ankle-mimicking-prosthetic-foot-prototype-4-0-during-walking-physiological-determinants
#3
Kevin De Pauw, Pierre Cherelle, Bart Roelands, Dirk Lefeber, Romain Meeusen
BACKGROUND: Evaluating the effectiveness of a novel prosthetic device during walking is an important step in product development. OBJECTIVE: To investigate the efficacy of a novel quasi-passive ankle prosthetic device, Ankle Mimicking Prosthetic Foot 4.0, during walking at different speeds, using physiological determinants in transtibial and transfemoral amputees. STUDY DESIGN: Nonrandomized crossover design for amputees. METHODS: Six able-bodied subjects, six unilateral transtibial amputees, and six unilateral transfemoral amputees underwent a 6-min walk test at normal speed, followed by series of 2-min walking at slow, normal, and fast speeds...
April 1, 2018: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/29623810/step-count-accuracy-of-stepwatch-and-fitbit-one%C3%A2-among-individuals-with-a-unilateral-transtibial-amputation
#4
Elisa S Arch, Jaclyn M Sions, John Horne, Barry A Bodt
BACKGROUND: Step counts, obtained via activity monitors, provide insight into activity level in the free-living environment. Accuracy assessments of activity monitors are limited among individuals with lower-limb amputations. OBJECTIVES: (1) To evaluate the step count accuracy of both monitors during forward-linear and complex walking and (2) compare monitor step counts in the free-living environment. STUDY DESIGN: Cross-sectional study. METHODS: Adult prosthetic users with a unilateral transtibial amputation were equipped with StepWatch and FitBit One™...
April 1, 2018: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/29622245/editorial-commentary-we-know-we-need-to-fix-knee-meniscal-radial-root-tears-but-how-best-to-perform-the-repairs
#5
EDITORIAL
Robert F LaPrade
The present work further contributes to building the base of the research pyramid by noting the importance of repairing knee meniscal radial root tears. Because of the extensive biomechanical studies that have now been published on the restoration of joint mechanics and with what I believe results in a higher likelihood of an improved healing environment with securing the meniscus root tear down to bone, I would strongly recommend that when one does see a meniscus root tear that the transtibial pullout root repair technique be considered over a side-to-side repair...
April 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29614468/energy-expenditure-in-people-with-transtibial-amputation-walking-with-crossover-and-energy-storing-prosthetic-feet-a-randomized-within-subject-study
#6
Cody L McDonald, Patricia A Kramer, Sara J Morgan, Elizabeth G Halsne, Sarah M Cheever, Brian J Hafner
BACKGROUND: Energy storing feet are unable to reduce the energy required for normal locomotion among people with transtibial amputation. Crossover feet, which incorporate aspects of energy storing and running specific feet, are designed to maximize energy return while providing stability for everyday activities. RESEARCH QUESTION: Do crossover prosthetic feet reduce the energy expenditure of walking across a range of speeds, when compared with energy storing feet among people with transtibial amputation due to non-dysvascular causes? METHODS: A randomized within-subject study was conducted with a volunteer sample of twenty-seven adults with unilateral transtibial amputation due to non-dysvascular causes...
March 27, 2018: Gait & Posture
https://www.readbyqxmd.com/read/29614465/running-at-submaximal-speeds-the-role-of-the-intact-and-prosthetic-limbs-for-trans-tibial-amputees
#7
Siobhan C Strike, Daniela Acrone, Michael Orendurff
BACKGROUND: Dynamic Elastic Response prostheses are designed absorb and return strain energy in running. Past research has focused on running prostheses with a single toe spring designed for high speeds. RESEARCH QUESTION: To determine how runners with amputation modulate the ground reaction force of each limb to run at different speeds using a general-purpose dynamic prosthesis which has a heel spring. METHODS: Overground running data were collected in 16 recreational runners (8 transtibial amputee using their own BladeXT prosthesis and 8 controls) using Vicon Nexus V...
March 27, 2018: Gait & Posture
https://www.readbyqxmd.com/read/29599517/increasing-prosthetic-foot-energy-return-affects-whole-body-mechanics-during-walking-on-level-ground-and-slopes
#8
W Lee Childers, Kota Z Takahashi
Prosthetic feet are designed to store energy during early stance and then release a portion of that energy during late stance. The usefulness of providing more energy return depends on whether or not that energy transfers up the lower limb to aid in whole body propulsion. This research examined how increasing prosthetic foot energy return affected walking mechanics across various slopes. Five people with a uni-lateral transtibial amputation walked on an instrumented treadmill at 1.1 m/s for three conditions (level ground, +7...
March 29, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29580940/relationships-among-perceived-functional-capacity-self-efficacy-and-disability-after-dysvascular-amputation
#9
Matthew J Miller, Dawn M Magnusson, Guy Lev, Thomas T Fields, Paul F Cook, Jennifer E Stevens-Lapsley, Cory L Christiansen
BACKGROUND: Prosthesis rehabilitation after dysvascular transtibial amputation (TTA) is focused on optimizing functional capacity with limited emphasis on promoting health self-efficacy. Self-efficacy interventions decrease disability for people living with chronic disease, but the influence of self-efficacy on disability is unknown for people with dysvascular TTA. OBJECTIVES: To identify if self-efficacy mediates the relationship between self-reported functional capacity and disability after dysvascular TTA...
March 23, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29574163/tibial-tunnel-widening-associated-with-anterior-cruciate-ligament-reconstruction-using-autogenous-hamstrings-a-comparison-between-antero-medial-portal-and-transtibial-techniques
#10
J Silberberg Muiño, A Nilo Fulvi, G Vera, J L Gutiérrez García, M Giménez Salvay, M Maroa Salvucci, A Ruiz Ollero
OBJECTIVE: Evaluate the enlargement effect of the tibial tunnel emergence of 2 different of anterior cruciate ligament reconstruction techniques: antero-medial portal (AMP) vs. transtibial (TT) technique. METHODS: A prospective, randomized controlled study was performed in 36 consecutive patients who underwent anterior cruciate ligament reconstruction with autologous hamstring tendon grafts employing the AMP and conventional TT techniques. Lateral and antero-posterior radiographs were obtained for each patient at 6 weeks and 12 months postoperatively...
March 21, 2018: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29552479/articulated-bone-block-for-posterior-cruciate-ligament-reconstruction-using-bone-patellar-tendon-bone-autograft-surgical-technique-to-facilitate-graft-passage
#11
Ramón Cugat, Eduard Alentorn-Geli, Xavier Cuscó, Jordi Navarro, Gilbert Steinbacher, Pedro Álvarez-Díaz, Roberto Seijas, David Barastegui, Montse García-Balletbó
Posterior cruciate ligament reconstruction using the transtibial technique provides successful clinical outcomes. However, a bone-patellar tendon-bone (BTB) autograft with the transtibial technique has not been used by some surgeons because of concerns with graft passage from the tibial to the femoral tunnels (sharp turn) that can damage graft fibers. In the present surgical technique, an arthroscopic, transtibial, single-bundle technique for posterior cruciate ligament reconstruction using the BTB autograft with an easy and effective technical tip to facilitate graft passage is presented...
February 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29515513/immersive-low-cost-virtual-reality-treatment-for-phantom-limb-pain-evidence-from-two-cases
#12
Elisabetta Ambron, Alexander Miller, Katherine J Kuchenbecker, Laurel J Buxbaum, H Branch Coslett
Up to 90% of amputees experience sensations in their phantom limb, often including strong, persistent phantom limb pain (PLP). Standard treatments do not provide relief for the majority of people who experience PLP, but virtual reality (VR) has shown promise. This study provides additional evidence that game-like training with low-cost immersive VR activities can reduce PLP in lower-limb amputees. The user of our system views a real-time rendering of two intact legs in a head-mounted display while playing a set of custom games...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29480094/the-impact-a-surgeon-has-on-primary-amputee-prosthetic-rehabilitation-a-survey-of-residual-lower-limb-quality
#13
Sellaiah Sooriakumaran, Maggie Uden, Sarah Mulroy, David Ewins, Thomas Collins
BACKGROUND: Substantial improvements have been perceived in surgical results following major lower limb amputation, but there remains observed variation in amputation quality for patients referred for prosthetic rehabilitation from different hospitals. OBJECTIVES: To assess various elements that influence residual limb quality and evaluate their impact on progress through initial prosthetic rehabilitation and mobility outcome after rehabilitation. STUDY DESIGN: Clinical survey...
February 1, 2018: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/29451922/identifying-classifier-input-signals-to-predict-a-cross-slope-during-transtibial-amputee-walking
#14
Courtney E Shell, Glenn K Klute, Richard R Neptune
Advanced prosthetic foot designs often incorporate mechanisms that adapt to terrain changes in real-time to improve mobility. Early identification of terrain (e.g., cross-slopes) is critical to appropriate adaptation. This study suggests that a simple classifier based on linear discriminant analysis can accurately predict a cross-slope encountered (0°, -15°, 15°) using measurements from the residual limb, primarily from the prosthesis itself. The classifier was trained and tested offline using motion capture and in-pylon sensor data collected during walking trials in mid-swing and early stance...
2018: PloS One
https://www.readbyqxmd.com/read/29438635/twenty-year-follow-up-study-comparing-operative-versus-nonoperative-treatment-of-anterior-cruciate-ligament-ruptures-in-high-level-athletes
#15
Daan T van Yperen, Max Reijman, Eline M van Es, Sita M A Bierma-Zeinstra, Duncan E Meuffels
BACKGROUND: An anterior cruciate ligament (ACL) rupture has major consequences at midterm follow-up, with an increasing chance of developing an old knee in a young patient. The long-term (≥20 years) effects of the operative and nonoperative treatment of ACL ruptures are still unclear. PURPOSE: To compare the long-term treatment outcomes of operative versus nonoperative treatment of ACL ruptures in high-level athletes. STUDY DESIGN: Cohort study; Level of evidence, 2...
February 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29437636/outcomes-following-limb-salvage-after-combat-hindfoot-injury-are-inferior-to-delayed-amputation-at-five-years
#16
P M Bennett, T Stevenson, I D Sargeant, A Mountain, J G Penn-Barwell
OBJECTIVES: The surgical challenge with severe hindfoot injuries is one of technical feasibility, and whether the limb can be salvaged. There is an additional question of whether these injuries should be managed with limb salvage, or whether patients would achieve a greater quality of life with a transtibial amputation. This study aims to measure functional outcomes in military patients sustaining hindfoot fractures, and identify injury features associated with poor function. METHODS: Follow-up was attempted in all United Kingdom military casualties sustaining hindfoot fractures...
February 2018: Bone & Joint Research
https://www.readbyqxmd.com/read/29414988/laboratory-and-community-based-health-outcomes-in-people-with-transtibial-amputation-using-crossover-and-energy-storing-prosthetic-feet-a-randomized-crossover-trial
#17
Sara J Morgan, Cody L McDonald, Elizabeth G Halsne, Sarah M Cheever, Rana Salem, Patricia A Kramer, Brian J Hafner
Contemporary prosthetic feet are generally optimized for either daily or high-level activities. Prosthesis users, therefore, often require multiple prostheses to participate in activities that span a range of mobility. Crossover feet (XF) are designed to increase the range of activities that can be performed with a single prosthesis. However, little evidence exists to guide clinical prescription of XF relative to traditional energy storing feet (ESF). The objective of this study was to assess the effects of XF and ESF on health outcomes in people with transtibial amputation...
2018: PloS One
https://www.readbyqxmd.com/read/29413449/trunk-movement-compensations-and-corresponding-core-muscle-demand-during-step-ambulation-in-people-with-unilateral-transtibial-amputation
#18
Brecca M M Gaffney, Cory L Christiansen, Amanda M Murray, Bradley S Davidson
The objective of this investigation was to identify demands from core muscles that corresponded with trunk movement compensations during bilateral step ambulation in people with unilateral transtibial amputation (TTA). Trunk rotational angular momentum (RAM) was measured using motion capture and bilateral surface EMG was measured from four bilateral core muscles during step ascent and descent tasks in people with TTA and healthy controls. During step ascent, the TTA group generated larger mediolateral (P = 0...
January 24, 2018: Journal of Electromyography and Kinesiology
https://www.readbyqxmd.com/read/29413195/editorial-commentary-knee-medial-meniscus-root-tears-you-may-not-have-seen-it-but-it-s-seen-you
#19
EDITORIAL
Aaron J Krych
Medial meniscus root tears are becoming increasingly recognized in clinical practice as a source of profound pain and dysfunction in patients. There has been considerable debate about the cause of these distinct meniscus tears, and what the optimal treatment should be for an individual patient. Midterm medial meniscus root repair results suggest that in a well-aligned knee with minimal degenerative change, transtibial root repair is an effective technique for improving pain, function, and possibly preventing further cartilage degeneration...
February 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29410114/differences-in-physical-performance-measures-among-patients-with-unilateral-lower-limb-amputations-classified-as-functional-level-k3-versus-k4
#20
Jaclyn Megan Sions, Emma Haldane Beisheim, Tara Jo Manal, Sarah Carolyn Smith, John Robert Horne, Frank Bernard Sarlo
OBJECTIVE: To determine if differences in physical function, assessed via self-report questionnaires and physical performance tests, exist between individuals with lower-limb loss using a prosthetic device classified as a K3 versus a K4 functional level. DESIGN: Cross-sectional study. SETTING: University of Delaware Physical Therapy Amputee Clinic. PARTICIPANTS: Participants (n=55) were included if they were aged ≥18 years with a unilateral transfemoral or transtibial amputation, classified as K3 or K4 functional level, completed all relevant outcome measures, and currently were using a prosthesis...
January 31, 2018: Archives of Physical Medicine and Rehabilitation
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