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https://www.readbyqxmd.com/read/28636429/autograft-versus-allograft-for-posterior-cruciate-ligament-reconstruction-an-updated-systematic-review-and-meta-analysis
#1
John W Belk, Matthew J Kraeutler, Justin M Purcell, Eric C McCarty
BACKGROUND: Multiple studies have demonstrated a higher risk of graft failure after anterior cruciate ligament reconstruction with allograft, but limited data are available comparing outcomes of posterior cruciate ligament reconstruction (PCLR) with autograft versus allograft. PURPOSE: To compare the clinical outcomes of autograft versus allograft for primary PCLR. STUDY DESIGN: Systematic review. METHODS: A systematic review was performed by searching PubMed, the Cochrane Library, and EMBASE to locate studies (level of evidence I-III) comparing clinical outcomes of autograft versus allograft in patients undergoing primary PCLR with the conventional transtibial technique...
June 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28567428/acl-roof-impingement-revisited-does-the-independent-femoral-drilling-technique-avoid-roof-impingement-with-anteriorly-placed-tibial-tunnels
#2
John A Tanksley, Brian C Werner, Evan J Conte, David P Lustenberger, M Tyrrell Burrus, Stephen F Brockmeier, F Winston Gwathmey, Mark D Miller
BACKGROUND: Anatomic femoral tunnel placement for single-bundle anterior cruciate ligament (ACL) reconstruction is now well accepted. The ideal location for the tibial tunnel has not been studied extensively, although some biomechanical and clinical studies suggest that placement of the tibial tunnel in the anterior part of the ACL tibial attachment site may be desirable. However, the concern for intercondylar roof impingement has tempered enthusiasm for anterior tibial tunnel placement...
May 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28567341/technical-note-anterior-cruciate-ligament-reconstruction-in-the-presence-of-an-intramedullary-femoral-nail-using-anteromedial-drilling
#3
Matthew Lacey, Joseph Lamplot, Kempland C Walley, Joseph P DeAngelis, Arun J Ramappa
AIM: To describe an approach to anterior cruciate ligament (ACL) reconstruction using autologous hamstring by drilling via the anteromedial portal in the presence of an intramedullary (IM) femoral nail. METHODS: Once preoperative imagining has characterized the proposed location of the femoral tunnel preparations are made to remove all of the hardware (locking bolts and IM nail). A diagnostic arthroscopy is performed in the usual fashion addressing all intra-articular pathology...
May 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28534664/predict-the-medicare-functional-classification-level-k-level-using-the-amputee-mobility-predictor-in-people-with-unilateral-transfemoral-and-transtibial-amputation-a-pilot-study
#4
Michael P Dillon, Matthew J Major, Brian Kaluf, Yuri Balasanov, Stefania Fatone
BACKGROUND: While Amputee Mobility Predictor scores differ between Medicare Functional Classification Levels (K-level), this does not demonstrate that the Amputee Mobility Predictor can accurately predict K-level. OBJECTIVES: To determine how accurately K-level could be predicted using the Amputee Mobility Predictor in combination with patient characteristics for persons with transtibial and transfemoral amputation. STUDY DESIGN: Prediction...
May 1, 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/28533599/the-effect-of-segmental-weight-of-prosthesis-on-hemodynamic-responses-and-energy-expenditure-of-lower-extremity-amputees
#5
Akmer Mutlu, Mohammad Dawood Kharooty, Yavuz Yakut
[Purpose] The aim of this study was to investigate the effect of segmental weight of the prosthesis on hemodynamic responses and energy expenditure in lower extremity amputees. [Subjects and Methods] Thirteen patients with a mean age of 44 ± 15.84 years and with unilateral transtibial, transfemoral and Syme's amputation were included to the study. The difference between the lightest and the heaviest prosthesis, 250 g used as the weight. All the patients completed the measurements first without weight and then with 250 g weight on the ankle joint...
April 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28510478/two-tunnel-transtibial-repair-of-radial-meniscus-tears-produces-comparable-results-to-inside-out-repair-of-vertical-meniscus-tears
#6
Mark E Cinque, Andrew G Geeslin, Jorge Chahla, Grant J Dornan, Robert F LaPrade
BACKGROUND: Radial meniscus tears disrupt the circumferential fibers and thereby compromise meniscus integrity. Historically, radial tears were often treated with meniscectomy because of an incomplete understanding of the biomechanical consequences of these tears, limited information regarding the biomechanical performance of repair, and the technical difficulty associated with repair. There is a paucity of studies on the outcomes of the repair of radial meniscus tears. Purpose/Hypothesis: The purpose was to determine the outcomes of 2-tunnel transtibial repair of radial meniscus tears and compare these results to the outcomes of patients who underwent the repair of vertical meniscus tears with a minimum of 2-year follow-up...
May 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28507781/isolated-posterior-cruciate-ligament-tears-an-update-of-management
#7
REVIEW
Alfonso Vaquero-Picado, E Carlos Rodríguez-Merchán
Isolated posterior cruciate ligament (PCL) tears are much less frequent than anterior cruciate ligament (ACL) tears.Abrupt posterior tibial translation (such as dashboard impact), falls in hyperflexion and direct hyperextension trauma are the most frequent mechanisms of production.The anterolateral bundle represents two-thirds of PCL mass and is reconstructed in single-bundle techniques.The PCL has an intrinsic capability for healing. This is the reason why, nowadays, the majority of isolated PCL tears are managed non-operatively, with rehabilitation and bracing...
April 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28499159/sensitivity-of-biomechanical-outcomes-to-independent-variations-of-hindfoot-and-forefoot-stiffness-in-foot-prostheses
#8
Peter Gabriel Adamczyk, Michelle Roland, Michael E Hahn
Many studies have reported the effects of different foot prostheses on gait, but most results cannot be generalized because the prostheses' properties are seldom reported. We varied hindfoot and forefoot stiffness in an experimental foot prosthesis, in increments of 15N/mm, and tested the parametric effects of these variations on treadmill walking in unilateral transtibial amputees, at speeds from 0.7 to 1.5m/s. We computed outcomes such as prosthesis energy return, center of mass (COM) mechanics, ground reaction forces, and joint mechanics, and computed their sensitivity to component stiffness...
May 9, 2017: Human Movement Science
https://www.readbyqxmd.com/read/28487630/analysis-of-interrelationships-among-voluntary-and-prosthetic-leg-joint-parameters-using-cyclograms
#9
Farahiyah Jasni, Nur Azah Hamzaid, Nor Elleeiana Mohd Syah, Tze Y Chung, Noor Azuan Abu Osman
The walking mechanism of a prosthetic leg user is a tightly coordinated movement of several joints and limb segments. The interaction among the voluntary and mechanical joints and segments requires particular biomechanical insight. This study aims to analyze the inter-relationship between amputees' voluntary and mechanical coupled leg joints variables using cyclograms. From this analysis, the critical gait parameters in each gait phase were determined and analyzed if they contribute to a better powered prosthetic knee control design...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28484908/in-out-versus-out-in-technique-for-acl-reconstruction-a-prospective-clinical-and-radiological-comparison
#10
Edoardo Monaco, Mattia Fabbri, Andrea Redler, Raffaele Iorio, Jacopo Conteduca, Giuseppe Argento, Andrea Ferretti
BACKGROUND: Several studies have recently shown better restoration of normal knee kinematics and improvement of rotator knee stability after reconstruction with higher femoral tunnel obliquity. The aim of this study is to evaluate tunnel obliquity, length, and posterior wall blowout in single-bundle anterior cruciate ligament (ACL) reconstruction, comparing the transtibial (TT) technique and the out-in (OI) technique. MATERIALS AND METHODS: Forty consecutive patients operated on for ACL reconstruction with hamstrings were randomly divided into two groups: group A underwent a TT technique, while group B underwent an OI technique...
May 8, 2017: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/28476209/vacuum-level-effects-on-knee-contact-force-for-unilateral-transtibial-amputees-with-elevated-vacuum-suspension
#11
Hang Xu, Kasey Greenland, Donald Bloswick, Jie Zhao, Andrew Merryweather
The elevated vacuum suspension system (EVSS) has demonstrated unique health benefits for amputees, but the effect of vacuum pressure values on knee contact force (KCF) is still unclear. The objective of this study was to investigate the effect of vacuum levels on KCF for unilateral transtibial amputees (UTA) using the EVSS. Three-dimensional gait was modeled for 9 UTA with five vacuum levels (0-20inHg [67.73kPa], 5inHg [16.93kPa] increments) and 9 non-amputees based on kinematic and ground reaction force data...
April 20, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28470463/-the-endo-exo-prosthesis-treatment-concept-improvement-in-quality-of-life-after-limb-amputation
#12
T Hoffmeister, F Schwarze, H H Aschoff
Osseointegrated, percutaneous implants as the force bearer for exoprosthetics after limb amputation have been used in individual cases for clinical rehabilitation of amputees during the past years. Most experience in this field in Germany has been accumulated at the Sana Klinik in Lübeck with the so-called endo-exo prosthesis (EEP) system. The two-step implantation procedure can now be considered as reliable. Following a well-documented learning curve initial soft tissue problems concerning the cutaneous stoma can now be regarded as exceptions...
May 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28470462/-connecting-adapter-for-coupling-exoprostheses-to-endoshafts-demands-on-orthopedic-technicians-with-respect-to-planning-and-application
#13
H Grundei, A Timmermann
INTRODUCTION: Transcutaneous, bone anchored prostheses have proved to be an alternative for amputees. In addition to the safe osseointegration of the implant, the correct prosthetic alignment is also important. Therefore, the interaction between prosthesis components and the prosthesis wearer is significant and the role of the certified prosthetist should not be underestimated. AIM: The aim of treatment is the best possible compensation of disability after limb loss with increase of physical abilities and comfort of the prosthesis wearer by means of bone anchored prosthesis...
May 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28468477/-lower-limb-amputations-and-rehabilitation
#14
Reinhild Lange, Unn Ljøstad
BACKGROUND We wished to study the therapy for lower limb amputees at Sørlandet Hospital Kristiansand after restructuring of activities in 2004.MATERIAL AND METHOD All lower limb amputees hospitalised in the Department of Physical Medicine and Rehabilitation between March 2012 and July 2015 were followed up prospectively.RESULTS A total of 50 patients with 54 amputations were followed up for at least three months. Altogether 31 transtibial amputations, 22 transfemoral amputations and one knee disarticulation were performed...
May 2017: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
https://www.readbyqxmd.com/read/28463204/design-and-characterization-of-a-quasi-passive-pneumatic-foot-ankle-prosthesis
#15
Jeffrey Lee, Luke Mooney, Elliott Rouse
The majority of commercially available passive prosthetic feet are not capable of providing joint mechanics that match that of the intact human ankle. Due to their cantilever design, their stiffness characteristics contrast with what has been observed in the biological ankle; namely, an increase in stiffness during the stance phase of walking. In this study, we introduce the design and control of a pneumatic foot-ankle prosthesis that attempts to provide biomimetic mechanics. The prosthesis is comprised of a pneumatic cylinder in series with a fiberglass leaf spring, and a solenoid valve to control the flow of air between the two sides of the cylinder...
April 28, 2017: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/28450144/while-mortality-rates-differ-following-dysvascular-partial-foot-and-transtibial-amputation-should-they-influence-the-choice-of-amputation-level
#16
Michael Dillon, Stefania Fatone, Matthew Quigley
While there is strong evidence to show that the risk of dying after transtibial amputation is higher than partial foot amputation, we are concerned by the implication that amputation level influences mortality, and that such interpretations of the evidence may be used to inform decisions about the choice of amputation level. We argue that the choice of partial foot or transtibial amputation does not influence the risk of mortality. The highest mortality rates are observed in studies with older people with more advanced systemic disease and multiple comorbidities...
April 24, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28433866/the-effect-of-vacuum-assisted-socket-suspension-on-prospective-community-based-falls-by-users-of-lower-limb-prostheses
#17
Noah J Rosenblatt, Tess Ehrhardt
Individuals with lower limb amputation are at increased risk of falling compared to age-matched peers. The purpose of this study was to quantify the effect of socket suspension on the risk of falling, by comparing prospectively tracked falls between a group of participants that used vacuum assisted socket suspension (VASS) and a group that did not use this system. Fifteen current users of VASS and 12 non-VASS users received an email every two weeks for one year, with a link to an online survey that asked whether they fell (i...
April 8, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28419034/complications-and-functional-outcomes-after-pantalar-dislocation
#18
Kaeleen A Boden, Douglas S Weinberg, Heather A Vallier
BACKGROUND: Pantalar dislocations without associated talar fracture are rare and have high risks of complications, including infection, osteonecrosis, and posttraumatic osteoarthrosis. Limited information on later function exists. This study evaluated complications and outcomes following pantalar dislocation without talar fracture. METHODS: Nineteen patients were identified with open (n = 14) or closed (n = 5) pantalar dislocations without talar fracture. Ten male and 9 female patients with a mean age of 39...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28409107/a-transosseous-bone-bridge-repair-for-posterior-horn-meniscal-root-tears-during-anterior-cruciate-ligament-reconstruction
#19
Jonathan M Frank, Daniel J Liechti, Jack Anavian, Thomas R Hackett
Meniscal root tears occur in isolation or concurrently with ligamentous knee injury and cause significantly altered knee mechanics with the loss of normal meniscus hoop stress. This loss of normal meniscus function can result in abnormal knee kinematics and, subsequently, more rapid degenerative changes of the knee articular surface. In the setting of anterior cruciate ligament tear, the posterolateral meniscus root is most commonly damaged. Several techniques exist for meniscus root repair; however, none have been shown to be clearly superior...
February 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28409105/anatomic-single-bundle-anterior-cruciate-ligament-reconstruction-using-the-modified-transtibial-technique
#20
Dhong Won Lee, Jin Goo Kim
We present a technique for anterior cruciate ligament (ACL) reconstruction using hamstring tendon autograft with a modified transtibial technique. Our modified transtibial technique has the advantages of the conventional transtibial technique that is familiar to surgeons and that allows the press-fit fixing and enables us to make a relatively long femoral tunnel. To make the femoral tunnel at the anatomic position, the triangular, funnel-shaped bony trough was made to slip the eccentrically positioned guide pin into the anticipated anatomic center with a free-hand technique after marking the anatomic ACL footprint using a microfracture awl through the anteromedial portal...
February 2017: Arthroscopy Techniques
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