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Jessica C Rivera, Renee M Greer, Mary Ann Spott, Anthony E Johnson
BACKGROUND: The Military Orthopaedic Trauma Registry (MOTR) was designed to replicate the Department of Defense Trauma Registry's (DoDTR's) role as pillar for data-driven management of extremity war wounds. The MOTR continuously undergoes quality assurance checks to optimize the registry data for future quality improvement efforts. We conducted a quality assurance survey of MOTR entrants to determine if a simple MOTR data pull could provide robust orthopedic-specific information toward the question of causes for late amputation...
November 2016: Journal of Trauma and Acute Care Surgery
Erhan Sukur, Yunus Emre Akman, Ahmet Senel, Ethem Ayhan Unkar, Huseyin Nevzat Topcu, And Yusuf Ozturkmen
BACKGROUND: Among the many factors that determine the outcome following anterior cruciate ligament (ACL) reconstruction, the position of the femoral tunnel is known to be critically important and is still the subject of extensive research. OBJECTIVE: We aimed to retrospectively compare the outcomes of arthroscopic ACL reconstruction using transtibial (TT) or anteromedial (AMP) drilling techniques for femoral tunnel placement. METHODS: ACL reconstruction was performed using the TT technique in 49 patients and the AMP technique in 56 patients...
2016: Open Orthopaedics Journal
Andrew R Palisch, Ronald R Winters, Marc H Willis, Collin D Bray, Theodore B Shybut
The menisci play an important biomechanical role in axial load distribution of the knees by means of hoop strength, which is contingent on intact circumferentially oriented collagen fibers and meniscal root attachments. Disruption of the meniscal root attachments leads to altered biomechanics, resulting in progressive cartilage loss, osteoarthritis, and subchondral edema, with the potential for development of a subchondral insufficiency fracture. Identification of meniscal root tears at magnetic resonance (MR) imaging is crucial because new arthroscopic surgical techniques (transtibial pullout repair) have been developed to repair meniscal root tears and preserve the tibiofemoral cartilage of the knee...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
T Koller, D Baumgartner
There is preliminary evidence that phantom pain is associated with disturbed organization of the sensory cortex and that this organization can be normalized with two-point discrimination (TPD) training. In this case study, a reduction in phantom pain and painful phantom sensation during a test period of 19 days, was achieved using an automated TPD procedure. In a patient with a transtibial amputation, pain levels decreased from a mean of 2.3/10 on the visual analog scale (VAS) to 1.3/10 (VAS) and the painful phantom sensation level decreased from a mean 3...
October 10, 2016: Der Schmerz
Marco Nitri, Jorge Chahla, David Civitarese, Sanjeev Bhatia, Samuel G Moulton, Christopher M LaPrade, Robert F LaPrade
Complete radial tears of the medial meniscus significantly decrease the meniscal tissue's ability to dissipate tibiofemoral loads and have been described as functionally similar to a total meniscectomy, predisposing patients to early osteoarthritis. At present, no consensus exists regarding the optimal surgical treatment of a radial meniscal tear. Current repair techniques have led to a reportedly high rate of incomplete healing or healing of the meniscus in a nonanatomic, gapped position, which compromises its ability to withstand hoop stresses...
August 2016: Arthroscopy Techniques
Walter Kim, Peter McQueen, Jonathan N Watson, Mark R Hutchinson
Anterior cruciate ligament (ACL) reconstruction is one of the most extensively studied surgical procedures in orthopaedics. The importance of this ligament for knee function and stability has been widely studied. For athletes who participate in activities involving cutting, twisting, and running, surgical reconstruction of the ACL has become the standard of care. However, there is much debate regarding the techniques involved in ACL reconstruction, including graft choice, technique of drilling the femoral tunnel, and single- versus double-bundle reconstruction...
August 2016: Arthroscopy Techniques
Roberto E Quesada, Joshua M Caputo, Steven H Collins
Amputees using passive ankle-foot prostheses tend to expend more metabolic energy during walking than non-amputees, and reducing this cost has been a central motivation for the development of active ankle-foot prostheses. Increased push-off work at the end of stance has been proposed as a way to reduce metabolic energy use, but the effects of push-off work have not been tested in isolation. In this experiment, participants with unilateral transtibial amputation (N=6) walked on a treadmill at a constant speed while wearing a powered prosthesis emulator...
October 3, 2016: Journal of Biomechanics
Hiroaki Hobara, Satoru Hashizume, Yoshiyuki Kobayashi, Masaaki Mochmaru
The aim of this study was to investigate differences of the spatiotemporal parameters in a 100-m sprint among elite, sub-elite, and non-elite sprinters with a unilateral transtibial amputation. Using publicly available Internet broadcasts, we analyzed 125, 19, and 33 records from 30 elite, 12 sub-elite, and 22 non-elite sprinters, respectively. For each sprinter's run, the average velocity, step frequency, and step length were calculated using the number of steps in conjunction with the official race time. Average velocity was greatest in elite sprinters (8...
2016: PloS One
Kamiar Ghoseiri, Yong Ping Zheng, Aaron K L Leung, Mehdi Rahgozar, Gholamreza Aminian, Tat Hing Lee, Mohammad Reza Safari
The accumulation of heat inside the prosthetic socket increases skin temperature and fosters perspiration, which consequently leads to high tissue stress, friction blister, discomfort, unpleasant odor, and decreased prosthesis suspension and use. In the present study, the prototype of a temperature measurement and control (TM&C) system was designed, fabricated, and functionally evaluated in a phantom model of the transtibial prosthetic socket. The TM&C system was comprised of twelve Thermistors that were divided equally into two groups that arranged internal and external to a prosthetic silicone liner...
October 3, 2016: Assistive Technology: the Official Journal of RESNA
Houda Migaou Miled, Hichem Ben Brahim, Yafa Hadj Hassine, Soumaya Boudokhane, Nesrine Abdelkafi, Aymen Haj Salah, Sana Salah, Anis Jellad, Zohra Ben Salah Frih
OBJECTIVE: Evaluate the quality of life and psychological state of the lower limb amputees. PATIENTS AND METHODS: Prospective study on the lower limb amputees followed at the Physical Medicine and Rehabilitation department of the University Hospital of Monastir. The variables analyzed were epidemiological, clinical with an assessment of the patients quality of life using the quality score of life "Short form 36" (SF_36) and a psychological evaluation by the score "Hospital Anxiety and Depression scale" (HAD)...
September 2016: Annals of Physical and Rehabilitation Medicine
Houda Migaou Miled, Hichem Ben Brahim, Yafa Hadj Hassine, Soumaya Boudokhane, Nesrine Abdelkafi, Aymen Haj Salah, Sana Salah, Anis Jellad, Zohra Ben Salah Frih
OBJECTIVE: Assess satisfaction of lower limb amputees towards their device. PATIENTS AND METHODS: Prospective study of device-fitted lower limb amputees followed at the Physical Medicine and Rehabilitation department at the University Hospital of Monastir. Epidemiological and clinical parameters were assessed with evaluation of fitted patients' satisfaction towards their prosthesis (survey on the satisfaction of patients with lower limb amputations towards their prosthesis) (SAT-PRO)...
September 2016: Annals of Physical and Rehabilitation Medicine
Armando Iannicello, Kirill Alekseyev, Thomas Hordt, Marc Ross
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Timothy R Dillingham, Jim Marschalek, Jessica Kenia
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Nathaniel T Pickle, Jason M Wilken, Jennifer M Aldridge Whitehead, Anne K Silverman
Sloped walking requires altered strategies for maintaining dynamic balance relative to level-ground walking, as evidenced by changes in sagittal-plane whole-body angular momentum (H) in able-bodied individuals. The ankle plantarflexor muscles are critical for regulating H, and functional loss of these muscles from transtibial amputation affects this regulation. However, it is unclear if a powered prosthesis, which more closely emulates intact ankle function than a passive energy-storage-and-return prosthesis, affects H differently during sloped walking...
October 3, 2016: Journal of Biomechanics
Jan-Hendrik Naendrup, Jason P Zlotnicki, Tom Chao, Kanto Nagai, Volker Musahl
Anterior cruciate ligament (ACL) reconstruction aims to restore the translational and rotational motion to the knee joint that is lost after injury. However, despite technical advancements, clinical outcomes are less than ideal, particularly in return to previous activity level. A major issue is the inability to standardize treatment protocols due to variations in materials and approaches used to accomplish ACL reconstruction. These include surgical techniques such as the transtibial and anteromedial portal methods that are currently under use and the wide availability of graft types that will be used to reconstruct the ACL...
September 13, 2016: Current Reviews in Musculoskeletal Medicine
Douglas E Lucas, B Collier Watson, G Alex Simpson, Gregory C Berlet, Christopher F Hyer
: Ankle fractures are a common injury treated by orthopaedic surgeons. The distal tibiofibular syndesmosis can be injured during these fractures as well as in isolation. They pose a significant challenge with regard to the diagnosis of instability as well as evaluating reduction after fixation. Multiple studies have demonstrated that traditional radiographic analysis fails to accurately identify syndesmotic diastasis, instability, or malreduction. Ankle arthroscopy has been proposed as an alternative way to evaluate the syndesmosis...
September 9, 2016: Foot & Ankle Specialist
Brian J Hafner, John C Cagle, Katheryn J Allyn, Joan E Sanders
BACKGROUND: A diverse range of elastomeric liner products are available to people with transtibial amputation. However, little information is available about how prosthetists select the product best suited to each patient. OBJECTIVES: To determine how prosthetists obtain information about liners, which features are most relevant to the selection process, and which products are used most for patients with transtibial amputation. STUDY DESIGN: Cross-sectional survey...
September 9, 2016: Prosthetics and Orthotics International
Baojun Chen, Yanggang Feng, Qining Wang
In recent years, the development of myoelectric control for robotic lower-limb prostheses makes it possible for amputee users to volitionally control prosthetic joints. However, the human-centered control loop is not closed due to the lack of sufficient feedback of prosthetic joint movement, and it may result in poor control performance. In this research, we propose a vibrotactile stimulation system to provide the feedback of ankle joint position, and validate the necessity of combining it with volitional myoelectric control to achieve improved control performance...
2016: Frontiers in Neurorobotics
Shane R Wurdeman, Kendra K Schmid, Sara A Myers, Adam L Jacobsen, Nicholas Stergiou
OBJECTIVE: To determine changes in average daily step count (ADSC) and 6-minute walk test (6MWT) due to use of low-activity feet (LA) and high-activity energy-storage-and-return (ESAR) feet, and examine the sensitivity of these measures to properly classify different prosthetic feet. DESIGN: Individuals with transtibial amputations (n = 28) participated in a 6-week, randomized crossover study. During separate 3-week periods, participants wore either a LA foot (eg, solid-ankle-cushioned-heel) or an ESAR foot...
August 31, 2016: American Journal of Physical Medicine & Rehabilitation
Tyler D Klenow, Jason T Kahle, M Jason Highsmith
BACKGROUND: The "dead spot" phenomenon in prosthetics is a disruption in forward progression observed in the rearfoot of passive prosthetic foot-ankle systems which results in a compensatory and inefficient gait pattern by amputees. A metric to quantify the dead spot as a kinetic event has not yet been introduced. The present study implements a three-part metric to evaluate the dead spot in terms of time, magnitude, and total area using center of pressure velocity and a novel threshold value calculation...
October 2016: Clinical Biomechanics
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