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https://www.readbyqxmd.com/read/28721590/high-non-anatomic-tunnel-position-rates-in-acl-reconstruction-failure-using-both-transtibial-and-anteromedial-tunnel-drilling-techniques
#1
Vera Jaecker, Tabea Zapf, Jan-Hendrik Naendrup, Thomas Pfeiffer, Ajay C Kanakamedala, Arasch Wafaisade, Sven Shafizadeh
INTRODUCTION: Although it is well known from cadaveric and biomechanical studies that transtibial femoral tunnel (TT) positioning techniques are associated with non-anatomic tunnel positions, controversial data exist as so far no clinical differences could have been found, comparing transtibial with anteromedial techniques (AM). The purpose of the study was to analyze if graft failure following TT ACL reconstruction was more commonly associated with non-anatomic tunnel position in comparison with the AM technique...
July 18, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28707050/tensile-strength-of-the-pullout-repair-technique-for-the-medial-meniscus-posterior-root-tear-a-porcine-study
#2
Masataka Fujii, Takayuki Furumatsu, Haowei Xue, Shinichi Miyazawa, Yuya Kodama, Tomohito Hino, Yusuke Kamatsuki, Toshifumi Ozaki
PURPOSE: The purpose of this study was to compare the load-to-failure of different common suturing techniques with a new technique for the medial meniscus posterior root tear (MMPRT). METHODS: Thirty porcine medial menisci were randomly assigned to three suturing techniques used for transtibial pullout repair of the MMPRT (n = 10 per group). Three different meniscal suture configurations were studied: the two simple suture (TSS) technique, the conventional modified Mason-Allen suture (MMA) technique, and the new MMA technique using the FasT-Fix combined with the Ultrabraid (F-MMA)...
July 14, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28706841/technique-for-transtibial-knotless-repair-of-lateral-meniscus-root-avulsion
#3
Emily Harnden, Timothy Lin, Adam Wilson, John B Reid
Tear of the meniscal root results in loss of circumferential hoop tension in the meniscus and increased tibiofemoral contact pressure, leading to cartilage wear. Repair of the meniscal root can restore function of the meniscus. Many techniques for root repair have recently been described. We present a technique for root repair using a transtibial socket and knotless suture technique that can be performed through standard arthroscopy portals.
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706808/transosseous-posterior-meniscal-root-reinsertion-using-knotless-anchor-for-tibial-fixation
#4
Alejandro Espejo-Baena, Alejandro Espejo-Reina, María Josefa Espejo-Reina, María Belén Martín-Castilla, Jaime Dalla-Rosa Nogales, Enrique Sevillano-Pérez
A technique for posterior meniscal root reinsertion is presented. With the arthroscope in the central transtendinous portal for a better view, a 5-mm transtibial tunnel is created with the aid of an anterior cruciate ligament guide open to 45°. A suture device, which consists of a long needle with an eyelet on its tip, is introduced through the tunnel with a suture thread inserted through the eyelet, while the meniscus is stabilized with a grasper inserted through the anterior portal. The meniscus is pierced with the device, and the suture thread is recovered with said grasper...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706793/medial-meniscus-posterior-root-repair-using-a-transtibial-technique
#5
Jarret M Woodmass, Rohith Mohan, Michael J Stuart, Aaron J Krych
The meniscal roots are critical in maintaining the normal shock absorbing function of the meniscus. If a meniscal root tear is left untreated, meniscal extrusion can occur rendering the meniscus nonfunctional resulting in degenerative arthritis. Two main repair techniques are described: (1) suture anchors (direct fixation) and (2) sutures pulled through a tibial tunnel (indirect fixation). Meniscal root repair using a suture anchor technique is technically challenging requiring a posterior portal and a curved suture passing device that can be difficult to manipulate within the knee...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28705487/amputee-locomotion-frequency-content-of-prosthetic-vs-intact-limb-vertical-ground-reaction-forces-during-running-and-the-effects-of-filter-cut-off-frequency
#6
Dovin Kiernan, Ross H Miller, Brian S Baum, Hyun Joon Kwon, Jae Kun Shim
Compared to intact limbs, running-specific prostheses have high resonance non-biologic materials and lack active tissues to damp high frequencies. These differences may lead to ground reaction forces (GRFs) with high frequency content. If so, ubiquitously applying low-pass filters to prosthetic and intact limb GRFs may attenuate veridical high frequency content and mask important and ecologically valid data from prostheses. To explore differences in frequency content between prosthetic and intact limbs we divided signal power from transtibial unilateral amputees and controls running at 2...
June 21, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28704685/dynamic-balance-changes-within-three-weeks-of-fitting-a-new-prosthetic-foot-component
#7
Jenny A Kent, Nicholas Stergiou, Shane R Wurdeman
Balance during walking is of high importance to prosthesis users and may affect walking during baseline observation and evaluation. The aim of this study was to determine whether changes in walking balance occurred during an adaptation period following the fitting of a new prosthetic component. Margin of stability in the medial-lateral direction (MOSML) and an anterior instability margin (AIM) were used to quantify the dynamic balance of 21 unilateral transtibial amputees during overground walking. Participants trialled two prosthetic feet presenting contrasting movement/balance constraints; a Higher Activity foot similar to that of their own prosthesis, and a Lower Activity foot...
July 5, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28704467/locomotor-adaptability-in-persons-with-unilateral-transtibial-amputation
#8
Benjamin J Darter, Amy J Bastian, Erik J Wolf, Elizabeth M Husson, Bethany A Labrecque, Brad D Hendershot
BACKGROUND: Locomotor adaptation enables walkers to modify strategies when faced with challenging walking conditions. While a variety of neurological injuries can impair locomotor adaptability, the effect of a lower extremity amputation on adaptability is poorly understood. OBJECTIVE: Determine if locomotor adaptability is impaired in persons with unilateral transtibial amputation (TTA). METHODS: The locomotor adaptability of 10 persons with a TTA and 8 persons without an amputation was tested while walking on a split-belt treadmill with the parallel belts running at the same (tied) or different (split) speeds...
2017: PloS One
https://www.readbyqxmd.com/read/28704265/limits-of-stability-in-patients-with-vascular-due-to-diabetes-and-nonvascular-unilateral-transtibial-amputation-a-cross-sectional-study
#9
Francisco Molina-Rueda, Alberto Molero-Sánchez, María Carratalá-Tejada, Alicia Cuesta-Gómez, Juan C Miangolarra-Page, Isabel M Alguacil-Diego
The aim of the study was to investigate the differences in the stability limits between patients with vascular and nonvascular unilateral transtibial amputation (UTA) and patients without amputation. Eighteen patients with UTA who used a prosthesis were divided into two groups: vascular (n=9) and nonvascular (n=9). Twenty-four patients without amputation served as the control group. Computerized dynamic posturography Smart EquiTest System, version 8.0 was used for measuring stability limits. The limits of stability test was used to assess the participants' ability to voluntarily sway to various locations in space...
July 12, 2017: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
https://www.readbyqxmd.com/read/28702391/comparative-evaluation-of-the-results-of-three-techniques-in-the-reconstruction-of-the-anterior-cruciate-ligament-with-a-minimum-follow-up-of-two-years
#10
Ricardo de Paula Leite Cury, Jan Willem Cerf Sprey, André Luiz Lima Bragatto, Marcelo Valentim Mansano, Herman Fabian Moscovici, Luiz Gabriel Betoni Guglielmetti
OBJECTIVE: To compare the clinical results of the reconstruction of the anterior cruciate ligament by transtibial, transportal, and outside-in techniques. METHODS: This was a retrospective study on 90 patients (ACL reconstruction with autologous flexor tendons) operated between August 2009 and June 2012, by the medial transportal (30), transtibial (30), and "outside-in" (30) techniques. The following parameters were assessed: objective and subjective IKDC, Lysholm, KT1000, Lachman test, Pivot-Shift and anterior drawer test...
May 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28696164/surgical-predictors-of-clinical-outcomes-after-revision-anterior-cruciate-ligament-reconstruction
#11
Christina R Allen, Allen F Anderson, Daniel E Cooper, Thomas M DeBerardino, Warren R Dunn, Amanda K Haas, Laura J Huston, Brett Brick A Lantz, Barton Mann, Sam K Nwosu, Kurt P Spindler, Michael J Stuart, Rick W Wright, John P Albright, Annunziato Ned Amendola, Jack T Andrish, Christopher C Annunziata, Robert A Arciero, Bernard R Bach, Champ L Baker, Arthur R Bartolozzi, Keith M Baumgarten, Jeffery R Bechler, Jeffrey H Berg, Geoffrey A Bernas, Stephen F Brockmeier, Robert H Brophy, Charles A Bush-Joseph, J Brad Butler, John D Campbell, James L Carey, James E Carpenter, Brian J Cole, Jonathan M Cooper, Charles L Cox, R Alexander Creighton, Diane L Dahm, Tal S David, David C Flanigan, Robert W Frederick, Theodore J Ganley, Elizabeth A Garofoli, Charles J Gatt, Steven R Gecha, James Robert Giffin, Sharon L Hame, Jo A Hannafin, Christopher D Harner, Norman Lindsay Harris, Keith S Hechtman, Elliott B Hershman, Rudolf G Hoellrich, Timothy M Hosea, David C Johnson, Timothy S Johnson, Morgan H Jones, Christopher C Kaeding, Ganesh V Kamath, Thomas E Klootwyk, Bruce A Levy, C Benjamin Ma, G Peter Maiers, Robert G Marx, Matthew J Matava, Gregory M Mathien, David R McAllister, Eric C McCarty, Robert G McCormack, Bruce S Miller, Carl W Nissen, Daniel F O'Neill, Brett D Owens, Richard D Parker, Mark L Purnell, Arun J Ramappa, Michael A Rauh, Arthur C Rettig, Jon K Sekiya, Kevin G Shea, Orrin H Sherman, James R Slauterbeck, Matthew V Smith, Jeffrey T Spang, Steven J Svoboda, Timothy N Taft, Joachim J Tenuta, Edwin M Tingstad, Armando F Vidal, Darius G Viskontas, Richard A White, James S Williams, Michelle L Wolcott, Brian R Wolf, James J York
BACKGROUND: Revision anterior cruciate ligament (ACL) reconstruction has been documented to have worse outcomes compared with primary ACL reconstruction. HYPOTHESIS: Certain factors under the control of the surgeon at the time of revision surgery can both negatively and positively affect outcomes. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: Patients undergoing revision ACL reconstruction were identified and prospectively enrolled between 2006 and 2011...
June 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28692486/standard-and-amputation-adjusted-body-mass-index-measures-comparison-and-relevance-to-functional-measures-weight-related-comorbidities-and-dieting
#12
Christopher Kevin Wong, Ryan J Wong
People with limb loss may misjudge weight-related health when not adjusting body mass index (BMI) for amputation level. This cross-sectional, community-based study compared BMI and amputation-adjusted BMI (A-BMI) and evaluated relationships among BMI categories, function, and dieting. Subjects provided self-reported demographic, functional, and medical/prosthetic data including height and weight and completed performance-based balance and gait measures. A Web-based A-BMI calculator adjusted for amputation levels...
July 7, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28682728/improved-quality-of-life-after-transtibial-amputation-in-patients-with-diabetes-related-foot-complications
#13
Dane K Wukich, Junho Ahn, Katherine M Raspovic, Javier La Fontaine, Larry A Lavery
The purpose of this study was to evaluate health-related quality of life after major lower-extremity amputation in a cohort of patients with diabetes mellitus. We evaluated 81 patients with diabetes and transtibial amputation (TTA) who had a minimum of 1 year of follow-up. Of these 81 patients, 50.6% completed the Short Form Survey (SF-36) and the Foot and Ankle Ability Measure (FAAM) preoperatively and postoperatively. Outcome measures before and after TTA were compared using Welch's ANOVA for continuous variables and Fisher's exact test for categorical variables...
June 2017: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/28682674/free-flap-transfer-for-coverage-of-transmetatarsal-amputation-stump-to-preserve-residual-foot-length
#14
Hyung Min Hahn, Kwang Sik Jeong, Myong Chul Park, Dong Ha Park, Il Jae Lee
Surgical management of soft-tissue defects of the forefoot and midfoot caused by trauma or diabetic complications can be challenging because locoregional tissue is insufficient to provide adequate flap. This deficiency necessitates higher-level amputations, such as Chopart or even transtibial amputation, resulting in far more debilitating functional outcomes than are seen with partial foot amputation. The purpose of this study was to examine the surgical outcomes after transmetatarsal amputation and a free-flap transfer to preserve foot length...
March 2017: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/28674738/three-single-loops-enhance-the-biomechanical-behavior-of-the-transtibial-pull-out-technique-for-posterior-meniscal-root-repair
#15
Lawrence Camarda, Giuseppe Pitarresi, Michele Lauria, Federico Fazzari, Michele D'Arienzo
PURPOSE: To investigate the effect of applying an additional suture to enhance the biomechanical behavior of the suture-meniscus construct used during the transtibial pull-out repair technique. METHODS: A total of 20 fresh-frozen porcine tibiae with intact medial menisci were used. In one half of all specimens (N = 10), two non-absorbable sutures were passed directly over the meniscal root from the tibia side of the meniscus to the femoral side (2SS). In other ten specimens, three sutures were passed over the meniscal root (3SS)...
July 3, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28659414/how-do-prosthetic-stiffness-height-and-running-speed-affect-the-biomechanics-of-athletes-with-bilateral-transtibial-amputations
#16
Owen N Beck, Paolo Taboga, Alena M Grabowski
Limited available information describes how running-specific prostheses and running speed affect the biomechanics of athletes with bilateral transtibial amputations. Accordingly, we quantified the effects of prosthetic stiffness, height and speed on the biomechanics of five athletes with bilateral transtibial amputations during treadmill running. Each athlete performed a set of running trials with 15 different prosthetic model, stiffness and height combinations. Each set of trials began with the athlete running on a force-measuring treadmill at 3 m s(-1), subsequent trials incremented by 1 m s(-1) until they achieved their fastest attainable speed...
June 2017: Journal of the Royal Society, Interface
https://www.readbyqxmd.com/read/28655287/the-influence-of-traumatic-transfemoral-amputation-on-metabolic-cost-across-walking-speeds
#17
Elizabeth Russell Esposito, Christopher A Rábago, Jason Wilken
BACKGROUND: Recent literature indicates equivalent costs of walking can be achieved after a transtibial amputation when the individual is young, active, and/or has extensive access to rehabilitative care. It is unknown if a similar cohort with transfemoral amputation can also achieve lower metabolic costs of walking than previously reported. OBJECTIVE: Compare metabolic cost in individuals with a transfemoral amputation to controls and to the literature across a range of walking speeds...
June 1, 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/28650802/translational-motion-tracking-of-leg-joints-for-enhanced-prediction-of-walking-tasks
#18
Roman Mark Stolyarov, Gary Burnett, Hugh Herr
OBJECTIVE: Prediction of walking tasks in powered leg prostheses is an important problem in the development of biomimetic prosthesis controllers. This article proposes a novel method to predict upcoming walking tasks by estimating the translational motion of leg joints using an inertial measurement unit. METHODS: We asked six subjects with unilateral transtibial amputations to traverse flat ground, ramps, and stairs using a powered prosthesis while inertial signals were remotely collected...
June 22, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28636429/autograft-versus-allograft-for-posterior-cruciate-ligament-reconstruction-an-updated-systematic-review-and-meta-analysis
#19
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
#20
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
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