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Clinics in Sports Medicine

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https://read.qxmd.com/read/31079777/limb-alignment-the-key-to-success
#1
EDITORIAL
Annunziato Ned Amendola, Davide Edoardo Bonasia
No abstract text is available yet for this article.
July 2019: Clinics in Sports Medicine
https://read.qxmd.com/read/31079776/knee-osteotomies-a-powerful-tool
#2
EDITORIAL
Mark D Miller
No abstract text is available yet for this article.
July 2019: Clinics in Sports Medicine
https://read.qxmd.com/read/31079775/degenerative-meniscal-tears-and-high-tibial-osteotomy-do-current-treatment-algorithms-need-to-be-realigned
#3
REVIEW
Codie A Primeau, Trevor B Birmingham, Kristyn M Leitch, C Thomas Appleton, J Robert Giffin
Degenerative medial meniscal tears (DMMTs) are a common feature of early knee osteoarthritis (OA). Varus alignment is a strong risk factor for medial compartment knee OA and its progression. We propose that high tibial osteotomy (HTO) should be considered much earlier in the treatment algorithm for patients presenting with recurring medial knee pain, varus alignment, and DMMT, absent of radiographic OA. We provide rationale for investigating HTO as a disease-modifying intervention for secondary prevention in knee OA, and present case examples as low-level proof of principle...
July 2019: Clinics in Sports Medicine
https://read.qxmd.com/read/31079774/the-use-of-navigation-in-osteotomies-around-the-knee
#4
REVIEW
Thomas Neri, Darli Myat, David Parker
Osteotomies around the knee for treating osteoarthritis or knee instability are currently well-established procedures. Success of these realignment procedures is based on the accuracy and the reliability of correction angles in the coronal and sagittal alignment. In this context of improving precision and adapting the correction to each patient, navigation is currently being widely used. The rationale for its use is based on understanding the advantages and limitations, technical principles, and potential pitfalls...
July 2019: Clinics in Sports Medicine
https://read.qxmd.com/read/31079773/the-role-of-osteotomy-in-chronic-valgus-instability-and-hyperextension-valgus-thrust-medial-closing-wedge-distal-femoral-varus-osteotomy-and-lateral-opening-wedge-high-tibial-osteotomy
#5
REVIEW
Philip P Roessler, Alan Getgood
Chronic valgus instability with concomitant valgus malalignment is a challenging diagnosis that cannot be successfully treated with ligament surgery alone. Hyperextension valgus thrust may be a symptom of this configuration, expressing the need for thorough diagnosis and treatment. The present article will help to understand pathoanatomy and mechanisms of chronic valgus instability in combination with malalignment and provide a description of treatment techniques, in particular medial closing wedge distal femoral varus osteotomy (MCWDFVO) and lateral opening wedge high tibial osteotomy (LOWHTO), and their indications to deal with both issues simultaneously...
July 2019: Clinics in Sports Medicine
https://read.qxmd.com/read/31079772/high-tibial-osteotomy-and-anterior-cruciate-ligament-reconstruction-revision
#6
REVIEW
Antonino Cantivalli, Federica Rosso, Davide Edoardo Bonasia, Roberto Rossi
High tibial osteotomy (HTO) may be performed in association with anterior cruciate ligament (ACL) reconstruction/revision in patients with medial osteoarthritis, varus malalignment, and anterior instability. Furthermore, it may be performed in patients with varus alignment and increased posterior tibial slope (exceeding 12°), because it is related to an increased risk for ACL failure. There are different techniques to perform HTO, and consequently, a concomitant HTO and ACL reconstruction/revision. This article describes the indication, surgical techniques, and outcomes of concomitant HTO and ACL reconstruction/revision...
July 2019: Clinics in Sports Medicine
https://read.qxmd.com/read/31079771/high-tibial-osteotomy-and-medial-meniscus-transplant
#7
REVIEW
Joseph N Liu, Avinesh Agarwalla, Andreas H Gomoll
Concomitant high tibial osteotomy and meniscal allograft transplant is indicated in patients with medial meniscus deficiency and varus deformity. A synergistic relationship likely exists between knee realignment and restoration of meniscal and chondral tissue. Therefore, it is important to address all sources of pathology, such as meniscal or chondral defects, when addressing axis malalignment. In this article, we review the indications, preoperative considerations, technique, postoperative rehabilitative protocol, and outcomes in patients undergoing high tibial osteotomy with medial meniscal allograft transplant...
July 2019: Clinics in Sports Medicine
https://read.qxmd.com/read/31079770/distal-femoral-osteotomy-and-lateral-meniscus-allograft-transplant
#8
REVIEW
Natalie L Leong, Taylor M Southworth, Brian J Cole
Distal femoral varus-producing osteotomy can be performed in the setting of lateral meniscal transplant to correct valgus malalignment of the knee and thus offload the lateral compartment. Advantages of a lateral opening wedge over medial closing wedge osteotomy include a single bone cut, avoidance of vascular structures, and theoretically better control of the amount of correction. It is important to address all knee joint comorbidities, including meniscal deficiency, chondral and osteochondral defects, and ligamentous insufficiency...
July 2019: Clinics in Sports Medicine
https://read.qxmd.com/read/31079769/lateral-closing-wedge-high-tibial-osteotomy-for-medial-compartment-arthrosis-or-overload
#9
REVIEW
Giulio Maria Marcheggiani Muccioli, Stefano Fratini, Eugenio Cammisa, Vittorio Vaccari, Alberto Grassi, Laura Bragonzoni, Stefano Zaffagnini
Lateral closing wedge osteotomies are still actual treatments of unicompartmental arthrosis and deformities. This article focuses on surgical timing, indications, and technique to achieve a pain-free knee joint and a normal weight forces distribution.
July 2019: Clinics in Sports Medicine
https://read.qxmd.com/read/31079768/medial-closing-wedge-distal-femoral-osteotomy
#10
REVIEW
Nicholas C Duethman, Christopher D Bernard, Christopher L Camp, Aaron J Krych, Michael J Stuart
The main indication for performing a distal femoral osteotomy is valgus malalignment of the knee joint. The ideal candidates are young and active individuals with isolated lateral compartment arthritis. The goal of the procedure is to create a neutral mechanical axis of the limb to relieve pain and preserve the knee joint. The amount of correction is calculated from a preoperative, high-quality, weight-bearing radiograph from the hip to ankle. This technically challenging operation is a viable option for patients with valgus malalignment because early survivorship is strong and patient-reported outcome scores are significantly improved...
July 2019: Clinics in Sports Medicine
https://read.qxmd.com/read/31079767/lateral-opening-wedge-distal-femoral-osteotomy-for-lateral-compartment-arthrosis-overload
#11
REVIEW
Carola Pilone, Federica Rosso, Umberto Cottino, Roberto Rossi, Davide Edoardo Bonasia
Distal femoral osteotomy (DFO) is a valid option for the treatment of young and active patients with lateral compartment osteoarthritis/overload and valgus malalignment. DFOs can be performed with a closing wedge or opening wedge technique. Lateral opening wedge DFO is usually preferred for smaller corrections, whereas medial closing wedge for larger corrections and in patients with high risk of nonunion. This article describes the relevant aspects regarding lateral opening wedge DFO, including patient selection, preoperative planning, surgical technique, results, and complications...
July 2019: Clinics in Sports Medicine
https://read.qxmd.com/read/31079766/medial-opening-wedge-high-tibial-osteotomy-for-medial-compartment-arthrosis-overload
#12
REVIEW
Molly Day, Brian R Wolf
Medial opening-wedge high tibial osteotomy has become increasingly popular for treating isolated, medial compartment arthrosis in younger, more active patients. Relative indications include age younger than 55 to 60 years, normal weight, preserved range of motion, and isolated medial compartment osteoarthritis or overload. Several surgical techniques exist for stabilization of the osteotomy with similar outcomes. Complication rates after medial opening-wedge high tibial osteotomy vary from 29% to 37%, with highest risk of nonunion, fracture, stiffness, and loss of correction...
July 2019: Clinics in Sports Medicine
https://read.qxmd.com/read/31079765/improved-methods-to-measure-outcomes-after-high-tibial-osteotomy
#13
REVIEW
Amanda L Lorbergs, Trevor B Birmingham, Codie A Primeau, Hayden F Atkinson, Kendal A Marriott, J Robert Giffin
Observational studies suggest high tibial osteotomy produces substantial improvements in knee loading and stability that can limit the progression of joint damage; decrease pain; improve function and quality of life; and delay the need for knee replacement surgery. It can be cost-effective in knee osteoarthritis. However, systematic reviews and clinical practice guidelines are unable to provide strong recommendations, because limited high-level evidence supports its therapeutic value versus other treatments...
July 2019: Clinics in Sports Medicine
https://read.qxmd.com/read/31079764/patient-evaluation-and-indications-for-osteotomy-around-the-knee
#14
REVIEW
Biagio Zampogna, Sebastiano Vasta, Rocco Papalia
Osteotomy is recognized as a knee joint-preserving surgical procedure to treat frontal and/or sagittal plane malalignment with or without associated instability. This article outlines the preoperative clinical and imaging assessments of prospective patients undergoing osteotomy. In addition, indications and contraindications as well as surgical planning are presented.
July 2019: Clinics in Sports Medicine
https://read.qxmd.com/read/30878053/knee-multiligament-injury
#15
EDITORIAL
Bruce A Levy, Benjamin Freychet
No abstract text is available yet for this article.
April 2019: Clinics in Sports Medicine
https://read.qxmd.com/read/30878052/multiple-ligament-knee-injuries-expert-insight
#16
EDITORIAL
Mark D Miller
No abstract text is available yet for this article.
April 2019: Clinics in Sports Medicine
https://read.qxmd.com/read/30878051/osteotomies-in-the-multiple-ligament-injured-knee-when-is-it-necessary
#17
REVIEW
Niv Marom, Norimasa Nakamura, Robert G Marx, Michael J Stuart
The multiple ligament-injured knee is a complex injury requiring a comprehensive and thorough evaluation prior to tailoring an appropriate treatment plan. Surgical repair and reconstruction of the involved ligaments are frequently discussed in the literature; however, osteotomy to correct limb malalignment may be just as important to obtaining a good outcome. Limb realignment must be carefully evaluated and treated. Isolated soft tissue procedures are prone to failure if significant malalignment, deformity, and thrust are ignored...
April 2019: Clinics in Sports Medicine
https://read.qxmd.com/read/30878050/all-inside-posterior-cruciate-ligament-reconstruction-surgical-technique-and-outcome
#18
REVIEW
Benjamin Freychet, Vishal S Desai, Thomas L Sanders, Nicholas I Kennedy, Aaron J Krych, Michael J Stuart, Bruce A Levy
Several reconstructive techniques exist to treat posterior cruciate ligament (PCL) deficiency. The purpose of this study is to report knee function and clinical stability after PCL reconstruction (PCLR) using an all-inside technique. Thirty-two patients with isolated or combined PCL injuries treated with all-inside PCLR using soft tissue allograft were included. Documented physical examination findings including ligamentous stability examination were recorded. All-inside, single-bundle PCLR demonstrated satisfactory clinical and functional outcomes comparable with previous other PCLR techniques...
April 2019: Clinics in Sports Medicine
https://read.qxmd.com/read/30878049/repair-and-augmentation-with-internal-brace-in-the-multiligament-injured-knee
#19
REVIEW
John Dabis, Adrian Wilson
The internal brace is a ligament repair bridging concept using braided ultra-high-molecular-weight polyethylene suture tape and knotless bone anchors to reinforce ligament strength to allow early mobilization during early-phase healing. This concept can be used in the management of anterior cruciate ligament, posterior cruciate ligament, anterolateral ligament, medial collateral ligament, posteromedial corner, and posterolateral corner injuries. Ligament reinforcement is a concept in which a graft is reinforced and can be used in all aspects of knee ligament reconstruction...
April 2019: Clinics in Sports Medicine
https://read.qxmd.com/read/30878048/fibular-collateral-ligament-posterolateral-corner-injury-when-to-repair-reconstruct-or-both
#20
REVIEW
Mitchell I Kennedy, Andrew Bernhardson, Gilbert Moatshe, Patrick S Buckley, Lars Engebretsen, Robert F LaPrade
The posterolateral corner (PLC) of the knee was regarded as the "dark side" of the knee because of limited understanding of its anatomy and biomechanics and because of poor outcomes after injuries to PLC structures. These injuries rarely occur in isolation, with 28% reported as isolated PLC injuries. Nonoperative treatment of these injuries has led to persistent instability, development of early osteoarthritis, and poor outcomes. Several techniques for reconstruction of the PLC have been described, and all are reported to improve outcomes...
April 2019: Clinics in Sports Medicine
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