Knee

The treatment of a patient with amputation above the knee who has suffered a femoral neck fracture is a challenge for both the orthopedic surgeon and the rehabilitation team. We present a case, in which different difficulties are discussed in their treatment, choice of implant and return to their daily activities. The clinical case of a young man diagnosed with supracondylar bilateral traumatic amputation, with fracture of the femoral neck, treated by total non-cemented hip arthroplasty is presented. The functionality of the total hip prosthesis with Houghton scale after 12 months, obtaining a final score of 9 points which are the result of a satisfactory rehabilitation...

Anterior cruciate ligament injury (ACL) of the knee is a severe traumatic injury that greatly decreases the function and sometimes leaves very important sequelae for the young patient so surgery for ligament reconstruction is the suitable treatment, there are several techniques for the elaboration of tunnels with difference in the portals, the methods of fixation and the different grafts used and each one of the authors defend their techniques giving their advantages and disadvantages and possible complications associated...

INTRODUCTION: ACL injuries are found within the most common ligament injuries. This has led to the development of different surgical techniques to restore knee stability. MATERIAL Y METHODS: Clinical study, randomized, blind comparing ACL reconstruction techniques with One Band and «U-Two» using clinical scales and arthrometria with KT-1000 and Pivot Shift Meter. RESULTS: Of 36 patients, 52.94% was drawn for the One Band technique and 47...

INDRODUCTION: Knee arthroscopy is one of the most commonly performed procedures. General anesthesia and spinal blockage are the most common forms of anesthesia. We consider that this surgery can be managed with intra-articular local anesthesia, thus avoiding prolonged stays in recovery, with effective pain management and optimization of presurgical, intrasurgical and post-surgical times. MATERIAL AND METHODS: Prospective, quasi-experimental, longitudinal study to compare two anesthetic procedures: intraarticular anesthesia (lidocaine with epinephrine, bupivacaine and fentanyl) without the use of ischemia (group A); spinal blockage and use of ischemia (group B) by assessing age, surgery time, pain during surgery and 24 hour post-op VA scale, time spent in recovery, need to administer general anesthesia or anesthetic rescue doses, 24-hour range of motion...

BACKGROUND: Reducing blood loss and transfusions in patients operated on primary TKR is associated with a better clinical and functional outcome. The use of Tranexamic Acid (ATX) is one of the methods used to decrease that bleeding. MATERIAL AND METHODS: Results in Hb, Hto, rate of bleeding and transfusion, surgical time and pain between groups A (with ATX) and group B (without tranexamic acid) after TKR are compared. Results: Statistically significant differences were found during surgery and perisurgical bleeding, in the decrease of Hb at 24 hours, transfusion rate, surgical time and pain to wandering in favor of group A...

Pyoderma gangrenosum (PG) is an extra-intestinal skin lesion in inflammatory bowel disease (IBD) as is erythema nodosum. Vedolizumab (VED) is a monoclonal antibody that targets α4β7 integrin and has an intestinal selective mechanism. Despite good therapeutic effects on colitis, the effect on extra-intestinal manifestations (EIMs) remains unclear. Here we report a case of ulcerative colitis complicated by PG during treatment with VED, which was successfully treated with prednisolone in combination with adsorptive granulocyte and monocyte apheresis (GMA)...

The main objective was to investigate if the cumulative load of the lower limbs, defined as the product of external load and step rate, could be predicted using spatiotemporal variables gathered with a commercially available wearable device in running. Therefore, thirty-nine runners performed two running tests at 10 and 12 km/h, respectively. Spatiotemporal variables (step rate, ground contact time and vertical oscillation) were collected using a commercially available wearable device. Kinetic variables, measured with gold standard equipment (motion capture system and instrumented treadmill) and used for the calculation of a set of variables representing cumulative load, were peak vertical ground reaction force (peak vGRF), vertical instantaneous loading rate (VILR), vertical impulse, braking impulse, as well as peak extension moments and angular impulses of the ankle, knee and hip joints...

Contrast-enhanced computed tomography is an emerging diagnostic technique for osteoarthritis. However, the effects of increased water content, as well as decreased collagen and proteoglycan concentrations due to cartilage degeneration, on the diffusion of cationic and non-ionic agents, are not fully understood. We hypothesize that for a cationic agent, these variations increase the diffusion rate while decreasing partition, whereas, for a non-ionic agent, these changes increase both the rate of diffusion and partition...

OBJECTIVE: CircRNA, a type of circular RNA, has recently been shown to be a potential target for osteoarthritis (OA). Circular RNA HIPK3 (CircHIPK3) is reported to be abnormally expressed in various disease tissues and affects the occurrence and development of the disease. However, the role and underlying mechanism of CircRNA HIPK3 in osteoarthritis are still unclear. The purpose of this study is to explore the effect of CircRNA HIPK3 on osteoarthritis and analyze its regulatory mechanism...

INTRODUCTION: Reduced muscle strength is a high risk factor for type 2 diabetes mellitus, and this association is especially strong in non-obese male individuals. However, it remains unclear how reduced muscle strength affects susceptibility to diabetes. We have examined whether lower limb muscle strength is associated with insulin resistance in non-obese Japanese male subjects. METHODS: Measurements from 64 non-diabetic, non-obese, middle-aged Japanese men were analyzed...

PURPOSE: To determine the incidence of meniscal ramp lesions in an anterior cruciate ligament (ACL) injured knees and to clarify whether ramp lesions are related to chronic ACL deficiency and increased knee instability. METHODS: Consecutive ACL injured patients were evaluated arthroscopically for a ramp lesion via a trans-notch view and evidence of menisco-capsular injury was recorded. Other concomitant injuries to the knee were also noted. Incidence of meniscal ramp lesions, delay before surgery, and anterior-posterior stability was analyzed...

PURPOSE: All-inside meniscal repair devices have evolved to allow surgeons to undertake complex repairs in a timely and efficient manner. This is advantageous in active patients, where meniscus preservation is critical in preserving joint function and stability. The aim of the study was to evaluate the failure rate of all-inside meniscal repair performed in patients undergoing reconstructive ligament surgery using a particular meniscal repair device. METHODS: Patients were identified using a single-site prospectively maintained patient registry...

PURPOSE: A stringent outcome assessment is a key aspect for establishing evidence-based clinical guidelines for anterior cruciate ligament (ACL) injury treatment. The aim of this consensus statement was to establish what data should be reported when conducting an ACL outcome study, what specific outcome measurements should be used and at what follow-up time those outcomes should be assessed. METHODS: To establish a standardized approach to assessment of clinical outcome after ACL treatment, a consensus meeting including a multidisciplinary group of ACL experts was held at the ACL Consensus Meeting Panther Symposium, Pittsburgh, PA; USA, in June 2019...

BACKGROUND: The analgesic effects of transcranial Direct Current Stimulation (tDCS) combined with physical therapy remain unclear. OBJECTIVE: To systematically review available evidence comparing tDCS with any physical therapy modality (PTM) to PTM alone or PTM with sham tDCS on pain relief on common musculoskeletal (MSK) conditions, namely knee osteoarthritis (KOA), chronic low back pain (CLBP), myofascial pain syndrome (MPS) and fibromyalgia. METHODS: EMBASE and MEDLINE were searched from inception to April 2019 for randomized controlled trials...

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Background: Conservative management is generally the primary treatment for intramuscular hemangimas. However, many patients will require surgery later in their life, after suffering a long period of pain. We aimed to evaluate the oncologic and functional outcomes of surgery as the initial treatment of single-muscle hemangiomas. Methods: Medical profiles of 17 patients with hemangiomas of vastus medialis for whom surgery was selected as the initial treatment were reviewed...

Background: Although some surgical techniques have been described for the operative treatment of unstable Osteochondritis dissecans (OCD) of the knee, outcomes are variable and are not satisfying totally. The aim of the present study is to evaluate the outcomes of autogenous osteochondral grafting for OCD of the knee. Methods: In a case series study, from June 2014 to July 2015, 16 patients with stage II-IV OCD (International Cartilage Repair Society (ICRS)) of the femoral condyle were investigated...

Background: The maintenance of deformity in the ankle and hindfoot after correction of knee deformity following knee arthroplasty may cause abnormal tension in the knee and patient dissatisfaction. The aim of this study was to determine the effect of knee arthroplasty on the hindfoot alignment in patients with severe genu varum and valgum. Methods: A total of 84 patients with primary osteoarthritis, were enrolled in the study. The knee deformity was measured using a long leg film before surgery...

Background: Acquiring knowledge about anatomic and geometric quantities of bones is among the most vital parameters in orthopedic surgery that has a significant effect on the treatment of various disorders and subsequent outcomes. The aim of this study was to obtain anthropometric information for distal femur in order to compare with similar dimensions of prosthesis used in total knee arthroplasty (TKA) surgery and to design more suitable and optimal components. Methods: Morphological data of distal femur were measured in 132 knees (81 males and 51 females) using magnetic resonance imaging (MRI)...