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Knee trauma

Toby Jennison, Rathan Yarlagadda
INTRODUCTION: Interprosthetic fractures occur between a total knee replacement and a femoral stem of either a hemiarthroplasty or total hip replacement. The number of interprosthetic fractures will increase as the number of joint replacements rises. There is currently a paucity of literature looking at the outcomes of interprosthetic fractures. Therefore, we performed a retrospective study to: (1) determine fracture union in patients following surgical treatment of a femoral interprosthetic fracture, (2) measure outcomes included mortality and complications...
February 7, 2019: Orthopaedics & Traumatology, Surgery & Research: OTSR
E C Müller, K-H Frosch
With 1% of all skeletal fractures patellar fractures are rare. The majority of cases are caused by a direct trauma to the flexed knee. The diagnosis is made via the injury mechanism as well as the physical and radiological findings. In conventional x‑ray imaging the extent of injury often is underrated, which mostly leads to the necessity of a computed tomography (CT) scan. The aim of the treatment is the reconstruction of the extensor mechanism and the anatomical reconstruction of the articular surface...
February 11, 2019: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Jan Dauwe, Olivier Van Kerkhove, Ines Unterfrauner, Dirk Dauwe
Introduction: Avulsion fractures of the tibial intercondylar eminence are rare and occur mostly in children. The purpose of this paper is to present a case of this rare pathology and to underline the importance of early diagnosis. Case Report: A male 8-year-old child presented with pain in his left knee and difficulties to walk after a combined injury of falling and contact trauma. Radiographic studies with conventional X-ray and computed tomography (CT) scan depicted a fracture of the intercondylar eminence...
September 2018: Journal of Orthopaedic Case Reports
Florin Allemann, Sandro Heining, Boris Zelle, Christian Probst, Hans-Christoph Pape
Background: In terms of upper extremity fractures by patients with multiple injuires, a lot of studies have assessed the functional outcome following trauma to have less favorable outcomes in regards to functional recovery. We tested the hypothesis that differences in clinical outcome occur between shaft and articular injuries of the upper extremity, when patients that sustained neurologic deficits (e.g. brachial plexus lesions) are excluded. Methods: We involved Patients with isolated or combined upper extremity fracture, ISS > 16 in a level one trauma center...
2019: Patient Safety in Surgery
Yufeng Zhou, Kai Yang
INTRODUCTION: Surgery or trauma may induce extensive arthrofibrosis around joints and tendon for the restrictive range of motion. Although some approaches were proposed, this problem is not solved satisfactorily. Extracorporeal shock wave therapy (ESWT) has been used for orthopedic, musculoskeletal, and fibrotic disorders. Whether it could prevent the formation of arthrofibrosis during the joint repair is unknown. METHODS: Intra-articular adhesions were created in the right knee of the rabbit by cortical bone shaving and subsequent cast immobilization...
February 2, 2019: Injury
Fay R K Sanders, J Carel Goslings, Ron A A Mathôt, Tim Schepers
Background and purpose - The incidence of surgical site infections (SSIs) in trauma/orthopedic surgery varies between different body parts. Antibiotic prophylaxis (e.g., with cefazolin) lowers infection rates in closed fracture surgery and in primary arthroplasty. For prophylactic antibiotics to prevent infections, sufficient concentrations at the target site (location of surgery) are required. However, dosage recommendations and the corresponding efficacy are unclear. This review assesses target site cefazolin concentrations and the effect of variation in dose and location of target site during orthopedic extremity surgery...
February 11, 2019: Acta Orthopaedica
Qi-Fang He, Han-Xu Wang, Hui Sun, Yu Zhan, Bin-Bin Zhang, Xue-Tao Xie, Cong-Feng Luo
OBJECTIVE: To present our clinical experience of treating varus malunion of the distal femur through a medial open-wedge osteotomy with double-plate fixation. METHODS: A prospective cohort study was performed. From January 2005 to February 2015, 15 consecutive patients with varus malunion following distal femur fractures were surgically treated at a single level I trauma center. The coronal and sagittal deformity were corrected by a medial open-wedge osteotomy of the distal femur...
February 5, 2019: Orthopaedic Surgery
Franz Hilber, Christian Pfeifer, Clemens Memmel, Johannes Zellner, Peter Angele, Michael Nerlich, Maximilian Kerschbaum, Daniel Popp, Florian Baumann, Werner Krutsch
INTRODUCTION: Patellar dislocation and rupture of the medial patellofemoral ligament (MPFL) are frequently seen in daily orthopedic practice. Besides initial non-surgical treatment, surgery and subsequent rehabilitation are crucial for restoring stability in the femoropatellar joint. This study investigated current rehabilitation strategies after patellar dislocation because knowledge on this topic has been severely limited so far. MATERIALS AND METHODS: The current rehabilitation protocols of 42 orthopedic and trauma surgical institutions were analyzed regarding their recommendations on weight bearing, range of motion (ROM), and use of movement devices and orthosis...
January 17, 2019: Injury
Massimiliano Leigheb, Giuseppe Guzzardi, Michela Barini, Michele Abruzzese, Silvia Riva, Alessio Paschè, Francesco Pogliacomi, Lia Rimondini, Alessandro Stecco, Federico Alberto Grassi, Alessandro Carriero
Objective The aim of this work is to evaluate the diagnostic accuracy of 0.3T sectoral MR imaging, compared with arthroscopy, for meniscal, cruciate ligaments and chondral knee lesions. Materials and Methods We conducted a retrospective study analyzing all the consecutive knees subjected to arthroscopy at our institution between January 2014 and June 2017 and preceded within 3 months by knee MR examination at our institution with 0.3 T equipment. Patients with history of a new trauma in the time interval between MR exam and arthroscopy were excluded from the study...
December 10, 2018: Acta Bio-medica: Atenei Parmensis
Cailong Liu, Axiao Pan, Xiaowei Chen, Jianxin Tu, Xiaoru Xia, Li Sun
OBJECTIVES: This study aimed to investigate microRNA (miRNA) expression profiles in synovium tissues of rheumatoid arthritis (RA) patients by RNA sequencing and to evaluate the values of dysregulated miRNAs in RA diagnosis and monitoring. METHODS: Thirty RA patients who underwent knee arthroscopy and 30 controls with knee trauma who underwent surgery were consecutively recruited, and synovium tissue samples of both groups were obtained during surgeries. In the exploration part, miRNA and mRNA expression profiles of 3 RA samples and 3 control samples were detected using RNA sequencing then followed by bioinformatic analyses...
February 1, 2019: Clinical Rheumatology
Vivek Trikha, Sahil Gaba, Prabhat Agrawal, Saubhik Das, Arvind Kumar, Buddhadev Chowdhury
Objectives: The management of high energy tibial plateau fractures is a surgical challenge. Recently described Luo's classification is based on CT scans and is more objective with a better inter-observer agreement as compare to Schatzker and AO/OTA classifications. We describe the functional results of a series of 53 cases classified and managed according to the Luo's column concept. Methods: A retrospective review of 53 high energy tibial plateau fractures, operated between January 2012 and March 2015 at a Level I trauma center, was performed...
January 2019: Journal of Clinical Orthopaedics and Trauma
Elizabeth M Polfer, Benjamin W Hoyt, Adam J Bevevino, Jonathan A Forsberg, Benjamin K Potter
OBJECTIVES: To determine if there is a patient-reported functional difference between combat-related knee disarticulations (KD) and transfemoral amputations (TFA). SETTING: Role 3 Military Trauma Centers PATIENTS:: We identified and contacted all KDs and TFAs performed at Walter Reed National Military Medical Center, Walter Reed Army Medical Center, and National Naval Medical Center from January 2003 until July 2012 to participate in a retrospective functional cohort analysis...
January 22, 2019: Journal of Orthopaedic Trauma
Marianne Luetmer, Benjamin Mundell, Hilal Maradit Kremers, Sue Visscher, Kurtis M Hoppe, Kenton R Kaufman
BACKGROUND: Low back pain (LBP) is common among individuals with transfemoral amputation (TFA) and has a negative impact on quality of life. Little is known about healthcare utilization for LBP among this population and whether utilization varies by amputation etiology. OBJECTIVE: To determine if individuals with TFA have an increased likelihood of seeking care or reporting symptoms of acute or chronic LBP during physician visits post-amputation compared to matched individuals without amputation...
January 31, 2019: PM & R: the Journal of Injury, Function, and Rehabilitation
Azadeh Sharafi, Rahman Baboli, Gregory Chang, Ravinder R Regatte
BACKGROUND: In addition to the articular cartilage, osteoarthritis (OA) affects several other tissues such as tendons, ligaments, and subchondral bone. T1ρ relaxation study of these short T2 tissues may provide a more comprehensive evaluation of OA. PURPOSE: To develop a 3D spin-lattice relaxation in the rotating frame (T1ρ ) prepared zero echo time (ZTE)-based pointwise encoding time reduction with radial acquisition (3D-T1ρ -PETRA) sequence for relaxation mapping of semisolid short-T2 tissues on a clinical 3 T scanner...
January 28, 2019: Journal of Magnetic Resonance Imaging: JMRI
Grace E Martin, Amanda Pugh, Susan G Williams, Dennis Hanseman, Vanessa Nomellini, Amy T Makley, Timothy A Pritts, Michael D Goodman
BACKGROUND: Deep vein thrombosis (DVT) remains a significant cause of morbidity after injury. Lower extremity duplex ultrasound screening (LEDUS) is designed to identify early, asymptomatic DVTs in moderate and high risk patients. We sought to describe when thrombus is detected and identify which trauma patients benefit from LEDUS. MATERIALS AND METHODS: A retrospective review was conducted on trauma patients who were moderate or high risk for venous thromboembolism based on risk assessment profile (RAP) scoring...
March 2019: Journal of Surgical Research
Nicolás García, A Debandi, G Delgado, J Rosales, M Verdugo
Congenital absence of the cruciate ligaments is a very rare condition, with most reported cases being related to the anterior cruciate ligament (ACL). Posterior cruciate ligament (PCL) congenital abnormalities have been described as almost always being associated with other anomalies. We present a case of a patient with lateral knee pain and subjective instability sensation after a low-energy trauma secondary to a lateral meniscus tear, with absence of the PCL on MRI examination and thickened meniscofemoral ligaments, with anterior and superior insertion at the femur, in the footprint of PCL...
January 28, 2019: Skeletal Radiology
Maryellen P Brucato, Matthew F Wachtler, Ellianne M Nasser
Pathologic fractures of the calcaneus secondary to osteomyelitis (OM) have rarely been reported in the literature. This case series describes 5 patients who were treated in our institution for chronic OM of the calcaneus and subsequently suffered a fracture of the involved calcaneus in the absence of trauma. All 5 patients had a history of insulin-dependent diabetes mellitus and were treated with a range of surgical treatments including open reduction and internal fixation, external fixation, and excision of the fracture fragment...
January 23, 2019: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Iwona Pawłowska, Grzegorz Ziółkowski, Jadwiga Wójkowska-Mach, Tomasz Bielecki
OBJECTIVE: The aims of the study were to analyse the surgical site infections (SSIs) in patients operated at an orthopaedic ward and to describe the drug-resistance of the aetiology of those infections. Also, analyse the possibility of SSI control through microbiological surveillance. Additionally, we have studied the information inferred by aggregating cumulative antibiograms for the SSIs of the studied orthopaedic unit. DESIGN: Cross-sectional studies carried out in 2013-2015...
January 24, 2019: International Orthopaedics
Juriaan van den Berg, Stefaan Nijs, Harm Hoekstra
INTRODUCTION: The three-column concept has been proposed as tool in surgical decision-making for treating tibial plateau fractures. Recent studies have underscored the negative effect of posterior column tibial plateau fractures on clinical outcome. The purpose of this study was to assess the value of the three-column concept and posterior plating in posterior column fractures. We hypothesized that treating patients according to the three-column concept improves functional outcome. METHODS: 111 consecutive tibial plateau fractures, treated between January 2009 and December 2016, with at least a posterior column fracture were included...
January 23, 2019: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Pietro G di Summa, Gianluca Sapino, Mario Cherubino, Giorgio De Santis, Sebastien Durand, Patrice Zaugg, Olivier Bauquis, Wassim Raffoul
BACKGROUND: We evaluated composite anterolateral thigh (ALT) flaps including vascularized fascia lata (FL), for stable soft tissue coverage and tendons restoration at various joint levels in a one-stage procedure. METHODS: We performed a retrospective investigation including 21 "functional" ALT flaps between November 2006 and December 2016. In all patients included, FL was shaped to anatomical reproduce a tendon structure. Functional analysis included range of motion and force assessment...
January 22, 2019: Microsurgery
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