11,964 results match your criteria Fracture Knee


Does Osteoarticular Allograft Reconstruction Achieve Long-term Survivorship after En Bloc Resection of Grade 3 Giant Cell Tumor of Bone?

Clin Orthop Relat Res 2020 May 26. Epub 2020 May 26.

J. I. Albergo, G. L Farfalli, A Cabas-Geat, P. Roitman, M. A. Ayerza, L. A. Aponte-Tinao, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

Background: En bloc resection of benign tumors is only indicated in aggressive lesions with substantial destruction of the affected bone. Few reports have evaluated the long-term outcome of Grade 3 giant cell tumor of bone (GCTB; defined as severe bone destruction and soft tissue extension) treated with en bloc resection and reconstruction with a massive allograft. We recently reported that patients with benign tumors achieved better allograft reconstruction survivorship compared with those treated for a malignant bone tumor. Read More

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http://dx.doi.org/10.1097/CORR.0000000000001337DOI Listing

Biomechanical Study on the Stress Distribution of the Knee Joint After Tibial Fracture Malunion with Residual Varus-Valgus Deformity.

Orthop Surg 2020 May 27. Epub 2020 May 27.

Department of Orthopedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China.

Objective: To investigate the effect of residual varus and valgus deformity on the stress distribution of the knee joint after tibial fracture malunion.

Methods: Fourteen adult cadaver specimens were selected to establish the models of tibial fractures, which were fixed subsequently at neutral position (anatomical reduction) and malunion positions (at 5°, 10°, and 15° valgus positions, and 5°, 10°, and 15° varus positions). The stress distribution on the medial and lateral plateau of the tibia was quantitatively measured using ultra-low-pressure sensitive film technology. Read More

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http://dx.doi.org/10.1111/os.12668DOI Listing

Intraoperative Proximal Tibia Periprosthetic Fractures in Primary Total Knee Arthroplasty.

J Knee Surg 2020 May 27. Epub 2020 May 27.

Department of Orthopaedic Surgery, New England Baptist Hospital, Boston, Massachusetts.

Intraoperative fracture of the proximal tibia is a rare complication of total knee arthroplasty (TKA) with few studies available reporting risk factors or prognosis. A review of our prospective joint registry was performed to determine the incidence and associated risk factors of intraoperative tibia fractures during primary TKA; 14,966 TKAs of all manufacturers were performed with 9 intraoperative tibia fractures. All fractures occurred in a single TKA design. Read More

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http://dx.doi.org/10.1055/s-0040-1708037DOI Listing

Treatment of Periarticular Fractures of the Knee Using the Less Invasive Stabilization System: A Retrospective Clinical Trial.

Cureus 2020 Apr 22;12(4):e7773. Epub 2020 Apr 22.

Orthopaedics and Traumatology, Bursa Acıbadem Hospital, Bursa, TUR.

Introduction Periarticular fractures of the knee in adults are generally treated with internal fixation. The Less Invasive Stabilization System (LISS) plate, developed by Arbeitsgemeinschaft Osteosynthesefragen (AO)/Association for the Study of Internal Fixation (ASIF) in the late 1990s, allows reduction and biological fixation through smaller incisions without violating periosteal blood supply. It offers several advantages for the treatment of complex periarticular fractures of the knee. Read More

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http://dx.doi.org/10.7759/cureus.7773DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7243630PMC

Antibiotic-loaded bone cement in primary total knee arthroplasty: does it reduce the risk of periprosthetic joint infection?

Hosp Pract (1995) 2020 May 27:1-8. Epub 2020 May 27.

Department of Orthopaedic Surgery, "La Paz" University Hospital-IdiPaz , Madrid, Spain.

Background: Total knee arthroplasty (TKA) is a widely used technique, the purpose of which is to improve or eliminate knee pain produced by osteoarthritis. One of the most severe complications of primary TKA is periprosthetic joint infection (PJI). To reduce the risk of PJI, some surgeons use antibiotic-loaded bone cement (ALBC) in primary TKA, but others do not. Read More

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http://dx.doi.org/10.1080/21548331.2020.1769417DOI Listing

Comparison of 8-year knee osteoarthritis progression in 2 siblings: a case-based review.

Clin Rheumatol 2020 May 26. Epub 2020 May 26.

College of Nursing, University of Massachusetts, Amherst, MA, USA.

Because the pathophysiology of knee osteoarthritis is poorly understood, optimal evidence-based clinical management is uncertain. Sibling comparison studies can help inform a clinical model to guide preventive care. We compared the 8-year clinical outcomes in 2 sisters with a family history of osteoarthritis, normal BMI, and absence of knee pain at baseline. Read More

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http://dx.doi.org/10.1007/s10067-020-05181-6DOI Listing

Tibial Plateau Fracture with Avulsion Fracture of Tibial Tuberosity: A Case Report and Review of Literature.

Cureus 2020 Apr 21;12(4):e7756. Epub 2020 Apr 21.

Orthopaedics, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, IND.

Tibial tuberosity fractures are usually seen in the adolescent age group and are very rare in adults. Here we describe a case of knee injury following a road traffic accident. The patient had tibial tuberosity avulsion along with tibial plateau fracture. Read More

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http://dx.doi.org/10.7759/cureus.7756DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7243061PMC

Understanding the role of total knee arthroplasty for primary treatment of tibial plateau fracture: a systematic review of the literature.

J Orthop Traumatol 2020 May 25;21(1). Epub 2020 May 25.

Section of Orthopaedic Surgery, Department of Surgery, University of Calgary, North Tower, Foothills Medical Centre, 1403 29 St NW, Calgary, T2N 2T9, AB, Canada.

Background: Surgical fixation of tibial plateau fracture in elderly patients with open reduction and internal fixation (ORIF) provides inferior outcomes compared with younger patients. Primary total knee arthroplasty (TKA) may be of benefit in elderly patients with a combination of osteoporotic bone and metaphyseal comminution. However, there continues to be conflicting evidence on the use of TKA for primary treatment of tibial plateau fracture. Read More

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http://dx.doi.org/10.1186/s10195-020-00546-8DOI Listing

Open tibia plateau fracture with intra-osseous dislocation of the patella and quadriceps tendon rupture: a case report.

BMC Surg 2020 May 25;20(1):114. Epub 2020 May 25.

Department of Orthopaedics, The Second Affiliated Hospital of Kunming Medical University, Kunming, China.

Background: Both tibial plateau fractures and extensor apparatus injuries are serious injuries to the knee joint that generally do not occur in the same patient. We report a rare case of open tibial plateau fracture combined with quadriceps tendon rupture and complete displacement of the patella into the tibial plateau fracture.

Case Presentation: The case involved a male who was 19 years old who had been in a motorcycle accident. Read More

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http://dx.doi.org/10.1186/s12893-020-00770-3DOI Listing

Acute Total Knee Replacement in Rheumatoid Arthritis Patients with Proximal Tibial Fractures: A Case Series.

J Knee Surg 2020 May 25. Epub 2020 May 25.

Department of Orthopedics, Shariati Hospital, Tehran university of Medical Sciences, Tehran, Iran.

Management of proximal tibial fractures is a challenging issue in patients with rheumatoid arthritis (RA). In the present study, we aimed to describe our experience of acute total knee replacement in RA patients.This case series included 11 RA patients with simultaneous insufficiency fractures of the proximal tibia, who were treated by acute total knee replacement. Read More

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http://dx.doi.org/10.1055/s-0040-1710563DOI Listing

Effectiveness of circular external fixator in periprosthetic fractures around the knee.

BMC Musculoskelet Disord 2020 May 21;21(1):317. Epub 2020 May 21.

Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.

Background: The incidence of periprosthetic fractures after total joint arthroplasty (TJA) is rising due to an increasing number of TJAs performed annually and the growing elderly population. In many elderly patients with periprosthetic fractures, the bone strength is lowered due to the deterioration of bone quality and a decrease in bone quantity; rigid fixation of the fracture is difficult. It is a challenging operation for orthopedic surgeons. Read More

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http://dx.doi.org/10.1186/s12891-020-03352-9DOI Listing

Rates and Risk Factors for Failure of Surgical Repair of the Knee Extensor Mechanism.

J Orthop Trauma 2020 Jun;34(6):e203-e207

Department of Orthopaedics, University of Rochester, Rochester, NY.

Objectives: To evaluate rates and risk factors for failed surgical repair of the knee extensor mechanism.

Design: Retrospective cohort study.

Setting: Academic medical center. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001720DOI Listing

Increased Intercondylar Femoral Box Cut-to-Femur Size Ratio During Posterior-Stabilized Total Knee Arthroplasty Increases Risk for Intraoperative Fracture.

Arthroplast Today 2020 Jun 11;6(2):180-185. Epub 2020 May 11.

Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, LA, USA.

Background: Iatrogenic intraoperative fractures are preventable complications in total knee arthroplasty. As press-fit fixation becomes more popular, further investigation into risk factors is needed. Some authors have suggested that smaller femurs may be at higher risk in posterior-stabilized constructs owing to industry designs trending toward larger, constant box sizes that increase the amount of bone resection relative to bone stock. Read More

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http://dx.doi.org/10.1016/j.artd.2020.03.014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218157PMC

Isolated, Closed Superficial Femoral Artery Rupture without Fracture Following Blunt Trauma; A Case Report and Literature Review.

Bull Emerg Trauma 2020 Apr;8(2):125-128

Department of Orthopaedics, Post-Graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India.

Injury to the femoral artery usually occurs either in open penetrating injuries or in association with fractures, but is unlikely with closed blunt trauma without fracture. We reported a 24-year-old female with a right-sided closed complete rupture of the superficial femoral artery without any bone injury and contralateral femoral shaft fracture following riding a bike and hitting by a tractor over both lower limbs. The right thigh and knee were swollen and tender with absent distal pulses without any knee instability. Read More

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http://dx.doi.org/10.30476/BEAT.2020.46454DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7211384PMC

Analysis of modified double-bundle anterior cruciate ligament reconstruction with implantless fixation on tibial side.

Chin J Traumatol 2020 Apr 30. Epub 2020 Apr 30.

Department of Orthopaedics, PGIMER & Dr RML Hospital, New Delhi 110001, India.

Purpose: To avoid potential problems of double-bundle anterior cruciate ligament reconstruction (ACLR), various modifications have been reported. This study analyzed a novel technique of modified double-bundle (MDB) ACLR without implant on tibial side in comparison to single-bundle (SB) ACLR.

Methods: Eighty cases of isolated anterior cruciate ligament tear (40 each in SB or MDB group) were included. Read More

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http://dx.doi.org/10.1016/j.cjtee.2020.04.007DOI Listing

Surgical treatment of femoral medial condyle fracture with lag screws and proximal tibial plate: A case report.

Int J Surg Case Rep 2020 May 11;70:101-105. Epub 2020 May 11.

Department of Orthopaedic Surgery, Yaizu City Hospital, Shizuoka, Japan. Electronic address:

Introduction: Femoral medial condyle fracture is a rare fracture. Here, we report a case of femoral medial condyle fracture treated with lag screws and proximal tibial plate as a buttress plate.

Case Presentation: A 80-year-old woman fell down 15 steps at her home and reported to our hospital with severe right knee pain. Read More

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http://dx.doi.org/10.1016/j.ijscr.2020.04.060DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7226634PMC

Improved Visualization by Central Subluxation of the Lateral Meniscus in Comminuted Lateral Tibial Plateau Fractures.

J Knee Surg 2020 May 15. Epub 2020 May 15.

Department of Trauma, Hand and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

The goal of surgical reconstruction of comminuted tibial plateau fractures is an anatomical reconstruction and stable fixation of the articular surface. This can be difficult due to poor visualization of the posterolateral and central segments of the articular surface of the proximal tibia. To improve visualization, the lateral approach can be extended with an osteotomy of the femoral epicondyle. Read More

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http://dx.doi.org/10.1055/s-0040-1709518DOI Listing

[Posterior popliteal fossa S-shaped incision with double-window approach in treating posterior column of tibial plateau fractures].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2020 May;34(5):574-578

Department Ⅱ of Knee Surgery, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), Luoyang Henan, 471002, P.R.China.

Objective: To evaluate the effectiveness and safty of posterior popliteal fossa S-shaped incision with double-window approach for the treatment of posterior column of tibial plateau fractures.

Methods: A retrospective analysis was made on the clinical data of 13 patients with complex tibial plateau fractures involving both posteromedial and posterolateral columns between May 2015 and July 2017. There were 9 males and 4 females, aged 33-64 years (mean, 46. Read More

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http://dx.doi.org/10.7507/1002-1892.201906076DOI Listing

Which Risk Factors Predict Knee Ligament Injuries in Severely Injured Patients?-Results from an International Multicenter Analysis.

J Clin Med 2020 May 12;9(5). Epub 2020 May 12.

Committee on Emergency Medicine, Intensive Care and Trauma Management (Sektion NIS) of the German Trauma Society (DGU), 10623 Berlin, Germany.

Introduction: Ligament injuries around the knee joint and knee dislocations are rare but potentially complex injuries associated with high-energy trauma. Concomitant neurovascular injuries further affect their long-term clinical outcomes. In contrast to isolated ligamentous knee injuries, epidemiologic data and knowledge on predicting knee injuries in severely injured patients is still limited. Read More

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http://dx.doi.org/10.3390/jcm9051437DOI Listing

Gender difference in bowing of the sagittal femoral morphology measurement using magnetic resonance imaging.

Surg Radiol Anat 2020 May 13. Epub 2020 May 13.

Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.

The importance of femoral sagittal bowing on total knee arthroplasty (TKA) has not been actively discussed. Femoral sagittal bowing can lead to cortex damage, fractures, or femoral malalignment. Therefore, the purpose of this study was to evaluate femoral sagittal bowing at different segments of the femur in the Korean population, and to discuss the implications on total knee arthroplasty. Read More

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http://dx.doi.org/10.1007/s00276-020-02488-6DOI Listing

Kitesurf injury trauma evaluation study: A prospective cohort study evaluating kitesurf injuries.

World J Orthop 2020 Apr 18;11(4):243-251. Epub 2020 Apr 18.

Department of Orthopedic Surgery, Xpert Clinic, Amsterdam 1103 TB, the Netherlands.

Background: Kitesurfing is an increasingly popular and potentially dangerous extreme water sport. We hypothesized that kitesurfing has a higher injury rate than other (contact) sports and that the minority of injuries are severe.

Aim: To investigate the incidence and epidemiology of kitesurfing injuries in a Dutch cohort during a complete kitesurfing season. Read More

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http://dx.doi.org/10.5312/wjo.v11.i4.243DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7206197PMC

[Current treatment strategies for lower leg fractures in adults].

Unfallchirurg 2020 Jun;123(6):479-490

Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland.

Shaft fractures of the tibia and fibula mainly affect younger patients and are therefore of great socioeconomic importance. Due to the high proportion of high-energy direct trauma mechanisms and the thin soft tissue covering layer of the ventromedian tibia, open factures occur in up to 39%. A structured diagnostic and therapeutic approach is essential for successful treatment. Read More

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http://dx.doi.org/10.1007/s00113-020-00805-7DOI Listing

Missed Sleeve Fracture of the Superior Pole of Patella.

Acta Chir Orthop Traumatol Cech 2020 ;87(2):127-128

Istanbul Medipol University School of Medicine, Department of Orthopaedics and Traumatology, Istanbul, Turkey.

Patellar sleeve fracture is a form of injury in which small osseous fragments avulsed with periosteum and cartilage. 15-year-old male patient, playing in school football team, apllied to our clinic with a history of previously missed patellar superior pole sleeve avulsion fracture. Care must be taken in order not to miss the patellar superior pole sleeve fractures, which are very rare in children. Read More

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January 2020

[A boy with acute pain in his right buttock].

Ned Tijdschr Geneeskd 2020 Apr 30;164. Epub 2020 Apr 30.

Máxima MC, afd. Orthopedie, Veldhoven.

A 14-year-old boy presented to the emergency department with pain in his right buttock after a breakdance move. He got injured while simultaneously hyperflexing his hip and extending his knee. Upon physical examination he had tenderness over his right ischial tuberosity and an inability to perform combined hip extension and knee flexion. Read More

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Isolated Distal Fibular Stress Fracture after Total Hip Arthroplasty in a Patient with Developmental Dysplasia of the Hip.

Case Rep Orthop 2020 20;2020:4218719. Epub 2020 Jan 20.

Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Japan.

Stress fractures following total hip arthroplasty in the lower limbs away from the surgical area are very rare. We report a case of stress fracture in the isolated distal fibula that presented five months after total hip arthroplasty in a patient with developmental dysplasia of the hip. A 67-year-old woman diagnosed with coxarthrosis of the right hip joint, classified as Crowe's group 3, underwent total hip arthroplasty with acetabular reconstruction using a bulk bone graft. Read More

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http://dx.doi.org/10.1155/2020/4218719DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7201552PMC
January 2020

Factors Affecting Compliance With Weight-Bearing Restriction and the Amount of Weight-Bearing in the Elderly With Femur or Pelvic Fractures.

Ann Rehabil Med 2020 Apr 29;44(2):109-116. Epub 2020 Apr 29.

Department of Rehabilitation Medicine, Chungbuk National University Hospital, Cheongju, Korea.

Objective: To determine the factors affecting the amount of weight-bearing during gait training in the elderly patients who underwent internal fixation after femur or pelvic fractures and how well they performed the weight-bearing restriction as directed by the physiatrist.

Methods: In this retrospective chart review study, we measured the amount of weight-bearing on the affected side in 50 patients undergoing internal fixation surgery and rehabilitation after femur or pelvic fracture using a force plate. Patients receiving non-weight-bearing or partial weight-bearing education were considered to perform weight-bearing restriction well when the amount of weight-bearing was <50 lb. Read More

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http://dx.doi.org/10.5535/arm.2020.44.2.109DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7214136PMC

Clinical outcomes of open reduction and internal fixation for intra-articular complex tibial plateau non-union with 3-year minimum follow-up.

J Orthop Sci 2020 May 7. Epub 2020 May 7.

Department of Orthopaedic Surgery, School of Medicine, Jichi Medical University, Shimotsuke, Japan.

Background: A tibial plateau fracture is one of the most challenging fractures for both knee and trauma surgeons because of the high incidence of post-traumatic knee osteoarthritis. To our knowledge, there has been no study concerning the clinical outcomes after surgery in patients with non-union of complex intra-articular tibial plateau fractures. Thus, the present study aimed to assess and report the clinical outcomes in them. Read More

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http://dx.doi.org/10.1016/j.jos.2020.04.003DOI Listing

Method of forensic assessment of risk factors of treatment failure outcomes as an element of quality management of medical care.

Wiad Lek 2020 ;73(5):1041-1047

Sumy State University, Sumy, Ukraine.

Objective: The aim: The aim of this research was to study causes of the development of adverse outcomes in isolated femоral diaphyseal fractures.

Patients And Methods: Materials and methods: A retrospective analysis of the protocols of clinical and radiological examination of 21 patients was performed. Based on the initial expert assessment, these patients have not been established the severity of injuries due to the development of complications in the postoperative period. Read More

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January 2020

Analysis of Risk Factors for Ramp Lesions Associated With Anterior Cruciate Ligament Injury.

Am J Sports Med 2020 May 8:363546520918207. Epub 2020 May 8.

Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.

Background: The incidence of meniscocapsular junction tears of the medial meniscus posterior horn, known as , is reported to be 9.3% to 23.9%. Read More

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http://dx.doi.org/10.1177/0363546520918207DOI Listing

All arthroscopic coracoclavicular button fixation is efficient for Neer type II distal clavicle fractures.

Knee Surg Sports Traumatol Arthrosc 2020 May 7. Epub 2020 May 7.

Department of Orthopaedics and Traumatology, Bezmialem Vakif University Medical School, Istanbul, Turkey.

Purpose: Neer type II distal clavicle fractures are associated with a high rate of non-union or malunion due to impaired coracoclavicular ligament stability. The purpose of this study was to assess the clinical and radiological outcomes of arthroscopically assisted indirect osteosynthesis for type II distal clavicle fractures using a cortical suture button device.

Methods: Seventeen patients Neer type II fractures of the distal clavicle were treated surgically using cortical suture button fixation between 2012 and 2017. Read More

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http://dx.doi.org/10.1007/s00167-020-06048-8DOI Listing

Anatomic structures at risk in anteroposterior screw fixation of posterior malleolar fractures: A cadaver study.

Foot Ankle Surg 2020 Apr 27. Epub 2020 Apr 27.

Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, United States. Electronic address:

Introduction: Percutaneous anterior-posterior (AP) screw is an option for posterior malleolus fracture fixation when the fracture fragment can be reduced indirectly by the mean of ligamentotaxis. However, anterior anatomic structures could be injured during screw placement.

Materials And Methods: Eleven below-knee cadavers were employed for the placement of AP screws in an attempt of fixing assumed Haraguchi Type-I posterior malleolar fractures. Read More

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http://dx.doi.org/10.1016/j.fas.2020.03.010DOI Listing

Risk factors of periprosthetic femoral fracture after total knee arthroplasty.

Rev Esp Cir Ortop Traumatol 2020 May 4. Epub 2020 May 4.

Servicio de Cirugía Ortopédica y Traumatología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.

Introduction And Objectives: Periprosthetic fractures after primary knee arthroplasty has great importance in our environment due to the increase in their incidence and to the challenge they pose to the surgeon. Multiple factors have been associated with its production. The objective of the study was to identify the risk factors that could influence the appearance of these fractures, which of them are all modifiable and generate a probability prediction model based on these factors. Read More

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http://dx.doi.org/10.1016/j.recot.2020.03.001DOI Listing

Treatment of Periprosthetic Nonunions of the Lower Extremity.

Orthopedics 2020 May 5:1-6. Epub 2020 May 5.

Multiple studies have reported nonunion rates of 3% to 17% following peri-prosthetic fractures. Determining management strategies based on the available literature is difficult because existing studies are small and involve heterogeneous treatments and multiple surgeons. The purpose of this study was to describe a consecutive series of patients who presented to the authors' clinic with a periprosthetic nonunion of the lower extremity and to report the methods used to achieve limb salvage and the associated complications. Read More

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http://dx.doi.org/10.3928/01477447-20200428-04DOI Listing

Taylor Spatial Frame™ or reamed intramedullary nailing for closed fractures of the tibial shaft. A randomized controlled trial.

J Orthop Trauma 2020 May 5. Epub 2020 May 5.

Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway.

Objectives: To compare a modern ring fixator (Taylor Spatial Frame (TSF)) and reamed intramedullary nailing (IMN) for treatment of closed tibial shaft fractures.

Design: Randomized controlled trial.

Setting: Two university hospitals. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001802DOI Listing

Spontaneous Osteonecrosis/Subchondral Insufficiency Fractures of the Knee: High Rates of Conversion to Surgical Treatment and Arthroplasty.

J Bone Joint Surg Am 2020 May;102(9):821-829

Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, Rochester, Minnesota.

Background: Spontaneous osteonecrosis of the knee has recently been termed subchondral insufficiency fracture of the knee (SIFK) to appropriately recognize the etiology of mechanical overloading of the subchondral bone. The purpose of this study was to assess clinical outcomes of SIFK based on progression to surgical treatment and arthroplasty, and to evaluate the risk factors that increase the progression to arthroplasty.

Methods: A retrospective review was performed on patients with a diagnosis of SIFK, as confirmed with use of magnetic resonance images (MRIs). Read More

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http://dx.doi.org/10.2106/JBJS.19.00381DOI Listing

Nontraumatic Multiple-Organ Fat Embolism: An Autopsy Case and Review of Literature.

Am J Forensic Med Pathol 2020 Jun;41(2):131-134

From the School of Forensic Medicine.

The patient was an 88-year-old woman with a 10-year history of hypertension. She was suspected to have been hit by a car. At the time of the event, she was conscious and able to stand on her own and had no obvious injuries. Read More

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http://dx.doi.org/10.1097/PAF.0000000000000544DOI Listing

Surgical advantages of using 3D patient-specific models in high-energy tibial plateau fractures.

Eur J Trauma Emerg Surg 2020 May 6. Epub 2020 May 6.

Department of Orthopedic Surgery, Faculty of Medicine, Ege University, Izmir, Turkey.

Purpose: Treatment of tibial plateau fractures are difficult due to the intra-articular nature of the proximal tibia and extensive involvement of the soft tissue envelope. In this study, we investigated the surgical experience acquired using digitally designed life-size fracture models to guide as a template to place plates and screws in the treatment of tibial plateau fractures and anatomic reduction of joint.

Methods: 20 tibial plateau frature patients were divided into two equal surgery groups as conventional versus 3D model assisted. Read More

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http://dx.doi.org/10.1007/s00068-020-01378-1DOI Listing

Complex Multiplanar Fracture of the Distal Femur with an Undescribed Pattern: A Case Report and Review of the Literature.

Cureus 2020 Apr 4;12(4):e7533. Epub 2020 Apr 4.

Orthopaedics, Post Graduate Institute of Medical Education and Research, Chandigarh, IND.

Distal femur fractures in younger age groups are associated with high-impact injury leading to severe comminution and soft tissue injuries. Most of the intra-articular distal femur fractures occur as a result of axial loading accompanied by a variable amount of flexion. An 18-year-old male patient who had met with a road traffic accident was brought to the trauma center. Read More

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http://dx.doi.org/10.7759/cureus.7533DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7198098PMC

An Unusual Complex Posterolateral Osteoligamentous Injury of the Knee in an Adolescent.

Cureus 2020 Apr 4;12(4):e7532. Epub 2020 Apr 4.

Orthopaedics, Post Graduate Institute of Medical Education and Research, Chandigarh, IND.

We present an unusual and complex case of a 16-year-old adolescent male who injured his right knee and sustained combined avulsion injuries of posterior cruciate ligament (PCL) at the tibial insertion site, iliotibial band at lateral tibial condyle, and lateral collateral ligament (LCL) at femoral insertion site akin to osteoligamentous posterolateral corner injury. Anatomical reduction of the femoral LCL avulsion fragment was performed and fixed with a two 4-mm partially threaded cancellous screw. Iliotibial band avulsion was buttressed using Ellis t-plate and fixed with two 4-mm partially threaded cancellous screws. Read More

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http://dx.doi.org/10.7759/cureus.7532DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7198076PMC

ACR Appropriateness Criteria® Acute Trauma to the Knee.

J Am Coll Radiol 2020 May;17(5S):S12-S25

Specialty Chair, Mayo Clinic, Phoenix, Arizona.

Acute trauma to the knee is a common presentation seen in the emergency department. After a routine clinical examination, imaging is frequently performed to facilitate the diagnosis and almost always starts with radiographs. If clinically indicated, advanced cross-sectional imaging may then be performed for further evaluation. Read More

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http://dx.doi.org/10.1016/j.jacr.2020.01.041DOI Listing

Percutaneous Superficial Medial Collateral Ligament Release Outcomes During Medial Meniscal Arthroscopy: A Systematic Review.

Arthrosc Sports Med Rehabil 2020 Apr 19;2(2):e153-e159. Epub 2020 Jan 19.

University Hospitals Sports Medicine Institute, Cleveland, Ohio, U.S.A.

Purpose: To systematically review the literature to better understand the technique, outcomes, and complications after percutaneous superficial medial collateral ligament (sMCL) lengthening during knee arthroscopy to address isolated medial meniscal pathology.

Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines using a PRISMA checklist. The inclusion criteria consisted of English-language articles or articles with English-language translations documenting the use of percutaneous sMCL lengthening during arthroscopic knee surgery to treat isolated meniscal pathology (repair vs meniscectomy) with reported postoperative outcomes and complications. Read More

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http://dx.doi.org/10.1016/j.asmr.2019.10.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7190537PMC

Avoiding Above-the-Knee Amputation with a Free Tibiofibular-Talocalcaneal Fillet Flap and Free Latissimus Dorsi Flap.

Indian J Plast Surg 2020 Mar 1;53(1):135-139. Epub 2020 Apr 1.

Department of Plastic Surgery, Hospital Universitario y Politécnico La Fe, Valencia, Spain.

Despite the advances achieved in reconstructive surgery, amputation is still the only option after some severe traumas. Preservation of the knee joint is considered a significant functional advantage. We present the case of a 39-year-old man with a comminuted Gustilo type IIIC open tibia fracture with massive bone loss. Read More

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http://dx.doi.org/10.1055/s-0040-1708226DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7192697PMC

What Is the Critical Tibial Resection Depth During Unicompartmental Knee Arthroplasty? A Biomechanical Study of Fracture Risk.

J Arthroplasty 2020 Apr 10. Epub 2020 Apr 10.

Naval Medical Center, San Diego CA.

Background: Fracture after medial unicompartmental knee arthroplasty (UKA) is a rare complication. Biomechanical studies evaluating association between depth of resection and maximum load to failure are lacking. The purpose of this study is to establish the relationship between depth of resection of the medial tibial plateau and mean maximum load to failure. Read More

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http://dx.doi.org/10.1016/j.arth.2020.04.005DOI Listing

Patellofemoral ankylosis: case report and technical note.

Arch Orthop Trauma Surg 2020 May 2. Epub 2020 May 2.

Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350 - Santa Cecília, Porto Alegre, Rio Grande do Sul, 90035-903, Brazil.

Introduction: It is our understanding that there is no consensual solution for the treatment of post-traumatic patellar ankylosis; therefore, the purpose of this work is to present two cases of patellofemoral retinacular interposition arthroplasty, and its corresponding technical note. CASE 1: Female, 24, patellar ankylosis secondary to supratranscondylar fracture, associated with comminuted diaphyseal tibia fracture. CASE 2: Female, 48, patellar ankylosis secondary to femoral diaphysis and lateral femoral condyle fracture. Read More

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http://dx.doi.org/10.1007/s00402-020-03396-5DOI Listing

Complications and subsequent surgery after intra-medullary nailing for tibial shaft fractures: Review of 8110 patients.

Injury 2020 Apr 22. Epub 2020 Apr 22.

Department of Orthopaedic & Trauma Surgery, Flinders Medical Centre, Flinders University, Adelaide, SA, 5042, Australia.

Background: Intramedullary nailing of tibial shaft fractures has been common practice for decades. Nevertheless, complications occur frequently, and subsequent surgery is often required. To improve our understanding on how we may improve trauma care for patients with tibial shaft fractures, this study systematically reviewed all currently available evidence to assess the incidence of complications and rate of re-operations following intramedullary nailing of traumatic tibial fractures. Read More

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http://dx.doi.org/10.1016/j.injury.2020.04.021DOI Listing

Underestimation and undertreatment of osteoporosis in patients awaiting primary total knee arthroplasty.

Arch Orthop Trauma Surg 2020 May 2. Epub 2020 May 2.

Department of Orthopedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, South Korea.

Introduction: Osteoporosis is generally regarded as a risk factor for periprosthetic fracture during or after primary total knee arthroplasty (TKA). Despite this, little is known about osteoporosis in patients undergoing elective primary TKA Therefore, we sought to investigate the prevalence of osteoporosis and rates of pharmacologic osteoporosis treatment prior to primary TKA. We hypothesized that preoperative osteoporosis is underestimated and undertreated in the primary TKA population. Read More

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http://dx.doi.org/10.1007/s00402-020-03462-yDOI Listing

Management of lower limb fractures in patients with spinal cord injuries.

ANZ J Surg 2020 May 1. Epub 2020 May 1.

Department of Orthopaedics and Trauma, Royal North Shore Hospital, Sydney, New South Wales, Australia.

Background: Low-energy fractures of the lower limb in patients post spinal cord injury (SCI) present significant management challenges. This is the first Australian study to review the experience from a tertiary referral SCI centre and aims to identify trends and suggest therapeutic options.

Methods: Retrospective review over a 5-year period in patients with SCI treated for a lower limb fragility fracture. Read More

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http://dx.doi.org/10.1111/ans.15924DOI Listing

Negative pressure wound therapy for surgical wounds healing by primary closure.

Cochrane Database Syst Rev 2020 May 1;5:CD009261. Epub 2020 May 1.

School of Biological Sciences, Faculty of Biology, Medicine & Health, Manchester, UK.

Background: Indications for the use of negative pressure wound therapy (NPWT) are broad and include prophylaxis for surgical site infections (SSIs). Existing evidence for the effectiveness of NPWT on postoperative wounds healing by primary closure remains uncertain.

Objectives: To assess the effects of NPWT for preventing SSI in wounds healing through primary closure, and to assess the cost-effectiveness of NPWT in wounds healing through primary closure. Read More

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http://dx.doi.org/10.1002/14651858.CD009261.pub5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7192856PMC

Comparison of Different Magnitudes of Applied Syndesmotic Clamp Force: A Cadaveric Study.

J Foot Ankle Surg 2020 May - Jun;59(3):452-456

Professor, Nova Southeastern University College of Osteopathic Medicine, Ft. Lauderdale, FL.

Overcompression of the ankle syndesmosis was once thought to be improbable. Recent studies using computerized tomography (CT) however, have demonstarted otherwise; raising pertinent questions regarding the factors associated with and consequences of syndesmotic overcompression. The purpose of the present study was to directly compare different magnitudes of applied clamp force on the coronal reduction of ankle syndesmosis. Read More

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http://dx.doi.org/10.1053/j.jfas.2019.08.028DOI Listing
January 2019

Hinge location and apical drill holes in opening wedge high tibial osteotomy: A finite element analysis.

J Orthop Res 2020 Apr 30. Epub 2020 Apr 30.

Department of Orthopaedics, Royal Infirmary of Edinburgh, UK.

At the time of medial opening wedge high tibial osteotomy (HTO) to realign the lower limb and offload medial compartment knee osteoarthritis, unwanted fractures can propagate from the osteotomy apex. The aim of this study was to use finite element (FE) analysis to determine the effect of hinge location and apical drill holes on cortical stresses and strains in HTO. A monoplanar medial opening wedge HTO was created above the tibial tuberosity in a composite tibia. Read More

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http://dx.doi.org/10.1002/jor.24704DOI Listing