4,729 results match your criteria Lower Extremity Reconstruction Knee


Intraoperative joint balancing procedure using an imageless robotic assisted technique does not necessarily result in kinematically aligned bicruciate stabilized total knee arthroplasty.

J Robot Surg 2022 Jun 30. Epub 2022 Jun 30.

Adult Reconstruction Center, Ichinomiya Onsen Hot Hospital, 1745 Tsuboi, Ichinomiyacho, Fuefuki-city, Yamanashi, 405-0077, Japan.

The primary aim of this study was to retrospectively evaluate the hip- knee- ankle. (HKA) angle and prosthetic alignment with three-dimensional computed tomography (3DCT) measurements in patients who underwent robotic-assisted (RA) TKA, with consideration of the soft tissue envelope via an intraoperative joint-balancing procedure. We hypothesized that intraoperative consideration of soft tissue laxity in individual patients using imageless RA technology will not necessarily result in kinematically aligned bicruciate stabilized total knee arthroplasty (KA TKA). Read More

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Blood Flow Restriction Therapy Preserves Lower Extremity Bone and Muscle Mass After ACL Reconstruction.

Sports Health 2022 Jun 27:19417381221101006. Epub 2022 Jun 27.

Orthopedic Biomechanics Research Laboratory, Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, Texas.

Background: Muscle atrophy is common after an injury to the knee and anterior cruciate ligament reconstruction (ACLR). Blood flow restriction therapy (BFR) combined with low-load resistance exercise may help mitigate muscle loss and improve the overall condition of the lower extremity (LE).

Purpose: To determine whether BFR decreases the loss of LE lean mass (LM), bone mass, and bone mineral density (BMD) while improving function compared with standard rehabilitation after ACLR. Read More

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Postaxial hypoplasia of the lower extremity associated with congenital dislocation of the patella: A case report.

Medicine (Baltimore) 2022 Jun 24;101(25):e29283. Epub 2022 Jun 24.

Health Science Division, Division of Plastic and Reconstructive Surgery, Unit of Hip and Pelvis Orthopedic Surgery, Hospital de Traumatología y Ortopedia No. 21, Instituto Mexicano del Seguro Social (IMSS), Monterrey, N.L., México.

Rationale: Evaluation of clinical and radiologic abnormalities in patients with postaxial hypoplasia of the lower extremity (PHLE) for treatment decisions represents a major challenge, which is more complicated when PHLE is associated with congenital dislocation of the patella.

Patient Concerns: : Herein, we present the case of an 8-year-old female patient with evident length inequality in her left lower extremity and inability to walk.

Diagnoses: Radiological evaluation revealed PHLE with fibular hemimelia, proximal femoral focal deficiency, tarsal coalition, and congenital patellar dislocation of the patella. Read More

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The Role of Stability and Alignment in Improving Patient Outcomes After Total Knee Arthroplasty.

JBJS Rev 2022 May 2;10(5). Epub 2022 May 2.

Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts.

»: Total knee arthroplasty (TKA) is an effective treatment option for many patients, but a small group of patients are dissatisfied following TKA.

»: Alignment, in combination with balance, stability, and knee kinematics, is an important modifiable surgical factor that can affect patient outcomes.

»: Driven by the subset of dissatisfied patients after TKA, new techniques have evolved in the search for a more anatomic reconstruction of individual knee morphology and a more accurate approximation of the individual lower-extremity alignment. Read More

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The use of intrathecal morphine for acute postoperative pain in lower limb arthroplasty surgery: a survey of practice at an academic hospital.

J Orthop Surg Res 2022 Jun 21;17(1):323. Epub 2022 Jun 21.

Department of Anaesthesiology, University of the Witwatersrand, Johannesburg, South Africa.

Background And Purpose Of The Study: Intrathecal morphine (ITM) provides optimal postoperative analgesia in patients who are scheduled for total knee and hip operation with spinal anaesthesia. However, the ideal dose at which maximal analgesic effect occurs with minimal side effects is not known. This study aimed to describe the use of two doses of ITM and side effect profile in patients undergoing elective hip and knee arthroplasty. Read More

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Limb Salvage with Multiple Modalities: A Case Report of a Diabetic Heel Ulcer Associated with Peripheral Arterial Disease.

Adv Skin Wound Care 2022 Jul;35(7):1-5

Kyoichi Matsuzaki, MD, PhD, is Professor, Department of Plastic and Reconstructive Surgery, International University of Health and Welfare, School of Medicine, Chiba, Japan. Akira Miyamoto, MD, PhD, is Advisor, Cardiovascular Center, Takatsu General Hospital, Kanagawa, Japan. The authors have disclosed no financial relationships related to this article. Submitted June 2, 2021; accepted in revised form September 7, 2021.

Abstract: A large diabetic heel ulcer with peripheral arterial disease is an independent predictor of limb loss; below-knee amputation is not uncommon in such cases. One treatment is multimodal therapy, which includes partial calcanectomy. Because there is a limit to the ulcer surface area that can be sutured after partial calcanectomy, the remaining raw surface is treated with another method. Read More

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Females have Lower Knee Strength and Vertical Ground Reaction Forces During Landing than Males Following Anterior Cruciate Ligament Reconstruction at the Time of Return to Sport.

Int J Sports Phys Ther 2022 1;17(4):556-565. Epub 2022 Jun 1.

Atrium Health Musculoskeletal Institute.

Purpose: There is a high rate of second anterior cruciate ligament (ACL) injury (ipsilateral graft or contralateral ACL) upon return-to-sport (RTS) following ACL reconstruction (ACLR). While a significant amount of epidemiological data exists demonstrating sex differences as risk factors for primary ACL injury, less is known about sex differences as potential risk factors for second ACL injury. The purpose of this study is to determine if there are sex-specific differences in potential risk factors for second ACL injury at the time of clearance for RTS. Read More

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Femur Length is Correlated with Isometric Quadriceps Strength in Post-Operative Patients.

Int J Sports Phys Ther 2022 2;17(4):628-635. Epub 2022 Jun 2.

Twin City Orthopedics.

Background: Few existing studies have examined the relationship between lower extremity bone length and quadriceps strength.

Purpose/hypothesis: To evaluate the relationship between lower extremity, tibia and femur lengths, and isometric quadriceps strength in patients undergoing knee surgery. The null hypothesis was that there would be no correlation between lower extremity length and isometric quadriceps strength. Read More

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Hybrid Bone-Grafting Technique for Staged Revision Anterior Cruciate Ligament Reconstruction.

JBJS Essent Surg Tech 2021 Oct-Dec;11(4). Epub 2021 Oct 12.

Division of Sports Medicine and Shoulder Surgery, Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California.

Although most patients who undergo anterior cruciate ligament (ACL) reconstruction achieve long-term functional stability and symptom relief, graft rupture rates range from 2% to 10%. A small subset of these patients require a 2-stage revision ACL reconstruction because of tunnel osteolysis or tunnel malposition that will interfere with the planned revision tunnel placement. In the present article, we describe the hybrid use of arthroscopically delivered injectable allograft matrix in the femur and pre-shaped bone dowels in the tibia for the treatment of lower-extremity bone deficiencies. Read More

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October 2021

Challenges of total knee arthroplasty in osteogenesis imperfecta: case report and literature review.

J Int Med Res 2022 May;50(5):3000605221097369

Department of Orthopaedic Surgery, University Hospital in Hradec Kralove, Charles University, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic.

The majority of adults with mild osteogenesis imperfecta report significant functional impairment due to musculoskeletal concerns. Knee osteoarthritis is common in these patients. Although total knee arthroplasty has become a highly efficient surgical technique for osteoarthritis, this procedure remains uncommon in patients with osteogenesis imperfecta. Read More

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Atypical Lower Limb Mechanics During Weight Acceptance of Stair Descent at Different Time Frames After Anterior Cruciate Ligament Reconstruction.

Am J Sports Med 2022 Jul 23;50(8):2125-2133. Epub 2022 May 23.

Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.

Background: An anterior cruciate ligament (ACL) rupture may result in poor sensorimotor knee control and, consequentially, adapted movement strategies to help maintain knee stability. Whether patients display atypical lower limb mechanics during weight acceptance of stair descent at different time frames after ACL reconstruction (ACLR) is unknown.

Purpose: To compare the presence of atypical lower limb mechanics during the weight acceptance phase of stair descent among athletes at early, middle, and late time frames after unilateral ACLR. Read More

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Total Joint Arthroplasty Training (Prehabilitation and Rehabilitation) in Lower Extremity Arthroplasty.

J Am Acad Orthop Surg 2022 Jun;30(11):e799-e807

From the Division of Adult Reconstruction, Department of Orthopaedics & Rehabilitation, University of Rochester (Ginnetti), Vori Health (O'Connor), Movement is Life (O'Connor), Arthroplasty Services, Brigham & Women's Hospital, Harvard Medical School (Chen), and the Division of Adult Reconstruction, Department of Orthopaedics & Rehabilitation, University of Rochester (Myers).

Lower extremity total joint arthroplasty (TJA) has an established track record of success and a subset of patients who fail to experience desired improvements. Current TJA success can be attributed to refined surgical techniques, improved preparation of patients for surgery, and enhanced postoperative recovery protocols. One aspect of preoperative patient preparation and enhanced postoperative recovery includes training regimens intended to prepare patients for TJA and facilitate TJA functional recovery (often referred to as using the jargon prehabilitation and rehabilitation). Read More

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Thigh muscle co-contraction patterns in individuals with anterior cruciate ligament reconstruction, athletes and controls during a novel double-hop test.

Sci Rep 2022 May 19;12(1):8431. Epub 2022 May 19.

Department of Community Medicine and Rehabilitation - Physiotherapy Section, Umeå, University, 901 87, Umeå, Sweden.

Efficient neuromuscular coordination of the thigh muscles is crucial in maintaining dynamic knee stability and thus reducing anterior cruciate ligament (ACL) injury/re-injury risk. This cross-sectional study measured electromyographic (EMG) thigh muscle co-contraction patterns during a novel one-leg double-hop test among individuals with ACL reconstruction (ACLR; n = 34), elite athletes (n = 22) and controls (n = 24). Participants performed a forward hop followed by a 45° unanticipated diagonal hop either in a medial (UMDH) or lateral direction (ULDH). Read More

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Does a knee joint position sense test make functional sense? Comparison to an obstacle clearance test following anterior cruciate ligament injury.

Phys Ther Sport 2022 May 11;55:256-263. Epub 2022 May 11.

Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.

Objectives: To evaluate knee joint position sense (JPS) among individuals with anterior cruciate ligament reconstruction (ACLR), cleared for return to sport, and investigate whether JPS errors are associated with outcomes of a functional obstacle clearance test (OC; downward vision occluded).

Design: Cross-sectional.

Setting: Controlled laboratory. Read More

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[Treatment of Gustilo-Anderson B type injury of distal femur complicated with bone defect by membrane induction technique].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2022 May;36(5):609-613

Department of Bone Microsurgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an Shaanxi, 710054, P. R. China.

Objective: To evaluate the effectiveness of membrane induction technique in the treatment of Gustilo-Anderson ⅢB type injury of distal femur complicated with bone defect.

Methods: The clinical data of 20 patients with Gustilo-Anderson ⅢB type injury of distal femur complicated with bone defects admitted between January 2019 and December 2020 were retrospectively analyzed, including 15 males and 5 females, with an average age of 35 years (range, 19-70 years). Causes of injuries included 15 cases of traffic accidents and 5 cases of falling from height. Read More

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[Surgical planning and mid-term effectiveness of four major lower extremity arthroplasties in patients with rheumatoid arthritis].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2022 May;36(5):567-572

Orthopedic Research Institue, Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P. R. China.

Objective: To investigate the surgical planning and the mid-term effectiveness of four major lower extremity arthroplasties (4JA) in patients with rheumatoid arthritis (RA).

Methods: A clinical data of 25 patients with RA, who received 4JA and were followed up more than 3 years between June 2012 and September 2018, was retrospectively analyzed. There were 3 males and 22 females, with an average age of 48. Read More

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[Study on the accuracy of automatic segmentation of knee CT images based on deep learning].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2022 May;36(5):534-539

Senior Department of Orthopedics, the Fourth Medical Center of Chinese PLA General Hospital, Beijing, 100048, P. R. China.

Objective: To develop a neural network architecture based on deep learning to assist knee CT images automatic segmentation, and validate its accuracy.

Methods: A knee CT scans database was established, and the bony structure was manually annotated. A deep learning neural network architecture was developed independently, and the labeled database was used to train and test the neural network. Read More

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Terminology for osteochondral lesions of the ankle: proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle.

J ISAKOS 2022 04 14;7(2):62-66. Epub 2022 Jan 14.

Department of Orthopaedics, Sahlgrenska University Hospital, Sahlgrenska Academy, Gothenburg University, Göteborg, Sweden.

Background: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle is based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on "terminology for osteochondral lesions of the ankle" developed at the 2019 International Consensus Meeting on Cartilage Repair of the Ankle. Read More

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What Is the Clinical Benefit of Common Orthopaedic Procedures as Assessed by the PROMIS Versus Other Validated Outcomes Tools?

Clin Orthop Relat Res 2022 May 10. Epub 2022 May 10.

Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Background: Patient-reported outcome measures (PROMs), including the Patient-reported Outcomes Measurement Information System (PROMIS), are increasingly used to measure healthcare value. The minimum clinically important difference (MCID) is a metric that helps clinicians determine whether a statistically detectable improvement in a PROM after surgical care is likely to be large enough to be important to a patient or to justify an intervention that carries risk and cost. There are two major categories of MCID calculation methods, anchor-based and distribution-based. Read More

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The accuracy of an extramedullary femoral cutting system in total knee arthroplasty in patients with severe coronal femoral bowing: a radiographic study.

J Orthop Surg Res 2022 May 7;17(1):257. Epub 2022 May 7.

State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China.

Background: Intramedullary (IM) femoral alignment instrument is imprecise for the coronal alignment in total knee arthroplasty (TKA) in patients with severe lateral bowing of the femur, while the extramedullary (EM) alignment system does not depend on the structure of the femoral medullary cavity. The aim of this retrospective study was to compare the accuracy of postoperative limb alignment with the two femoral alignment techniques for patients with severe coronal femoral bowing.

Methods: From January 2017 to December 2019, patients with end-stage knee osteoarthritis and coronal femoral bowing angle (cFBA) ≥ 5° who underwent total knee arthroplasty TKA at our institution were enrolled in the study. Read More

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The effects of total knee arthroplasty on knee proprioception of patients with knee osteoarthritis: a meta-analysis.

J Orthop Surg Res 2022 May 7;17(1):258. Epub 2022 May 7.

School of Biomedical Engineering, Capital Medical University, No. 10 Xitoutiao, You An Men Wai, Fengtai District, Beijing, 100069, People's Republic of China.

Background: Studies have given some pieces of evidence for the effect of total knee arthroplasty (TKA) on knee proprioception of patients with knee osteoarthritis (KOA), but their results were conflicting. This review was performed to provide an updated evidence-based meta-analysis investigating the influence of TKA on knee proprioception.

Methods: The electronic databases including PubMed, Google Scholar, and the Cochrane Library were accessed from their inception to March 2020. Read More

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Radiographic Assessment of Aseptic Loosening of Tumor-Type Knee Prosthesis in Distal Femur.

Orthop Surg 2022 Jun 7;14(6):1143-1151. Epub 2022 May 7.

Department of Orthopaedics, The 960th Hospital of the PLA, Jinan, China.

Objective: To measure the full-length anteroposterior and lateral radiographs of lower limbs after the resection of a tumor in the distal femur and tumor-type knee prosthesis replacement and to analyze the factors leading to aseptic loosening of the prosthesis.

Methods: A total of 26 cases of tumor-type knee prosthesis replacement or revision due to the distal femoral tumor at our hospital from January 2007 to December 2019 were retrospectively analyzed. The patients were divided into the loosening and unloosening groups depending on whether aseptic loosening occurred after surgery. Read More

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Monitoring joint mechanics in anterior cruciate ligament reconstruction using depth sensor-driven musculoskeletal modeling and statistical parametric mapping.

Med Eng Phys 2022 05 7;103:103796. Epub 2022 Apr 7.

Department of Kinesiology and Sport Sciences, School of Education & Human Development, University of Miami, 1507 Levante Ave. Max Orovitz Building 132, Coral Gables, FL 33143, United States. Electronic address:

The incidence of anterior cruciate ligament injury and reconstruction (ACLR) may set the stage for the development of early onset osteoarthritis in these patients. Development of accessible quantitative motion capture methodologies for recurrent monitoring of knee joint loading during daily activities following ACLR is necessary. This study aimed to compare lower extremity kinetics between ACLR affected limbs, ACLR unaffected limbs, and dominant limbs of healthy control subjects during over-ground gait and stair ascent using a single depth sensor-driven musculoskeletal modeling approach. Read More

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Energy Absorption Contribution Deficits in Participants Following Anterior Cruciate Ligament Reconstruction: Implications for Second Anterior Cruciate Ligament Injury.

J Sport Rehabil 2022 May 2:1-7. Epub 2022 May 2.

Johns Hopkins All Children's Hospital at IMG Academy, Bradenton, FL,USA.

Context: Lower-extremity loading patterns change after anterior cruciate ligament reconstruction (ACLR). However, there is limited research regarding energy absorption contribution (EAC) of athletes following ACLR who reinjure their ACL and those who do not. EAC can be utilized as a measure of joint loading during tasks. Read More

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The impact of a digital joint school educational programme on post-operative outcomes following lower limb arthroplasty: a retrospective comparative cohort study.

BMC Health Serv Res 2022 Apr 29;22(1):580. Epub 2022 Apr 29.

Department of Orthopaedic Surgery, James Cook University Hospital, Middlesbrough, UK.

Background: As part of an ongoing service improvement project, a digital 'joint school' (DJS) was developed to provide education and support to patients undergoing total hip (THR) and total knee (TKR) replacement surgery. The DJS allowed patients to access personalised care plans and educational resources using web-enabled devices, from being listed for surgery until 12 months post-operation. The aim of this study was to compare a cohort of patients enrolled into the DJS with a cohort of patients from the same NHS trust who received a standard 'non-digital' package of education and support in terms of Health-Related Quality of Life (HRQoL), functional outcomes and hospital length of stay (LoS). Read More

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Proximal Femoral Focal Deficiency/Congenital Femoral Deficiency: Evaluation and Management.

J Am Acad Orthop Surg 2022 07 28;30(13):e899-e910. Epub 2022 Apr 28.

From the Shriners Hospital for Children-Philadelphia, Philadelphia, PA (Nossov and Franklin), Temple University College of Public Health, Philadelphia, PA (Hollin), and Colorado Joint Replacement, Porter Adventist Hospital, Denver, CO (Phillips).

Proximal focal femoral deficiency is a congenital transverse deficiency in which the femur is globally smaller with a typical proximal deformity at the hip that may include distal involvement of knees, leg, and feet. Congenital femoral deficiency (CFD) describes a broader spectrum of longitudinal deficiency inclusive of proximal focal femoral deficiency. CFD may also include lateral distal femoral hypoplasia, knee cruciate ligament deficiency, rotational instability, patellar dislocation, fibular hemimelia, ray absence, and contralateral limb involvement. Read More

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Postural control during single leg stance in individuals with clinical indication for combined reconstruction of the anterior cruciate and the anterolateral ligaments of the knee: a cross-sectional study.

BMC Musculoskelet Disord 2022 Apr 25;23(1):383. Epub 2022 Apr 25.

Department of Physical Therapy, Speech and Occupational Therapy, Universidade de São Paulo, São Paulo, SP, Brazil.

Background: Several studies have shown persistent postural control deficits and rotatory instability in patients after isolated Anterior Cruciate Ligament (ACL) reconstruction. There is evidence to support that the Anterolateral Ligament (ALL) plays an important role in the remaining anterolateral rotatory laxity of the knee. There are no further evidences in order to understand how patients with a combined ACL + ALL reconstruction surgery indication behave regarding postural control. Read More

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Successful Conservative Treatment of an Acute Arterial Occlusion After Total Knee Arthroplasty: Report of 2 Cases and Review of the Literature.

Am J Case Rep 2022 Apr 24;23:e936295. Epub 2022 Apr 24.

Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.

BACKGROUND Acute arterial occlusion after total knee arthroplasty (TKA) is a rare but occasionally limb-threatening complication. Successful outcomes of surgical treatment for acute arterial occlusion after TKA have been frequently reported in the literature; however, few reports have described conservative treatment. This case report describes the successful conservative treatment of popliteal artery occlusion after TKA. Read More

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Is modular control related to functional outcomes in individuals with knee osteoarthritis and following total knee arthroplasty?

PLoS One 2022 22;17(4):e0267340. Epub 2022 Apr 22.

Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, Ohio, United States of America.

Background: Individuals who undergo total knee arthroplasty (TKA) for treatment of knee osteoarthritis often experience suboptimal outcomes. Investigation of neuromuscular control strategies in these individuals may reveal factors that contribute to these functional deficits. The purpose of this pilot study was to determine the relationship between patient function and modular control during gait before and after TKA. Read More

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