3,402 results match your criteria Lower Extremity Reconstruction Knee


[Limited orthopaedic surgery combined with external fixation for the treatment of lower extremity sequelae of middle and old aged post-poliomyelitis].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2018 Oct;32(10):1249-1254

Department of Orthopaedics, Rehabilitation Hospital of the National Research Center for Rehabilitation Technical Aids, Beijing, 100176, P.R.China.

Objective: To summarize the effectiveness of limited orthopedic surgery combined with external fixation for the treatment of lower extremity sequelae of middle and old aged post-poliomyelitis, and then to explore the strategy of surgical correction and functional reconstruction method.

Methods: From the database of 23 310 cases of poliomyelitis sequelae treated by QIN Sihe Orthopaedic Surgical team between September 1982 and December 2017, 629 patients over 41 years old were retrieved and the epidemiological characteristics of the patients were analyzed. Between March 2011 and June 2015, 57 patients with poliomyelitis sequelae treated with limited operation and external fixation were followed up 2-6 years, and the history of poliomyelitis sequelae was 41-67 years (mean, 47. Read More

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http://dx.doi.org/10.7507/1002-1892.201806022DOI Listing
October 2018

Surgical outcomes of extracorporeal irradiation and re-implantation in extremities for high grade osteosarcoma: A retrospective cohort study and a systematic review of the literature.

J Bone Oncol 2019 Feb 10;14:100210. Epub 2018 Dec 10.

Orthopedic Laboratory and Research Network (OLARN), Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

Purpose: To assess the failure rate and mode failure of high-grade osteosarcoma patients who received extracorporeal irradiation and re-implantation (ECIR) in extremities.

Patients And Methods: For the cohort study, patients who had received ECIR at a single institution between January 1996 and December 2014 were retrospectively evaluated. Characteristics of failure and time to failure were recorded and analyzed. Read More

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http://dx.doi.org/10.1016/j.jbo.2018.100210DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6299161PMC
February 2019

Quadriceps weakness associates with greater T1ρ relaxation time in the medial femoral articular cartilage 6 months following anterior cruciate ligament reconstruction.

Knee Surg Sports Traumatol Arthrosc 2018 Dec 17. Epub 2018 Dec 17.

Department of Orthopaedics, University of North Carolina at Chapel Hill, 102 Mason Farm Rd # 2, Chapel Hill, NC, 27599, USA.

Purpose: Quadriceps weakness following anterior cruciate ligament reconstruction (ACLR) is linked to decreased patient-reported function, altered lower extremity biomechanics and tibiofemoral joint space narrowing. It remains unknown if quadriceps weakness is associated with early deleterious changes to femoral cartilage composition that are suggestive of posttraumatic osteoarthritis development. The purpose of the cross-sectional study was to determine if quadriceps strength was associated with T1ρ relaxation times, a marker of proteoglycan density, of the articular cartilage in the medial and lateral femoral condyles 6 months following ACLR. Read More

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http://dx.doi.org/10.1007/s00167-018-5290-yDOI Listing
December 2018
1 Read

Blood Flow-Restricted Training for Lower Extremity Muscle Weakness due to Knee Pathology: A Systematic Review.

Sports Health 2018 Nov 26:1941738118811337. Epub 2018 Nov 26.

Cincinnati Sportsmedicine and Orthopaedic Center-Mercy Health and the Noyes Knee Institute, Cincinnati, OH, USA.

Context:: Blood flow-restricted training (BFRT) has been suggested to treat lower extremity muscle weakness. The efficacy of BFRT for muscle problems related to knee pathology is unclear.

Objective:: To determine whether BFRT (1) improves muscle strength and cross-sectional area (CSA) for chronic knee-related lower extremity atrophy and (2) prevents muscle atrophy after knee surgery. Read More

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http://journals.sagepub.com/doi/10.1177/1941738118811337
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http://dx.doi.org/10.1177/1941738118811337DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6299354PMC
November 2018
5 Reads

Abnormal Biomechanics at 6 Months Are Associated With Cartilage Degeneration at 3 Years After Anterior Cruciate Ligament Reconstruction.

Arthroscopy 2018 Nov 22. Epub 2018 Nov 22.

Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, U.S.A.. Electronic address:

Purpose: To investigate the changes in landing biomechanics over a 3-year period and their correlation with cartilage degenerative changes in the medial tibiofemoral joint of the knee after anterior cruciate ligament reconstruction (ACLR) using magnetic resonance T1ρ mapping.

Methods: Thirty-one anterior cruciate ligament-injured patients underwent magnetic resonance imaging of the injured knee before ACLR and 3 years after ACLR, as well as biomechanical analysis of a drop-landing task at 6 months and 3 years after ACLR. Sixteen healthy individuals were recruited and underwent knee magnetic resonance imaging and biomechanical assessment during a drop-landing task. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07498063183062
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http://dx.doi.org/10.1016/j.arthro.2018.07.033DOI Listing
November 2018
7 Reads

Reconstruction of chronic proximal hamstring avulsion injuries using ipsilateral distal hamstring tendons results in good clinical outcomes and patient satisfaction.

Knee Surg Sports Traumatol Arthrosc 2018 Nov 23. Epub 2018 Nov 23.

Perth Orthopaedic and Sports Medicine Centre, West Perth, Western Australia, 6005, Australia.

Purpose: To report outcomes following proximal hamstring reconstruction employing an ipsilateral distal hamstring tendon autograft, in patients with chronic proximal ruptures.

Methods: Six patients presenting with a chronic proximal hamstring avulsion and a medial time from injury of 11.0 months (range 7-18), confirmed via magnetic resonance imaging, underwent proximal hamstring repair using a free graft harvested from the ipsilateral distal hamstrings. Read More

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http://dx.doi.org/10.1007/s00167-018-5310-yDOI Listing
November 2018
7 Reads

Psychometric Evaluation of the Patient's Knee Implant Performance Questionnaire.

Value Health 2018 11 30;21(11):1305-1312. Epub 2018 Jun 30.

RTI Health Solutions, Research Triangle Park, NC, USA.

Objectives: To evaluate the psychometric properties of Patient's Knee Implant Performance Questionnaire (PKIP), a new patient-reported measure of knee implant functional performance assessing patient experiences before and after primary total knee arthroplasty (TKA).

Methods: The psychometric analysis sample (n = 761) was based on an ongoing, multisite, prospective, noncomparative, longitudinal study of patients undergoing TKA. The PKIP was completed at three study visits: presurgery (visit 1), less than 1 year (visit 3, days 1-303), and minimum 1 year (visit 4, days 304-668). Read More

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http://dx.doi.org/10.1016/j.jval.2018.05.006DOI Listing
November 2018
6 Reads

Passive-dynamic ankle-foot orthosis improves medium-term clinical outcomes after severe lower extremity trauma.

J R Army Med Corps 2018 Nov 9. Epub 2018 Nov 9.

Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre (DMRC) Headley Court, Surrey, UK.

Introduction: Individuals with delayed below-knee amputation have previously reported superior clinical outcomes compared with lower limb reconstruction. The UK military have since introduced a passive-dynamic ankle-foot orthosis (PDAFO) into its rehabilitation care pathway to improve limb salvage outcomes. The aims were to determine if wearing a PDAFO improves medium-term clinical outcomes and what influence does multidisciplinary team (MDT) rehabilitation have after PDAFO fitting? Also, what longitudinal changes in clinical outcomes occur with MDT rehabilitation and how do these results compare with patients with previous lower extremity trauma discharged prior to PDAFO availability?

Methods: We retrospectively evaluated levels of mobility, activities of daily living, anxiety, depression and pain in a heterogeneous group of 23 injured UK servicemen 34±11 months after PDAFO provision. Read More

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http://jramc.bmj.com/lookup/doi/10.1136/jramc-2018-001082
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http://dx.doi.org/10.1136/jramc-2018-001082DOI Listing
November 2018
7 Reads

A tourniquet-less technique using saline epinephrine irrigation system in an arthroscopic ACL reconstruction in patient with history of popliteal artery ligation.

Int J Surg Case Rep 2018 1;53:157-162. Epub 2018 Nov 1.

Resident of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Gadjah Mada, Indonesia; Department of Orthopaedic and Traumatology, Soeradji Tirtonegoro General Hospital Klaten, Indonesia; Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Gadjah Mada - Sardjito General Hospital Yogyakarta, Indonesia.

Introduction: Pneumatic tourniquets use in surgery to create a bloodless surgical field. The majority of orthopaedic surgeon use a tourniquet inflated above systemic blood pressure during arthroscopic anterior cruciate ligament (ACL) reconstruction. A tourniquet use is not free of complications. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S22102612183046
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http://dx.doi.org/10.1016/j.ijscr.2018.10.040DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6216074PMC
November 2018
7 Reads

The Surgical Applications of Biologics in Sports Medicine.

Authors:
F Alan Barber

Sports Med Arthrosc Rev 2018 Dec;26(4):196-199

Plano Orthopedic Sports Medicine Center, Plano, TX.

Over the past 25 years an increased appreciation of the positive impact of biologic interventions has driven significant advances in the surgical treatment of shoulder and knee conditions. These biologic adjuncts to treatment promote improved outcomes and have set the stage and increased research and development in this arena. Read More

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http://dx.doi.org/10.1097/JSA.0000000000000219DOI Listing
December 2018
6 Reads

Age-Related Functional Decline Following Total Knee Arthroplasty: Risk Adjustment is Mandatory.

J Arthroplasty 2019 Feb 22;34(2):228-234. Epub 2018 Sep 22.

Department of Orthopedic Surgery, Hospital for Special Surgery, Orthopaedic Surgery - Adult Reconstruction Joint Replacement, New York, NY.

Background: Patient-reported outcome measures (PROMs) are being used increasingly to determine the success of total knee arthroplasty (TKA). Our goal is to investigate whether advanced age is associated with lower PROM scores.

Methods: We used our hospital's TKA registry to examine the relationship between age and PROMs in all patients 50-90 years of age who underwent unilateral or simultaneous bilateral primary TKA between 2007 and 2011 with a primary diagnosis of osteoarthritis. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S08835403183082
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http://dx.doi.org/10.1016/j.arth.2018.09.046DOI Listing
February 2019
1 Read

Reducing costly falls after total knee arthroplasty.

World J Orthop 2018 Oct 18;9(10):198-202. Epub 2018 Oct 18.

Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA 22903, United States.

Aim: To investigate whether adductor canal nerve block (ACB) reduces patient falls when compared to femoral nerve block (FNB) after total knee arthroplasty (TKA).

Methods: We conducted an institutional review of all-cause falls after TKA from January 2013 to August 2016 using a quality improvement database. Our inclusion criteria were patients with diagnosis of primary knee osteoarthritis who underwent primary unilateral TKA with either a FNB or an ACB and sustained a fall during their hospitalization. Read More

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http://dx.doi.org/10.5312/wjo.v9.i10.198DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6198292PMC
October 2018
1 Read

Assessing lower extremity coordination and coordination variability in individuals with anterior cruciate ligament reconstruction during walking.

Gait Posture 2019 Jan 10;67:154-159. Epub 2018 Oct 10.

University of Tennessee Health Science Center, Memphis, TN 38163, United States.

Background: Despite our knowledge of several biomechanical risk factors related to anterior cruciate ligament (ACL) injury, such as decreased knee flexion, increased knee abduction, and increased hip flexion, adduction and internal rotation during walking, jogging, and landing from a jump, the incidence of ACL tears remains high. Quantifying variability in the lower extremity provides a continuous measure of joint coordination and function that may elicit an additional aspect of ACL injury mechanisms.

Research Question: The aim of this study was to assess joint coordination patterns and variability in individuals following ACL reconstruction (ACLR). Read More

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https://linkinghub.elsevier.com/retrieve/pii/S09666362183169
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http://dx.doi.org/10.1016/j.gaitpost.2018.10.010DOI Listing
January 2019
76 Reads
2.752 Impact Factor

Inertial Sensor Angular Velocities Reflect Dynamic Knee Loading during Single Limb Loading in Individuals Following Anterior Cruciate Ligament Reconstruction.

Sensors (Basel) 2018 Oct 15;18(10). Epub 2018 Oct 15.

Human Performance Laboratory, Division of Biokinesiology and Physical Therapy, University of Southern California, 1540 E Alcazar St., CHP-155, Los Angeles, CA 90089-9006, USA.

Difficulty quantifying knee loading deficits clinically in individuals following anterior cruciate ligament reconstruction (ACLr) may underlie their persistence. Expense associated with quantifying knee moments (KMom) and power (KPow) with gold standard techniques precludes their use in the clinic. As segment and joint kinematics are used to calculate moments and power, it is possible that more accessible inertial sensor technology can be used to identify knee loading deficits. Read More

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http://dx.doi.org/10.3390/s18103460DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6210898PMC
October 2018

Atlas-Based 3D Intensity Volume Reconstruction from 2D Long Leg Standing X-Rays: Application to Hard and Soft Tissues in Lower Extremity.

Adv Exp Med Biol 2018 ;1093:105-112

Institute for Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland.

In this chapter, the reconstruction of 3D intensity volumes of femur, tibia, and three muscles around the thigh region from a pair of calibrated X-ray images is addressed. We present an atlas-based 2D-3D intensity volume reconstruction approach by combining a 2D-2D nonrigid registration-based 3D landmark reconstruction procedure with an adaptive regularization step. More specifically, an atlas derived from the CT acquisition of a healthy lower extremity, together with the input calibrated X-ray images, is used to reconstruct those musculoskeletal structures. Read More

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http://link.springer.com/10.1007/978-981-13-1396-7_9
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http://dx.doi.org/10.1007/978-981-13-1396-7_9DOI Listing
January 2018
1 Read

3X-Knee: A Novel Technology for 3D Preoperative Planning and Postoperative Evaluation of TKA Based on 2D X-Rays.

Adv Exp Med Biol 2018 ;1093:93-103

Institute for Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland.

This chapter introduces a solution called "3X-knee" that can robustly derive 3D models of the lower extremity from 2D long leg standing X-ray radiographs for preoperative planning and postoperative treatment evaluation of total knee arthroplasty (TKA). There are three core components in 3X-knee technology: (1) a knee joint immobilization apparatus, (2) an X-ray image calibration phantom, and (3) a statistical shape model-based 2D-3D reconstruction algorithm. These three components are integrated in a systematic way in 3X-knee to derive 3D models of the complete lower extremity from 2D long leg standing X-ray radiographs acquired in weight-bearing position. Read More

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http://link.springer.com/10.1007/978-981-13-1396-7_8
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http://dx.doi.org/10.1007/978-981-13-1396-7_8DOI Listing
January 2018
1 Read

Viabahn stent graft compared with prosthetic surgical above-knee bypass in treatment of superficial femoral artery disease: Long-term results of a retrospective analysis.

Medicine (Baltimore) 2018 Oct;97(40):e12449

Department of Thoracic and Cardiovascular Surgery, University Medical Center, Georg-August University, Göttingen.

The prosthetic surgical above-knee bypass (pAKB) is a standard therapy in superficial femoral artery (SFA) occlusive disease in absence of suitable vein. Viabahn graft has been established as a promising alternative. Since limited comparative data are available, we conducted a retrospective study to compare long-term outcomes of these 2 therapies in a real-world setting. Read More

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http://Insights.ovid.com/crossref?an=00005792-201810050-0001
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http://dx.doi.org/10.1097/MD.0000000000012449DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6200476PMC
October 2018
5 Reads

Sex Differences on the Landing Error Scoring System Among Individuals With Anterior Cruciate Ligament Reconstruction.

J Athl Train 2018 Sep 1;53(9):837-843. Epub 2018 Oct 1.

Department of Kinesiology, School of Education, School of Medicine and Public Health, The University of Wisconsin-Madison.

Context: : After anterior cruciate ligament reconstruction (ACLR), women have a greater risk of incurring a second anterior cruciate ligament injury and they display different landing movement patterns than men. It remains unclear if clinical movement-assessment tools, such as the Landing Error Scoring System (LESS), can detect sex differences in movement patterns after ACLR.

Objective: : To compare total LESS scores and individual LESS errors between men and women with a history of ACLR. Read More

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http://dx.doi.org/10.4085/1062-6050-459-17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6208307PMC
September 2018

Bundled Payment Arrangements: Keys to Success.

J Am Acad Orthop Surg 2018 Dec;26(23):817-822

From the Department of Orthopaedic Surgery, NYU Langone Medical Center, New York, NY.

The Centers for Medicare & Medicaid Services is committed to moving 50% of its fee-for-service care to value-based alternative payment models by 2018. The Comprehensive Care for Joint Replacement model is a mandatory agency program that bundles lower extremity joint arthroplasties into episodes of care that extend from the index admission to 90 days after discharge. This program, which began on April 1, 2016, includes many of the hospitals that perform total joint arthroplasties. Read More

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http://Insights.ovid.com/crossref?an=00124635-900000000-9957
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http://dx.doi.org/10.5435/JAAOS-D-17-00022DOI Listing
December 2018
9 Reads

Comparison of drop jump landing biomechanics and asymmetry among adolescents with hamstring, patellar and quadriceps tendon autografts for anterior cruciate ligament reconstruction.

Knee 2018 Dec 22;25(6):1065-1073. Epub 2018 Sep 22.

Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Blvd MS 69, Los Angeles, CA 90027, USA; Keck School of Medicine, University of Southern California, 1975 Zonal Ave, Los Angeles, CA 90033, USA. Electronic address:

Background: Adolescent anterior cruciate ligament reconstruction (ACLR) commonly utilizes hamstring (HT), patellar (PT) or quadriceps (QT) tendon autografts, but consensus is lacking regarding optimal graft choice. This study compared landing biomechanics and asymmetries among ACLR patients with HT, PT and QT grafts and uninjured controls.

Methods: This retrospective study included 61 adolescents with unilateral ACLR (27 HT, 20 PT, 14 QT; four to 12 months post-surgery, mean 6. Read More

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http://dx.doi.org/10.1016/j.knee.2018.09.005DOI Listing
December 2018
11 Reads

An Analysis of the Influence of Physical Activity Level on Total Knee Arthroplasty Expectations, Satisfaction, and Outcomes: Increased Revision in Active Patients at Five to Ten Years.

J Bone Joint Surg Am 2018 Sep;100(18):1539-1548

Adult Reconstruction & Joint Replacement Division, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY.

This article was updated on September 19, 2018, because of a previous error. On page 1546, in the section titled "Discussion," the sentence that had read "Although a significant improvement was found in the vast majority of the inactive group, surprisingly, a majority of the active group (72.7%) reported a decrease in their activity levels below their baseline at 5 to 10 years postoperatively. Read More

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http://dx.doi.org/10.2106/JBJS.17.00920DOI Listing
September 2018

Mandatory Medicare Bundled Payment Program for Lower Extremity Joint Replacement and Discharge to Institutional Postacute Care: Interim Analysis of the First Year of a 5-Year Randomized Trial.

JAMA 2018 09;320(9):892-900

National Bureau of Economic Research, Cambridge, Massachusetts.

Importance: Bundled payments are an increasingly common alternative payment model for Medicare, yet there is limited evidence regarding their effectiveness.

Objective: To report interim outcomes from the first year of implementation of a bundled payment model for lower extremity joint replacement (LEJR).

Design, Setting, And Participants: As part of a 5-year, mandatory-participation randomized trial by the Centers for Medicare & Medicaid Services, eligible metropolitan statistical areas (MSAs) were randomized to the Comprehensive Care for Joint Replacement (CJR) bundled payment model for LEJR episodes or to a control group. Read More

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http://dx.doi.org/10.1001/jama.2018.12346DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6142993PMC
September 2018
1 Read

Association of Hospital Participation in a Medicare Bundled Payment Program With Volume and Case Mix of Lower Extremity Joint Replacement Episodes.

JAMA 2018 09;320(9):901-910

Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia.

Importance: Medicare's Bundled Payments for Care Improvement (BPCI) initiative for lower extremity joint replacement (LEJR) surgery has been associated with a reduction in episode spending and stable-to-improved quality. However, BPCI may create unintended effects by prompting participating hospitals to increase the overall volume of episodes paid for by Medicare, which could potentially eliminate program-related savings or prompt them to shift case mix to lower-risk patients.

Objective: To evaluate whether hospital BPCI participation for LEJR was associated with changes in overall volume and case mix. Read More

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http://dx.doi.org/10.1001/jama.2018.12345DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6142996PMC
September 2018
1 Read

Repair of knee deep burn wound with descending genicular artery-saphenous artery perforator flaps in elderly patients (a STROBE-compliant article).

Medicine (Baltimore) 2018 Aug;97(35):e12127

Department of Bone surgery, Central Hospital of Hanzhong City, Hanzhong, China.

It is difficult to repair knee deep burn wounds in elderly patients. In this study, we observed the therapeutic effects of descending genicular artery-saphenous artery perforator flaps on knee deep burn wounds in elderly patients.Between December 2013 and February 2018, we repaired knee third-degree burn wounds using descending genicular artery-saphenous artery perforator flaps of 20 × 12 cm to 23 × 13 cm in 56 elderly patients. Read More

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http://dx.doi.org/10.1097/MD.0000000000012127DOI Listing
August 2018
7 Reads

Walking Ground Reaction Force Post-ACL Reconstruction: Analysis of Time and Symptoms.

Med Sci Sports Exerc 2019 Feb;51(2):246-254

Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC.

Purpose: The association between lower-extremity loading and clinically relevant knee symptoms at different time points after anterior cruciate ligament reconstruction (ACLR) is unclear. Vertical ground reaction force (vGRF) from walking was compared between individuals with and without clinically relevant knee symptoms in three cohorts: <12 months post-ACLR, 12-24 months post-ACLR, and >24 months post-ACLR.

Methods: One hundred twenty-eight individuals with unilateral ACLR were classified as symptomatic or asymptomatic, based on previously defined cutoff values for the Knee Osteoarthritis and Injury Outcome Score (<12 months post-ACLR [symptomatic n = 28, asymptomatic n = 24]; 12-24 months post-ACLR [symptomatic n = 15, asymptomatic n = 15], and >24 months post-ACLR [symptomatic, n = 13; asymptomatic, n = 33]). Read More

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http://Insights.ovid.com/crossref?an=00005768-900000000-9682
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http://dx.doi.org/10.1249/MSS.0000000000001776DOI Listing
February 2019
35 Reads

Donor-Site Morbidity of Vascularized Bone Flaps from the Distal Femur: A Systematic Review.

Plast Reconstr Surg 2018 09;142(3):363e-372e

Baltimore, Md.; Boston, Mass.; and Aurora, Colo. From The Curtis National Hand Center, MedStar Union Memorial Hospital; the Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center; and the Division of Plastic and Reconstructive Surgery, University of Colorado Medical Center.

Background: Vascularized grafts from the femur, including the medial femoral condyle and medial femoral trochlea, are increasingly being used. It is critical to understand the lower extremity complications from flap harvest.

Methods: The authors searched available literature reporting on femoral flaps using PubMed, Embase, Cochrane Database, and Web of Science. Read More

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http://dx.doi.org/10.1097/PRS.0000000000004691DOI Listing
September 2018
1 Read

Alignment and Balance Methods in Total Knee Arthroplasty.

J Am Acad Orthop Surg 2018 Oct;26(20):709-716

From the Department of Orthopedic Surgery, New York University Langone Medical Center, New York, NY (Dr. Jaffe), Orthopedic Institute of New Jersey, Moristown, NJ (Dr. Dundon), and Vancouver, BC Canada (Dr. Camus).

Total knee arthroplasty is one of the most commonly performed orthopaedic surgical procedures in the United States. Primary concepts in the surgical technique include restoring limb alignment and soft-tissue balance about the knee. Currently, traditional mechanical alignment concepts that focus on restoring neutral limb alignment have been challenged by the principle of kinematic alignment. Read More

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http://dx.doi.org/10.5435/JAAOS-D-16-00428DOI Listing
October 2018
10 Reads

[Effectiveness of one-stage total knee arthroplasty with tibial stem extender for knee arthritis complicated with tibial stress fracture].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2018 09;32(9):1177-1180

Department of Bone and Joint Surgery, Xi'an Honghui Hospital, Affiliated to Medical College of Xi'an Jiaotong University, Xi'an Shaanxi, 710054, P.R.China.

Abstract: To evaluate the early effectiveness of one-stage total knee arthroplasty (TKA) with tibial stem extender for knee arthritis complicated with tibial stress fractures.

Methods: Between January 2014 and November 2016, 12 patients (12 knees) with knee arthritis and tibial stress fractures underwent one-stage TKA with tibial stem extender. There were 5 males and 7 females with an average age of 71. Read More

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http://dx.doi.org/10.7507/1002-1892.201802047DOI Listing
September 2018
10 Reads

Effect of dual task on gait asymmetry in patients after anterior cruciate ligament reconstruction.

Sci Rep 2018 Aug 13;8(1):12057. Epub 2018 Aug 13.

Institute of Sports Medicine, Peking University Third Hospital, Beijing Key Laboratory of Sports Injuries, Beijing, China.

Individuals who received anterior cruciate ligament (ACL) reconstruction surgeries demonstrated lower extremity movement asymmetries. The purpose of this study was to determine if psychological impairment was a contributor to lower extremity movement asymmetries in walking for individuals who received ACL reconstruction surgeries. Three-dimensional videographic and force plate data were collected for 25 males after unilateral ACL reconstruction performing walking without (single-task condition) and with the concurrent cognitive task (dual-task condition). Read More

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http://dx.doi.org/10.1038/s41598-018-30459-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6089886PMC
August 2018
6 Reads

Limb Salvage and Functional Outcomes following Free Tissue Transfer for the Treatment of Recalcitrant Diabetic Foot Ulcers.

J Reconstr Microsurg 2018 Aug 12. Epub 2018 Aug 12.

Department of Plastic Surgery, Center for Wound Healing, MedStar Georgetown University Hospital, Washington, DC.

Background:  Recent evidence documenting high success rates following microvascular diabetic foot reconstruction has led to a paradigm shift in favor of more aggressive limb preservation. The primary aim of this study was to examine reconstructive and functional outcomes in patients who underwent free tissue transfer (FTT) for recalcitrant diabetic foot ulcers (DFUs) at our tertiary referral center for advanced limb salvage.

Methods:  Between June 2013 and June 2016, 29 patients underwent lower extremity FTT for diabetic foot reconstruction by the senior author (K. Read More

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http://dx.doi.org/10.1055/s-0038-1667363DOI Listing
August 2018
2 Reads

Overlapping Lower Extremity Total Joint Arthroplasty Does Not Increase the Risk of 90-Day Complications.

Orthopedics 2018 Sep 10;41(5):e695-e700. Epub 2018 Aug 10.

Although total hip arthroplasty and total knee arthroplasty commonly overlap, there are concerns about the safety and quality of this scenario. The objectives of this study were to (1) compare the operative time and the incidence of 90-day complications between overlapping and nonoverlapping total joint arthroplasties; and (2) evaluate the effect of the duration of overlap on operative time and the incidence of 90-day complications. A total of 9192 patients who underwent primary total hip arthroplasty or total knee arthroplasty at a large academic hospital from 2005 to 2014 were identified. Read More

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http://dx.doi.org/10.3928/01477447-20180806-01DOI Listing
September 2018

RELATIONSHIP BETWEEN THE LOWER QUARTER Y-BALANCE TEST SCORES AND ISOKINETIC STRENGTH TESTING IN PATIENTS STATUS POST ACL RECONSTRUCTION.

Int J Sports Phys Ther 2018 Apr;13(2):152-159

Department of Physical Therapy and Occupational Therapy, Sports Medicine Division, Duke University Health System, Durham, NC, USA.

Background: ACL injuries are common among sports populations and achieving adequate lower extremity strength is important prior to return to play. Access to isokinetic testing equipment that measures lower extremity strength is limited. Screening tools that measure functional criteria are accessible to clinicians, however the tools' relationship to strength constructs have not been investigated in an ACL reconstructed (ACLR) population. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6063058PMC
April 2018
10 Reads

Ankle Dorsiflexion displacement is associated with hip and knee kinematics in females following anterior cruciate ligament reconstruction.

Res Sports Med 2018 Aug 7:1-13. Epub 2018 Aug 7.

b Department of Exercise and Sport Science , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA.

The purpose of this study was to examine associations between ankle dorsiflexion (ankle-DF) displacement and knee and hip kinematics and kinetics during a jump-landing task in females following anterior cruciate ligament reconstruction (ACLR). Females (n = 23) with a history of unilateral ACLR (≥ 6-months post-ACLR) underwent a three-dimensional lower extremity biomechanical evaluation. Pearson Product Moment (r) correlations assessed associations between ankle-DF displacement and knee and hip kinematic and kinetic variables. Read More

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https://www.tandfonline.com/doi/full/10.1080/15438627.2018.1
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http://dx.doi.org/10.1080/15438627.2018.1502180DOI Listing
August 2018
10 Reads

The Aberrant Anterior Tibial Artery and its Surgical Risk.

Am J Orthop (Belle Mead NJ) 2018 Jul;47(7)

Indiana University Health Methodist Hospital, School of Medicine, Indianapolis, IN.

Vascular injury to the popliteal artery during knee surgery is uncommon, but it has significant consequences not only for the patient but also to the surgeon since it poses the threat of malpractice litigation. The vascular anatomy of the lower extremity is variable especially when it involves both the popliteal artery and its branches. An aberrant vascular course may increase the risk of iatrogenic vascular injury during surgery. Read More

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http://dx.doi.org/10.12788/ajo.2018.0057DOI Listing

Computation of the role of kinetics, kinematics, posterior tibial slope and muscle cocontraction on the stability of ACL-deficient knee joint at heel strike - Towards identification of copers from non-copers.

J Biomech 2018 Aug 20;77:171-182. Epub 2018 Jul 20.

Division of Applied Mechanics, Department of Mechanical Engineering, École Polytechnique, Montréal, Québec, Canada.

Rupture of anterior cruciate ligament (ACL) undermines normal activity and function of the knee joint and places it at higher risk of re-injury and degeneration. ACL reconstruction surgery neither necessarily ensures return to pre-injury activities nor alleviates risk of long-term degeneration. Here in this computational investigation of a lower-extremity hybrid model at heel strike (HS) of gait, we search for factors that influence the stability of the joint and hence the distinct performances between post-ACL injury copers and non-copers. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00219290183049
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http://dx.doi.org/10.1016/j.jbiomech.2018.07.003DOI Listing
August 2018
21 Reads

Open Versus Endovascular Revascularization of Below-Knee Arteries in Patients With End-Stage Renal Disease and Critical Limb Ischemia.

Vasc Endovascular Surg 2018 Nov 18;52(8):613-620. Epub 2018 Jul 18.

1 Department of Vascular Surgery, University Hospital Erlangen, Erlangen, Germany.

Background:: Evaluation of below-the-knee open revascularization (OR) versus endovascular revascularization (EVT) in patients with end-stage renal disease and critical limb ischemia (CLI) was performed.

Patients And Methods:: Seventy-seven dialysis patients with CLI and infrapopliteal involvement from 2007 to 2017 were included. Thirty-five patients received OR and 42 patients were treated with EVT. Read More

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http://dx.doi.org/10.1177/1538574418789036DOI Listing
November 2018
12 Reads
0.766 Impact Factor

Percutaneous Deep Venous Arterialization for Severe Critical Limb Ischemia in Patients With No Option of Revascularization: Early Experience From Two European Centers.

Cardiovasc Intervent Radiol 2018 Oct 17;41(10):1474-1480. Epub 2018 Jul 17.

Vascular and Oncological Interventional Radiology, Hôpital Européen Georges-Pompidou, Université Paris Descartes Paris Cité Sorbonne, 20 Rue Leblanc, 75015, Paris, France.

Purpose: To report our initial experience of fully percutaneous deep venous arterialization (pDVA) for the treatment of chronic critical limb ischemia (cCLI) after failed distal angioplasty.

Materials And Methods: pDVA was performed in five consecutive patients by creating an arteriovenous fistula (AVF) between a below the knee artery and its satellite deep vein. In this early experience, only patients with failed prior interventional attempts at establishing flow with no distal targets for an arterial bypass were selected. Read More

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http://dx.doi.org/10.1007/s00270-018-2020-2DOI Listing
October 2018
1 Read

Predicting patient reported outcome in total knee arthroplasty using body mass index and limb measurements.

Knee 2018 Oct 13;25(5):915-922. Epub 2018 Jul 13.

Department of Trauma and Orthopaedic Surgery, Gatehouse Building, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G40SF, United Kingdom of Great Britain and Northern Ireland.

Background: Body mass index (BMI) has not been shown to correlate with Patient Reported Outcome Measures (PROMs) following total knee arthroplasty (TKA). We investigated the relationship between weight, BMI, limb morphology, and Oxford Knee Score (OKS). Furthermore, the utility of a novel radiological measurement, the Knee Mass Index (KMI), was investigated. Read More

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http://dx.doi.org/10.1016/j.knee.2018.06.015DOI Listing
October 2018
14 Reads

Free-style puzzle flap as a cross-leg pedicled flap: the concept of re-using a flap in acute burns, a case report.

Burns Trauma 2018 2;6. Epub 2018 Feb 2.

Department of Plastic Reconstructive Surgery, Burn Center, Hôpital Saint Louis, AP-HP 1 Avenue Claude Vellefaux, 75010 Paris, France.

Background: In well-selected cases, flaps can play a pivotal role in optimizing outcomes in the acute phase of burns. A previous redundant flap could be reused or recycled as a donor site from which a new flap could be raised.

Case Presentation: We report the case of a patient with full thickness burns on both legs, leading to the exposure of joints of the right ankle and the right foot and left patellar tendon. Read More

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http://dx.doi.org/10.1186/s41038-018-0107-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6040606PMC
February 2018

Two-Plane Assessment of Knee Muscles Isometric and Isokinetic Torques After Anterior Cruciate Ligament Reconstruction.

Med Sci Monit 2018 Jul 14;24:4882-4893. Epub 2018 Jul 14.

The Center of Rehabilitation and Medical Education, Wrocław, Poland.

BACKGROUND We tested the hypothesis that, in patients participating in 17 weeks of postoperative physiotherapy after anterior cruciate ligament reconstruction (ACLR), maximal isometric torque (IT) and peak torque (PT) generated by the muscles affecting the operated knee joint in the sagittal and transverse planes are not restored. We also present the application of IT and PT measurements of the muscles affecting the knee joint in 2 planes of motion. MATERIAL AND METHODS IT and PT of the knee extensor and flexor muscles and the muscles internally rotating the shin were measured in 30 males who participated in postoperative physiotherapy for 17 weeks after ACLR (ACLR group) and 30 males with no injuries (control group). Read More

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http://dx.doi.org/10.12659/MSM.908411DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6069442PMC
July 2018
13 Reads

Clinical Characteristics of Lower Extremity Surgical Site Infections in Dermatologic Surgery Based Upon 24-Month Retrospective Review.

J Drugs Dermatol 2018 Jul;17(7):766-771

Dermatologic surgery performed on the lower extremities has an increased risk for surgical site infections (SSI). Our objective was to evaluate the clinical characteristics associated with SSI following Mohs micrographic surgery (MMS) and wide local excisions (WLE) performed below the knee. We performed a single-center retrospective chart review of patients (n=271) that underwent these procedures. Read More

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July 2018
6 Reads

Participants at three months post-operative anterior cruciate ligament reconstruction (ACL-R) demonstrate differences in lower extremity energy absorption contribution and quadriceps strength compared to healthy controls.

Knee 2018 Oct 9;25(5):782-789. Epub 2018 Jul 9.

Fort Worth Orthopedics, 6301 Harris Pkwy. Suite 200, Fort Worth, TX 76132, United States of America.

Background: The purpose of this study was to compare hip and knee energy absorption contribution (EAC) during a double limb squat (DLS) and quadriceps strength in patients three months post-operative ACL-R versus matched healthy controls.

Methods: Twenty-four ACL-R participants (Age = 15.5 ± 1. Read More

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http://dx.doi.org/10.1016/j.knee.2018.06.014DOI Listing
October 2018
12 Reads

Continued Improvements in Quadriceps Strength and Biomechanical Symmetry of the Knee After Postoperative Anterior Cruciate Ligament Reconstruction Rehabilitation: Is It Time to Reconsider the 6-Month Return-to-Activity Criteria?

J Athl Train 2018 Jun 5;53(6):535-544. Epub 2018 Jul 5.

School of Kinesiology.

Context:   Patients who undergo anterior cruciate ligament reconstruction (ACLR) present with strength and biomechanical deficits at return to activity (RTA). Deficits in strength and biomechanical symmetry impair function during activity and may predispose patients to subsequent injury.

Objective:   To compare strength and biomechanical function in patients with ACLR at RTA and more than 12 months post-ACLR. Read More

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http://dx.doi.org/10.4085/1062-6050-478-15DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6089034PMC
June 2018
26 Reads

Whole-body biomechanical differences between limbs exist 9 months after ACL reconstruction across jump/landing tasks.

Scand J Med Sci Sports 2018 Dec 6;28(12):2567-2578. Epub 2018 Aug 6.

Department of Life Sciences, Roehampton University, London, UK.

Introduction: Previous studies examining jump tasks after anterior cruciate ligament reconstruction (ACLR) have focused on performance measures without examining joint kinematic and kinetic variables. The aim of this study was to identify differences in biomechanical and performance measures between limbs across tests 9 months after surgery.

Methods: Four jump tests (double-leg drop jump (DLDJ), single-leg drop jump (SLDJ), single-leg hop for distance (SLHD) and hurdle hop (HH)) were carried out on 156 male subjects in a 3D motion capture laboratory 9 months after surgery. Read More

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http://dx.doi.org/10.1111/sms.13259DOI Listing
December 2018
22 Reads

Intravenous tranexamic acid and lower limb arthroplasty-a randomised controlled feasibility study.

Anaesth Intensive Care 2018 07;46(4):386-395

Senior Statistician, Data Design and Statistics Service, Adelaide Health Technology Assessment, School of Public Health, The University of Adelaide, Adelaide, South Australia.

Tranexamic acid (TA) is widely reported to reduce bleeding and the risk of blood transfusion in patients undergoing lower limb arthroplasty. No study in this setting has had adequate power to examine for the effect of TA on either uncommon, but clinically important, adverse events or patient-centric endpoints. A large randomised controlled trial (RCT) is required to address these questions. Read More

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CT pulmonary angiography in lower limb arthroplasty.

Bone Joint J 2018 07;100-B(7):938-944

Musgrave Park Hospital, Belfast, Co. Antrim, UK.

Aims: The aims of this study were to determine the indications and frequency of ordering a CT pulmonary angiography (CTPA) following primary arthroplasty of the hip and knee, and to determine the number of positive scans in these patients, the location of emboli and the outcome for patients undergoing CTPA.

Patients And Methods: We analyzed the use of CTPA, as an inpatient and up to 90 days as an outpatient, in a cohort of patients and reviewed the medical records and imaging for each patient undergoing CTPA.

Results: Out of 11 249 patients, scans were requested in 229 (2. Read More

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http://dx.doi.org/10.1302/0301-620X.100B7.BJJ-2017-1239.R4DOI Listing
July 2018
12 Reads

Postural Adjustments Following ACL Rupture and Reconstruction: A Longitudinal Study.

Int J Sports Med 2018 Jul 28;39(7):549-554. Epub 2018 Jun 28.

Università degli Studi di Roma 'Foro Italico', Department of Movement, Human and Health Sciences, Roma, Italy.

Longitudinal changes in compensatory and anticipatory postural adjustments around the knee were investigated from rupture of ACL until return to play after reconstruction. Twelve ACL-injured participants (ACL-P) were asked to respond to unpredictable and predictable perturbations before (T1), 2 (T2) and 6 months after (T3) reconstruction. Twelve healthy participants served as controls. Read More

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http://dx.doi.org/10.1055/a-0599-6401DOI Listing

Modern treatment of meniscal tears.

EFORT Open Rev 2018 May 21;3(5):260-268. Epub 2018 May 21.

Ghent University, Faculty of Medicine, Department of Orthopaedics and Traumatology, De Pintelaan, Ghent, Belgium.

The complex ultrastructure of the meniscus determines its vital functions for the knee, the lower extremity, and the body.The most recent concise, reliable, and valid classification system for meniscal tears is the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) Classification, which takes into account the subsequent parameters: tear depth, tear pattern, tear length, tear location/rim width, radial location, location according to the popliteal hiatus, and quality of the meniscal tissue.It is the orthopaedic surgeon's responsibility to combine clinical information, radiological images, and clinical experience in an effort to individualize management of meniscal tears, taking into account factors related to the patient and lesion. Read More

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http://dx.doi.org/10.1302/2058-5241.3.170067DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5994634PMC
May 2018
17 Reads

Development of an occupational advice intervention for patients undergoing lower limb arthroplasty (the OPAL study).

BMC Health Serv Res 2018 06 28;18(1):504. Epub 2018 Jun 28.

South Tees Hospitals NHS Foundation Trust, Middlesbrough, England, UK.

Background: There are an increasing number of patients of working age undergoing hip and knee replacements. Currently there is variation in the advice and support given about sickness absence, recovery to usual activities and return to work after these procedures. Earlier, sustainable, return to work improves the health of patients and benefits their employers and society. Read More

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http://dx.doi.org/10.1186/s12913-018-3238-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6022501PMC