827 results match your criteria Lower Extremity Reconstruction Tibia


Asymmetric limb lengthening in the treatment of tibial hemimelia caused by osteomyelitis: A case report.

Medicine (Baltimore) 2019 Jan;98(3):e14031

Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.

Rationale: Tibial hemimelia is known as a rare congenital lower limb deficiency. It has been classified into different types based on Jones classification, and the traditional treatment of tibial hemimelia is amputation. Here we present a variant and unclassified case of tibial hemimelia, which was caused by osteomyelitis. Read More

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http://dx.doi.org/10.1097/MD.0000000000014031DOI Listing
January 2019

[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
1 Read

[Application of femoral-femoral artery bypass grafting combined with transverse tibial bone transporting for lower extremity arteriosclerosis obliterans or combined with diabetic foot].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2018 Dec;32(12):1576-1580

Department of Hand Surgery, Repair and Reconstruction Surgery, Lower Limb Vascular Disease, the Second Hospital of Tangshan (the Affiliated Hospital of North China Polytechnic University), Tangshan Hebei, 063000, P.R.China.

Objective: To discuss the effectiveness of femoral-femoral artery bypass grafting combined with transverse tibial bone transporting in treatment of lower extremity arteriosclerosis obliterans (ASO) or combined with diabetic foot.

Methods: Between March 2014 and June 2016, 9 patients with lower extremity ASO or combined with diabetic feet were treated with femoral-femoral artery bypass grafting and transverse tibial bone transporting. All patients were male, aged from 63 to 82 years with an average of 74. Read More

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http://dx.doi.org/10.7507/1002-1892.201806124DOI Listing
December 2018
1 Read

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

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

Identifying Predictors of Time to Soft-Tissue Reconstruction following Open Tibia Fractures.

Plast Reconstr Surg 2018 Dec;142(6):1620-1628

Durham, N.C.; and Philadelphia, Pa. From Duke University School of Medicine; the Division of Plastic and Reconstructive Surgery, the Department of Biostatistics and Bioinformatics, and the Department of Orthopaedic Surgery, Division of Orthopaedic Trauma, Duke University Medical Center; and the Department of Bioengineering, University of Pennsylvania.

Background: Controversy remains regarding the optimal timing of soft-tissue coverage following severe lower extremity trauma. This study identifies nationwide practice patterns and factors associated with discrepancies in time to first flap surgery following open tibia fractures.

Methods: A retrospective analysis was performed on the National Trauma Databank from 2008 to 2015 to identify patients who presented with an open tibia fracture and underwent subsequent flap reconstruction. Read More

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http://dx.doi.org/10.1097/PRS.0000000000005007DOI Listing
December 2018
2.993 Impact Factor

Extensive Bone Lengthening for a Patient with Linear Morphea.

Case Rep Orthop 2018 19;2018:4535804. Epub 2018 Aug 19.

Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi 466-8550, Japan.

Localized scleroderma, also known as morphea, is a rare condition characterized by progressive sclerosis of the skin and associated atrophy of the underlying tissues. The linear type of localized scleroderma is the most frequent form in childhood, usually affecting unilateral extremities. Fibrosclerosis of the fasciae and muscles can spread across joints and impair the range of motion of the joint. Read More

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http://dx.doi.org/10.1155/2018/4535804DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6120294PMC
August 2018
1 Read

Ankle Arthrodesis with Free Vascularized Fibula Autograft Using Saphenous Vein Grafts: A Case Series.

Plast Reconstr Surg 2018 09;142(3):806-809

Philadelphia, Pa. From the University of Pennsylvania.

Background: In select high-risk cases of ankle arthrodesis, conventional techniques may lead to a high incidence of failure because of a combination of multiple operations; high risk of infection; avascular, often bulky allografts; and poor soft-tissue quality. In high-risk distal limb salvage, the authors have performed ankle arthrodesis using a free vascularized fibula graft from the ipsilateral limb with saphenous vein grafts.

Methods: The authors present data from six patients. Read More

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http://Insights.ovid.com/crossref?an=00006534-201809000-0004
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http://dx.doi.org/10.1097/PRS.0000000000004671DOI Listing
September 2018
6 Reads

Evaluation of perfusion by near-infrared fluorescence imaging in late pedicle obstruction of a parascapular flap to the lower extremity: A case report.

Microsurgery 2018 Nov 24;38(8):912-916. Epub 2018 Aug 24.

Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Hand and Plastic Surgery, University of Heidelberg, Heidelberg, Germany.

Late free flap failures due to pedicle obstruction are rare adverse events. The purpose of this report is to present a case in which the near-infrared indocyanine green video angiography (ICG-NIR-VA) was used to evaluate the perfusion in a compromised fasciocutaneous flap in the late postoperative period. A 55-year-old male patient, who initially suffered from an open tibial fracture, developed concurrent osteomyelitis with fistulae of the proximal tibia requiring excision. Read More

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http://dx.doi.org/10.1002/micr.30366DOI Listing
November 2018
1 Read

[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

[Effectiveness of posterior intercostal artery perforator flap in repair of donor defect after latissimus dorsi myocutaneous flap transfer].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2018 09;32(9):1187-1191

Department of Burn &  Plastic and Hand &  Foot Surgery, the Second Hospital of Yulin City , Yulin Shaanxi, 719000, P.R.China.

Objective: To investigate the feasibility and effectiveness of the latissimus dorsi myocutaneous flap in repair of large complex tissue defects of limb and the relaying posterior intercostal artery perforator flap in repair of donor defect after latissimus dorsi myocutaneous flap transfer.

Methods: Between January 2016 and May 2017, 9 patients with large complex tissue defects were treated. There were 8 males and 1 female with a median age of 33 years (range, 21-56 years). Read More

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http://dx.doi.org/10.7507/1002-1892.201803046DOI Listing
September 2018
2 Reads

[New progress in the treatment of chronic wound of diabetic foot].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2018 Jul;32(7):832-837

Department of Orthopaedics, Beijing Shijitan Hospital, CMU, Beijing, 100038, P.R.China.

Diabetic foot is one of the serious complications of diabetic patients. It is caused by diabetes combined with different degrees of lower extremity vascular lesions and neuropathy, and the wound can not heal for a long time. The serious results can cause bone marrow infection, bone destruction, and have high disability and death rate. Read More

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http://www.rrsurg.com/article/10.7507/1002-1892.201806058
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http://dx.doi.org/10.7507/1002-1892.201806058DOI Listing
July 2018
16 Reads

The Soleus Muscle Flap: An Overview of Its Clinical Applications for Lower Extremity Reconstruction.

Ann Plast Surg 2018 Dec;81(6S Suppl 1):S109-S116

From the Division of Plastic Surgery, Department of Surgery, University of California Davis Medical Center, Sacramento, CA.

Lower extremity reconstruction often poses several challenges for the reconstructive surgeon. Because of limited local tissue options, patients who sustain extensive middle to distal third tibia fractures used to be at higher risk of limb loss without adequate soft tissue coverage. The traditional principle of reconstructing middle and distal third leg wounds with free tissue transfer is being challenged by advances in understanding of local muscle flap anatomy and surgical techniques to improve the efficacy of local flaps. Read More

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http://dx.doi.org/10.1097/SAP.0000000000001499DOI Listing
December 2018
1 Read

Biological Intercalary Reconstruction with Bone Grafts After Joint-Sparing Resection of the Lower Limb: Is this an Effective and Durable Solution for Joint Preservation?

Surg Technol Int 2018 06;32:346-345

Department of Orthopaedic Oncology and Reconstructive Surgery University of Florence, Azienda Ospedaliera, Universitaria Careggi, Florence, Italy.

Due to advances in neoadjuvant therapies and preoperative imaging modalities, joint-sparing resections have become appealing in bone tumor surgery. However, the intercalary reconstruction of metadiaphyseal bone defects of the femur and the tibia after juxta-articular tumor resection remains challenging. Both biological and prosthetic reconstructions have been used for joint-sparing resections, but little is known about the long-term outcome of these procedures. Read More

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June 2018
8 Reads

Combined application of latissimus dorsi myocutaneous flap and iliac bone flap in the treatment of chronic osteomyelitis of the lower extremity.

J Orthop Surg Res 2018 May 18;13(1):117. Epub 2018 May 18.

Department of Hand Surgery, Ruihua Affiliated Hospital of Soochow University, No. 5 Tayun Road, Suzhou, 215104, China.

Background: To evaluate the clinical efficacy and safety of latissimus dorsi myocutaneous flap (stage I) combined with iliac bone flap (stage II) in the treatment of chronic osteomyelitis of the lower extremity.

Methods: Clinical data of 18 patients undergoing latissimus dorsi myocutaneous flap in combination with iliac bone flap grafting were retrospectively analyzed. Among them, 2 patients developed chronic osteomyelitis of the lower segment of the femur, 4 were diagnosed with chronic osteomyelitis of the tibial plateau, and 12 with chronic osteomyelitis of the lower segment of the tibia. Read More

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https://josr-online.biomedcentral.com/articles/10.1186/s1301
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http://dx.doi.org/10.1186/s13018-018-0824-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5960194PMC
May 2018
2 Reads
1.580 Impact Factor

Lower-limb reconstruction with chimeric flaps: The quad flap.

Microsurgery 2018 May 7. Epub 2018 May 7.

Division of Plastic and Reconstructive Surgery, Mayo Clinic Hospital, Phoenix, Arizona.

Early soft-tissue coverage is critical for treating traumatic open lower-extremity wounds. As free-flap reconstruction evolves, injuries once thought to be nonreconstructable are being salvaged. Free-tissue transfer is imperative when there is extensive dead space or exposure of vital structures such as bone, tendon, nerves, or blood vessels. Read More

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http://doi.wiley.com/10.1002/micr.30335
Publisher Site
http://dx.doi.org/10.1002/micr.30335DOI Listing
May 2018
9 Reads

Proximal versus Distal Recipient Vessels in Lower Extremity Reconstruction: A Retrospective Series and Systematic Review.

J Reconstr Microsurg 2018 Jun 6;34(5):334-340. Epub 2018 Apr 6.

Hansjörg Wyss Department of Plastic and Reconstructive Surgery, New York University Langone Medical Center, New York, New York.

Background:  Recipient vessels proximal to the zone of injury have traditionally been preferred for lower extremity reconstruction. However, more recent data have shown mixed outcomes when performing anastomoses distal to the zone of injury. We investigated the impact of recipient vessel location on free flap outcomes. Read More

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http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1621746
Publisher Site
http://dx.doi.org/10.1055/s-0037-1621746DOI Listing
June 2018
4 Reads

Numerical investigation of driver lower extremity injuries in finite element frontal crash reconstruction.

Traffic Inj Prev 2018 02;19(sup1):S21-S28

a Wake Forest University School of Medicine , Winston-Salem , North Carolina.

Objective: Lower extremity injuries are the most frequent Abbreviated Injury Scale (AIS) 2 injury for drivers in frontal crashes. The objective was to reconstruct 11 real-world motor vehicle crashes (2 with AIS 2+ distal lower extremity injury and 9 without lower extremity injury) and to analyze the vehicle parameters and driver attributes that affect injury risk.

Methods: Eleven frontal crashes were reconstructed with a finite element simplified vehicle model (SVM) using a semi-automated optimization method. Read More

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http://dx.doi.org/10.1080/15389588.2017.1376051DOI Listing
February 2018
4 Reads

Assessment of Function after Free Tissue Transfer to the Lower Extremity for Chronic Wounds Using the Lower Extremity Functional Scale.

J Reconstr Microsurg 2018 Jun 16;34(5):327-333. Epub 2018 Feb 16.

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

Background:  Free tissue transfer is one option for preservation of form and function in the native limb, in the setting of soft tissue paucity. However, the data on patient functionality after microvascular intervention is inconsistently reported. The Lower Extremity Function Scale (LEFS) measures patient-reported difficulty in carrying out 20 physical activities, on a Likert scale, the sum of which correlates with descriptive functional stages of 1-5. Read More

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http://dx.doi.org/10.1055/s-0037-1621736DOI Listing
June 2018
5 Reads

Chondrosarcoma in Metachondromatosis: A Rare Case Report.

Acta Med Iran 2017 Dec;55(12):793-799

Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran.

Metachondromatosis which was first described in 1971 by Maroteaux is a rare genetic disease consisting of osteochondromas and enchondromas, caused by loss of function of the PTPN11 gene. It is distinct from other cartilaginous tumors such as multiple osteochondromas and hereditary multiple exostosis by the distribution and orientation of lesions, and pattern of inheritance. In Metachondromatosis osteochondromas typically occur in hands, feet, femur, and tibia while enchondromas commonly affect the pelvic bones and femurs. Read More

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December 2017
2 Reads

Tibial tunnel enlargement and joint instability after anterior cruciate ligament reconstruction. A prospective comparison between autograft and allograft.

Acta Cir Bras 2017 Dec;32(12):1064-1074

MD, Division of Orthopedics, The General Hospital of Jinan Military Command, China. Intellectual and scientific content of the study, technical procedures, manuscript preparation, critical revision, final approval.

Purpose: To investigate tibial tunnel widening and knee instability after ACL reconstruction with hamstring autograft or irradiated soft tissue allograft.

Methods: Eight-two patients were divided into two groups: autograft group and allograft group. Radiographic and clinical evaluations were performed. Read More

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http://dx.doi.org/10.1590/s0102-865020170120000008DOI Listing
December 2017
7 Reads

Fat grafting for resurfacing an exposed implant in lower extremity: A case report.

Medicine (Baltimore) 2017 Dec;96(48):e8901

Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University.

Rationale: Although numerous reconstruction protocols have been reported for lower leg trauma, those for distal leg trauma remain few. We present the case of a woman with an implant exposure wound, who was successfully treated through fat grafting, without major flap surgery.

Patient Concerns: An 83-year-old woman with an exposed implant in lower extremity received reconstruction surgery once and the surgery failed. Read More

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http://dx.doi.org/10.1097/MD.0000000000008901DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5728778PMC
December 2017
4 Reads

The Natural History of the Development of Trevor Disease of the Hip and Subsequent Arthroplasty: A Case Report.

JBJS Case Connect 2017 Jul-Sep;7(3):e67

1Department of Orthopaedic Surgery, Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Case: Trevor disease (dysplasia epiphysealis hemimelica [DEH]) is a rare, intra-articular anomaly of cartilaginous overgrowth of the epiphysis. The usual presentation is on 1 side of the body and on 1 side of the epiphysis. The natural history of this disease is not clear because the lesions often are treated during childhood. Read More

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http://dx.doi.org/10.2106/JBJS.CC.16.00277DOI Listing
August 2018
7 Reads

Rectus femoris branch: An alternative blood supply for a distally based anterolateral thigh flap.

J Plast Reconstr Aesthet Surg 2018 02 2;71(2):232-238. Epub 2017 Nov 2.

Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing, China.

Successful raising of a distally based anterolateral thigh (dALT) flap mainly depends on a well-developed lateral circumflex femoral artery (LCFA) descending branch and an intact vascular connection between the descending branch and the vascular network of the knee. However, in some clinical scenarios, the descending branch is hypoplastic or the vascular connection of the knee is compromised. We present six cases of using dALT flaps in soft tissue defect reconstruction of the knee with either of the above-mentioned conditions. Read More

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http://dx.doi.org/10.1016/j.bjps.2017.10.017DOI Listing
February 2018
4 Reads

Contact Kinematics Correlates to Tibial Component Migration Following Single Radius Posterior Stabilized Knee Replacement.

J Arthroplasty 2018 03 6;33(3):740-745. Epub 2017 Oct 6.

Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, Western University and London Health Sciences Centre, London, Ontario, Canada.

Background: Contact kinematics between total knee arthroplasty components is thought to affect implant migration; however, the interaction between kinematics and tibial component migration has not been thoroughly examined in a modern implant system.

Methods: A total of 24 knees from 23 patients undergoing total knee arthroplasty with a single radius, posterior stabilized implant were examined. Patients underwent radiostereometric analysis at 2 and 6 weeks, 3 and 6 months, and 1 and 2 years to measure migration of the tibial component in all planes. Read More

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http://dx.doi.org/10.1016/j.arth.2017.09.064DOI Listing
March 2018
5 Reads

Does Calipered Kinematically Aligned TKA Restore Native Left to Right Symmetry of the Lower Limb and Improve Function?

J Arthroplasty 2018 02 25;33(2):398-406. Epub 2017 Sep 25.

Department of Mechanical Engineering, University of California, Davis, Davis, California.

Background: Kinematically aligned total knee arthroplasty (KA TKA) strives to restore the native left to right symmetry of the lower limb; however, the reproducibility of achieving this target is unknown. The present study determined the proportion of patients with left to right symmetry and the improvement in patient-reported function after calipered KA TKA.

Methods: A review of 562 postoperative scanograms identified 102 patients (53 women) with a KA TKA in one limb, no other skeletal abnormalities in either limb, and symmetrical rotation between limbs on the scanogram. Read More

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http://dx.doi.org/10.1016/j.arth.2017.09.039DOI Listing
February 2018
9 Reads

Reconstruction of lower extremity primary malignant and metastatic bone tumours with modular endoprosthesis.

Niger J Clin Pract 2017 Sep;20(9):1127-1132

Department of Orthopedic and Traumatology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey.

Introduction: This study is aimed to assess the functional results of cases with lower extremity malignant and metastatic bone tumours that were treated with modular tumour resection prostheses.

Materials And Methods: 49 patients were retrospectively examined. 27 (55. Read More

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http://dx.doi.org/10.4103/1119-3077.217243DOI Listing
September 2017
12 Reads

Not All Gustilo Type IIIB Fractures Are Created Equal: Arterial Injury Impacts Limb Salvage Outcomes.

Plast Reconstr Surg 2017 Nov;140(5):1033-1041

New York, N.Y. From the Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center; and the Division of Plastic Surgery, Department of Surgery, Mount Sinai Health System.

Background: Open tibia fractures are commonly stratified by the Gustilo classification, an orthopedic grading system that does not incorporate the presence of arterial injury when limb perfusion is intact. In the authors' experience, however, the presence of arterial injury appears to negatively impact microsurgical outcomes.

Methods: In a retrospective review of 806 lower extremity reconstructions between 1979 and 2016, 361 soft-tissue flaps performed for Gustilo type IIIB/C coverage met inclusion criteria. Read More

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http://dx.doi.org/10.1097/PRS.0000000000003766DOI Listing
November 2017
5 Reads

Comparison of Clinical Results and Injury Risk of Posterior Tibial Cortex Between Attune and Press Fit Condylar Sigma Knee Systems.

J Arthroplasty 2018 02 6;33(2):391-397. Epub 2017 Oct 6.

Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, South Korea.

Background: We compared clinical and radiographic results after total knee arthroplasty (TKA) using Attune and Press Fit Condylar Sigma, and investigated whether use of the current prosthesis increased injury risk to the tibial cortex in Asian patients. We also assessed whether a preoperative posterior tibial slope angle (PSA) is associated with the injury when using the current prosthesis.

Methods: The 300 TKAs with Attune (group A) were compared to the 300 TKAs with Press Fit Condylar Sigma (group B). Read More

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http://dx.doi.org/10.1016/j.arth.2017.09.056DOI Listing
February 2018
3 Reads

The deep layer of the tractus iliotibialis and its relevance when using the direct anterior approach in total hip arthroplasty: a cadaver study.

Arch Orthop Trauma Surg 2017 Dec 14;137(12):1755-1760. Epub 2017 Oct 14.

Department of Orthopaedic Surgery, Experimental Orthopaedics, Medical University of Innsbruck, Innrain 36, 6020, Innsbruck, Austria.

Introduction: Surgical approaches through smaller incisions reveal less of the underlying anatomy, and therefore, detailed knowledge of the local anatomy and its variations is important in minimally invasive surgery. The aim of this study was to determine the location, extension, and histomorphology of the deep layer of the iliotibial band during minimally invasive hip surgery using the direct anterior approach (DAA).

Materials And Methods: The morphology of the iliotibial tract was determined in this cadaver study on 40 hips with reference to the anterior superior iliac spine and the tibia. Read More

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http://dx.doi.org/10.1007/s00402-017-2820-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5686244PMC
December 2017
2 Reads

Neutral alignment leads to higher knee society scores after total knee arthroplasty in preoperatively non-varus patients: a prospective clinical study using 3D-CT.

Knee Surg Sports Traumatol Arthrosc 2018 Jun 12;26(6):1602-1609. Epub 2017 Oct 12.

Department of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland, 4101, Bruderholz, Switzerland.

Purpose: The optimal coronal alignment is still under debate. However, in most of the studies, alignment was only assessed using radiographs, which are not accurate enough for assessment of tibial and femoral TKA position. The primary purpose of this study was to assess the relationship between coronal TKA alignment using 3D-reconstructed CTs and clinical outcome in patients with preoperative varus in comparison with patients with natural or valgus deformity. Read More

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http://dx.doi.org/10.1007/s00167-017-4744-yDOI Listing
June 2018
10 Reads
1 Citation
2.840 Impact Factor

Influence of Increased Posterior Tibial Slope in Total Knee Arthroplasty on Knee Joint Biomechanics: A Computational Simulation Study.

J Arthroplasty 2018 02 21;33(2):572-579. Epub 2017 Sep 21.

Joint Reconstruction Center, Department of Orthopaedic Surgery, Yonsei Sarang Hospital, Seoul, Republic of Korea.

Background: The reconstructed posterior tibial slope (PTS) plays a significant role in restoring knee kinematics in cruciate-retaining-total knee arthroplasty (TKA). A few studies have reported the effect of the PTS on biomechanics.

Methods: This study investigates the effect of the PTS on tibiofemoral (TF) kinematics, patellofemoral (PF) contact stress, and forces at the quadriceps, posterior cruciate ligament (PCL) and collateral ligament after cruciate-retaining-TKA using computer simulations. Read More

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http://dx.doi.org/10.1016/j.arth.2017.09.025DOI Listing
February 2018
13 Reads

Tear drop-free anterolateral thigh flap, a versatile design for lower limb reconstruction after trauma.

Microsurgery 2018 Mar 21;38(3):278-286. Epub 2017 Sep 21.

Department of Plastic and Reconstructive Surgery, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, United Kingdom.

Background: In lower limb reconstruction the cosmetic outcome is influenced by the contouring of the flap at the recipient site as well as by the donor site closure. It is also important to minimise compression of the flap pedicle. We discuss the outcomes of a versatile ALT flap design that allows freedom in skin paddle tailoring without elongating the scar, reduction of the tension over the pedicle and improved cosmetic results of both donor and recipient sites. Read More

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http://dx.doi.org/10.1002/micr.30235DOI Listing
March 2018
4 Reads

Tibial shaft anatomy differs between Caucasians and East Asian individuals.

Knee Surg Sports Traumatol Arthrosc 2018 Sep 22;26(9):2758-2765. Epub 2017 Sep 22.

Rothman Institute, Thomas Jefferson University Hospital, 925 Chestnut Street, 5th Floor, Philadelphia, PA, 19107, USA.

Purpose: The orientation and distance from the shaft of the femur and tibia to the articular surface centre is important for performing total knee arthroplasty (TKA) with cementless stems. It is important to understand anatomic differences between races to match the tibial and femoral shaft axis to the knee articular surface. Thus, the purpose of this study was to compare knee morphology between Caucasian and East Asian individuals to determine the optimal placement of tibial and femoral stems. Read More

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http://dx.doi.org/10.1007/s00167-017-4724-2DOI Listing
September 2018
11 Reads

Preoperative Diagnosis Can Predict Conversion Total Knee Arthroplasty Outcomes.

J Arthroplasty 2018 01 24;33(1):124-129.e1. Epub 2017 Aug 24.

Division of Adult Reconstruction, Department of Orthopaedic Surgery, NYU Langone Medical Center, Hospital for Joint Diseases, New York, NY.

Background: Compared to total knee arthroplasty (TKA) for primary osteoarthritis, conversion TKAs in the post-traumatic setting are associated with increased operative times, infection rates, and readmissions. We aim at determining how post-traumatic osteoarthritis and previous knee surgery influence postoperative outcomes in conversion TKA.

Methods: Seventy-two conversion TKA procedures with prior knee trauma at a single institution between April 2012 and 2016 were examined. Read More

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http://dx.doi.org/10.1016/j.arth.2017.08.019DOI Listing
January 2018
9 Reads

Acute traumatic rupture of the patellar tendon in pediatric population: Case series and review of the literature.

Injury 2017 Nov 1;48(11):2515-2521. Epub 2017 Sep 1.

Department of Orthopaedic Surgery, Texas Children's Hospital, Houston, TX, USA.

Background: Intact knee extensor mechanism is required for the normal function of the lower extremity. Patellar tendon rupture is a relatively rare injury with peak age incidence around 40 years and usually occurs midsubstance. The occurrence of pure patellar tendon rupture without bony avulsion is an extremely rare injury in the pediatric population with few cases reported in the literature with limited information regarding frequency, complications, and outcomes in children. Read More

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http://dx.doi.org/10.1016/j.injury.2017.08.069DOI Listing
November 2017
7 Reads

Comparison of the iAssist Handheld Guidance System to Conventional Instruments for Mechanical Axis Restoration in Total Knee Arthroplasty.

J Arthroplasty 2018 01 9;33(1):61-66. Epub 2017 Jun 9.

Department of Orthopedic Surgery, University of California, San Diego, San Diego, California.

Background: Recent advances in total knee arthroplasty (TKA) include an intelligent instrument system designed to provide intraoperative guidance to reduce mechanical alignment errors. Internal position-sensing technology is integrated into microelectronic pods that attach to cutting blocks. The purpose of this prospective, randomized study was to determine whether this iAssist system enables the surgeon to make more accurate bone resections and better restore the mechanical axis compared to conventional instruments in TKA. Read More

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http://dx.doi.org/10.1016/j.arth.2017.06.004DOI Listing
January 2018
2 Reads

The Effect of Patient-Specific Instrumentation Incorporating an Extramedullary Tibial Guide on Operative Efficiency for Total Knee Arthroplasty.

Biomed Res Int 2017 3;2017:2034782. Epub 2017 Aug 3.

Joint Reconstruction Center, Department of Orthopaedic Surgery, Yonsei Sarang Hospital, 10 Hyoryeong-ro, Seocho-gu, Seoul 06698, Republic of Korea.

This retrospective study was to determine if patient-specific instrumentation (PSI) for total knee arthroplasty (TKA) leads to shortened surgical time through increased operating room efficiency according to different tibial PSI designs. 166 patients underwent primary TKA and were categorized into three groups as follows: PSI without extramedullary (EM) tibial guide (group 1, = 48), PSI with EM tibial guide (group 2, = 68), and conventional instrumentation (CI) group (group 3, = 50). Four factors were compared between groups, namely, operative room time, thickness of bone resection, tibial slope, and rotation of the component. Read More

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http://dx.doi.org/10.1155/2017/2034782DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5559926PMC
May 2018
5 Reads

Experimental pre-clinical assessment of the primary stability of two cementless femoral knee components.

J Mech Behav Biomed Mater 2017 11 27;75:322-329. Epub 2017 Jul 27.

Radboud university medical center, Radboud Institute for Health Sciences, Orthopaedic Research Lab, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands; Laboratory for Biomechanical Engineering, University of Twente, Enschede, The Netherlands.

To achieve long-lasting fixation of cementless implants, an adequate primary stability is required. We aimed to compare primary stability of a new cementless femoral knee component (Attune®) against a conventional implant (LCS®) under different loading conditions. Six pairs of femora were prepared following the normal surgical procedure. Read More

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http://dx.doi.org/10.1016/j.jmbbm.2017.07.043DOI Listing
November 2017
19 Reads

Short-term results of the management of severe bone defects in primary TKA with cement and K-wires.

Acta Orthop Traumatol Turc 2017 Oct 30;51(5):388-392. Epub 2017 Jul 30.

Nisantasi Orthopaedics Center, Bursa, Turkey.

Objective: The aim of this study was to evaluate the results of cement and kirschner wire augmentation in the management of bone defects in primary TKA.

Methods: Twenty-four patients (10 male, 14 female; mean age: 66 years) with uncontained unilateral medial tibial articular bone defect who underwent TKA between 2010 and 2014 were included in this study. The average follow up time was 33. Read More

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http://dx.doi.org/10.1016/j.aott.2017.02.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6197322PMC
October 2017
9 Reads

Relatively Loose Flexion Gap Improves Patient-Reported Clinical Scores in Cruciate-Retaining Total Knee Arthroplasty.

J Knee Surg 2018 Jul 30;31(6):573-579. Epub 2017 Jul 30.

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

Although appropriate soft tissue balancing is well recognized as essential procedure in total knee arthroplasty (TKA), poor relationship between intraoperative soft tissue balance and physician-reported clinical outcomes was reported. Since physician-derived scores are reported to be poorly related to patient-reported scores, patient-derived outcome scales have received a great deal of attention and have become increasingly important. Thus, it should be clarified whether intraoperative soft tissue balance influences patient-reported clinical outcomes. Read More

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http://dx.doi.org/10.1055/s-0037-1604446DOI Listing

[Extracorporeal irradiation : Reimplantation of bone segments in the treatment of malignant bone tumours].

Authors:
A H Krieg

Orthopade 2017 Aug;46(8):681-687

Knochen- und Weichteiltumorzentrum der Universität Basel (KWUB), Kinderorthopädie, Universitätskinderspital beider Basel (UKBB), Spitalstr. 33, 4056, Basel, Schweiz.

Background: Malignant bone tumors themselves and the wide resection required because of them may cause huge bone defects in the bone segment involved. Autologous bone grafts are a reliable option to cover these defects in many cases but their availability is limited. Besides common alternative reconstruction methods, including the use of allografts and/or prostheses, especially extracoroporeal irradiation (ECI) and reimplantation of the bone segment involved is attracting increasingly more attention nowadays. Read More

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http://dx.doi.org/10.1007/s00132-017-3445-zDOI Listing
August 2017
1 Read

Posterior cruciate ligament is twisted and flat structure: new prospective on anatomical morphology.

Knee Surg Sports Traumatol Arthrosc 2018 Jan 15;26(1):31-39. Epub 2017 Jul 15.

Department of Orthopaedic Surgery, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.

Purpose: This cadaveric study aimed to elucidate PCL morphology by observing the anatomical relationship with other structures and the fibre layers of the PCL in cross section for remnant preserving PCL reconstruction.

Methods: Seventeen fresh-frozen cadaveric knees were studied, using the clock-face method to analyse the anatomical relationship between the PCL and Humphrey's ligament. The width and thickness of the PCL, Humphrey's and Wrisberg's ligaments were measured. Read More

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http://dx.doi.org/10.1007/s00167-017-4634-3DOI Listing
January 2018
22 Reads

Use of a 72-cm-long extended bilateral deep inferior epigastric artery perforator free flap for reconstruction of a lower leg with no suitable recipient vessel around the injury zone: A case report.

Microsurgery 2018 Jan 13;38(1):89-93. Epub 2017 Jul 13.

Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.

In free-flap reconstruction of the lower extremity, due either to trauma or pre-existing vascular disease, healthy vessels may not be readily available in the proximity of the defect. A variety of options including a cross-leg free flap, vein grafts, arteriovenous loops, and "bridging" flaps have been used to address the issue. The purpose of this report is to present a case in which a 72-cm long extended bilateral deep inferior epigastric artery perforator (DIEP) free flap was used for coverage of a 20 × 25 cm soft tissue defect of the lower leg following a Gustilo grade IIIC fracture in a 29-year-old man. Read More

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http://dx.doi.org/10.1002/micr.30202DOI Listing
January 2018
16 Reads

An in Vivo Simulation of Isometry of the Anterolateral Aspect of the Healthy Knee.

J Bone Joint Surg Am 2017 Jul;99(13):1111-1118

1Bioengineering Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 2Focus Clinic Orthopedic Surgery, Medical Center Haaglanden and Bronovo-Nebo, The Hague, the Netherlands 3Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, the Netherlands 4Steadman Philippon Research Institute, Vail, Colorado.

Background: To assess the isometry of theoretical lateral extra-articular reconstruction (LER), we evaluated theoretical grafts attached to various points on the lateral femoral condylar area and to either Gerdy's tubercle or the anatomic attachment site of the anterolateral ligament to the tibia.

Methods: In 18 subjects, healthy knees with no history of either injury or surgery involving the lower extremity were studied. The subjects performed a sit-to-stand motion (from approximately 90° of flexion to full extension), and each knee was studied using magnetic resonance and dual fluoroscopic imaging techniques. Read More

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http://dx.doi.org/10.2106/JBJS.16.01139DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5490333PMC
July 2017
25 Reads

Anatomical Footprint of the Tibialis Anterior Tendon: Surgical Implications for Foot and Ankle Reconstructions.

Biomed Res Int 2017 4;2017:9542125. Epub 2017 Jun 4.

Center for Anatomy and Cell Biology, Division of Anatomy, Medical University of Vienna, Vienna, Austria.

This study aimed to analyze precisely the dimensions, shapes, and variations of the insertional footprints of the tibialis anterior tendon (TAT) at the medial cuneiform (MC) and first metatarsal (MT1) base. Forty-one formalin-fixed human cadaveric specimens were dissected. After preparation of the TAT footprint, standardized photographs were made and the following parameters were evaluated: the footprint length, width, area of insertion, dorsoplantar location, shape, and additional tendon slips. Read More

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http://dx.doi.org/10.1155/2017/9542125DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5474259PMC
March 2018
4 Reads

Megaprosthesis of the knee in tumor and revision surgery.

Acta Biomed 2017 06 7;88(2S):129-138. Epub 2017 Jun 7.

.

The introduction of multidisciplinary approach with chemo and radiotherapy, the advances in surgical and the improvements of diagnostic techniques allowed limb salvage surgery in most cases of bone sarcomas instead of amputation. Modular megaprostheses are the most common method of reconstruction after segmental resection of the long bones in the extremities for their availability, immediate fixation, early weight bearing, good function. Despite the advances in materials and implant designs, these systems have an high incidence of complications. Read More

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http://dx.doi.org/10.23750/abm.v88i2 -S.6523DOI Listing
June 2017
18 Reads

Changes in Hip, Knee, and Ankle Coronal Alignments After Total Hip Arthroplasty With Transverse Femoral Shortening Osteotomy for Unilateral Crowe Type IV Developmental Dysplasia of the Hip.

J Arthroplasty 2017 11 1;32(11):3449-3456. Epub 2017 Jun 1.

Baltalimani Bone and joint Diseases Training and Research Hospital, Istanbul, Turkey.

Background: To investigate changes in lower extremity coronal alignment in patients with unilateral Crowe type IV developmental dysplasia of the hip who underwent total hip arthroplasty with transverse femoral shortening osteotomy.

Methods: We reviewed the preoperative and 1-year postoperative full-length lower extremity radiographs of 25 patients. Femoral offset (FO), mechanical hip-knee-ankle angle, anatomical axis, mechanical axis deviation (MAD), mechanical lateral proximal femoral angle, anatomical medial proximal femoral angle, mechanical lateral distal femoral angle, anatomical lateral distal femoral angle, knee joint line congruency angle, mechanical medial proximal tibial angle, mechanical lateral distal tibial angle, ankle joint line orientation angle, tibial plafond talus angle, extremity length, and pelvic obliquity were measured on both the operative and nonoperative sides. Read More

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http://dx.doi.org/10.1016/j.arth.2017.05.044DOI Listing
November 2017
11 Reads

Circular external fixation and cemented PMMA spacers for the treatment of complex tibial fractures and infected nonunions with segmental bone loss.

J Orthop Surg (Hong Kong) 2017 May-Aug;25(2):2309499017716242

2 Walk-a-Mile Centre for Advanced Orthopaedics, Netcare Unitas Hospital, Mediclinic Midstream Hospital, Pretoria, South Africa.

Purpose: The purpose of this study was to compare the outcome of combined circular external fixation and cemented polymethylmethacrylate (PMMA) spacer application between a cohort of patients with grade 3 open fractures and infected tibial nonunions and concomitant segmental bone loss.

Methods: The study was designed as a retrospective cohort study. All patients who were treated for complex tibial fractures or infected nonunions with segmental bone loss between 2009 and 2013 were included if they were aged between 16 years and 60 years, sustained acute traumatic grade 3 open tibial fractures, presented with infected nonunion, and were followed up for a minimum of 12 months. Read More

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http://dx.doi.org/10.1177/2309499017716242DOI Listing
February 2018
8 Reads