846 results match your criteria Lower Extremity Reconstruction Tibia


Microsurgical Reconstruction of the Lower Extremity.

Semin Plast Surg 2019 Feb 8;33(1):54-58. Epub 2019 Mar 8.

Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas.

Reconstruction of bony and soft tissue defects of the lower extremity has been revolutionized by the advent of microsurgical tissue transfer. There are numerous options for reconstruction. Possibilities include transfer of soft tissue, composite (bone and soft tissue) tissue, and functional muscle. Read More

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http://dx.doi.org/10.1055/s-0039-1677878DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6408237PMC
February 2019
2 Reads

Functional outcomes of traumatic lower extremity reconstruction.

J Clin Orthop Trauma 2019 Jan-Feb;10(1):178-181. Epub 2017 Aug 24.

Department of Plastic Surgery, Los Angeles County + University of Southern California Medical Center, 1983 Marengo St, Los Angeles, CA 90033, United States.

Background: Lower extremity trauma accounts for over 300,000 injuries annually. While soft tissue transfer is a well-accepted practice for open fracture coverage, functional outcomes remain unclear.

Hypothesis: This study investigates functional outcomes following soft tissue reconstruction for open tibial fractures. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S09765662173040
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http://dx.doi.org/10.1016/j.jcot.2017.08.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6349574PMC
August 2017
5 Reads

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
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370161PMC
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
4 Reads

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

Arthroscopy 2019 Feb 22;35(2):511-520. 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
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6361700PMC
February 2019
12 Reads

Modeling and classification of gait patterns between anterior cruciate ligament deficient and intact knees based on phase space reconstruction, Euclidean distance and neural networks.

Biomed Eng Online 2018 Nov 1;17(1):165. Epub 2018 Nov 1.

Department of Orthopedics, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.

Background: The anterior cruciate ligament (ACL) plays an important role in stabilizing translation and rotation of the tibia relative to the femur. ACL injury alters knee kinematics and usually links to the alternation of gait patterns. The aim of this study is to develop a new method to distinguish between gait patterns of patients with anterior cruciate ligament deficient (ACL-D) knees and healthy controls with ACL-intact (ACL-I) knees based on nonlinear features and neural networks. Read More

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https://biomedical-engineering-online.biomedcentral.com/arti
Publisher Site
http://dx.doi.org/10.1186/s12938-018-0594-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6211421PMC
November 2018
19 Reads

[Measurement of the tibial alignment after total knee replacement without the extramedullary cutting guide].

Beijing Da Xue Xue Bao Yi Xue Ban 2018 Oct;50(5):850-854

Department of Orthopaedics, Peking University First Hospital, Beijing 100034, China.

Objective: To evaluate the accuracy and analysis of the influencing factors of the tibia prosthetic coronal alignment after total knee arthroplasty without tibia extramedullary cutting guide.

Methods: In the study, 76 patients (96 knees) who had primary total knee arthroplasty in Peking University First Hospital from February 2012 to April 2016 were selected retrospectively. All of the cases were performed by the same experienced orthopedic surgeon team. Read More

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October 2018
8 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 12;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
2 Reads

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
2 Reads

An Open-label Single-arm Trial of a Novel Extramedullary Guide Coordinated with 3D Surgical Assistive Software for Total Knee Arthroplasty.

Acta Med Okayama 2018 Aug;72(4):441-445

Department of Orthopedic Surgery and Rheumatology, Nagoya Medical Center, Nagoya 460-0001,

There is no assistive device for extramedullary surgery coordinated with 3D surgical assistive software for the total knee arthroplasty (TKA). We developed a novel extramedullary universal guide coordinated with 3D surgical assistive software and a novel extramedullary patient-specific assistive guide for the placement of femoral components by referring to an area not affected by cartilage or bone spurs, and filed a patent application. In this study, we visualize and reconstruct the total alignment of the lower extremity in TKA using these surgical devices, and validate their precision. Read More

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http://ousar.lib.okayama-u.ac.jp/56186
Publisher Site
http://dx.doi.org/10.18926/AMO/56186DOI Listing
August 2018
8 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
16 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
4 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
21 Reads

Comparison of Pediatric Intercalary Allograft Reconstructions with and without a Free Vascularized Fibula.

Plast Reconstr Surg 2018 10;142(4):1065-1071

Rochester, Minn. From the Department of Orthopedic Surgery and the Division of Plastic and Reconstructive Surgery, Mayo Clinic.

Background: Lower extremity intercalary allograft reconstruction has traditionally been used to facilitate limb salvage. Combining the allograft with a free vascularized fibula graft has been described; however, there is a paucity of data comparing the outcome of these reconstructions.

Methods: Twenty-nine pediatric patients (15 boys and 14 girls) underwent lower extremity limb salvage with the use of intercalary cadaveric allograft at a mean age of 12 years. Read More

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http://dx.doi.org/10.1097/PRS.0000000000004794DOI Listing
October 2018
10 Reads

Laxity Profiles in the Native and Replaced Knee-Application to Robotic-Assisted Gap-Balancing Total Knee Arthroplasty.

J Arthroplasty 2018 09 14;33(9):3043-3048. Epub 2018 May 14.

Department of Clinical Research, OMNIlife Science, Raynham, MA.

Background: The traditional goal of the gap-balancing method in total knee arthroplasty is to create equal and symmetric knee laxity throughout the arc of flexion. The purpose of this study was to (1) quantify the laxity in the native and the replaced knee throughout the range of flexion in gap-balancing total knee arthroplasty (TKA) and (2) quantify the precision in achieving a targeted gap profile throughout flexion using a robotic-assisted technique with active ligament tensioning.

Methods: Robotic-assisted, gap-balancing TKA was performed in 14 cadaver specimens. Read More

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http://dx.doi.org/10.1016/j.arth.2018.05.012DOI Listing
September 2018
1 Read

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
2 Reads

Posterior Reference Position Affects Intraoperative Kinematic and Soft Tissue Balance in Navigated Posterior-Stabilized Total Knee Arthroplasty.

J Arthroplasty 2018 09 4;33(9):2851-2857. Epub 2018 May 4.

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

Background: The importance of medial compartment stability is recognized in total knee arthroplasty (TKA). To manage the medial extension-flexion gap, the posterior reference position can be changed from conventional posterior center to posterior medial in measured resection techniques. This study aimed to compare the intraoperative soft tissue balance and rotational kinematics between the posterior medial and posterior center reference groups. Read More

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http://dx.doi.org/10.1016/j.arth.2018.04.038DOI Listing
September 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
13 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

Computed Tomography Techniques Help Understand Wear Patterns in Retrieved Total Knee Arthroplasty.

J Arthroplasty 2018 09 16;33(9):3030-3037. Epub 2018 Apr 16.

Institute of Orthopaedics and Musculoskeletal Science, University College London, Royal National Orthopaedic Hospital, Stanmore, UK.

Background: Suboptimal total knee arthroplasty (TKA) position of both femoral and tibial components is thought to be linked with poor clinical outcomes, polyethylene wear and the "unexplained" painful knee arthroplasty. The aim of this study was to better understand the effect of implant orientation on knee implant performance.

Methods: We analyzed 30 retrieved contemporary TKA implants. Read More

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http://dx.doi.org/10.1016/j.arth.2018.04.010DOI Listing
September 2018
11 Reads
2.670 Impact Factor

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

Microsurgery 2019 Feb 7;39(2):182-187. 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
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http://dx.doi.org/10.1002/micr.30335DOI Listing
February 2019
10 Reads

Using a Tibial Short Extension Stem Reduces Tibial Component Loosening After Primary Total Knee Arthroplasty in Severely Varus Knees: Long-term Survival Analysis With Propensity Score Matching.

J Arthroplasty 2018 08 30;33(8):2512-2517. Epub 2018 Mar 30.

Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Background: Patients with severe preoperative varus deformity have been reported to have high rates of loosening after total knee arthroplasty (TKA), primarily on the tibial side. This study investigated whether a short extension stem for the tibial component in severely varus knees would reduce the failure rate due to loosening on the tibial side.

Methods: Patients who underwent TKA, performed by a single surgeon using a single implant between November 1998 and January 2009, were retrospectively evaluated. Read More

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http://dx.doi.org/10.1016/j.arth.2018.03.058DOI Listing
August 2018
1 Read

Anthropometric Measurements of Knee Joints in the Hispanic Population.

J Arthroplasty 2018 08 27;33(8):2640-2646. Epub 2018 Mar 27.

Levitetz Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, FL.

Background: Total knee arthroplasty (TKA) systems provide a set of incrementally sized tibial and femoral components intended to accommodate most knee parameters. However, the most commonly used systems in the United States were developed using data from Caucasian patients which might not lead to the best fit in non-Caucasians. Therefore, we wanted to evaluate whether these TKA systems proportionally match femoral and tibial measurements in Hispanics. Read More

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http://dx.doi.org/10.1016/j.arth.2018.03.052DOI Listing
August 2018
4 Reads

Variability in Elongation and Failure of the Medial Collateral Ligament After Pie-Crusting With 16- and 18-Gauge Needles.

J Arthroplasty 2018 08 17;33(8):2636-2639. Epub 2018 Mar 17.

Department of Orthopedics, Hospital for Special Surgery, New York, New York.

Background: In knee arthroplasty with preoperative varus deformity, medial collateral ligament (MCL) release may be needed to achieve balance. Pie-crusting allows for controlled release, but questions remain regarding its ability to obtain predictable results. We compared 16- vs18-gauge needle punctures and determined the number of punctures required to (1) lengthen the MCL by 1 mm and (2) cause ligament failure. Read More

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http://dx.doi.org/10.1016/j.arth.2018.03.021DOI Listing
August 2018
6 Reads

Anatomical Features of the Descending Genicular Artery to Facilitate Surgical Exposure for the Subvastus Approach-A Cadaveric Study.

J Arthroplasty 2018 08 27;33(8):2647-2651. Epub 2018 Mar 27.

Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba City, Chiba, Japan.

Background: The purpose of this cadaveric study was to clarify the proximal limit for the subvastus approach (SVA) in total knee arthroplasty to decrease potential vascular injury.

Methods: Seventy embalmed knees underwent a modified SVA using a 14-cm oblique medial incision. Anatomical features of the descending genicular artery (DGA) were investigated with regard to variation, distance of the vessels from surgical landmarks, and sex differences. Read More

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http://dx.doi.org/10.1016/j.arth.2018.03.046DOI Listing
August 2018
6 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
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http://dx.doi.org/10.1055/s-0037-1621746DOI Listing
June 2018
8 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
7 Reads

Periarticular Soft Tissue Envelope Size and Postoperative Wound Complications Following Total Knee Arthroplasty.

J Arthroplasty 2018 07 17;33(7S):S249-S252. Epub 2018 Feb 17.

Department of Orthopaedic Surgery, New York University Langone Medical Center, Hospital for Joint Diseases, New York, NY.

Background: Periprosthetic joint infection following total knee arthroplasty (TKA) is a serious complication often related to obesity which leads to poor patient outcomes and increased resource utilization. A periarticular soft tissue index (PASTI) may help predict postoperative wound complications than BMI alone.

Methods: Three hundred seventy-six TKA patients with a preoperative, lateral knee X-ray radiograph and 1 year of follow up were analyzed. Read More

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http://dx.doi.org/10.1016/j.arth.2018.02.046DOI Listing
July 2018
44 Reads

Implant and limb survival after resection of primary bone tumors of the lower extremities and reconstruction with mega-prostheses fifty patients followed for a mean of forteen years.

Int Orthop 2018 05 12;42(5):1175-1181. Epub 2018 Mar 12.

The Musculoskeletal Tumor Section, The Department of Orthopedic Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

Purpose: Previous studies reported variable outcome and failure rates after mega-prosthetic reconstructions in the lower extremities. The purpose of this study was to make a long-term single-center evaluation of patients treated with limb-sparing surgery and reconstruction with mega-prostheses in the lower extremities.

Methods: We identified 50 patients (osteosarcoma (n = 30), chondrosarcoma (n = 9), osteoclastoma (n = 6), Ewing sarcoma (n = 4), angiosarcoma (n = 1)), who underwent limb-sparing reconstruction of the lower extremities (proximal femur (n = 9), distal femur (n = 29), proximal tibia (n = 9), and the entire femur (n = 3)) between 1985 and 2005. Read More

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http://dx.doi.org/10.1007/s00264-018-3861-7DOI Listing
May 2018
1 Read

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
9 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
3 Reads

Native rotational knee kinematics are lost in bicruciate-retaining total knee arthroplasty when the tibial component is replaced.

Knee Surg Sports Traumatol Arthrosc 2018 Nov 24;26(11):3249-3256. Epub 2018 Jan 24.

Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15, Kuramoto, Tokushima, 770-8503, Japan.

Purpose: To compare the kinematics between native knees and knees that have undergone bicruciate-retaining (BCR) total knee arthroplasty (TKA) with cruciate-retaining (CR) TKA converted from BCR TKA in the same whole-body cadaveric specimen using a navigation system and, if differences exist, to investigate the point at which normal kinematics are lost during the procedure.

Methods: The rotational kinematics throughout passive flexion of the native knee and of knees after meniscectomy, femoral replacement, BCR TKA, or CR TKA were assessed in nine fresh frozen cadavers using an image-free navigation system.

Results: The rotational kinematic pattern of a knee after BCR TKA was different from that of a native knee, especially in the early flexion phase, and was similar to that after CR TKA. Read More

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http://link.springer.com/10.1007/s00167-018-4842-5
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http://dx.doi.org/10.1007/s00167-018-4842-5DOI Listing
November 2018
6 Reads

Following the correction of varus deformity of the knee through total knee arthroplasty, significant compensatory changes occur not only at the ankle and subtalar joint, but also at the foot.

Knee Surg Sports Traumatol Arthrosc 2018 Nov 18;26(11):3230-3237. Epub 2018 Jan 18.

Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, 23 Kyunghee-daero, Dongdaemun-gu, Seoul, 02447, South Korea.

Purpose: This study aimed to assess radiological changes of the ankle joint, subtalar joint and foot following the correction of varus deformity of the knee with total knee arthroplasty (TKA). It was hypothesized that following the correction of varus deformity by TKA, compensatory reactions would occur at the subtalar joint in accordance with the extent of the correction.

Methods: For this prospective study, 375 knees of patients who underwent TKA between 2011 and 2012 were enrolled. Read More

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http://dx.doi.org/10.1007/s00167-018-4840-7DOI Listing
November 2018

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
9 Reads

Does Patients' Perception of Leg Length After Total Hip Arthroplasty Correlate With Anatomical Leg Length?

J Arthroplasty 2018 05 13;33(5):1562-1566. Epub 2017 Dec 13.

Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI.

Background: This study assessed the correlation among the patients' perception of the leg length discrepancy (LLD) after total hip arthroplasty (THA) and the anatomical and functional leg length, pelvic and knee alignments, and foot height.

Methods: Patients without significant spinal pathology or previous spine or lower extremity surgery who underwent primary THA (101 patients) were evaluated using EOS images obtained in standing position. All 3-dimensional measures were evaluated and compared for the repeatability and reproducibility and correlation with patients' perception of leg length. Read More

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http://dx.doi.org/10.1016/j.arth.2017.12.004DOI Listing
May 2018
6 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
5 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
8 Reads

Uncemented vs Cemented Cruciate Retaining Total Knee Arthroplasty in Patients With Body Mass Index Greater Than 30.

J Arthroplasty 2018 04 1;33(4):1082-1088. Epub 2017 Dec 1.

Department of Orthopaedics, University at Buffalo, Buffalo General Medical Center, Buffalo, New York.

Background: Aseptic loosening of cemented and uncemented tibial components continues to be a source of implant failure after total knee arthroplasty (TKA) in the obese population. There is limited literature reviewing uncemented cruciate retaining (CR) components in the obese population.

Methods: A clinical and radiographic review was performed on 325 patients who underwent a cemented or uncemented TKA with a CR knee prosthesis and body mass index ≥30 kg/m between January 2010 and June 2013. Read More

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http://dx.doi.org/10.1016/j.arth.2017.11.043DOI Listing
April 2018
9 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
11 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
7 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
4 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