1,133 results match your criteria Lower Extremity Reconstruction Tibia

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

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

Twin City Orthopedics.

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

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

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

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

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

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

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October 2021

Role of Perforating Artery Pedicled Neurotrophic Flap in the Treatment of Compound Tissue Defect of Tibia Using the Ilizarov Technique.

Orthop Surg 2022 May 18. Epub 2022 May 18.

Orthopaedic Department, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.

Objective: To describe our experience with the combined use of pedicled neurotrophic flap and distraction osteogenesis in the management of complex lower extremity injuries with composite bone and soft tissue defects and assess the functional and cosmetic results of this method.

Methods: A pedicled flap with a marked perforator artery was applied for soft tissue coverage after radical debridement and temporary external fixation. In the second stage, the Ilizarov external fixator was used in place of the temporary external fixator for reconstruction of the segmental bone defect by distraction osteogenesis. Read More

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

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

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

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

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

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Modified donor blood flow-preserved cross-leg anterolateral thigh flap procedure for complex lower extremity reconstruction.

J Orthop Surg Res 2022 May 12;17(1):262. Epub 2022 May 12.

Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, Hefei, 230022, Anhui, China.

Background: Complex lower limb reconstruction due to severe trauma remains a challenge for reconstructive surgeons. Here, we introduce a modified donor blood flow-preserved cross-leg anterolateral thigh flap procedure and evaluate its clinical efficacy.

Methods: Between January 2013 and December 2019, 22 patients (range 10 to 64 years old) with unilateral lower limb injury underwent modified donor blood flow-preserved cross-leg anterolateral thigh flap procedures. Read More

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

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

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

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

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

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Twenty Years Development of Tibial Cortex Transverse Transport Surgery in PR China.

Orthop Surg 2022 Jun 7;14(6):1034-1048. Epub 2022 May 7.

The Second Clinical Medical College of Zhejiang Chinese Medical University, Zhejiang, China.

Tibial cortex transverse transport (TTT) surgery is an extension of the Ilizarov technique. Based on the law of tension-stress, its primary function is to rebuild microcirculation which can relieve ischemic symptoms and promote wound healing. It has received more and more scholars' attention and has experienced a series of changes for 20 years since it entered PR China. Read More

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Timing of antibiotic administration, wound debridement, and the stages of reconstructive surgery for open long bone fractures of the upper and lower limbs.

Cochrane Database Syst Rev 2022 04 1;4:CD013555. Epub 2022 Apr 1.

Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.

Background: Open fractures of the major long bones are complex limb-threatening injuries that are predisposed to deep infection. Treatment includes antibiotics and surgery to debride the wound, stabilise the fracture and reconstruct any soft tissue defect to enable infection-free bone repair. There is a need to assess the effect of timing and duration of antibiotic administration and timing and staging of surgical interventions to optimise outcomes. Read More

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Post-Operative Results of ACL Reconstruction Techniques on Single-Leg Hop Tests in Athletes: Hamstring Autograft vs. Hamstring Grafts Fixed Using Adjustable Cortical Suspension in Both the Femur and Tibia.

Medicina (Kaunas) 2022 Mar 16;58(3). Epub 2022 Mar 16.

Memorial Sisli Hospital, Orthopaedics and Traumatology, Istanbul 34384, Turkey.

: Anterior cruciate ligament (ACL) tears are common injuries in the athletic population, and accordingly, ACL reconstruction (ACLR) is among the most common orthopedic surgical procedures performed in sports medicine. This study aims to compare the semitendinosus/gracilis (ST/G) and ACL hamstring grafts fixed using adjustable cortical suspension in both the femur and tibia (MAI) ACLR techniques. We aimed to compare the results of single-leg hop tests (SLHT) applied in different directions and limb symmetry indices (LSI) in athletes with a 6-month post-operative ACLR history. Read More

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[Evolution of Epiphysiodesis Surgery].

Andes Pediatr 2021 Oct;92(5):733-738

Escuela de Medicina, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile.

Introduction: Surgical modulation of physeal growth, currently better known as "Guided Growth", is a procedure used as a treatment for length differences or axis alterations of the extremities. Although its use is increasing due to the development of new less invasive techniques, there are no statistical analyzes in the literature that support this.

Objective: To evaluate the incidence of the surgery codified as "Epi- physiodesis (Femur and/or Tibia)" in the Chilean population, from January 1st, 2010 to December 31, 2019, the days of hospital stay associated with that code and the demographic data of the analyzed po pulation. Read More

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October 2021

Novel approach to estimate distraction forces in distraction osteogenesis and application in the human lower leg.

J Mech Behav Biomed Mater 2022 04 18;128:105133. Epub 2022 Feb 18.

3D-Surgery, Department of General, Trauma and Reconstructive Surgery, University Hospital LMU Munich, Munich, Germany.

Purpose: In distraction osteogenesis (DO) of long bones, new bone tissue is distracted to lengthen limbs or reconstruct bone defects. However, mechanical boundary conditions in human application such as arising forces are mainly based on limited empirical data. Our aim was the numerical determination of the callus distraction force (CDF) and the total distraction force (TDF) during DO in the tibia of adults to advance the understanding of callus tissue behavior and optimize DO procedures. Read More

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Patient-Specific Instrumentation vs Standard Referencing in Total Ankle Arthroplasty: A Comparison of the Radiologic Outcome.

Foot Ankle Int 2022 Jun 24;43(6):741-749. Epub 2022 Feb 24.

University of Basel, Basel, Switzerland.

Background: Existing literature on the superiority of patient-specific instrumentation (PSI) in total ankle arthroplasty (TAA) over standard referencing (SR) is limited. Advantages presented include better implant alignment, shorter operating times, and increased accuracy of implant size prediction. The aim of this retrospective study was to analyze PSI in the hands of an experienced foot and ankle surgeon new to both PSI and SR for this specific implant, in regard to determining implant alignment, operative times, and radiologic short-term outcome and predicting implant size for tibial and talar components. Read More

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Effects of lower limb rotation on the measurement accuracy of coronal alignment in long-leg radiographs after total knee arthroplasty.

Chin Med J (Engl) 2022 Jan 31;135(5):619-621. Epub 2022 Jan 31.

Department of Orthopedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830054, China.

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January 2022

SPECT/CT Assessment of In-Vivo Loading of the Knee Correlates with Polyethylene Deformation in Retrieved Total Knee Arthroplasty.

Tomography 2022 01 7;8(1):180-188. Epub 2022 Jan 7.

The Royal National Orthopaedic Hospital, Stanmore HA7 4LP, UK.

Background: SPECT/CT distribution patterns in patients with total knee replacements have previously been correlated with factors such as time of implantation, implant type and alignment. It is unknown, however, if an increased and more extended bone tracer uptake (BTU) in SPECT/CT, representing loading of the joint, correlates with findings from retrieval studies. The aim of this study was to further understand this subject. Read More

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January 2022

Small Random Angular Variations in Pelvic Tilt and Lower Extremity Can Cause Error in Static Image-based Preoperative Hip Arthroplasty Planning: A Computer Modeling Study.

Clin Orthop Relat Res 2022 04;480(4):818-828

Department of Orthopaedic Surgery, New York University, New York, NY, USA.

Background: Many THA simulation models rely on a limited set of preoperative static radiographs to replicate sagittal pelvic tilt during functional positions and to recommend an implant orientation that minimizes the risk of prosthetic impingement. However, possible random changes in pelvic or lower extremity angular motions and the effect of coronal and axial pelvic tilt are not included in these preoperative models.

Questions/purposes: (1) Can prosthetic impingement occur if the pelvic tilt or lower extremity alignment randomly varies up to ± 5° from what is measured on a single preoperative static radiographic image? (2) Do changes in coronal and axial pelvic tilt or lower extremity alignment angles have a similar effect on the risk of prosthetic impingement?

Methods: A de-identified pelvis and lower-body CT image of a male patient without previous THA or lower extremity surgery was used to import the pelvis, femur, and tibia into a verified MATLAB computer model. Read More

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Quadriceps muscle strength at 2 years following anterior cruciate ligament reconstruction is associated with tibiofemoral joint cartilage volume.

Knee Surg Sports Traumatol Arthrosc 2022 Jun 7;30(6):1949-1957. Epub 2022 Jan 7.

Department of Medicine Dentistry and Health Sciences, Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, VIC, Australia.

Purpose: Quadriceps strength deficits following anterior cruciate ligament reconstruction (ACLR) are linked to altered lower extremity biomechanics, tibiofemoral joint (TFJ) space narrowing and cartilage composition changes. It is unknown, however, if quadriceps strength is associated with cartilage volume in the early years following ACLR prior to the onset of posttraumatic osteoarthritis (OA) development. The purpose of this cross-sectional study was to examine the relationship between quadriceps muscle strength (peak and across the functional range of knee flexion) and cartilage volume at ~ 2 years following ACLR and determine the influence of concomitant meniscal pathology. Read More

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Comparison of Prophylactic Intravenous Antibiotic Regimens After Endoprosthetic Reconstruction for Lower Extremity Bone Tumors: A Randomized Clinical Trial.

JAMA Oncol 2022 Mar;8(3):345-353

Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.

Importance: The use of perioperative, prophylactic, intravenous antibiotics is standard practice to reduce the risk of surgical site infection after oncologic resection and complex endoprosthetic reconstruction for lower extremity bone tumors. However, evidence guiding the duration of prophylactic treatment remains limited.

Objective: To assess the effect of a 5-day regimen of postoperative, prophylactic, intravenous antibiotics compared with a 1-day regimen on the rate of surgical site infections within 1 year after surgery. Read More

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The Proximal Tibia Loses Bone Mineral Density After Anterior Cruciate Ligament Injury: Measurement Technique and Validation of a Quantitative Computed Tomography Method.

Arthrosc Sports Med Rehabil 2021 Dec 2;3(6):e1921-e1930. Epub 2021 Nov 2.

Department of Orthopedic Surgery.

Purpose: To develop a standardized method for tibial tunnel volumetric bone mineral density (BMD) analysis with quantitative computed tomography (qCT) using cadaveric specimens to provide validation of this technique on a healthy control population and to determine whether osteopenia occurs following an anterior cruciate ligament (ACL) injury.Methods: qCT was used to develop a volumetric BMD (mg/cm) measurement technique throughout the region of a standard tibial tunnel. This method was applied to 90 lower extremities, including 10 matched cadaveric knees, 10 matched healthy knees, 25 ACL-injured knees, and 25 contralateral ACL-uninjured knees. Read More

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December 2021

Assessment of Femoral Version Should be Assessed Independently of Conventional Measures in Patellofemoral Instability.

Iowa Orthop J 2021 12;41(2):77-81

Department of Orthopedics and Rehabilitation, University of Iowa Hospitals & Clinics, Iowa City, IA, USA.

Background: The purpose of the present study is to determine the association between femoral version and traditional pathologic bony factors commonly used to measure and define patellofemoral alignment.

Methods: We performed a retrospective review of patients treated for patellofemoral instability (PFI) at a single institution. Patients included underwent magnetic resonance imaging (MRI) of the lower extremity using a rotational protocol prior to medial patellofemoral ligament reconstruction with or without tibial tubercle osteotomy. Read More

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December 2021

Graft position at the femoral condyle affects knee mobility after posterior cruciate ligament replacement.

Knee 2022 Jan 7;34:118-123. Epub 2021 Dec 7.

Department of Trauma Surgery, BG Unfallklinik Murnau, Prof. Kuentscher Str. 8, 82418 Murnau, Germany.

Background: In some cases posterior cruciate ligament (PCL) tears require surgical reconstruction. As the femoral footprint of the ligament is quite large, an ideal graft fixation position on the medial notch wall has not yet been identified. The aim of this study was to compare three different graft fixation positions within the anatomical footprint of the PCL and test it for posterior tibial translation at different knee flexion angles. Read More

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January 2022

Is the femoral component flexion affected by the sagittal femoral shaft bowing in conventional intramedullary guided TKA?

J Orthop Surg Res 2021 Dec 4;16(1):701. Epub 2021 Dec 4.

Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China.

Background: The aim of the present study was to investigate the influence of sagittal femoral bowing on sagittal femoral component alignment, and whether there was correlation between sagittal femoral component alignment and coronal femoral component alignment.

Methods: We retrospectively reviewed 77 knees in 71 patients who had undergone primary TKA for advanced osteoarthritis. All surgeries were performed by using a standard medial parapatellar approach. Read More

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December 2021

Three-dimensional morphometric differences of resected distal femurs and proximal tibias in osteoarthritic and normal knees.

BMC Musculoskelet Disord 2021 Dec 4;22(1):1013. Epub 2021 Dec 4.

Department of Orthopaedics, Shaanxi Provincial People's Hospital (third affiliated hospital of Xi'an jiaotong University), No. 256, Youyi West Road, Xi'an, China.

Background: There is a paucity of data concerning the morphological differences of resected distal femurs and proximal tibias in osteoarthritic (OA) and normal knees. The objective of this study was to determine whether morphometric differences in the surfaces of resected distal femurs and proximal tibias exist between OA and normal knees in a Chinese population.

Methods: Ninety-four OA knees and ninety-five normal knees were evaluated in Chinese individuals. Read More

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December 2021

Limb Salvage after Lower-Leg Fracture and Popliteal Artery Transection-The Role of Vessel-First Strategy and Bone Fixation Using the Ilizarov External Fixator Device: A Case Report.

Medicina (Kaunas) 2021 Nov 9;57(11). Epub 2021 Nov 9.

Departamento de Ortopedia, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil.

Open traumatic lesion of the popliteal artery is relatively rare. Ischemia time longer than 6 h and severity of limb ischemia have been shown to be associated with an increased risk of limb loss. Severe local infection is critical in the presence of major soft tissue trauma or open fractures. Read More

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November 2021

Validation and accuracy evaluation of automatic segmentation for knee joint pre-planning.

Knee 2021 Dec 29;33:275-281. Epub 2021 Oct 29.

BEAMS Department, Université Libre de Bruxelles, Bruxelles, Belgium.

Background: Proper use of three-dimensional (3D) models generated from medical imaging data in clinical preoperative planning, training and consultation is based on the preliminary proved accuracy of the replication of the patient anatomy. Therefore, this study investigated the dimensional accuracy of 3D reconstructions of the knee joint generated from computed tomography scans via automatic segmentation by comparing them with 3D models generated through manual segmentation.

Methods: Three unpaired, fresh-frozen right legs were investigated. Read More

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December 2021

A statistical shape model of the tibia-fibula complex: sexual dimorphism and effects of age on reconstruction accuracy from anatomical landmarks.

Comput Methods Biomech Biomed Engin 2022 Jun 3;25(8):875-886. Epub 2021 Nov 3.

Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.

A statistical shape model was created for a young adult population and used to predict tibia and fibula geometries from bony landmarks. Reconstruction errors with respect to CT data were quantified and compared to isometric scaling. Shape differences existed between sexes. Read More

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Early definitive internal fixation for infected nonunion of the lower limb.

J Orthop Surg Res 2021 Oct 20;16(1):632. Epub 2021 Oct 20.

Department of Orthopedic Surgery, Korea University Guro Hospital, College of Medicine, Korea University, 148, Gurodong-ro, Guro-gu, 08308, Seoul, Republic of Korea.

Background: The management of an infected nonunion of long bones is difficult and challenging. A staged procedure comprising radical debridement followed by definitive internal fixation was favored. However, no standard treatment has been established to determine the appropriate waiting period between initial debridement and definitive internal fixation. Read More

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October 2021

Accuracy of different navigation systems for femoral and tibial implantation in total knee arthroplasty: a randomised comparative study.

Arch Orthop Trauma Surg 2021 Dec 15;141(12):2267-2276. Epub 2021 Oct 15.

Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa City, Ishikawa, 920-0934, Japan.

Purpose: It remains to be established whether optical computed tomography (CT)-free and acceleration-based navigation systems differ in terms of implantation accuracy and clinical outcomes for total knee arthroplasty. This randomised prospective study compared the implantation accuracy of these two navigation systems in total knee arthroplasty.

Methods: Optical CT-free navigation (ExactechGPS) or acceleration-based navigation (KneeAlign2) was randomly assigned to the left or right knee of 45 patients who underwent a single-stage bilateral total knee arthroplasty: the ExactechGPS (n = 45) and KneeAlign2 groups (n = 45) were compared. Read More

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December 2021

Postoperative femoral anteroposterior position while standing correlates with the posterior tibial slope and posterior femoral condylar offset in medial pivot total knee arthroplasty.

Biomed Mater Eng 2022 ;33(1):51-64

Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Science, Niigata, Niigata, Japan.

Background: After total knee arthroplasty (TKA), the femur tends to be located posteriorly under weight-bearing (WB) conditions, and a paradoxical femoral anterior motion occurs, leading to joint instability.

Objective: We aimed to clarify factors which affect the postoperative femoral anteroposterior position relative to the tibia under WB conditions (A-P position) in medial pivot (MP) TKA.

Methods: Among 126 knees (81 women) with primary TKA using MP prosthesis for varus osteoarthritic knees, 70 knees had cruciate-retaining inserts (CR) with the reduced conformity and 56 knees had cruciate-substituting inserts (CS) with the full conformity. Read More

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January 2022

Determining the Ratio of Wedge Height to Degree of Correction for Anterior Tibial Closing Wedge Osteotomies for Excessive Posterior Tibial Slope.

Am J Sports Med 2021 11 30;49(13):3519-3527. Epub 2021 Sep 30.

Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, USA.

Background: Anterior closing wedge osteotomy of the proximal tibia may be considered in revision anterior cruciate ligament (ACL) reconstruction surgery for patients with excessive posterior tibial slope (PTS).

Purpose: (1) To determine the ratio of wedge thickness to degrees of correction for supratubercle (ST) versus transtubercle (TT) osteotomies for anterior closing wedge osteotomies and (2) to evaluate the accuracy of ST and TT osteotomies in achieving slope correction.

Study Design: Controlled laboratory study. Read More

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November 2021

Short-Term Complications and Outcomes of the Cadence Total Ankle Arthroplasty.

Foot Ankle Int 2022 Mar 22;43(3):371-377. Epub 2021 Sep 22.

Rothman Orthopaedic Institute, Philadelphia, PA, USA.

Background: Total ankle arthroplasty (TAA) is an increasingly popular option for the operative treatment of ankle arthritis. The Cadence TAA entered clinical use in 2016 and was designed to address common failure modes of prior systems. We report early complications and radiographic and clinical outcomes of this total ankle system at a minimum of 2 years of follow-up. Read More

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