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Fibular Hemimelia
Published in Benjamin Joseph, Selvadurai Nayagam, Randall T Loder, Anjali Benjamin Daniel, Essential Paediatric Orthopaedic Decision Making, 2022
Caroline M Blakey, James A Fernandes
Options for stabilising joints Knee Anterior cruciate ligament reconstructionAnkle Reconstruction of a “lateral malleolus”Ankle fusion
Sports injuries in the elderly
Published in Charles M Court-Brown, Margaret M McQueen, Marc F Swiontkowski, David Ring, Susan M Friedman, Andrew D Duckworth, Musculoskeletal Trauma in the Elderly, 2016
Marc Tompkins, Robby Sikka, David Fischer
In general, anterior cruciate ligament reconstruction (ACL-R) has been shown to produce good results in an older population (Table 45.2). Studies looking only at older patients report good outcomes scores, return of function and improved stability.32–37 Blyth et al. demonstrated an improvement in International Knee Documentation Committee (IKDC), Lysholm, Cincinnati and Tegner scores, as well as on examination, in a group of 30 patients over the age of 50 at mean follow-up of 46 months.35 In studies directly comparing younger and older patients, there are similar findings between the groups. Osti et al. compared 20 patients over the age of 50 and 20 patients under the age of 30 and found similar improvement on physical examination and in IKDC and Lysholm scores with no difference between groups for final scores.38 In our own patient population, we evaluated 19 consecutive patients over the age of 50. The majority (90%) returned to the same level of sports participation, but more slowly than younger patients with a mean of 11 months for the older patients to return; there were no failures.39
The Kidney (KI)
Published in Narda G. Robinson, Interactive Medical Acupuncture Anatomy, 2016
Clinical Relevance: Pseudoaneurysms sometimes develop after orthopedic surgery. In the case of anterior cruciate ligament reconstruction, arteries affected include the medial inferior genicular artery and popliteal artery.11 When acute, these vascular lesions can cause sudden bleeding into the joint cavity. Acute and voluminous hemarthrosis usually presents with a pulsatile mass within the first few weeks after surgery, although a pseudoaneurysm may develop after ten weeks. Their growth may compress nerves and nearby veins, potentially leading to deep vein thrombosis and occasionally amputation. A pseudoaneurysm differs from a true aneurysm by not involving all layers of an artery. Instead, a collection of blood forms between the two outer layers of an artery, the tunica media and the tunica adventitia. Pseudoaneurysms occur more frequently following total knee arthroplasty, but also after several other types of orthopedic interventions, including arthroscopic meniscectomy and the aforementioned anterior cruciate ligament reconstruction.
Sensitivity analysis of the knee ligament forces to the surgical design variation during anterior cruciate ligament reconstruction: a finite element analysis
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Malek Adouni, Tanvir R. Faisal, Yasin Y. Dhaher
Approximately 250,000 anterior cruciate ligament ruptures occur annually with a cost of treatment exceeding $2 billion, among which mostly incurred for surgical reconstruction (Prodromos 2007; Gianotti et al. 2009; Bates and Hewett 2016; Wiggins et al. 2016). The primary goals of anterior cruciate ligament reconstruction (ACL-R) are to restore the knee’s stability and reinstate healthy functional activity (Nakamura et al. 2017). However, some studies have demonstrated that the successful recovery of standard joint movement patterns during dynamic or static activities is hardly achieved (Bush-Joseph et al. 2001; Lewek et al. 2002; Papannagari et al. 2006; Stergiou et al. 2007; Tashman et al. 2007; Webster and Feller 2011; Zabala et al. 2013; Signorelli et al. 2016; Zaffagnini et al. 2016). The failure to restore normal movement would influence both the joint active-passive response as a whole and the mechanical role of the remaining intact components, such as collateral and cruciate ligaments, with a high likelihood of increasing the rate of postsurgical revision or failure (Klimkiewicz et al. 2000; Strobel et al. 2001; Liow et al. 2003; Fujimoto et al. 2004; Mesfar and Shirazi-Adl 2006; Shimokochi and Shultz 2008; Gianotti et al. 2009; Hart et al. 2009; Iriuchishima et al. 2010; Norris et al. 2012; Richter et al. 2018; Svantesson et al. 2019).
Acute postoperative pain management with percutaneous peripheral nerve stimulation: the SPRINT neuromodulation system
Published in Expert Review of Medical Devices, 2021
Rodney A. Gabriel, Brian M. Ilfeld
Anterior Cruciate Ligament Reconstruction. The use of ultrasound-guided percutaneous PNS has also been described in a small feasibility study for patients undergoing anterior cruciate ligament reconstruction[13]. Like the previous feasibility trials described, patients were randomized to receive either sham or active stimulation for 5 minutes, then crossover the next 5 minutes, followed by 30 minutes of active stimulation. Ten patients were recruited and received PNS to the femoral nerve, which was placed days before surgery. During the initial 5-minute treatment period, those who received active stimulation had a 7% decrease in pain over that time period, while those in the sham group experienced a 4% increase in pain (potentially because of the unblocked sciatic nerve contributing to the apparent inadequate analgesia). Those who initially received sham had an 11% decrease in pain during the crossover treatment. Postoperatively, 80% of patients required additional continuous adductor canal nerve block for rescue analgesia during the first 2 days after surgery. After that, both pain scores and opioid use were minimal.
French translation and validation of the “Anterior Knee Pain Scale” (AKPS)
Published in Disability and Rehabilitation, 2019
F. Buckinx, S. Bornheim, G. Remy, J. Van Beveren, Jy. Reginster, O. Bruyère, N. Dardenne, J. F. Kaux
Patellofemoral pain (PFP) is an overuse condition that is not generally linked to injuries or any known intra‐articular damage to the knee [1]. PFP is defined as pain behind or around the patella, which is aggravated by at least one activity that loads the patellofemoral joint during weight bearing on a flexed knee (e.g., Squatting, stair ambulation, jogging/running, hopping/jumping) [2,3]. The risk factors associated with PFP are multifactorial. These include abnormal patellofemoral joint alignment and trochlear morphology, quadriceps muscle weakness, abnormal biomechanics during gait [2]. An anterior cruciate ligament reconstruction increases the risk of PFP [2,4]. This disorder can have a big effect on patients’ quality of life. Other associated symptoms include crepitus and functional deficit. PFP symptoms cause many athletes to limit their sportive activities [5] and affect participation in activities of daily living [6]. According to some authors, PFP will eventually lead to osteoarthritis [4,7]. PFP is one of the most common knee problems experienced by active adults and adolescents [8]. This syndrome, constitutes 5% of all injuries and 25% of all knee-related injuries [1,9]. It occurs more frequently in women than in men [3]. It is also more common among obese people and athletes [10,11].