Pub Date : 2023-11-30DOI: 10.2174/0118743250261768231127111757
Peggy J. Ebner, Stuart H. Kuschner
Carpal tunnel syndrome and trigger finger are common hand problems. Each can be a cause of pain and disability. Treatment for each diagnosis can be nonoperative or, when nonoperative treatment has failed and when symptoms warrant, treatment can be surgical. Carpal tunnel syndrome and trigger finger can present independently of each other, or, in some cases, both can be present in the same hand. Data was collected using PearlDiver proprietary software (PearlDiver, Inc, Colorado Springs, CO). This is a national data set from the United States representing 157 million distinct patients over the period from January 2010 to October 2021. PearlDiver was queried for all patients who underwent carpal tunnel release (represented by CTP-64721 for open carpal tunnel releases and CTP-29848 for endoscopic releases) and trigger finger release (represented by CTP-26055) on the same day. Our search identified the number of carpal tunnel releases and the number of carpal tunnel releases + trigger finger release (same day). Carpal tunnel release + trigger finger release represent 8.4% of the total number of carpal tunnel release procedures. Patients who present with carpal tunnel syndrome may be advised that they are at increased risk of developing trigger fingers.
{"title":"Carpal Tunnel Syndrome and Trigger Finger. Sometimes Related","authors":"Peggy J. Ebner, Stuart H. Kuschner","doi":"10.2174/0118743250261768231127111757","DOIUrl":"https://doi.org/10.2174/0118743250261768231127111757","url":null,"abstract":"Carpal tunnel syndrome and trigger finger are common hand problems. Each can be a cause of pain and disability. Treatment for each diagnosis can be nonoperative or, when nonoperative treatment has failed and when symptoms warrant, treatment can be surgical. Carpal tunnel syndrome and trigger finger can present independently of each other, or, in some cases, both can be present in the same hand. Data was collected using PearlDiver proprietary software (PearlDiver, Inc, Colorado Springs, CO). This is a national data set from the United States representing 157 million distinct patients over the period from January 2010 to October 2021. PearlDiver was queried for all patients who underwent carpal tunnel release (represented by CTP-64721 for open carpal tunnel releases and CTP-29848 for endoscopic releases) and trigger finger release (represented by CTP-26055) on the same day. Our search identified the number of carpal tunnel releases and the number of carpal tunnel releases + trigger finger release (same day). Carpal tunnel release + trigger finger release represent 8.4% of the total number of carpal tunnel release procedures. Patients who present with carpal tunnel syndrome may be advised that they are at increased risk of developing trigger fingers.","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"35 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139206445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Damage to a discoid meniscus often indicates a complex tear, the treatment for which has not yet been resolved. This study aimed to assess the clinical efficacy of arthroscopic partial meniscectomy with suture repair for discoid lateral meniscus in patients under 40 years of age. Methods: A total number of 10 patients aged < 40 years who underwent partial meniscectomy with meniscal repair for lateral discoid meniscal tears were included in the study. Clinical assessment was evaluated pre-and post-surgery, and magnetic resonance imaging was performed at a mean of 9.5 months after surgery. Results: The Lysholm score improved from 43 ± 19.3 to 87.2 ± 7.8 (range: 94 − 100) at the last follow-up after surgery. The International Knee Documentation Committee score improved from 21.8 ±10.4 to 87.7 ± 4.8 at the last follow-up time after surgery. MRI revealed partial healing of the meniscus in six patients and residual damage of the meniscus in four patients. Extrusion was noted in three patients shown in coronal plane images. Conclusion: Arthroscopic partial meniscectomy with suture repair for discoid lateral meniscus in 10 patients under 40 years of age led to satisfactory clinical outcomes after a mean period of 11.2 months. However, in three cases, although the symptoms have improved, the remaining meniscus had worn off.
{"title":"Arthroscopic Partial Meniscectomy with Suture Repair for Discoid Lateral Meniscus in Patients under 40 Years of Age","authors":"Takatomo Mine, Haruki Nakano, Michio Shinohara, Ryutaro Kuriyama, Yasuhiro Tominaga, Koichiro Ihara, Takanori Yonehara","doi":"10.2174/18743250-v17-e230910-2023-4","DOIUrl":"https://doi.org/10.2174/18743250-v17-e230910-2023-4","url":null,"abstract":"Background: Damage to a discoid meniscus often indicates a complex tear, the treatment for which has not yet been resolved. This study aimed to assess the clinical efficacy of arthroscopic partial meniscectomy with suture repair for discoid lateral meniscus in patients under 40 years of age. Methods: A total number of 10 patients aged < 40 years who underwent partial meniscectomy with meniscal repair for lateral discoid meniscal tears were included in the study. Clinical assessment was evaluated pre-and post-surgery, and magnetic resonance imaging was performed at a mean of 9.5 months after surgery. Results: The Lysholm score improved from 43 ± 19.3 to 87.2 ± 7.8 (range: 94 − 100) at the last follow-up after surgery. The International Knee Documentation Committee score improved from 21.8 ±10.4 to 87.7 ± 4.8 at the last follow-up time after surgery. MRI revealed partial healing of the meniscus in six patients and residual damage of the meniscus in four patients. Extrusion was noted in three patients shown in coronal plane images. Conclusion: Arthroscopic partial meniscectomy with suture repair for discoid lateral meniscus in 10 patients under 40 years of age led to satisfactory clinical outcomes after a mean period of 11.2 months. However, in three cases, although the symptoms have improved, the remaining meniscus had worn off.","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"287 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135922950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-13DOI: 10.2174/0118743250262232230921044133
Harin Parikh, Andrew Phillips, Michael Stone, Ryu Yoshida, Meghan McCullough, Mojca Herman, Steven Shin
Golf is a sport enjoyed by a rapidly growing population. While it is perceived as a low-demand activity, golf and its thousands of high-energy rotational swings can result in a plethora of upper extremity injuries. We examine the biomechanics of the golf swing and carry out a review, divided by anatomical region of the upper extremity (shoulder, elbow, forearm, wrist, and hand), of common injuries associated with golf. Part I of this review details the shoulder and elbow pathology seen in golfers, while Part II covers the forearm, wrist, and hand injuries associated with the sport. PubMed was searched for articles using terms that corresponded to the specific injury and golf. Additional data was obtained via outside journal searches that did not appear in PubMed. This is a clinical review. Specific phases of the golf swing place golfers at risk for unique injuries that may affect either the leading (left side in a right-handed golfer) or trailing (right side in a left-handed golfer) extremity. Amateur and professional golfers are at higher risk for different injuries, as pros are more likely to suffer overuse injuries, while amateurs may have injuries secondary to improper grip or swing form. We identify and comment on six shoulders, two elbow, eight forearm and wrist, and three hand injuries associated with golf. Current trends in management, as well as golf-specific rehabilitation and return to sport timelines, are discussed for each injury. Growing participation and an aging population make golf a common source of upper extremity injury. We delineate 19 of the most common upper extremity injuries that golfers face and equip providers with up-to-date information to appropriately diagnose, manage, and rehabilitate these injuries.
{"title":"Keeping the Swing on Par: Golfers and Upper Extremity Injuries they Face","authors":"Harin Parikh, Andrew Phillips, Michael Stone, Ryu Yoshida, Meghan McCullough, Mojca Herman, Steven Shin","doi":"10.2174/0118743250262232230921044133","DOIUrl":"https://doi.org/10.2174/0118743250262232230921044133","url":null,"abstract":"Golf is a sport enjoyed by a rapidly growing population. While it is perceived as a low-demand activity, golf and its thousands of high-energy rotational swings can result in a plethora of upper extremity injuries. We examine the biomechanics of the golf swing and carry out a review, divided by anatomical region of the upper extremity (shoulder, elbow, forearm, wrist, and hand), of common injuries associated with golf. Part I of this review details the shoulder and elbow pathology seen in golfers, while Part II covers the forearm, wrist, and hand injuries associated with the sport. PubMed was searched for articles using terms that corresponded to the specific injury and golf. Additional data was obtained via outside journal searches that did not appear in PubMed. This is a clinical review. Specific phases of the golf swing place golfers at risk for unique injuries that may affect either the leading (left side in a right-handed golfer) or trailing (right side in a left-handed golfer) extremity. Amateur and professional golfers are at higher risk for different injuries, as pros are more likely to suffer overuse injuries, while amateurs may have injuries secondary to improper grip or swing form. We identify and comment on six shoulders, two elbow, eight forearm and wrist, and three hand injuries associated with golf. Current trends in management, as well as golf-specific rehabilitation and return to sport timelines, are discussed for each injury. Growing participation and an aging population make golf a common source of upper extremity injury. We delineate 19 of the most common upper extremity injuries that golfers face and equip providers with up-to-date information to appropriately diagnose, manage, and rehabilitate these injuries.","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135923088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-11DOI: 10.2174/18743250-v17-e230419-2022-17
Eytan Galanter, T. Damron
A custom endoprosthesis allowed for the preservation of the distal femoral physis with a short remaining metaphyseal segment after osteosarcoma resection in a 10-year-old boy. CASE This case illustrates a reconstructive alternative allowing physeal sparing with minimal remaining metaphyseal bone. At the three-year follow-up, the patient has remained complication-free with distal femoral growth maintaining symmetric limb length. When intercalary biologic reconstruction is not an option and the sacrifice of physis necessitates an extendible total femoral prosthesis, custom physeal sparing short segment press-fit fixation is an appropriate solution.
{"title":"Physeal Sparing Proximal Femoral Endoprosthetic Reconstruction with a Short Distal Segment: A Case Report","authors":"Eytan Galanter, T. Damron","doi":"10.2174/18743250-v17-e230419-2022-17","DOIUrl":"https://doi.org/10.2174/18743250-v17-e230419-2022-17","url":null,"abstract":"\u0000 \u0000 A custom endoprosthesis allowed for the preservation of the distal femoral physis with a short remaining metaphyseal segment after osteosarcoma resection in a 10-year-old boy. CASE\u0000 \u0000 \u0000 \u0000 This case illustrates a reconstructive alternative allowing physeal sparing with minimal remaining metaphyseal bone. At the three-year follow-up, the patient has remained complication-free with distal femoral growth maintaining symmetric limb length.\u0000 \u0000 \u0000 \u0000 When intercalary biologic reconstruction is not an option and the sacrifice of physis necessitates an extendible total femoral prosthesis, custom physeal sparing short segment press-fit fixation is an appropriate solution.\u0000","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84771863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-02DOI: 10.2174/18743250-v17-e230202-2022-13
Jennifer R Kallini, Antonia F. Chen, V. Shah
Medical and surgical management of knee pain in juvenile idiopathic arthritis (JIA) is rapidly evolving. It is important for the orthopaedic surgeon to remain informed. In this review, we discuss the recent trends in surgical management of JIA in light of recent medical advances for the disease. The purpose of this article is to summarize current recommendations for TKA in patients with JIA.
{"title":"Total Knee Arthroplasty In Patients With Juvenile Idiopathic Arthritis","authors":"Jennifer R Kallini, Antonia F. Chen, V. Shah","doi":"10.2174/18743250-v17-e230202-2022-13","DOIUrl":"https://doi.org/10.2174/18743250-v17-e230202-2022-13","url":null,"abstract":"Medical and surgical management of knee pain in juvenile idiopathic arthritis (JIA) is rapidly evolving. It is important for the orthopaedic surgeon to remain informed. In this review, we discuss the recent trends in surgical management of JIA in light of recent medical advances for the disease. The purpose of this article is to summarize current recommendations for TKA in patients with JIA.","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"136 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86305995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-28DOI: 10.2174/18743250-v16-e221228-2022-7
Kimon Toumazos, N. Williams
To review the use of knee and hip arthroplasty for patients with mucopolysaccharidoses (MPS) to inform clinicians and patients of this emerging area of orthopaedic practice and direct future studies. An Embase database review was conducted according to Preferred Reporting Item for Systematic Reviews and Meta-analyses (PRISMA) guidelines to identify relevant published articles. Extracted information included demographic data, indications for surgery, surgical details, post-operative outcomes and complications. Ten articles reported 15 patients with a total of 5 knee and 20 hip arthroplasties were identified and included. The mean age was 28.3 years and mean follow up duration for knee and hip arthroplasties was 3.6 years and 5.1 years respectively. Indications for surgery included pain in all patients, reduced range of motion, genu valgum and joint instability. Complex arthroplasty techniques were required including extensive soft tissue releases, instrumentation modification, screw fixation and modular/dysplasia arthroplasty components. There were four intra-operative fractures in hip arthroplasty patients and one hip arthroplasty underwent revision due to loosening. Pain resolution was documented for all knee arthroplasties and 90% of hip arthroplasties, whilst complications occurred in 9/20 (45%) of all arthroplasties. Arthroplasty surgery in this rare patient group can be successfully performed for pain relief and improvement in function with careful pre-operative planning and multidisciplinary management. Treating teams should be encouraged to share their experience to contribute to our understanding of indications, technique and outcomes for arthroplasty procedures in MPS patients.
{"title":"Hip and Knee Arthroplasty in Patients with Mucopolysaccharidosis: A Systematic Review ","authors":"Kimon Toumazos, N. Williams","doi":"10.2174/18743250-v16-e221228-2022-7","DOIUrl":"https://doi.org/10.2174/18743250-v16-e221228-2022-7","url":null,"abstract":"\u0000 \u0000 To review the use of knee and hip arthroplasty for patients with mucopolysaccharidoses (MPS) to inform clinicians and patients of this emerging area of orthopaedic practice and direct future studies.\u0000 \u0000 \u0000 \u0000 An Embase database review was conducted according to Preferred Reporting Item for Systematic Reviews and Meta-analyses (PRISMA) guidelines to identify relevant published articles. Extracted information included demographic data, indications for surgery, surgical details, post-operative outcomes and complications.\u0000 \u0000 \u0000 \u0000 Ten articles reported 15 patients with a total of 5 knee and 20 hip arthroplasties were identified and included. The mean age was 28.3 years and mean follow up duration for knee and hip arthroplasties was 3.6 years and 5.1 years respectively. Indications for surgery included pain in all patients, reduced range of motion, genu valgum and joint instability. Complex arthroplasty techniques were required including extensive soft tissue releases, instrumentation modification, screw fixation and modular/dysplasia arthroplasty components. There were four intra-operative fractures in hip arthroplasty patients and one hip arthroplasty underwent revision due to loosening. Pain resolution was documented for all knee arthroplasties and 90% of hip arthroplasties, whilst complications occurred in 9/20 (45%) of all arthroplasties.\u0000 \u0000 \u0000 \u0000 Arthroplasty surgery in this rare patient group can be successfully performed for pain relief and improvement in function with careful pre-operative planning and multidisciplinary management. Treating teams should be encouraged to share their experience to contribute to our understanding of indications, technique and outcomes for arthroplasty procedures in MPS patients.\u0000","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"233 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91447255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-02DOI: 10.2174/18743250-v16-e221202-2022-6
J. Johnston, J. Muir, C. Epi, Michael J Sloniewsky
The evidence supporting multiple courses of viscosupplementation for knee osteoarthritis continues to grow; however, the optimal treatment interval for repeat courses is less well understood. To address this, we compared baseline pain and disability scores in patients returning for subsequent treatment with their prior discharge scores. We retrospectively collected data from patients at 16 rehabilitation clinics who presented for repeated courses of viscosupplementation treatment for knee OA. Primary outcomes were pain (visual analog scale, VAS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores, which were collected following the initial treatment course and compared with scores upon return for treatment. The proportion of patients who fulfilled a minimal clinically important difference in each outcome was calculated. 61 patients (81 knees) were included in our analysis. After a 6-month treatment interval, no significant differences noted between post-discharge and returning scores for either VAS (p=0.73) or WOMAC (Pain: p=0.42; Function: p=0.54; Stiffness: p=0.29). Patients waiting 9 months to return for treatment saw a 45% increase in their pain scores (p=0.10) and significant worsening in WOMAC scores (Pain: p=0.007; Function: p=0.03; Stiffness: p=0.04). At 12 months, pain (p=0.01), WOMAC Pain (p=0.05) and WOMAC Stiffness (p=0.02) had all worsened significantly compared to discharge following the initial course. Our data indicate that patients who return for treatment within a 6 month treatment interval maintain their improvements, but that when the interval increases to 9 months or more, patients present as significantly worsened, having lost the benefit of their initial course of treatment.
{"title":"Optimal Treatment Interval of Viscosupplementation for Osteoarthritic Knee Pain: Real-world Evidence from a Retrospective Study","authors":"J. Johnston, J. Muir, C. Epi, Michael J Sloniewsky","doi":"10.2174/18743250-v16-e221202-2022-6","DOIUrl":"https://doi.org/10.2174/18743250-v16-e221202-2022-6","url":null,"abstract":"\u0000 \u0000 The evidence supporting multiple courses of viscosupplementation for knee osteoarthritis continues to grow; however, the optimal treatment interval for repeat courses is less well understood. To address this, we compared baseline pain and disability scores in patients returning for subsequent treatment with their prior discharge scores. \u0000 \u0000 \u0000 \u0000 We retrospectively collected data from patients at 16 rehabilitation clinics who presented for repeated courses of viscosupplementation treatment for knee OA. Primary outcomes were pain (visual analog scale, VAS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores, which were collected following the initial treatment course and compared with scores upon return for treatment. The proportion of patients who fulfilled a minimal clinically important difference in each outcome was calculated.\u0000 \u0000 \u0000 \u0000 61 patients (81 knees) were included in our analysis. After a 6-month treatment interval, no significant differences noted between post-discharge and returning scores for either VAS (p=0.73) or WOMAC (Pain: p=0.42; Function: p=0.54; Stiffness: p=0.29). Patients waiting 9 months to return for treatment saw a 45% increase in their pain scores (p=0.10) and significant worsening in WOMAC scores (Pain: p=0.007; Function: p=0.03; Stiffness: p=0.04). At 12 months, pain (p=0.01), WOMAC Pain (p=0.05) and WOMAC Stiffness (p=0.02) had all worsened significantly compared to discharge following the initial course. \u0000 \u0000 \u0000 \u0000 Our data indicate that patients who return for treatment within a 6 month treatment interval maintain their improvements, but that when the interval increases to 9 months or more, patients present as significantly worsened, having lost the benefit of their initial course of treatment. \u0000","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90428197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-18DOI: 10.2174/18743250-v16-e221018-2021-19
T. Mine, Yuuki Fukuda, Mami Handa, Hironori Takase, K. Ihara, H. Kawamura, Michio Shinohara, Ryutaro Kuriyama, Yasunari Tominaga
Pain and knee function improve immediately following total knee arthroplasty (TKA). However, immediate improvements in gait oscillation are not observed following TKA. This analysis aimed to chronologically assess changes in gait oscillation during walking in post-TKA patients. Twenty patients who were diagnosed with knee osteoarthritis underwent unilateral TKA. A Bi-Surface posterior-stabilized (PS) prosthesis with cementation was used for all patients. Acceleration (anterior, vertical, TKA side -, and -contralateral side directions) was examined during walking. A preoperative analysis was performed followed by postoperative analyses at 3, 6, 9, and 12 months. Acceleration in the anterior direction in the sacral region tended to increase until 6months post-TKA, but remained largely unchanged thereafter. In the dorsal vertebral region, acceleration to the anterior direction trended to decrease over time. Additionally, acceleration in the TKA-side direction in the sacral and dorsal vertebral region also tended to decrease over time. The post-TKA sacral-dorsal vertebral ratio in the TKA-side direction tended to increase over time, and the values on the contralateral side direction tended to increase for up to 6 months; however, there was no significant change thereafter. Acceleration in the anterior and lateral directions (TKA side) may improve chronologically after TKA, and gait may be performed mainly on the pelvic girdle during the postoperative course of TKA.
{"title":"Chronological Changes in Gait Oscillation in Patients after Total Knee Arthroplasty","authors":"T. Mine, Yuuki Fukuda, Mami Handa, Hironori Takase, K. Ihara, H. Kawamura, Michio Shinohara, Ryutaro Kuriyama, Yasunari Tominaga","doi":"10.2174/18743250-v16-e221018-2021-19","DOIUrl":"https://doi.org/10.2174/18743250-v16-e221018-2021-19","url":null,"abstract":"\u0000 \u0000 Pain and knee function improve immediately following total knee arthroplasty (TKA). However, immediate improvements in gait oscillation are not observed following TKA. This analysis aimed to chronologically assess changes in gait oscillation during walking in post-TKA patients.\u0000 \u0000 \u0000 \u0000 Twenty patients who were diagnosed with knee osteoarthritis underwent unilateral TKA. A Bi-Surface posterior-stabilized (PS) prosthesis with cementation was used for all patients. Acceleration (anterior, vertical, TKA side -, and -contralateral side directions) was examined during walking. A preoperative analysis was performed followed by postoperative analyses at 3, 6, 9, and 12 months.\u0000 \u0000 \u0000 \u0000 Acceleration in the anterior direction in the sacral region tended to increase until 6months post-TKA, but remained largely unchanged thereafter. In the dorsal vertebral region, acceleration to the anterior direction trended to decrease over time. Additionally, acceleration in the TKA-side direction in the sacral and dorsal vertebral region also tended to decrease over time. The post-TKA sacral-dorsal vertebral ratio in the TKA-side direction tended to increase over time, and the values on the contralateral side direction tended to increase for up to 6 months; however, there was no significant change thereafter.\u0000 \u0000 \u0000 \u0000 Acceleration in the anterior and lateral directions (TKA side) may improve chronologically after TKA, and gait may be performed mainly on the pelvic girdle during the postoperative course of TKA.\u0000","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87381444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-11DOI: 10.2174/18743250-v16-e2208180
Yung S Han, Elizabeth H. Cho, A. Martinez, P. Martineau
Posterior sternoclavicular joint dislocations are an extremely rare but potentially life-threatening injury that can occur in sports. A variety of surgical procedures have been proposed, but there is no consensus on the treatment of choice. It is also largely unknown if a safe return to high-risk sports is possible. We present a case of a posterior sternoclavicular joint dislocation in a 22-year-old male professional North American football player who had a recurrent irreducible posterior dislocation after initial injury management by closed reduction. The patient’s desire to return to football presented unique challenges to management. His sternoclavicular joint was subsequently reconstructed with semitendinosus allograft in a figure-of-eight augmented with suture anchors. After recovery, he returned to play as a running back in professional football symptom-free. Our patient's successful return to playing professional football after the sternoclavicular joint reconstruction suggests that this should be considered an effective treatment option when managing posterior sternoclavicular dislocation in high level contact sports players.
{"title":"Sternoclavicular Joint Reconstruction with Semitendinosus Allograft and Suture Anchors after Recurrent Posterior Dislocation in a Professional North American Football Player","authors":"Yung S Han, Elizabeth H. Cho, A. Martinez, P. Martineau","doi":"10.2174/18743250-v16-e2208180","DOIUrl":"https://doi.org/10.2174/18743250-v16-e2208180","url":null,"abstract":"\u0000 \u0000 Posterior sternoclavicular joint dislocations are an extremely rare but potentially life-threatening injury that can occur in sports. A variety of surgical procedures have been proposed, but there is no consensus on the treatment of choice. It is also largely unknown if a safe return to high-risk sports is possible.\u0000 \u0000 \u0000 \u0000 We present a case of a posterior sternoclavicular joint dislocation in a 22-year-old male professional North American football player who had a recurrent irreducible posterior dislocation after initial injury management by closed reduction. The patient’s desire to return to football presented unique challenges to management. His sternoclavicular joint was subsequently reconstructed with semitendinosus allograft in a figure-of-eight augmented with suture anchors. After recovery, he returned to play as a running back in professional football symptom-free.\u0000 \u0000 \u0000 \u0000 Our patient's successful return to playing professional football after the sternoclavicular joint reconstruction suggests that this should be considered an effective treatment option when managing posterior sternoclavicular dislocation in high level contact sports players.\u0000","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83043591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-10DOI: 10.2174/18743250-v16-e2208220
Takahiro Sato, Shuichi Chida, K. Nozaka, M. Kobayashi, T. Sakuraba, Ken Sasaki, Naohisa Miyakoshi
Distal femoral physeal injuries are a challenging clinical scenario because the injuries have a high risk of growth disturbance. The selected treatments include closed reduction and cast immobilization, percutaneous pin fixation, and cannulated screws or internal fixation, but these treatments have some complications. Circular external fixation enables rigid immobilization and walking with full weight bearing. To the best of our knowledge, there is no article on the results of using circular external fixation for distal femoral physeal injury. This case is the first in which circular external fixation for distal femoral physeal injury is used. A 9-year-old boy was injured in a skiing accident, and his injury was a Salter-Harris type II fracture of the distal femoral epiphysis. We immediately performed percutaneous pin fixation with circular external fixation under general anesthesia. After surgery, he was allowed to walk with full weight bearing. One year after surgery, he had no pain, and his knee regained full extension and 140°flexion. We consider circular external fixation to be an effective treatment option because of its rigid immobilization without injury to the plate. However, we and patients must fully acknowledge its difficulties (i.e., pin-site problems, neurologic injury, vascular injury, joint stiffness, and pain, and difficulty sleeping).
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