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Sagittal pelvic tilt change after total hip arthroplasty: An evaluation using supine frontal pelvic radiographs 全髋关节置换术后骨盆矢状面倾斜改变:仰卧位骨盆正面x线片评价
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.4103/jajs.jajs_13_22
MMohamed Sameer, K. Deep, Siddharth M. Shah
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引用次数: 0
Functional outcomes after modified Blair's procedure for ankle arthritis secondary to Hawkins type III talus injuries: A retrospective cohort study 改良Blair手术治疗Hawkins III型距骨损伤继发踝关节关节炎后的功能结局:一项回顾性队列研究
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.4103/jajs.jajs_66_22
D. Rastogi, Shailendra Singh, S. Waliullah, S. Singh, Ahmad Ozair
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引用次数: 0
Is posterior tibial slope and mechanism of failure crucial for an anatomically reconstructed primary hamstring graft anterior cruciate ligament? 胫骨后斜度和失效机制对解剖重建腘绳肌前交叉韧带至关重要吗?
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.4103/jajs.jajs_87_22
S. Supreeth, Aliya Sarhan Al Barwani, Khalid Al Manei, Suwailim Al Ghanami, S. Shanmugasundaram, VijayKumar Kotnoor
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引用次数: 0
Ultrastructural characteristics of chronically failed reconstructed anterior cruciate ligament 慢性失效重建前交叉韧带的超微结构特征
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.4103/jajs.jajs_41_22
G. Jain, Ram Datt, H. Nag, A. Mahmood, S. Shekhar, T. Nag
Background: In the present study, we have examined the ultrastructure of chronically failed reconstructed anterior cruciate ligament (ACL). We aimed to investigate a faulty ligamentization process of a failed reconstructed anterior cruciate ligament. In other words, we want to study ultrastructural alterations a failed ACL graft undergoes. Methods: Two patients who underwent revision ACL reconstruction for nontraumatic failure without discontinuity of the graft were included in the study. The first patient was a 40-year-old male who had undergone ACL reconstruction of his right knee 21 years back using the bone-patellar tendon-bone autograft. The second patient was a 23-year-old male who had sustained an ACL tear with a medial collateral ligament injury treated by isolated ACL reconstruction 3 years back using hamstring tendon autograft. We collected punch biopsy specimens from the failed ligaments of both the patients during revision ACL reconstruction. These specimens were examined for the density of collagen fibrils within a fascicle (per 1.5 μm2), cellular metabolism, and fibril diameter (nm) by transmission electron microscopy. Results: Fibroblasts of both the ligaments showed features of increased metabolism, more so in the first patient. Compared to the second patient, the fascicles of the first specimen were more loosely arranged. Both ligaments had a unimodal distribution of collagen fibrils. The first patient had a mean fibril diameter of 45.2 (+/−8.5) nm and an average fibril density of 376.8 fibrils per 1.5 μm2. The second patient had an average fibril diameter of 64.1 nm (+/−7) and a mean fibril density of 152.9 fibrils/1.5 μm2. The difference in these parameters of the two patients was statistically significant (P < 0.001). Conclusion: Our study suggests that the absence of thicker collagen fibrils with unimodal distribution, the altered density of the collagen fibrils within a fascicle, and ovoid fibroblasts with increased metabolism may symbolize bad ligamentization changes.
背景:在本研究中,我们检测了慢性失败的重建前交叉韧带(ACL)的超微结构。我们的目的是研究一个失败的重建前交叉韧带的韧带化过程。换句话说,我们想研究失败的前交叉韧带移植物所经历的超微结构改变。方法:将两名因无移植物不连续性的非创伤性失败而接受ACL翻修重建的患者纳入研究。第一位患者是一位40岁的男性,他在21年前用自体骨-髌腱-骨移植进行了右膝前交叉韧带重建。第二名患者是一名23岁的男性,他因内侧副韧带损伤而遭受前交叉韧带撕裂,3年前使用自体腘绳肌腱进行了单独的前交叉韧带重建。我们收集了两名患者在翻修ACL重建过程中失败韧带的穿孔活检标本。通过透射电子显微镜检查这些标本中束内胶原原纤维的密度(每1.5μm2)、细胞代谢和原纤维直径(nm)。结果:两条韧带的成纤维细胞都表现出代谢增加的特征,第一例患者更是如此。与第二个病人相比,第一个标本的束排列更加松散。两条韧带的胶原纤维均呈单峰分布。第一位患者的平均原纤维直径为45.2(+/-8.5)nm,平均原纤维密度为每1.5μm2 376.8根原纤维。第二名患者的平均原纤维直径为64.1 nm(+/-7),平均原纤维密度为152.9原纤维/1.5μm2。两名患者的这些参数差异具有统计学意义(P<0.001)。结论:我们的研究表明,缺乏具有单峰分布的较厚胶原原纤维、束内胶原原纤维密度的改变以及代谢增加的卵圆形成纤维细胞可能象征着不良的韧带化变化。
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引用次数: 0
Functional outcomes in quadruple arthroplasty of the hips and knees: A literature review of 306 cases with a minimum follow-up of 2 years 髋膝关节置换术的功能结果:306例患者的文献综述,随访时间至少为2年
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.4103/jajs.jajs_2_22
A. Vaish, Raju Vaishya, C. Yadav
Quadrupled arthroplasties of the lower limb are required mostly in cases with chronic and severe inflammatory arthritis. There may be a requirement of additional surgery for the foot and ankle or joints of an upper limb, especially in inflammatory arthritis, to improve the functional outcomes. The patient's self-motivation and patient selection for four joint arthroplasties are necessary for favorable outcomes. Surgical technique, prosthetic design, and postoperative rehabilitation play a vital role in functional outcomes. More multicenter, large series and registries are required with long-term follow-up in the future to frame the clinical practice guidelines.
在慢性和严重炎症性关节炎的情况下,大多需要下肢四重关节置换术。可能需要对足部和脚踝或上肢关节进行额外的手术,特别是在炎症性关节炎中,以改善功能结果。患者的自我激励和患者对四种关节置换术的选择是有利结果的必要条件。手术技术、假体设计和术后康复对功能结果起着至关重要的作用。未来需要更多的多中心、大系列和注册,并进行长期随访,以制定临床实践指南。
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引用次数: 0
Extensor mechanism failure following total knee arthroplasty 全膝关节置换术后伸肌机制失效
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.4103/jajs.jajs_29_22
S. Sharkey, Ikechukwu Ejiofor, B. V. van Duren, H. Akrawi, H. Pandit, S. Anand, V. Veysi, J. Palan
Extensor mechanism failure following total knee arthroplasty is a rare but potentially devastating complication with an overall incidence of 0.17%–2.5%. The 3 main causes of disruption include quadriceps tendon rupture, patellar fracture, or patellar tendon rupture. Clinical presentation can vary from asymptomatic to the acutely painful and swollen knee, but for most patients, there will be evidence of extensor lag and/or difficulty performing straight leg raise. A variety of treatment options have been described in the literature to date including nonoperative management with immobilization, particularly for patients with an extensor lag of <20°. Direct repair may be useful in the management of acute tendon ruptures; however, augmentation is now also recommended in addition. Options for augmentation include tendon autografts or synthetic materials. The use of allografts such as Achilles tendon allografts or complete extensor mechanism allografts and rotational flaps has also been described. Treatment of patellar fractures varies depending on fracture pattern, degree of extensor lag, presence of patellar component loosening, and patellar bone stock. The potential options for treatment include nonoperative management with immobilization, open reduction and internal fixation, patellectomy (either partial or complete), or revision surgery, although this list is not exhaustive. Outcomes are poor with complications including rerupture, postoperative infection, nonunion, or residual extensor lag with associated poor functional outcomes and high reoperation rates. There is a distinct lack of high-quality evidence in the literature at present, and as such, further research is required to make any recommendations for treatment.
全膝关节置换术后伸肌机制衰竭是一种罕见但具有潜在破坏性的并发症,总发生率为0.17%-2.5%。三个主要原因包括股四头肌腱断裂、髌骨骨折或髌腱断裂。临床表现可能从无症状到急性疼痛和肿胀的膝盖各不相同,但对于大多数患者来说,会有伸肌滞后和/或难以进行直腿抬高的证据。迄今为止,文献中描述了多种治疗方案,包括非手术固定治疗,尤其是伸肌滞后<20°的患者。直接修复可用于急性肌腱断裂的治疗;然而,现在也建议增加。增强的选择包括自体肌腱移植或合成材料。同种异体移植物的使用,如跟腱同种移植物或完全伸肌机制同种移植物和旋转皮瓣也已被描述。髌骨骨折的治疗因骨折类型、伸肌滞后程度、髌骨成分松动和髌骨骨存量而异。潜在的治疗选择包括非手术治疗,包括固定、开放复位和内固定、髌骨切除术(部分或全部)或翻修手术,尽管该列表并不详尽。结果不佳,并发症包括再断裂、术后感染、骨不连或残余伸肌滞后,相关的功能结果不佳,再次手术率高。目前的文献中明显缺乏高质量的证据,因此,需要进一步的研究来提出任何治疗建议。
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引用次数: 2
Current status of preventive and therapeutic strategies against biofilm formation in arthroplasty 关节置换术中生物膜形成的防治策略现状
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.4103/jajs.jajs_102_22
V. Bagaria, Anjali Tiwari, AmitKumar Yadav, R. Bhansali
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引用次数: 0
Regeneration of a discoid meniscus after saucerization, reinsertion of the anterior segment, and platelet-rich plasma injection in a 17-year-old girl 17岁女孩盘状半月板碟状切除术、前段植入及富血小板血浆注射后的再生
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.4103/jajs.jajs_73_22
F. Borim, Mikèl Sanchez, F. Soldado, J. Knorr
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引用次数: 0
The effects of intra-articular hyaluronate injections in young (<55 years) patients with glenohumeral joint osteoarthritis 关节内注射透明质酸对年轻(<55岁)肩关节骨性关节炎患者的影响
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.4103/jajs.jajs_4_22
U. Oduoza, M. Stoddart, A. Majed, D. Butt, M. Falworth, W. Rudge
Purpose: Glenohumeral joint (GHJ) osteoarthritis (OA) in younger patients represents a challenging problem. This study assessed the efficacy of intra-articular hyaluronate injection in patients below the age of 55 years. Methods: We reviewed our patient database from August 2013 to December 2016 for patients who received a fluoroscopic-guided intra-articular injection of hyaluronate. Those who had received interventional procedures within the preceding 12 months were excluded. We evaluated the response to the injection using the Oxford Shoulder Score (OSS). These scores were recorded before injection and at 6 weeks, 12 weeks, and 26 weeks postinjection. Radiographs were reviewed independently by two evaluators, and the severity of GHJ OA was categorized (mild, moderate, or severe) using the Samilson–Prieto classification. Results: Fifty-five patients were identified, with a mean age of 43 years (18.6–54.6 years). These cases were classified as being mild in 11 (20%), moderate in 21 (38%), and severe in 23 (42%) using Samilson-Prieto classification. In the severe group, there was a statistically significant improvement in the OSS at all time points. In the moderate group, there were statistically significant improvements at 6 weeks and 12 weeks but not at 6 months. In the mild group, there were no statistically significant changes. Conclusion: In patients under the age of 55 years with moderate-to-severe GHJ OA, there is a significant improvement in the OSS up to 12 weeks after intra-articular injection of hyaluronate, with improvements lasting up to 26 weeks in more severe cases. Hyaluronate is, therefore, a useful treatment option in younger patients and may potentially delay the need for arthroplasty.
目的:肱骨关节(GHJ)骨关节炎(OA)在年轻患者中是一个具有挑战性的问题。本研究评估了55岁以下患者关节内注射透明质酸的疗效。方法:我们回顾了2013年8月至2016年12月接受透视引导下关节内注射透明质酸的患者数据库。那些在过去12个月内接受过介入手术的人被排除在外。我们使用牛津肩关节评分(OSS)评估注射后的反应。分别在注射前、注射后6周、12周和26周记录这些评分。由两名评估者独立审查x线片,并使用Samilson-Prieto分类对GHJ - OA的严重程度进行分类(轻度、中度或重度)。结果:55例患者,平均年龄43岁(18.6-54.6岁)。根据Samilson-Prieto分类,这些病例分为轻度11例(20%),中度21例(38%),重度23例(42%)。在严重组中,OSS在所有时间点上都有统计学上显著的改善。在中等剂量组中,在6周和12周时有统计学意义上的改善,但在6个月时没有。在轻度组中,无统计学意义的变化。结论:在55岁以下的中重度GHJ型OA患者中,关节内注射透明质酸后12周,OSS有显著改善,在更严重的病例中,改善持续长达26周。因此,透明质酸对于年轻患者是一种有用的治疗选择,并可能潜在地延迟关节置换术的需要。
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引用次数: 1
A prospective observational study on short-term functional outcomes of primary reverse shoulder arthroplasty in the Indian population 一项关于印度人群初次肩关节置换术短期功能结果的前瞻性观察研究
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.4103/jajs.jajs_37_22
J. Chitten, M. Arora, Gaurav Bathla
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引用次数: 0
期刊
Journal of Arthroscopy and Joint Surgery
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