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[PMID]:29381920
[Au] Autor:Lin TY; Yang CY; Liu SC
[Ad] Endereço:Department of Orthopedics, Mackay Memorial Hospital Medical Center, New Taipei City, Taiwan, R.O.C.
[Ti] Título:Corrective osteotomy with retrograde Fassier-Duval nail in an osteogenesis imperfecta patient with bilateral genu valgum: A case report.
[So] Source:Medicine (Baltimore);96(47):e8459, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: The treatment of osteogenesis imperfecta (OI) requires a multidisciplinary approach to maximize function and reduce fracture incidence. The aim of this case report was to discuss an alternative surgical approach to stabilize a corrective osteotomy using the Fassier Duval (FD) system in an OI patient. PATIENT CONCERNS: A 20-year-old OI woman presented with left thigh pain, gait disturbance, and bilateral genu valgus deformities. DIAGNOSES: Physical examination and standing radiographs revealed bilateral genu valgum with previous fixation implants in the femoral and the left tibia. INTERVENTIONS: Staged surgery was performed. A previous Ender pin was removed from the left femur, and a FD nail was inserted in a retrograde fashion. An intercondylar fracture was encountered while inserting the female rod in the distal left femur. After removal of a previous Rush pin from the right femur, several complications were also encountered during FD nailing of the right femur. The tip threads of the FD male nail could not achieve adequate anchorage in the region of the greater trochanter. To prevent male nail dropping, a horizontal stop Kirschner pin was inserted close to the distal end of the female nail. OUTCOME: Despite perioperative problems such as rod dropping and occurrence of an intercondylar fracture of the left distal femur, bilateral retrograde nailing using the FD system was successful. An accurate entry portal is important when performing retrograde rodding. In addition, reaming the portal to a larger diameter in order to accommodate the large head of the female nail can prevent intraoperative intercondylar split, especially when combined with an osteotomy at the distal femur. LESSONS: Selection of the proper surgical technique is dependent on both the surgeon's experience and the condition of the patient. Although not an optimal device, a FD nail can be used as an IM nail for corrective osteotomy at the distal femur in an adult OI patient with a small femoral IM canal.
[Mh] Termos MeSH primário: Genu Valgum/complicações
Osteogênese Imperfeita/complicações
Osteogênese Imperfeita/cirurgia
Osteotomia/métodos
[Mh] Termos MeSH secundário: Pinos Ortopédicos
Feminino
Fraturas do Fêmur/complicações
Fraturas do Fêmur/cirurgia
Seres Humanos
Período Perioperatório
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008459


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[PMID]:28541005
[Au] Autor:Chang CB; Shetty GM; Lee JS; Kim YC; Kwon JH; Nha KW
[Ad] Endereço:Department of Orthopedic Surgery, Seoul National University, Boramae Hospital, Seoul, Korea.
[Ti] Título:A Combined Closing Wedge Distal Femoral Osteotomy and Medial Reefing Procedure for Recurrent Patellar Dislocation with Genu Valgum.
[So] Source:Yonsei Med J;58(4):878-883, 2017 Jul.
[Is] ISSN:1976-2437
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Recurrent patellar dislocation is often associated with genu valgum. The purpose of this study was to analyze the short-term results of single-incision, closing-wedge distal femoral osteotomy (CWDFO) combined with medial reefing and lateral release for recurrent patellar instability with genu valgum. MATERIALS AND METHODS: Combined CWDFO/medial reefing/lateral release was performed on 10 knees. Clinical evaluation was based on pre- and postoperative Knee Society Score (KSS) and Kujala patellofemoral score. Radiographic evaluation was performed with reference to the weight-bearing line (WBL), the femorotibial angle (FTA), and the mechanical lateral distal femoral angles in the knee-standing view. RESULTS: At a mean follow-up of 20±11.7 months (range, 12-42 months), KSS scores improved significantly, from 46.7±5.2 preoperatively to 87±4.4 postoperatively (p<0.001), as did the Kujala score, from 44±8 preoperatively to 86.6±6.8 postoperatively (p<0.001). The WBL decreased significantly, from 76±7% preoperatively to 41±11% postoperatively (p<0.001). The FTA was improved significantly, from 12.7±1.7° preoperatively to 4±4° postoperatively (p<0.001), as was the mLDFA, from 83±4° preoperatively to 91±1.3° postoperatively (p<0.001). CONCLUSION: Use of single-incision CWDFO combined with medial reefing and lateral release prevents patellar dislocation, corrects deformity, and improves clinical outcomes.
[Mh] Termos MeSH primário: Fêmur/cirurgia
Genu Valgum/complicações
Genu Valgum/cirurgia
Osteotomia/métodos
Luxação Patelar/complicações
Luxação Patelar/cirurgia
[Mh] Termos MeSH secundário: Adulto
Demografia
Feminino
Fêmur/diagnóstico por imagem
Fêmur/patologia
Seguimentos
Genu Valgum/diagnóstico por imagem
Seres Humanos
Masculino
Luxação Patelar/diagnóstico por imagem
Cuidados Pré-Operatórios
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171020
[Lr] Data última revisão:
171020
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170526
[St] Status:MEDLINE
[do] DOI:10.3349/ymj.2017.58.4.878


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[PMID]:28375411
[Au] Autor:Hoag SD; Chung K
[Ad] Endereço:St. Joseph's Hospital Health Center, Syracuse, NY, USA. Email: stephen.hoag@sjhsyr.org.
[Ti] Título:Severe polyarthralgia, high-grade fever, diffuse maculopapular rash on trunk and extremities · Dx?
[So] Source:J Fam Pract;66(4):E7-E9, 2017 Apr.
[Is] ISSN:1533-7294
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The patient was nauseous, and had been experiencing headaches, generalized weakness, and fatigue. Her physical exam revealed a maculopapular rash on her trunk and upper extremities. She had tenderness and pain, as well as decreased range of motion in her ankles, knees, and wrists. The patient had no erythema, swelling, petechiae, or bruising. She had a past medical history of Graves' disease and had received all of her childhood immunizations.
[Mh] Termos MeSH primário: Acetaminofen/uso terapêutico
Artralgia/tratamento farmacológico
Febre de Chikungunya/diagnóstico
Febre de Chikungunya/terapia
Exantema/tratamento farmacológico
Febre/tratamento farmacológico
Ibuprofeno/uso terapêutico
Oxicodona/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Analgésicos não Entorpecentes/uso terapêutico
Tornozelo/fisiopatologia
Tornozelo/virologia
Anti-Inflamatórios/uso terapêutico
Artralgia/diagnóstico
Artralgia/virologia
Região do Caribe
Combinação de Medicamentos
Exantema/diagnóstico
Exantema/virologia
Feminino
Febre/diagnóstico
Febre/virologia
Genu Valgum/fisiopatologia
Genu Valgum/virologia
Seres Humanos
Viagem
Resultado do Tratamento
Estados Unidos
Punho/fisiopatologia
Punho/virologia
[Pt] Tipo de publicação:CASE REPORTS
[Nm] Nome de substância:
0 (Analgesics, Non-Narcotic); 0 (Anti-Inflammatory Agents); 0 (Drug Combinations); 0 (oxycodone-acetaminophen); 362O9ITL9D (Acetaminophen); CD35PMG570 (Oxycodone); WK2XYI10QM (Ibuprofen)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170619
[Lr] Data última revisão:
170619
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170405
[St] Status:MEDLINE


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[PMID]:28253943
[Au] Autor:Vukadin OB; Blagojevic ZB; Bascarevic ZL; Slavkovic NS; Stevanovic V; Vukomanovic BD
[Ad] Endereço:Institute for orthopaedic surgery "Banjica" Belgrade, Serbia.
[Ti] Título:The Importance of Patellar Resurfacing in Total Knee Arthroplasty for Symptomatic Valgus Degenerative Deformity.
[Ti] Título:Význam náhrady kloubní plochy pately u totální náhrady kolenního kloubu pri symptomatické valgózní degenerativní deformite..
[So] Source:Acta Chir Orthop Traumatol Cech;84(1):30-34, 2017.
[Is] ISSN:0001-5415
[Cp] País de publicação:Czech Republic
[La] Idioma:eng
[Ab] Resumo:PURPOSE OF THE STUDY Patellar surface replacement during total knee arthroplasty is still a matter of discussion among orthopedic surgeons. The purpose of this study was to examine possible benefits of patellar surface replacement in selected patients with symptomatic degenerative valgus deformity. We have not found any studies in the literature that compare the results of patella management solely for valgus or varus knee deformity nor those that compare both. MATERIAL AND METHODS Patients were randomly assigned to a group that would receive patellar surface replacement during total knee arthroplasty and a group of patients in whom total knee arthroplasty was performed without patellar surface replacement. 60 patients were included in the study. Total knee arthroplasty with patellar resurfacing (TKAPR) was performed in 30, and without PR (TKA) in 30 of them. Results were prospectively gathered and compared at regular intervals. RESULTS There were no significant differences between groups for examined parameters except for Oxford Knee Score at 6 months which was in favor of patellar resurfacing group. DISCUSSION The decision whether to replace the patella or not is currently exclusively a matter of surgeon's choice. Establishing selection criteria for patients that would benefit from patella resurfacing could, therefore, be very useful for both patients and orthopaedic surgeons performing total knee replacement. CONCLUSIONS Although evidence in our study could not strongly suggest performing patella resurfacing in patients with valgus deformity, the results were slightly better in the patella resurfacing group and this trend could increase if larger series of patients would be employed. A longer follow-up period would be required for clear-cut decisions and more prospective studies are warranted. Key words: knee, arthroplasty, patella, replacement, valgus, deformity.
[Mh] Termos MeSH primário: Artroplastia do Joelho/métodos
Genu Valgum/cirurgia
Patela/cirurgia
[Mh] Termos MeSH secundário: Tomada de Decisão Clínica
Feminino
Seres Humanos
Masculino
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170412
[Lr] Data última revisão:
170412
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170304
[St] Status:MEDLINE


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[PMID]:28141689
[Au] Autor:Sweeney KR; Shi WJ; Gottschalk MB; Kappa JE; Bruce RW; Fletcher ND
[Ad] Endereço:*Emory Department of Orthopaedics †Emory University School of Medicine, Atlanta, GA ‡George Washington Department of Orthopaedics, Washington, DC.
[Ti] Título:Radiographic Assessment of Guided Growth: The Correlation Between Screw Divergence and Change in Anatomic Alignment.
[So] Source:J Pediatr Orthop;37(4):e261-e264, 2017 Jun.
[Is] ISSN:1539-2570
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Assessment of changes in anatomic alignment following guided growth traditionally utilizes full-length standing radiographs which subjects patients to larger radiation doses than does a single anteroposterior radiograph of the knee. In an effort to minimize radiation exposure, the present study sought to determine whether changes in screw divergence (SD) of the 2-hole tension band plate used for hemiepiphysiodesis reliably predicts change in alignment. METHODS: A retrospective review was conducted involving all patients with genu varum or genu valgum treated with hemiepiphysiodesis at a single institution. Preoperative anatomic alignment of the femur, using anatomic lateral distal femoral angle (aLDFA) and anatomic femoral-tibial angle (aTFA), and intraoperative divergence of hemiepiphysiodesis screws were compared with postoperative imaging. Linear regression analysis determined the relationship between changes in SD and changes in alignment, and multivariate regression analysis explored the relationship between the angular changes being measured and various demographic factors. RESULTS: Linear regression analysis revealed that for every 1 degree change in SD there was a resultant 1.80 degrees of change in aTFA and 2.11 degrees of change in aLDFA. Change in aTFA is predicted by the equation: [INCREMENT]aTFA=0.41×|[INCREMENT]SD|+1.39. The change in aLDFA was predicted by the equation [INCREMENT]aLDFA=0.27×[INCREMENT]SD+1.84 with a R2 of 0.31. [INCREMENT]aTFA and [INCREMENT]SD had a correlation coefficient of 0.68 (95% confidence interval, 0.54-0.78.) [INCREMENT]aLDFA and [INCREMENT]SD had a correlation coefficient of 0.56 (95% confidence interval, 0.42-0.68). [INCREMENT]SD and sex were the only 2 independent predictors for [INCREMENT]aLDFA and [INCREMENT]aTFA as determined by multivariate regression analysis. CONCLUSION: Change in coronal plane anatomic alignment in patients being treated for genu valgum or genu varum with hemiepiphysiodesis can be reasonably estimated by measuring the change in SD. Therefore, when following patients postoperatively, focal radiographic imaging of the knee can be utilized in lieu of standing full-length limb radiographs to limit radiation to the pelvis in this sensitive patient population. LEVEL OF EVIDENCE: Level III-retrospective comparative study.
[Mh] Termos MeSH primário: Alongamento Ósseo
Placas Ósseas
Genu Valgum/diagnóstico por imagem
Genu Varum/diagnóstico por imagem
Articulação do Joelho/crescimento & desenvolvimento
[Mh] Termos MeSH secundário: Idoso
Parafusos Ósseos
Feminino
Fêmur/crescimento & desenvolvimento
Fêmur/cirurgia
Genu Valgum/cirurgia
Genu Varum/cirurgia
Seres Humanos
Articulação do Joelho/cirurgia
Masculino
Meia-Idade
Período Pós-Operatório
Radiografia
Estudos Retrospectivos
Tíbia/crescimento & desenvolvimento
Tíbia/cirurgia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170201
[St] Status:MEDLINE
[do] DOI:10.1097/BPO.0000000000000950


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[PMID]:28140673
[Au] Autor:Steinberg N; Tenenbaum S; Hershkovitz I; Zeev A; Siev-Ner I
[Ad] Endereço:a Sackler Faculty of Medicine, Department of Anatomy and Anthropology , Tel-Aviv University , Tel-Aviv , Israel.
[Ti] Título:Lower extremity and spine characteristics in young dancers with and without patellofemoral pain.
[So] Source:Res Sports Med;25(2):166-180, 2017 Apr-Jun.
[Is] ISSN:1543-8635
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Very little is known about patellofemoral pain syndrome (PPFS) among young dancers. Understanding the mechanism of the injury and implementing a preventative programme are important in order to minimize the risk of PFPS. The aim of the current study is to determine the extent to which factors such as lower extremity and back characteristics are common among dancers with PFPS. The study population included 271 dancers with PFPS and 271 non-injured dancers, aged 10-16 years. All dancers were screened for morphometric profile, dance discipline (h/week), anatomical anomalies (present/absent of scoliosis, genu valgus/varum, etc.), and joint range of motion (measured by goniometer at the hip, knee, ankle, foot, and spinal joints). The predicting factors for PFPS among young dancers (10-11 years old) were: hyper hip abduction (OR = 0.906) and lower back and hamstring flexibility (OR = 3.542); for adolescent dancers (12-14 years old): hyper ankle dorsiflexion (OR = 0.888), hind foot-varum (OR = 0.260), and mobility of patella (OR = 2.666); and, for pre-mature dancers (15-16 years old): scoliosis (OR = 5.209), limited ankle plantar-flexion (OR = 1.060), and limited hip internal rotation (OR = 1.063). In conclusion, extrinsic and intrinsic parameters predisposing the dancers to knee injuries should be identified by screening in early stages of dance classes.
[Mh] Termos MeSH primário: Dança
Músculos Isquiotibiais/fisiologia
Articulações/fisiologia
Região Lombossacral/fisiologia
Síndrome da Dor Patelofemoral/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Articulação do Tornozelo/fisiologia
Estudos de Casos e Controles
Criança
Feminino
Genu Valgum/epidemiologia
Genu Varum/epidemiologia
Articulação do Quadril/fisiologia
Seres Humanos
Articulação do Joelho/fisiologia
Patela/fisiologia
Amplitude de Movimento Articular
Fatores de Risco
Rotação
Escoliose/epidemiologia
Somatotipos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171019
[Lr] Data última revisão:
171019
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170201
[St] Status:MEDLINE
[do] DOI:10.1080/15438627.2017.1282355


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[PMID]:28132085
[Au] Autor:Chiba K; Yonekura A; Miyamoto T; Osaki M; Chiba G
[Ad] Endereço:Department of Orthopaedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. kohchiba@estate.ocn.ne.jp.
[Ti] Título:Tibial condylar valgus osteotomy (TCVO) for osteoarthritis of the knee: 5-year clinical and radiological results.
[So] Source:Arch Orthop Trauma Surg;137(3):303-310, 2017 Mar.
[Is] ISSN:1434-3916
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Tibial condylar valgus osteotomy (TCVO) is a type of opening-wedge high tibial osteotomy for advanced medial knee osteoarthritis (OA) with subluxated lateral joint. We report the concept, the current surgical technique with a locking plate, and the short-term clinical and radiological results of this procedure. METHODS: 11 knees with medial OA and a widened lateral joint were treated by TCVO (KL stage III: 6, IV: 5). In this procedure, by the L-shaped osteotomy from the medial side of the proximal tibia to the intercondylar eminence and the valgus correction, lateralization of the mechanical axis and reduction of the subluxated lateral joint are obtained with early postoperative weight-bearing. Before, 6 months, 1, and 5 years after the operation, a visual analog scale (VAS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC), alignment of the lower extremity, and congruency and stability of the femorotibial joint were investigated. RESULTS: The VAS improved from an average of 73 mm to 13 mm, and the total WOMAC score from 52 to 14 before to 5 years after the operation, respectively. The mechanical axis changed from 1 to 60%, and the FTA changed from 186° to 171°. The joint line convergence angle (JLCA) changed from 6° to 1°, and the angle difference of JLCA between varus and valgus stress improved from 8° to 4° after the procedure. CONCLUSION: Improvements in pain and activities of daily living were observed by TCVO along with valgus correction of the lower extremity and stabilization of the femorotibial joint.
[Mh] Termos MeSH primário: Placas Ósseas
Genu Valgum/cirurgia
Osteoartrite do Joelho/cirurgia
Osteotomia/métodos
Tíbia/cirurgia
[Mh] Termos MeSH secundário: Atividades Cotidianas
Idoso
Deambulação Precoce
Feminino
Genu Valgum/diagnóstico por imagem
Seres Humanos
Articulação do Joelho/diagnóstico por imagem
Articulação do Joelho/cirurgia
Masculino
Meia-Idade
Ontário
Osteoartrite do Joelho/diagnóstico por imagem
Medição da Dor
Radiografia
Resultado do Tratamento
Suporte de Carga
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170524
[Lr] Data última revisão:
170524
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170130
[St] Status:MEDLINE
[do] DOI:10.1007/s00402-016-2609-3


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[PMID]:28125900
[Au] Autor:Eberbach H; Mehl J; Feucht MJ; Bode G; Südkamp NP; Niemeyer P
[Ad] Endereço:Department of Orthopaedic and Trauma Surgery, Freiburg University Hospital, Freiburg, Germany.
[Ti] Título:Geometry of the Valgus Knee: Contradicting the Dogma of a Femoral-Based Deformity.
[So] Source:Am J Sports Med;45(4):909-914, 2017 Mar.
[Is] ISSN:1552-3365
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Realignment osteotomies of valgus knee deformities are usually performed at the distal femur, as valgus alignment is considered to be a femoral-based deformity. This dogma, however, has not been proven in a large patient population. Valgus malalignment may also be caused by a tibial deformity or a combined tibial and femoral deformity. PURPOSE: The purposes of this study were (1) to analyze the coronal geometry of patients with valgus malalignment and identify the location of the underlying deformity and (2) to investigate the proportion of cases that require realignment osteotomy at the tibia, the femur, or both locations to avoid an oblique joint line. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: The analysis included 420 standing full-leg radiographs of patients with valgus malalignment (mechanical femorotibial angle [mFTA], ≥4°). A systematic analysis of the coronal leg geometry was performed including the mFTA, mechanical lateral distal femoral angle (mLDFA), mechanical medial proximal tibial angle (mMPTA), and joint-line convergence angle (JLCA). The localization of the deformity was determined according to the malalignment test described by Paley, and patients were assigned to 1 of 4 groups: femoral-based valgus deformity, tibial-based valgus deformity, femoral- and tibial-based valgus deformity, or intra-articular/ligamentary-based valgus deformity. Subsequently, the ideal osteotomy site was identified with the goal of a postoperative change of the joint line of two different maximum values, ±2° and ±4°, from its physiological varus position of 3°. RESULTS: Measurements of the coronal alignment revealed a mean (±SD) mFTA of 7.4° ± 4.3° (range, 4°-28.2°). The mean mLDFA and mean mMPTA were 84.8° ± 2.4° and 90.9° ± 2.6°, respectively. The mean JLCA was 1.2° ± 3.1°. The majority (41.0%) of valgus deformities were tibial based, 23.6% were femoral based, 26.9% were femoral and tibial based, and 8.6% were intra-articular/ligamentary based. To achieve a straight-leg axis and an anatomic postoperative joint line with a tolerance of ±4°, the ideal site of a corrective osteotomy was tibial in 55.2% of cases and femoral in 19.5% of cases. A double-level osteotomy would be necessary in 25.2% of cases. With a tolerance of ±2°, the ideal osteotomy site was the proximal tibia in 41.0% of cases and the distal femur in 13.6% of cases; a double-level osteotomy would be necessary in 45.5% of cases. CONCLUSION: In contrast to the widespread belief that valgus malalignment is usually caused by a femoral deformity, this study found that valgus malalignment was attributable to tibial deformity in the majority of patients. In addition, a combined femoral- and tibial-based deformity was more common than an isolated femoral-based deformity. As a clinical consequence, varus osteotomies to treat lateral compartment osteoarthritis must be performed at the tibial site or as a double-level osteotomy in a relevant number of patients to avoid an oblique joint line.
[Mh] Termos MeSH primário: Fêmur/cirurgia
Genu Valgum/patologia
Genu Valgum/cirurgia
Osteotomia
Tíbia/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Criança
Estudos Transversais
Feminino
Fêmur/diagnóstico por imagem
Fêmur/patologia
Genu Valgum/complicações
Genu Valgum/diagnóstico por imagem
Seres Humanos
Masculino
Meia-Idade
Osteoartrite do Joelho/etiologia
Radiografia
Estudos Retrospectivos
Tíbia/diagnóstico por imagem
Tíbia/patologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170629
[Lr] Data última revisão:
170629
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170128
[St] Status:MEDLINE
[do] DOI:10.1177/0363546516676266


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[PMID]:28110363
[Au] Autor:Thienpont E; Schwab PE; Cornu O; Bellemans J; Victor J
[Ad] Endereço:Department of Orthopaedic Surgery, University Hospital Saint Luc, Avenue Hippocrate 10, 1200, Brussels, Belgium. Emmanuel.thienpont@uclouvain.be.
[Ti] Título:Bone morphotypes of the varus and valgus knee.
[So] Source:Arch Orthop Trauma Surg;137(3):393-400, 2017 Mar.
[Is] ISSN:1434-3916
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Coronal deformity correction with total knee arthroplasty (TKA) is an important feature in the treatment of osteoarthritis (OA). The hypothesis of this study was that bone morphology would be different in varus and valgus deformity, both before osteoarthritis development as well as during and after the disease process of OA. MATERIALS AND METHODS: Retrospective study with measurements on preoperative and postoperative full leg standing radiographs of 96 patients who underwent TKA. The included patients were selected for this study because they had an OA knee on one side and a non-arthritic knee on the contralateral side presenting the same type of alignment as the to-be-operated knee (varus or valgus alignment on both sides). The control group of 46 subjects was a group of patients with neutral mechanical alignment who presented for ligamentous problems. A single observer measured mechanical alignment, anatomical alignment, anatomical-mechanical femoral angle and intra-articular bone morphology parameters with an accuracy of 1°. RESULTS: Varus OA group has less distal femoral valgus (mLDFA 89°) than control group (87°) and valgus OA group (mLDFA 85°). Varus OA group has same varus obliquity as control group (MPTA 87°) but more than valgus OA group (MPTA 90°). Joint Line Congruency Angle (JLCA) is 3°open on lateral side in varus and medially open in valgus OA group (2°). The non-arthritic valgus group presents a constitutional mechanical valgus of 184° Hip-Knee-Ankle (HKA) angle. DISCUSSION: Varus deformity in OA as measured with an HKA angle (HKA) <177° is a combination of distal femoral wear, tibial varus obliquity and lateral joint line opening. Valgus deformity in OA with an HKA > 183° is a combination of femoral distal joint line obliquity and wear combined with medial opening due to medial collateral ligament stretching. The clinical importance of bone morphotype analysis is that it shows the intra-articular potential of alignment correction when mechanical axis cuts are performed. CONCLUSION: Bone morphology in varus and valgus deformity is different before and after osteoarthritis. Perpendicular cuts to mechanical axes do not necessarily lead to neutral mechanical axis. Constitutional mechanical valgus was observed as 184° HKA angle before the development of OA. LEVEL OF EVIDENCE: Level IV study.
[Mh] Termos MeSH primário: Fêmur/diagnóstico por imagem
Genu Valgum/diagnóstico por imagem
Genu Varum/diagnóstico por imagem
Articulação do Joelho/diagnóstico por imagem
Osteoartrite do Joelho/diagnóstico por imagem
Tíbia/diagnóstico por imagem
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Articulação do Tornozelo/diagnóstico por imagem
Artroplastia do Joelho
Feminino
Fêmur/cirurgia
Articulação do Quadril/diagnóstico por imagem
Seres Humanos
Articulação do Joelho/cirurgia
Extremidade Inferior/diagnóstico por imagem
Masculino
Meia-Idade
Osteoartrite do Joelho/cirurgia
Período Pós-Operatório
Radiografia
Estudos Retrospectivos
Tíbia/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170524
[Lr] Data última revisão:
170524
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170123
[St] Status:MEDLINE
[do] DOI:10.1007/s00402-017-2626-x


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[PMID]:28089797
[Au] Autor:Martínez G; Drago S; Avilés C; Ibañez A; Hodgson F; Ramírez C
[Ad] Endereço:Department of Traumatology and Orthopedics, Clinical Hospital of Pontificia Universidad Católica de Chile, Santiago, Chile. Electronic address: ginomartinez@gmail.com.
[Ti] Título:Distal femoral hemiepiphysiodesis using screw and non-absorbable filament for the treatment of idiopathic genu valgum. Preliminary results of 12 knees.
[So] Source:Orthop Traumatol Surg Res;103(2):269-273, 2017 Apr.
[Is] ISSN:1877-0568
[Cp] País de publicação:France
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Different techniques for gradual correction of angular deformities of lower limbs exist. Screws and nonabsorbable filament has been described as an effective alternative for transitory hemiepiphysiodesis in New Zealand rabbits. HYPOTHESIS: Hemiepiphysiodesis using screws and non-absorbable filament is effective in pediatric population, for correction of genu valgum. METHODS: Retrospective evaluation, 12 knees in 6 patients younger than 15 years (3 female), operated because of genu valgum. An anchoring system with two 4.0mm cancellous screw with metal washer joined by FiberWire #2.0 filament. Initial and final intermalleolar distance (IMD) and mechanical lateral distal femoral angle were compared, recording complications. Mann-Whitney test was used for statistics, with significance value <0.05. RESULTS: All patients achieved the expected correction. IMD and mLDFA were significatively improved. Only one patient presents a minor perioperative complication. DISCUSSION: Lateral distal femoral hemiepiphysiodesis with screws and nonabsorbable filament resulted to be an effective alternative for genu valgum gradual correction in pediatric population. This is the first article that proposes this model, as an efficient and simple alternative for the treatment of genu valgum in pediatric patients. LEVEL OF EVIDENCE: Retrospective study, Level IV.
[Mh] Termos MeSH primário: Parafusos Ósseos
Genu Valgum/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Criança
Diáfises/cirurgia
Epífises/cirurgia
Feminino
Fêmur/diagnóstico por imagem
Fêmur/cirurgia
Seguimentos
Genu Valgum/diagnóstico por imagem
Seres Humanos
Extremidade Inferior/diagnóstico por imagem
Masculino
Procedimentos Ortopédicos/efeitos adversos
Procedimentos Ortopédicos/métodos
Radiografia
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170117
[St] Status:MEDLINE



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