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[PMID]:28926635
[Au] Autor:Jafarnezhadgero AA; Shad MM; Majlesi M; Granacher U
[Ad] Endereço:Department of Physical Education and Sport Sciences, University of Mohaghegh Ardabili, Ardabil, Iran.
[Ti] Título:A comparison of running kinetics in children with and without genu varus: A cross sectional study.
[So] Source:PLoS One;12(9):e0185057, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Varus knee alignment has been identified as a risk factor for the progression of medial knee osteoarthritis. However, the underlying mechanisms have not been elucidated yet in children. Thus, the aims of the present study were to examine differences in ground reaction forces, loading rate, impulses, and free moment values during running in children with and without genu varus. METHODS: Thirty-six boys aged 9-14 volunteered to participate in this study. They were divided in two age-matched groups (genu varus versus healthy controls). Body weight adjusted three dimensional kinetic data (Fx, Fy, Fz) were collected during running at preferred speed using two Kistler force plates for the dominant and non-dominant limb. RESULTS: Individuals with knee genu varus produced significantly higher (p = .01; d = 1.09; 95%) body weight adjusted ground reaction forces in the lateral direction (Fx) of the dominant limb compared to controls. On the non-dominant limb, genu varus patients showed significantly higher body weight adjusted ground reaction forces values in the lateral (p = .01; d = 1.08; 86%) and medial (p < .001; d = 1.55; 102%) directions (Fx). Further, genu varus patients demonstrated 55% and 36% greater body weight adjusted loading rates in the dominant (p < .001; d = 2.09) and non-dominant (p < .001; d = 1.02) leg, respectively. No significant between-group differences were observed for adjusted free moment values (p>.05). DISCUSSION: Higher mediolateral ground reaction forces and vertical loading rate amplitudes in boys with genu varus during running at preferred running speed may accelerate the development of progressive joint degeneration in terms of the age at knee osteoarthritis onset. Therefore, practitioners and therapists are advised to conduct balance and strength training programs to improve lower limb alignment and mediolateral control during dynamic movements.
[Mh] Termos MeSH primário: Genu Varum/fisiopatologia
Corrida
[Mh] Termos MeSH secundário: Adolescente
Fenômenos Biomecânicos
Criança
Estudos Transversais
Seres Humanos
Cinética
Articulação do Joelho/fisiologia
Masculino
[Pt] Tipo de publicação: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:170920
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0185057


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[PMID]:28772066
[Au] Autor:Sharma L; Chang AH; Jackson RD; Nevitt M; Moisio KC; Hochberg M; Eaton C; Kwoh CK; Almagor O; Cauley J; Chmiel JS
[Ad] Endereço:Northwestern University Feinberg School of Medicine, Chicago, Illinois.
[Ti] Título:Varus Thrust and Incident and Progressive Knee Osteoarthritis.
[So] Source:Arthritis Rheumatol;69(11):2136-2143, 2017 Nov.
[Is] ISSN:2326-5205
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To determine if varus thrust, a bowing out of the knee during gait (i.e., the first appearance or worsening of varus alignment during stance), is associated with incident and progressive knee osteoarthritis (OA), we undertook an Osteoarthritis Initiative ancillary study. We further considered hypothesized associations adjusted for static alignment, anticipating some attenuation. METHODS: Gait was observed for the presence of thrust by 1 of 2-3 examiners per study site at 4 sites. In eligible knees, incident OA was defined as subsequent incident Kellgren/Lawrence grade ≥2, whole- and partial-grade medial joint space narrowing (JSN), and annualized loss of joint space width (JSW); progression was defined as medial JSN and JSW loss. Outcome measures were assessed for up to 7 years of follow-up. Analyses were knee-level, using multivariable logistic and linear regression with generalized estimating equations to account for between-limb correlation. RESULTS: The incident OA sample included 4,187 knees (2,610 persons); the progression sample included 3,421 knees (2,284 persons). In knees with OA, thrust was associated with progression as assessed by each outcome measure, with adjustment for age, sex, body mass index, and pain on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale. In knees without OA, varus thrust was not associated with incident OA or other outcomes. After adjustment for alignment, the thrust-progression association was attenuated, but an independent association persisted for partial-grade JSN and JSW loss outcome models. WOMAC pain and alignment were consistently associated with all outcome measures. Within the stratum of varus knees, thrust was associated with an increased risk of progression. CONCLUSION: Varus thrust visualized during gait is associated with knee OA progression and should be a target of intervention development.
[Mh] Termos MeSH primário: Marcha/fisiologia
Genu Varum/epidemiologia
Osteoartrite do Joelho/epidemiologia
[Mh] Termos MeSH secundário: Idoso
Fenômenos Biomecânicos
Progressão da Doença
Feminino
Genu Varum/fisiopatologia
Seres Humanos
Incidência
Articulação do Joelho/diagnóstico por imagem
Modelos Lineares
Modelos Logísticos
Masculino
Meia-Idade
Análise Multivariada
Osteoartrite do Joelho/diagnóstico por imagem
Estudos Prospectivos
Radiografia
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170804
[St] Status:MEDLINE
[do] DOI:10.1002/art.40224


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[PMID]:28142346
[Au] Autor:Kim HJ; Lee HJ; Shin JY; Park KH; Min SG; Kyung HS
[Ad] Endereço:1 Department of Orthopaedic Surgery, Kyungpook National University Hospital, Daegu, Korea.
[Ti] Título:Preoperative planning using the picture archiving and communication system technique in high tibial osteotomy.
[So] Source:J Orthop Surg (Hong Kong);25(1):2309499016684701, 2017 Jan.
[Is] ISSN:2309-4990
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:PURPOSE: This study aimed to evaluate the accuracy of the picture archiving and communication system (PACS) method in order to select the correction angle and gap in open-wedge high tibial osteotomy (HTO) and clinical results of the patients. MATERIAL AND METHODS: This retrospective study analyzed 27 consecutive patients (30 knees) underwent open-wedge HTO using the PACS method between April 2013 and March 2015. Full-length lower limb radiographs obtained preoperatively and at the final follow-up were used to the percentages of crossing points of the weight-bearing line and tibial plateau with respect to the medial border and mechanical femur-tibia angle. Preoperatively predicted and postoperatively measured wedge angles and gaps were compared. The clinical results were evaluated using the Hospital for Special Surgery (HSS) knee score and the Knee Society score. RESULTS: At the 20.5 months (12-26.5) follow-up, the weight-bearing line on the tibial plateau was corrected from 17.3% to 61.3%, and the mechanical femur-tibia angle was corrected from 7.3° varus to 3.1° valgus. No significant difference in preoperative and postoperative measured values was observed ( p = 0.440 and p = 0.505). The mean HSS score increased from 66.7 to 88.8 ( p < 0.001). The knee score and function score of Knee Society increased from 62.0 to 88.7 ( p < 0.001) and from 60.2 to 91.7 ( p < 0.001), respectively. CONCLUSION: In open-wedge HTO, correction of angular deformity based on the PACS method could be an accurate correction method and the good clinical results could be obtained.
[Mh] Termos MeSH primário: Genu Varum/cirurgia
Osteoartrite do Joelho/cirurgia
Osteotomia
Sistemas de Informação em Radiologia
Tíbia/cirurgia
[Mh] Termos MeSH secundário: Adulto
Feminino
Genu Varum/diagnóstico por imagem
Seres Humanos
Masculino
Meia-Idade
Osteoartrite do Joelho/diagnóstico por imagem
Estudos Retrospectivos
Tíbia/diagnóstico por imagem
Suporte de Carga
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170202
[St] Status:MEDLINE
[do] DOI:10.1177/2309499016684701


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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]: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]:28087396
[Au] Autor:Kobayashi H; Akamatsu Y; Kumagai K; Kusayama Y; Aratake M; Saito T
[Ad] Endereço:Department of orthopaedic surgery, Yokohama city university, school of medicine, 3-9, Fukuura, Kanazawa, Yokohama, Kanagawa 236-0004, Japan. Electronic address: hi-deo@live.jp.
[Ti] Título:Influence of coronal bowing on the lower alignment and the positioning of component in navigation and conventional total knee arthroplasty.
[So] Source:Orthop Traumatol Surg Res;103(2):251-256, 2017 Apr.
[Is] ISSN:1877-0568
[Cp] País de publicação:France
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Coronal alignment is an important factor for the function and longevity of total knee arthroplasty (TKA). Coronal bowing of the lower extremity is common among Asians and it may pose a risk for malalignment of the lower leg and malposition of component. HYPOTHESIS: We hypothesized that coronal bowing itself has a risk for malalignment of the lower leg and malposition of femoral/tibial components and that navigation TKA is beneficial for patients with coronal bowing. We investigated the incidence of femoral/tibial bowing in patients treated with TKA and compared the radiographic parameters between the navigation group and the conventional group. Additionally, the influence of coronal bowing on these radiographic parameters was investigated. MATERIALS AND METHODS: We enrolled 35 patients with knee osteoarthritis and 70 bilateral simultaneous TKAs. The patients underwent TKA with the use of a computer tomography-free navigation in one knee and conventional TKA in the contralateral knee. Preoperative coronal bowing were measured, and the subjects were divided into 2 subgroups, i.e. the bowing group and the non-bowing group. Lateral bowing was expressed as plus (+) and medial bowing was expressed as minus (-). Various radiographic parameters, including coronal bowing, lower leg alignment, component position, and outliers were compared between the navigation group and the conventional group. RESULTS: Femoral bowing varied from -7.4° to 10.9° with an average of 3.0°. Tibial bowing varied from -4.1° to 4.6° with an average of 0.4°. The femoral component was placed more properly in the navigation group. Number of outlier regarding to the coronal femoral component angle to the femoral mechanical axis was 14 cases (37.8%) in the bowing group and 6 cases (18.2%) in the non-bowing group (P=0.04). DISCUSSION: In conclusion, coronal femoral bowing has an important effect on femoral bone cut in TKA. The navigated TKA was more consistent than conventional TKA in aiding proper alignments of femoral component. LEVEL OF EVIDENCE: Level II, comparative prospective study.
[Mh] Termos MeSH primário: Artroplastia do Joelho/métodos
Genu Varum/diagnóstico por imagem
Osteoartrite do Joelho/cirurgia
Cirurgia Assistida por Computador
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Grupo com Ancestrais do Continente Asiático
Feminino
Fêmur/diagnóstico por imagem
Fêmur/cirurgia
Genu Varum/complicações
Seres Humanos
Japão
Masculino
Meia-Idade
Osteoartrite do Joelho/complicações
Posicionamento do Paciente
Estudos Prospectivos
Radiografia
Estudos Retrospectivos
Tíbia/diagnóstico por imagem
Tíbia/cirurgia
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:COMPARATIVE STUDY; 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:170115
[St] Status:MEDLINE


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[PMID]:27261964
[Au] Autor:Welborn MC; Stevens P
[Ad] Endereço:*Shriners Hospital for Children, Portland, OR †University of Utah Primary Children's Hospital, Salt Lake City, UT.
[Ti] Título:Correction of Angular Deformities Due to Focal Fibrocartilaginous Dysplasia Using Guided Growth: A Preliminary Report.
[So] Source:J Pediatr Orthop;37(3):e183-e187, 2017 Apr/May.
[Is] ISSN:1539-2570
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Focal fibrocartilaginous dysplasia (FFCD) is a rare benign disorder that may result in tethering of the physis. These most commonly occur around the knee and may result in angular deformities of the involved extremity. To date treatment has ranged from observation, to curettage, to osteotomy. Our goal with this study is to evaluate the efficacy of guided growth in treating patients with angular deformity due to FFCD. METHODS: This is a retrospective review, we included 3 patients with angular deformities due to FFCD who had undergone 8 plate placement. We reviewed their preoperative and postoperative radiographs, assessed their sagittal and coronal balance and number of procedures. RESULTS: Three patients with FFCD of the femur with an average of 14 months underwent guided growth to correct their angular deformity. Once appropriate correction was achieved the hardware was removed. At final follow-up none of the patients required further surgical intervention for their angular deformity nor had they shown any evidence of recurrence. CONCLUSIONS: FFCD is a rare benign disorder, they most commonly affects the proximal tibia and distal femur and can result in significant angular deformities. Our review of the literature found all of the cases involving the femur progressed to the point where they needed surgical intervention. This ranged from curettage to osteotomy. In this case series we present 3 cases of FFCD of the distal femur that were treated minimally invasively with guided growth. LEVEL OF EVIDENCE: Level 4.
[Mh] Termos MeSH primário: Tratamento Conservador/métodos
Fêmur/anormalidades
Genu Varum/cirurgia
Regeneração Tecidual Guiada/métodos
Osteotomia/efeitos adversos
[Mh] Termos MeSH secundário: Fenômenos Biomecânicos
Fêmur/diagnóstico por imagem
Fêmur/cirurgia
Genu Varum/diagnóstico por imagem
Regeneração Tecidual Guiada/instrumentação
Seres Humanos
Lactente
Masculino
Radiografia
Estudos Retrospectivos
Tíbia/anormalidades
Tíbia/diagnóstico por imagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[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:160605
[St] Status:MEDLINE
[do] DOI:10.1097/BPO.0000000000000785


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[PMID]:26740086
[Au] Autor:Sasaki A; Sugita T; Aizawa T; Miyatake N; Kamimura M; Fujisawa H; Takahashi A
[Ad] Endereço:Department of Orthopaedic Surgery, Tohoku Orthopaedic Clinic, 4-9-22 Kamiyagari, Izumi-ku, Sendai City, 981-3121, Japan.
[Ti] Título:Evaluation of the size and position of the insertion of the anterior medial meniscus root in varus osteoarthritic knees.
[So] Source:Knee Surg Sports Traumatol Arthrosc;25(2):362-367, 2017 Feb.
[Is] ISSN:1433-7347
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Recent studies have suggested radial displacement of the medial meniscus as a cause of varus knee osteoarthritis (OA). Two anatomical studies reported that such displacement may be associated with anterior insertion of the medial meniscus anterior horn. It was aimed to evaluate the location and area of this insertion in patients with advanced knee OA. METHODS: Medial meniscus anterior horn insertions were classified into four types, as described in a previously reported classification during 225 total knee arthroplasty (TKA) in 184 patients. The incidence rates of insertion type were compared with previously reported rates in nearly normal or non-arthritic knees. The insertion surface area was also measured during 158 TKAs. RESULTS: Of the 225 knees, 82 (36.4 %), 93 (41.3 %), 35 (15.6 %), and 15 (6.7 %) were classified as I, II, III, and IV, respectively. An anteriorly inserted anterior horn was not more frequent in advanced varus OA knees than in previously reported nearly normal or non-arthritic knees. The insertion surface areas were 57.5 ± 18.9, 56.1 ± 16.0, and 56.4 ± 14.4 mm for types I, II, and III, respectively; these areas did not differ significantly. CONCLUSION: Since the incidence of an anteriorly inserted medial meniscus anterior horn was not higher in advanced varus OA knees than in normal or non-arthritic knees, an anteriorly inserted anterior horn may have little or no effect on the aetiology of varus OA knees. This study provides some information for clarifying the aetiology of knee OA. LEVEL OF EVIDENCE: IV.
[Mh] Termos MeSH primário: Genu Varum/patologia
Meniscos Tibiais/patologia
Osteoartrite do Joelho/patologia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Artroplastia do Joelho
Feminino
Genu Varum/cirurgia
Seres Humanos
Articulação do Joelho
Masculino
Meia-Idade
Tamanho do Órgão
Osteoartrite do Joelho/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170920
[Lr] Data última revisão:
170920
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160108
[St] Status:MEDLINE
[do] DOI:10.1007/s00167-015-3963-3


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[PMID]:25854499
[Au] Autor:Schröter S; Ateschrang A; Löwe W; Nakayama H; Stöckle U; Ihle C
[Ad] Endereço:Department of Traumatology and Reconstructive Surgery, BG Traumacenter Tübingen, University of Tübingen, Schnarrenbergstr. 95, 72076, Tuebingen, Germany. schroeter.steffen@t-online.de.
[Ti] Título:Early full weight-bearing versus 6-week partial weight-bearing after open wedge high tibial osteotomy leads to earlier improvement of the clinical results: a prospective, randomised evaluation.
[So] Source:Knee Surg Sports Traumatol Arthrosc;25(1):325-332, 2017 Jan.
[Is] ISSN:1433-7347
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Open wedge high tibial osteotomy is a widespread treatment option in patients with varus malalignment and medial compartment osteoarthritis. There is no standardised protocol for post-operative rehabilitation available. The purpose of this study was to compare two post-operative rehabilitation protocols and to evaluate the clinical outcome of early full weight-bearing after open wedge HTO. METHODS: One hundred and twenty consecutive patients with varus malalignment and medial compartment osteoarthritis received an open wedge HTO using an angular locking plate fixation between December 2008 and December 2011. All patients were assigned randomly into one of two groups with different post-operative rehabilitation protocols (11-day vs. 6-week 20-kg partial weight-bearing). Clinical outcome was evaluated using established instruments (Lequesne, Lysholm, HSS and IKDC scores) preoperatively, 6, 12 and 18 months post-operatively. Deformity analysis was performed preoperatively and during follow-up. RESULTS: All clinical scores showed a significant pre- to post-operative improvement. After 6 months, there was a higher improvement in the group of early full weight-bearing. The difference between preoperative and 6-month follow-up for the group with early full weight-bearing and for the group with 20-kg PWB for 6 weeks was 28 ± 26 and 18 ± 22, respectively, for the Lysholm score and -5.0 ± 5.1 and -3.0 ± 3.6, respectively, for the Lequesne score. CONCLUSIONS: Early full weight-bearing (11-day 20-kg partial weight-bearing) after open wedge HTO without bone graft leads to earlier improvement of the clinical results and can be recommended for post-operative rehabilitation after open wedge HTO and fixation with an angular locking plate. LEVEL OF EVIDENCE: Therapeutic study, Level I.
[Mh] Termos MeSH primário: Assistência ao Convalescente/métodos
Placas Ósseas
Genu Varum/cirurgia
Osteoartrite do Joelho/cirurgia
Osteotomia/reabilitação
Tíbia/cirurgia
Suporte de Carga
[Mh] Termos MeSH secundário: Adulto
Feminino
Genu Varum/complicações
Seres Humanos
Articulação do Joelho/cirurgia
Masculino
Meia-Idade
Osteoartrite do Joelho/complicações
Osteotomia/métodos
Estudos Prospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150410
[St] Status:MEDLINE
[do] DOI:10.1007/s00167-015-3592-x



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