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Pesquisa : A02.513.514.475 [Categoria DeCS]
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  1 / 2039 MEDLINE  
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PMID:29382009
Autor:Tan L; Wang T; Li YH; Yang T; Hao B; Zhu D; Sun DH
Endereço:Department of Orthopedic Traumatology.
Título:Patellar tendon ossification after retrograde intramedullary nailing for distal femoral shaft fracture: A case report and review of the literature.
Fonte:Medicine (Baltimore); 96(47):e8875, 2017 Nov.
ISSN:1536-5964
País de publicação:United States
Idioma:eng
Resumo:RATIONALE: Retrograde femoral nailing was one of the most important treatment means for distal femoral shaft fracture. However, studies regarding heterotopic ossification of the patellar tendon after retrograde intramedullary nailing for distal femoral shaft fracture are limited. We herein present a rare complication, namely heterotopic ossification of the patellar tendon, after retrograde intramedullary nailing for displaced femoral shaft fracture. PATIENT CONCERNS: We present a case of 25-year-old male with displaced femoral shaft fracture who was treated by retrograde intramedullary nailing. DIAGNOSES: During the period of follow-up, the patient developed symptomatic heterotopic ossification of the patellar tendon with extensively hard ossification area. INTERVENTIONS: Open surgery was recommended, but the patient has refused further treatment. OUTCOMES: The patient resulted in pain and restricted the range of motion of the affected knee. LESSONS: This case stresses the importance of longer-term follow-up and further attention into the possibility of heterotopic ossification of the patellar tendon.
Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE; REVIEW


  2 / 2039 MEDLINE  
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PMID:29189618
Autor:Kamienski M
Endereço:Mary Kamienski, PhD, APRN, FAEN, FAAN, Professor, and Specialty Director, Family Nurse Practitioner in Emergency Care, Rutgers Biomedical and Health Sciences, School of Nursing, Newark, NJ.
Título:Bilateral Patellar Tendon Rupture.
Fonte:Orthop Nurs; 36(6):379-382, 2017 Nov/Dec.
ISSN:1542-538X
País de publicação:United States
Idioma:eng
Resumo:The knee is the most complex and largest joint in the body. Injuries to any part of this joint affect the entire body. There are multiple injuries that can occur to the knee, with the most common being ligament and meniscus tears. A not-so-common injury to the knee is a patellar tendon rupture. A bilateral patellar tendon rupture is extremely rare. A case study of a 43-year-old man who sustained a bilateral patellar tendon rupture while playing softball is used to present this devastating injury. This discussion includes the incidence and diagnosis of the tear, surgical repair, as well as a description of the comprehensive rehabilitation process necessary to allow the patient to return to normal physical activity. Risks and complications of this surgery and the expected outcomes are also presented.
Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE


  3 / 2039 MEDLINE  
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PMID:27776906
Autor:Ushio T; Mizu-Uchi H; Okazaki K; Ma Y; Kuwashima U; Iwamoto Y
Endereço:Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
Título:The Anteroposterior Axis of the Proximal Tibia Can Change After Tibial Resection in Total Knee Arthroplasty: Computer Simulation Using Asian Osteoarthritis Knees.
Fonte:J Arthroplasty; 32(3):1006-1012, 2017 03.
ISSN:1532-8406
País de publicação:United States
Idioma:eng
Resumo:BACKGROUND: We evaluated the effect of cutting surface on the anteroposterior (AP) axis of the proximal tibia using a 3-dimensional (3D) bone model to ensure proper tibial rotational alignment in total knee arthroplasty. METHODS: 3D bone models were reconstructed from the preoperative computed tomography data of 93 Japanese osteoarthritis knees with varus deformity. The AP axis was defined as the perpendicular bisector of the medial and lateral condylar centers in a 3D coordinate system. Bone cutting of the proximal tibia was performed with various tibial posterior slopes (0°, 3°, 7°) to the mechanical axis, and we compared the AP axes before and after bone cutting. RESULTS: The AP axis before bone cutting crossed a point at about 16% (one-sixth) of the distance from the medial edge of the patellar tendon at its tibial attachment. The AP axis after bone cutting was significantly internally rotated at all posterior slopes: 4.1° at slope 0°, 3.0° at slope 3°, and 2.1° at slope 7°. The percentages of cases with differences of more than 3° or 5° were 66.7% and 34.4% at slope 0°, 53.8% and 24.7% at slope 3°, and 38.3% and 11.8% at slope 7°, respectively. CONCLUSION: The AP axis of the proximal tibia may be rotated internally after resection of the proximal tibia in total knee arthroplasty. Hence, surgeons should recognize the effect of changes in the cutting surface on rotational alignment of the proximal tibia.
Tipo de publicação: JOURNAL ARTICLE


  4 / 2039 MEDLINE  
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PMID:28877266
Autor:Sohirad S; Wilson D; Waugh C; Finnamore E; Scott A
Endereço:Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.
Título:Feasibility of using a hand-held device to characterize tendon tissue biomechanics.
Fonte:PLoS One; 12(9):e0184463, 2017.
ISSN:1932-6203
País de publicação:United States
Idioma:eng
Resumo:OBJECTIVES: To examine the feasibility of using the MyotonPRO digital palpation device in measuring the transverse stiffness of tendon tissue. DESIGN: Experimental study. METHODS: The MyotonPRO was used to measure the stiffness and related properties of ballistics gel in comparison with an external materials testing system (PCB electronics). The device was then used to measure the same properties of avian Achilles tendons before and after the removal of the overlying skin and subcutaneous tissue. Next, the test-retest reliability of the Achilles and patellar tendons was determined in humans. Finally, the stiffness of the Achilles tendon was measured before and after competitive running races of varying distances (10, 21 and 42 km, total number of athletes analyzed = 66). RESULTS: The MyotonPRO demonstrated a high degree of consistency when testing ballistics gel with known viscoelastic properties. The presence of skin overlying the avian Achilles tendon had a statistically significant impact on stiffness (p<0.01) although this impact was of very small absolute magnitude (with skin; 728 Nm ±17 Nm, without skin; Nm 704 Nm ±7 Nm). In healthy adults of normal body mass index (BMI), the reliability of stiffness values was excellent both for the patellar tendon (ICC, 0.96) and the Achilles tendon (ICC,0.96). In the the field study, men had stiffer tendons than women (p<0.05), and the stiffness of the Achilles tendon tended to increase following running (p = 0.052). CONCLUSIONS: The MyotonPRO can reliably determine the transverse mechanical properties of tendon tissue. The measured values are influenced by the presence of overlying skin, however this does not appear to compromise the ability of the device to record physiologically and clinically relevant measurements.
Tipo de publicação: JOURNAL ARTICLE
Nome de substância:0 (Gels)


  5 / 2039 MEDLINE  
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PMID:28569198
Autor:Lojszczyk-Szczepaniak A; Silmanowicz P; Komsta R; Osinski Z
Endereço:Laboratory of Radiology and Ultrasonography, Department and Clinic of Animal Surgery, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, Gleboka 30, 20-612, Lublin, Poland. anna.lojszczyk@gmail.com.
Título:Determination of reference values and frequency of occurrence of patella alta in German shepherd dogs: a retrospective study.
Fonte:Acta Vet Scand; 59(1):36, 2017 May 31.
ISSN:1751-0147
País de publicação:England
Idioma:eng
Resumo:BACKGROUND: Patella alta and patella baja are important conditions underlying a predisposition to many joint diseases, including patellar luxation and patellar chondromalacia of the articular cartilage. The frequencies of patella alta and patella baja have not yet been determined. The objectives of this study were to determine the frequency of patella alta and to determine reference values to the position of the vertical patella according to two modified techniques of the Insall-Salvati method in a group of 65 German shepherd dogs (115 stifle joints). RESULTS: The upper limits of reference values for the normal vertical position of the patella were 1.79 and 2.13, depending on the method of measurement. A high prevalence of patella alta was observed in the group of German shepherd dogs. A correlation was demonstrated between the classification of dogs' joints in the patella alta group and the multiplied risk of canine hip dysplasia (CHD) through the estimation of odds ratios. CONCLUSIONS: Dogs with patella alta were healthy dogs that did not exhibit orthopaedic problems in the stifle joints. The results revealed that the risk of CHD is twice as high in dogs with higher patellar ligament length to patella length ratio.
Tipo de publicação: JOURNAL ARTICLE; OBSERVATIONAL STUDY


  6 / 2039 MEDLINE  
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PMID:28410739
Autor:Pearson SJ; Engel AJ; Bashford GR
Endereço:Centre of Health, Sport and Rehabilitation Sciences Research, University of Salford, Manchester M6 6PU, United Kingdom. Electronic address: s.pearson@salford.ac.uk.
Título:Changes in tendon spatial frequency parameters with loading.
Fonte:J Biomech; 57:136-140, 2017 May 24.
ISSN:1873-2380
País de publicação:United States
Idioma:eng
Resumo:To examine and compare the loading related changes in micro-morphology of the patellar tendon. Fifteen healthy young males (age 19±3yrs, body mass 83±5kg) were utilised in a within subjects matched pairs design. B mode ultrasound images were taken in the sagittal plane of the patellar tendon at rest with the knee at 90° flexion. Repeat images were taken whilst the subjects were carrying out maximal voluntary isometric contractions. Spatial frequency parameters related to the tendon morphology were determined within regions of interest (ROI) from the B mode images at rest and during isometric contractions. A number of spatial parameters were observed to be significantly different between resting and contracted images (Peak spatial frequency radius (PSFR), axis ratio, spatial Q-factor, PSFR amplitude ratio, and the sum). These spatial frequency parameters were indicative of acute alterations in the tendon micro-morphology with loading. Acute loading modifies the micro-morphology of the tendon, as observed via spatial frequency analysis. Further research is warranted to explore its utility with regard to different loading induced micro-morphological alterations, as these could give valuable insight not only to aid strengthening of this tissue but also optimization of recovery from injury and treatment of conditions such as tendinopathies.
Tipo de publicação: JOURNAL ARTICLE


  7 / 2039 MEDLINE  
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PMID:28353085
Autor:Lee WC; Zhang ZJ; Masci L; Ng GYF; Fu SN
Endereço:Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China.
Título:Alterations in mechanical properties of the patellar tendon is associated with pain in athletes with patellar tendinopathy.
Fonte:Eur J Appl Physiol; 117(5):1039-1045, 2017 May.
ISSN:1439-6327
País de publicação:Germany
Idioma:eng
Resumo:PURPOSE: To compare tendon strain and stiffness between athletes with patellar tendinopathy and healthy controls, and explore whether the intensity of pain and dysfunction were related to the mechanical properties of the tendon. METHODS: Thirty-four male athletes with patellar tendinopathy and 13 healthy controls matched by age and activity levels were recruited. The in vivo mechanical properties of the patellar tendon were examined by ultrasonography and dynamometry. In subjects with patellar tendinopathy, the intensities of self-perceived pain (maximal pain in the past 7 days and pain during a single-legged declined-squat test) using the visual analogue scale and the assessment of functional disability using the Victorian Institute of Sport Assessment-patellar questionnaire, were collected. RESULTS: In subjects with patellar tendinopathy, tendon strain was significantly reduced by 22% (8.9 ± 3.7 vs. 14.3 ± 4.7%, P = 0.005) when compared with healthy controls. There was no significant group difference in tendon stiffness (P = 0.27). Significant negative correlations between tendon strain and the maximal self-perceived pain over 7 days (r = -0.37, P = 0.03), and pain during a single-legged declined-squat test (r = -0.37, P = 0.03) were detected. A trend of significant positive correlation was found between tendon stiffness and pain during a single-legged declined-squat test (r = 0.30, P = 0.09). CONCLUSION: Our findings show that tendon strain is reduced in athletes with patellar tendinopathy, and a lower tendon strain is associated with a greater magnitude of pain perceived.
Tipo de publicação: JOURNAL ARTICLE


  8 / 2039 MEDLINE  
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PMID:28345997
Autor:Pillard P; Livet V; Cabon Q; Bismuth C; Sonet J; Remy D; Fau D; Carozzo C; Viguier E; Cachon T
Título:Evaluation of a new method to determine the tibial tuberosity advancement distance required to reduce the patellar tendon-tibial plateau angle to 90° with the modified Maquet technique in dogs.
Fonte:Am J Vet Res; 78(4):517-528, 2017 Apr.
ISSN:1943-5681
País de publicação:United States
Idioma:eng
Resumo:OBJECTIVE To assess use of a new radiographic method to determine the distance by which the tibial tuberosity should be advanced to reduce the patellar tendon-tibial plateau angle (PTA) to 90° by means of the modified Maquet technique (MMT) in dogs. SAMPLE 24 pelvic limbs from 12 adult medium-sized to large-breed canine cadavers. PROCEDURES Radiographs of stifle joints at 135° extension in true lateral position were used to determine tibial tuberosity advancement distances for use in the MMT. A method was devised to incorporate the planned osteotomy axis; distal patellar translations of 0, 3, 5, or 10 mm; and advancement cage implant application level along the osteotomy site in advancement planning measurements. Concordance correlation coefficients (CCCs) were calculated to compare these adjusted advancement measurements with true advancement measurements obtained for the same joints in another study after treatment by MMT. Intraobserver, interobserver, and total agreement for selected measurements were determined by assessment of CCCs for results obtained by 3 blinded observers. RESULTS Agreement between true advancement measurements and measurements obtained with osteotomy axis and cage position method calculations that incorporated a 5-mm distal patellar translation distance was excellent (CCC, 0.96). Intraobserver and interobserver agreements for the planning measurements evaluated were good to excellent (CCC, 0.83 to 0.96). CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that the osteotomy axis and cage position method incorporating a 5-mm distal patellar translation distance has the potential to improve success rates for achieving a PTA of 90° in medium-sized to large-breed dogs undergoing MMT for treatment of cranial cruciate ligament rupture. Further research is warranted.
Tipo de publicação: JOURNAL ARTICLE


  9 / 2039 MEDLINE  
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PMID:28298067
Autor:Schilaty ND; Bates NA; Sanders TL; Krych AJ; Stuart MJ; Hewett TE
Endereço:Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Título:Incidence of Second Anterior Cruciate Ligament Tears (1990-2000) and Associated Factors in a Specific Geographic Locale.
Fonte:Am J Sports Med; 45(7):1567-1573, 2017 Jun.
ISSN:1552-3365
País de publicação:United States
Idioma:eng
Resumo:BACKGROUND: Second anterior cruciate ligament (ACL) tears after reconstruction occur at a reported rate of 20% to 30%. This high frequency indicates that there may be factors that predispose an athlete to graft failure and ACL tears of the contralateral knee. PURPOSE: To determine the incidence of second ACL injuries in a geographic population-based cohort over a 10-year observation period. STUDY DESIGN: Descriptive epidemiological study. METHODS: International Classification of Diseases, 9th Revision (ICD-9) codes relevant to the diagnosis of an ACL tear and the procedure code for ACL reconstruction were searched across the Rochester Epidemiology Project, a multidisciplinary county database, between the years of 1990 and 2000. This cohort of patients was tracked for subsequent ACL injuries through December 31, 2015. The authors identified 1041 patients with acute, isolated ACL tears. These patients were stratified by primary and secondary tears, sex, age, activity level, side of injury, sex by side of injury, and graft type. RESULTS: Of the 1041 unique patients with a diagnosed ACL tear in Olmsted County, Minnesota, from 1990 to 2000, there were 66 (6.0%) second ACL tears; 66.7% of these tears occurred on the contralateral side. A second ACL injury was influenced by graft type ( P < .0001), election of ACL reconstruction ( P = .0060), and sex by side of injury ( P = .0072). Nonparametric analysis of graft disruption by graft type demonstrated a higher prevalence of second ACL tears with allografts compared with hamstring ( P = .0499) or patellar tendon autografts ( P = .0012). CONCLUSION: The incidence of second ACL tears in this population-based cohort was 6.0%, with 66.7% of these tears occurring on the contralateral side from the original injury. There was a high population incidence of second ACL injuries in female patients younger than age 20 years. The utilization of patellar tendon autografts significantly reduced the risk of second ACL injuries compared with allografts or hamstring autografts in this cohort.
Tipo de publicação: JOURNAL ARTICLE


  10 / 2039 MEDLINE  
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PMID:28298052
Autor:Jacobs CA; Burnham JM; Makhni E; Malempati CS; Swart E; Johnson DL
Endereço:Department of Orthopedics and Sports Medicine, University of Kentucky, Lexington, Kentucky, USA.
Título:Allograft Augmentation of Hamstring Autograft for Younger Patients Undergoing Anterior Cruciate Ligament Reconstruction.
Fonte:Am J Sports Med; 45(4):892-899, 2017 Mar.
ISSN:1552-3365
País de publicação:United States
Idioma:eng
Resumo:BACKGROUND: Younger patients and those with smaller hamstring autograft diameters have been shown to be at significantly greater risk of graft failure after anterior cruciate ligament (ACL) reconstruction. To date, there is no information in the literature about the clinical success and/or cost-effectiveness of increasing graft diameter by augmenting with semitendinosus allograft tissue for younger patients. HYPOTHESIS: Hybrid hamstring grafts are a cost-effective treatment option because of a reduced rate of graft failure. STUDY DESIGN: Cohort study (economic and decision analysis); Level of evidence, 3. METHODS: We retrospectively identified patients younger than 18 years who had undergone ACL reconstruction by a single surgeon between 2010 and 2015. During this period, the operating surgeon's graft selection algorithm included the use of bone-patellar tendon-bone (BTB) autografts for the majority of patients younger than 18 years. However, hamstring autografts (hamstring) or hybrid hamstring autografts with allograft augment (hybrid) were used in skeletally immature patients and in those whom the surgeon felt might have greater difficulty with postoperative rehabilitation after BTB graft harvest. Patient demographics, graft type, graft diameter, the time the patient was cleared to return to activity, and the need for secondary surgical procedures were compared between the hamstring and hybrid groups. The clinical results were then used to assess the potential cost-effectiveness of hybrid grafts in this select group of young patients with an ACL injury or reconstruction. RESULTS: This study comprised 88 patients (hamstring group, n = 46; hybrid group, n = 42). The 2 groups did not differ in terms of age, sex, timing of return to activity, or prevalence of skeletally immature patients. Graft diameters were significantly smaller in the hamstring group (7.8 vs 9.9 mm; P < .001), which corresponded with a significantly greater rate of graft failure (13 of 46 [28.3%] vs 5 of 42 [11.9%]; P = .049). As a result of the reduced revision rate, the hybrid graft demonstrated incremental cost savings of US$2765 compared with the hamstring graft, and the hybrid graft was the preferred strategy in 89% of cases. CONCLUSION: Driven by increased graft diameters and the reduced risk of revision, hybrid grafts appear to be a more cost-effective treatment option in a subset of younger patients with an ACL injury.
Tipo de publicação: JOURNAL ARTICLE



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