Increasing the Knee Arc of Motion in Patients With Arthrogryposis: Minimum 2-year Follow-up.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-10-17 DOI:10.1097/BPO.0000000000002826

Aaron J Huser, Michael W Brown, Hans K Nugraha, David S Feldman

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引用次数: 0

Abstract

Background: Surgery for knee flexion contractures in patients with arthrogryposis multiplex congenital (AMC) have achieved extension to redirect the arc of motion and improve ambulation but has not demonstrated maintained increases in total range of motion (ROM). This study aimed to review the clinical outcomes of combined posterior knee release, proximal femoral shortening, and nerve decompression in patients with arthrogryposis.

Methods: A retrospective chart and radiographic review were performed on patients with AMC who underwent treatment for knee flexion deformities ≥30 degrees. ROM, ambulation status, and orthotic use were reviewed and analyzed. Complications were recorded.

Results: Twenty-nine patients with 51 knees and a mean age of 5.7 years were included. The mean follow-up was 36.9 months. The mean ROM increased from 49 to 80 degrees between pre-op and latest follow-up (P<0.0001). The mean final follow-up flexion deformity was 10 degrees (P<0.0001). Preoperative ROM was moderately correlated with final ROM (rs=0.51). The percentage of ambulatory patients improved from 39% to 93%. Five limbs experienced a fracture either intraoperatively or postoperatively, and 5 limbs required a return trip to the operating room.

Conclusions: Improved ambulation and knee ROM can be maintained in patients with AMC at a minimum 2-year follow-up. Prospective investigation and longer follow-up are required to validate these findings.

Level of evidence: Level IV-therapeutic.

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增加关节畸形患者的膝关节活动弧度：最短两年随访

背景：先天性关节发育不全（AMC）患者膝关节屈曲挛缩的手术治疗实现了膝关节的伸展，从而调整了运动弧度并改善了行走能力，但并没有证明总运动范围（ROM）的持续增加。本研究旨在回顾膝关节后路松解术、股骨近端缩短术和神经减压术联合治疗关节发育不良患者的临床效果：方法：对因膝关节屈曲畸形≥30度而接受治疗的AMC患者进行回顾性病历和影像学检查。对患者的膝关节活动度、行走状况和矫形器使用情况进行回顾性分析。并记录了并发症：共纳入29名患者，51个膝关节，平均年龄5.7岁。平均随访时间为 36.9 个月。从术前到最近一次随访，平均膝关节活动度从 49 度增加到 80 度（结论：术后膝关节活动度和行走能力得到改善：在至少两年的随访中，AMC患者的行走能力和膝关节活动度都能得到改善。需要进行前瞻性调查和更长时间的随访来验证这些发现：证据等级：IV级-治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.