Current Reviews in Musculoskeletal Medicine最新文献_第9页

Postoperative Rehabilitation for Arthroscopic Management of Femoroacetabular Impingement Syndrome: a Contemporary Review. 股骨髋臼撞击综合征关节镜治疗的术后康复:当代综述。

IF 4.1 2区医学

Current Reviews in Musculoskeletal Medicine Pub Date : 2023-09-01 DOI: 10.1007/s12178-023-09850-2

Stefan Hanish, Maaz Muhammed, Shayne Kelly, Steven DeFroda

{"title":"Postoperative Rehabilitation for Arthroscopic Management of Femoroacetabular Impingement Syndrome: a Contemporary Review.","authors":"Stefan Hanish, Maaz Muhammed, Shayne Kelly, Steven DeFroda","doi":"10.1007/s12178-023-09850-2","DOIUrl":"https://doi.org/10.1007/s12178-023-09850-2","url":null,"abstract":"Purpose of review: Femoroacetabular impingement syndrome (FAIS) is a common cause of hip pain that may potentially lead to osteoarthritis. Operative management of FAIS seeks to arthroscopically reshape the abnormal hip morphology and repair the labrum. For rehabilitation following operative management, a structured physical therapy program is unanimously recommended for the patient to return to their previous level of physical activity. Yet, despite this unanimous recommendation, significant heterogeneity exists among the current recommendations for postoperative physical therapy programs.Recent findings: A four-phase postoperative physical therapy protocol is favored among current literature, with each phase being comprised of its own goals, restrictions, precautions, and rehabilitation techniques. Phase 1 aims to protect the integrity of the surgically repaired tissues, reduce pain and inflammation, and regain ~ 80% of full ROM. Phase 2 guides a smooth transition to full weightbearing, so the patient may regain functional independence. Phase 3 helps the patient become recreationally asymptomatic and restores muscular strength and endurance. Finally, phase 4 culminates in the pain-free return to competitive sports or recreational activity. At this time, there exists no single, unanimously agreed upon postoperative physical therapy protocol. Among the current recommendations, variation exists regarding specific timelines, restrictions, precautions, exercises, and techniques throughout the four phases. It is imperative to reduce ambiguity in current recommendations and more specifically define postoperative physical therapy following operative management of FAIS to more expeditiously return patients to functional independence and physical activity.","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":"16 9","pages":"381-391"},"PeriodicalIF":4.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10427582/pdf/12178_2023_Article_9850.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10393003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Current Concepts in the Measurement of Glenohumeral Bone Loss. 肱骨盂骨丢失测量的最新概念。

IF 4.1 2区医学

Current Reviews in Musculoskeletal Medicine Pub Date : 2023-09-01 DOI: 10.1007/s12178-023-09852-0

Ryan R Thacher, Julia S Retzky, Mihir S Dekhne, Yousi A Oquendo, Harry G Greditzer

{"title":"Current Concepts in the Measurement of Glenohumeral Bone Loss.","authors":"Ryan R Thacher, Julia S Retzky, Mihir S Dekhne, Yousi A Oquendo, Harry G Greditzer","doi":"10.1007/s12178-023-09852-0","DOIUrl":"https://doi.org/10.1007/s12178-023-09852-0","url":null,"abstract":"Purpose: The extent of glenohumeral bone loss seen in anterior shoulder dislocations plays a major role in guiding surgical management of these patients. The need for accurate and reliable preoperative assessment of bone loss on imaging studies is therefore of paramount importance to orthopedic surgeons. This article will focus on the tools that are available to clinicians for quantifying glenoid bone loss with a focus on emerging trends and research in order to describe current practices.Recent findings: Recent evidence supports the use of 3D CT as the most optimal method for quantifying bone loss on the glenoid and humerus. New trends in the use of 3D and ZTE MRI represent exciting alternatives to CT imaging, although they are not widely used and require further investigation. Contemporary thinking surrounding the glenoid track concept and the symbiotic relationship between glenoid and humeral bone loss on shoulder stability has transformed our understanding of these lesions and has inspired a new focus of study for radiologists and orthopedist alike. Although a number of different advanced imaging modalities are utilized to detect and quantify glenohumeral bone loss in practice, the current literature supports 3D CT imaging to provide the most reliable and accurate assessments. The emergence of the glenoid track concept for glenoid and humeral head bone loss has inspired a new area of study for researchers that presents exciting opportunities for the development of a deeper understanding of glenohumeral instability in the future. Ultimately, however, the heterogeneity of literature, which speaks to the diverse practices that exist across the world, limits any firm conclusions from being drawn.","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":"16 9","pages":"419-431"},"PeriodicalIF":4.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10427601/pdf/12178_2023_Article_9852.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10393478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fracture Dislocations of the Glenohumeral Joint. 盂肱关节骨折脱位。

IF 4.1 2区医学

Current Reviews in Musculoskeletal Medicine Pub Date : 2023-08-01 DOI: 10.1007/s12178-023-09846-y

Joseph T Labrum, Nicolas P Kuttner, Yousif Atwan, Joaquin Sanchez-Sotelo, Jonathan D Barlow

{"title":"Fracture Dislocations of the Glenohumeral Joint.","authors":"Joseph T Labrum, Nicolas P Kuttner, Yousif Atwan, Joaquin Sanchez-Sotelo, Jonathan D Barlow","doi":"10.1007/s12178-023-09846-y","DOIUrl":"https://doi.org/10.1007/s12178-023-09846-y","url":null,"abstract":"Purpose of review: Proximal humerus fracture dislocations typically result from high-energy mechanisms and carry specific risks, technical challenges, and management considerations. It is vital for treating surgeons to understand the various indications, procedures, and complications involved with their treatment.Recent findings: While these injuries are relatively rare in comparison with other categories of proximal humerus fractures, fracture dislocations of the proximal humerus require treating surgeons to consider patient age, activity level, injury pattern, and occasionally intra-operative findings to select the ideal treatment strategy for each injury. Proximal humerus fracture dislocations are complex injuries that require special considerations. This review summarizes recent literature regarding the evaluation and management of these injuries as well as the indications and surgical techniques for each treatment strategy. Thorough pre-operative patient evaluation and shared decision-making should be employed in all cases. While nonoperative management is uncommonly considered, open reduction and internal fixation (ORIF), hemiarthroplasty, and reverse total shoulder replacement are at the surgeon's disposal, each with their own indications and complication profile.","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":"16 8","pages":"346-357"},"PeriodicalIF":4.1,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10382466/pdf/12178_2023_Article_9846.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10268459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Return to Sport After Hip and Knee Arthroplasty: Counseling the Patient on Resuming an Active Lifestyle. 髋关节和膝关节置换术后重返运动:建议患者恢复积极的生活方式。

IF 4.1 2区医学

Current Reviews in Musculoskeletal Medicine Pub Date : 2023-08-01 DOI: 10.1007/s12178-023-09839-x

Armin Arshi, Andrew J Hughes, Joseph X Robin, Javad Parvizi, Yale A Fillingham

{"title":"Return to Sport After Hip and Knee Arthroplasty: Counseling the Patient on Resuming an Active Lifestyle.","authors":"Armin Arshi, Andrew J Hughes, Joseph X Robin, Javad Parvizi, Yale A Fillingham","doi":"10.1007/s12178-023-09839-x","DOIUrl":"https://doi.org/10.1007/s12178-023-09839-x","url":null,"abstract":"Purposeof review: The purpose of this review is to summarize the available literature on the epidemiology, biomechanics, clinical outcomes, and complications of return to sport after TJA, as well as provide guidelines for patients' safe return to athletic activity.Recent findings: As volume and indications for total joint arthroplasty (TJA) expand, arthroplasty candidates today are demographically younger, more physically active, and have higher expectations for postoperative function. Many TJA patients wish to resume sports activity that may theoretically place their reconstruction under more biomechanical stress and risk for early wear or failure. Recommendations for postoperative patient activity following TJA have historically largely been surgeon-dependent and in the context of evolving prosthetic design and surgical techniques. We endorse a three-tiered framework for return to sporting activities: (1) low-impact sports are generally recommended, (2) intermediate-impact sports are generally recommended with experience, and (3) high-impact sports are generally not recommended though activity-specific joint decisions between patient and surgeon can be made.","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":"16 8","pages":"329-337"},"PeriodicalIF":4.1,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10382373/pdf/12178_2023_Article_9839.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10276712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Quadriceps Dysfunction Following Joint Preservation Surgery: A Review of the Pathophysiologic Basis and Mitigation Strategies. 关节保留手术后的股四头肌功能障碍：病理生理学基础和缓解策略综述。

IF 2.9 2区医学

Current Reviews in Musculoskeletal Medicine Pub Date : 2023-08-01 Epub Date: 2023-05-27 DOI: 10.1007/s12178-023-09844-0

Daniel J Cognetti, Thomas B Lynch, Elizabeth Rich, Asheesh Bedi, Aman Dhawan, Andrew J Sheean

{"title":"Quadriceps Dysfunction Following Joint Preservation Surgery: A Review of the Pathophysiologic Basis and Mitigation Strategies.","authors":"Daniel J Cognetti, Thomas B Lynch, Elizabeth Rich, Asheesh Bedi, Aman Dhawan, Andrew J Sheean","doi":"10.1007/s12178-023-09844-0","DOIUrl":"10.1007/s12178-023-09844-0","url":null,"abstract":"Purpose of review: To characterize quadriceps muscle dysfunction associated with knee joint preservation surgery, with a focus on its pathophysiology and promising approaches to mitigate its impact on clinical outcomes.Recent findings: Quadriceps dysfunction (QD) associated with knee joint preservation surgery results from a complex interplay of signaling, related to changes within the joint and from those involving the overlying muscular envelope. Despite intensive rehabilitation regimens, QD may persist for many months postoperatively and negatively impact clinical outcomes associated with various surgical procedures. These facts underscore the need for continued investigation into the potential detrimental effects of regional anesthetic and intraoperative tourniquet use on postoperative quadriceps function, with an outward focus on innovation within the field of postoperative rehabilitation. Neuromuscular stimulation, nutritional supplementation, cryotherapy, blood flow restriction (BFR), and open-chain exercises are all potential additions to postoperative regimens. There is compelling literature to suggest that these modalities are efficacious and may diminish the magnitude and duration of postoperative QD. A clear understanding of QD, with respect to its pathophysiology, should guide perioperative treatment and rehabilitation strategies and influence ongoing rehabilitation-based research and innovation. Moreover, clinicians must appreciate the magnitude of QD's effect on diminished clinical outcomes, risk for re-injury and patients' ability (or inability) to return to pre-injury level of activity following knee joint preservation procedures.","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":"16 8","pages":"338-345"},"PeriodicalIF":2.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10382434/pdf/12178_2023_Article_9844.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9898162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Management of Glenoid Bone Loss in Primary Reverse Total Shoulder Arthroplasty. 初次逆行全肩关节置换术中肩关节骨丢失的处理。

IF 4.1 2区医学

Current Reviews in Musculoskeletal Medicine Pub Date : 2023-08-01 DOI: 10.1007/s12178-023-09845-z

Nabil Mehta, Gregory P Nicholson

{"title":"Management of Glenoid Bone Loss in Primary Reverse Total Shoulder Arthroplasty.","authors":"Nabil Mehta, Gregory P Nicholson","doi":"10.1007/s12178-023-09845-z","DOIUrl":"https://doi.org/10.1007/s12178-023-09845-z","url":null,"abstract":"Purpose of review: Glenoid bone loss presents distinct challenges in reverse total shoulder arthroplasty (rTSA) which, if unaddressed, can cause complications including poor outcomes and early implant failure. The purpose of this review is to discuss the etiology, evaluation, and management strategies of glenoid bone loss in primary rTSA.Recent findings: Three-dimensional computed tomography (3D CT) imaging and preoperative planning software have revolutionized the understanding of complex glenoid deformity and wear patterns from bone loss. With this knowledge, a detailed preoperative plan can be created and implemented for a more optimal management strategy. When appropriately indicated, deformity correction techniques with biologic or metal augmentation are successful in addressing the glenoid bone deficiency, creating optimal implant position, and thus providing stable baseplate fixation and improving outcomes. Thorough evaluation and characterization of the degree of glenoid deformity with 3D CT imaging is necessary prior to treatment with rTSA. Eccentric reaming, bone grafting, and augmented glenoid components have shown promising results in correcting glenoid deformity due to bone loss, but long-term outcomes are currently unknown.","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":"16 8","pages":"358-370"},"PeriodicalIF":4.1,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10382449/pdf/12178_2023_Article_9845.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9900937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Preventing and Treating Infection in Reverse Total Shoulder Arthroplasty. 逆向全肩关节置换术中感染的预防与治疗。

IF 4.1 2区医学

Current Reviews in Musculoskeletal Medicine Pub Date : 2023-08-01 DOI: 10.1007/s12178-023-09843-1

Alexander R Markes, Joseph Bigham, C Benjamin Ma, Jaicharan J Iyengar, Brian T Feeley

{"title":"Preventing and Treating Infection in Reverse Total Shoulder Arthroplasty.","authors":"Alexander R Markes, Joseph Bigham, C Benjamin Ma, Jaicharan J Iyengar, Brian T Feeley","doi":"10.1007/s12178-023-09843-1","DOIUrl":"https://doi.org/10.1007/s12178-023-09843-1","url":null,"abstract":"Purpose of review: Periprosthetic infection after shoulder arthroplasty is relatively uncommon though associated with severe long-term morbidity when encountered. The purpose of the review is to summarize the recent literature regarding the definition, clinical evaluation, prevention, and management of prosthetic joint infection after reverse shoulder arthroplasty.Recent findings: The landmark report generated at the 2018 International Consensus Meeting on Musculoskeletal Infection has provided a framework for diagnosis, prevention, and management of periprosthetic infections after shoulder arthroplasty. Shoulder specific literature with validated interventions to reduce prosthetic joint infection is limited; however existing literature from retrospective studies and from total hip and knee arthroplasty allows us to make relative guidelines. One and two-stage revisions seem to demonstrate similar outcomes; however, no controlled comparative studies exist limiting the ability to make definitive recommendations between the two options. We report on recent literature regarding the current diagnostic, preventative, and treatment options for periprosthetic infection after shoulder arthroplasty. Much of the literature does not distinguish between anatomic and reverse shoulder arthroplasty, and further high-level shoulder specific studies are needed to answer questions generated from this review.","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":"16 8","pages":"371-380"},"PeriodicalIF":4.1,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10382412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10277202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Patellofemoral Instability in the Pediatric Population. 小儿髌骨股骨不稳症

IF 2.9 2区医学

Current Reviews in Musculoskeletal Medicine Pub Date : 2023-07-01 Epub Date: 2023-04-18 DOI: 10.1007/s12178-023-09836-0

Prushoth Vivekanantha, Dan Cohen, Devin Peterson, Darren de Sa

{"title":"Patellofemoral Instability in the Pediatric Population.","authors":"Prushoth Vivekanantha, Dan Cohen, Devin Peterson, Darren de Sa","doi":"10.1007/s12178-023-09836-0","DOIUrl":"10.1007/s12178-023-09836-0","url":null,"abstract":"Purpose of review: This review focuses on the etiology, diagnosis, and management of patellar instability in pediatric patients.Recent findings: Radiological outcomes such as tibial-tubercle to trochlear groove (TT-TG) distance used in diagnosis are subject to factors of influence such as femoral anteversion and knee flexion angle, and new measure such as tibial-tubercle to posterior cruciate ligament distance as well as TT-TG/trochlear width (TT-TG/TW) are under investigation. To prevent recurrent instability, surgical intervention for acute patellar dislocations may be advantageous compared to conservative management. Patellar instability is a common pathology found in pediatric cohorts. Diagnosis can be performed via a combination of history, physical examination maneuvers, and radiological risk factors such as patella alta, patellar tilt, trochlear dysplasia, and elevated TT-TG distances. Current literature advocates the usage of additional radiological measures to TT-TG such as TT-TG/TW, especially as TT-TG varies with age in younger patients. Recent literature potentially suggests the utilization of surgical procedures such as MPFL reconstruction or repair for acute dislocations in the hope of preventing recurrent instability. Special indications for pediatric patients include osteochondral fracture identification to help prevent patellofemoral osteoarthritis. A comprehensive workup and understanding of current literature can aid clinicians in aiming to prevent recurrent patellar dislocation in pediatric patients.","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":"16 7","pages":"255-262"},"PeriodicalIF":2.9,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10356699/pdf/12178_2023_Article_9836.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9851099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Lateral Meniscus Oblique Radial Tear (LMORT). 外侧半月板倾斜径向撕裂(LMORT)。

IF 4.1 2区医学

Current Reviews in Musculoskeletal Medicine Pub Date : 2023-07-01 DOI: 10.1007/s12178-023-09835-1

Adam V Daniel, Aaron J Krych, Patrick A Smith

{"title":"The Lateral Meniscus Oblique Radial Tear (LMORT).","authors":"Adam V Daniel, Aaron J Krych, Patrick A Smith","doi":"10.1007/s12178-023-09835-1","DOIUrl":"https://doi.org/10.1007/s12178-023-09835-1","url":null,"abstract":"Purpose of review: The lateral meniscus oblique radial tear (LMORT) of the posterior horn is a relatively new term for one of the more common types of lateral meniscal tears found in patients with acute anterior cruciate ligament (ACL) injuries. Given the importance of anatomical reduction and preservation of the lateral meniscus to maintain normal knee stability and slow the progression of early-onset osteoarthritis, LMORT classification and treatment guidelines have been formulated. This article provides a review of the prevalence, classification, biomechanics, surgical repair techniques, and outcomes related to LMORT injuries.Recent findings: Current research demonstrates favorable clinical results when LMORTs are surgically treated based on recent evidence. Biomechanically, repair of the higher grade 3 and 4 LMORT lesions have led to comparable results when compared to an intact lateral meniscus, and superior results when compared to partial meniscectomy and untreated tears. Ongoing research is aimed to determine the difference between LMORT repairs compared to intact lateral menisci at the time of ACL surgery regarding comparable patient outcomes. LMORT lesions are common tears of the lateral meniscus that should be treated surgically based on tear type at the time of ACL surgery. The benefit of doing so has already been demonstrated biomechanically.","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":"16 7","pages":"306-315"},"PeriodicalIF":4.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10356734/pdf/12178_2023_Article_9835.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9902765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Approaches to Septic Arthritis of the Knee Post Anterior Cruciate Ligament Reconstruction. 前交叉韧带重建后脓毒性膝关节炎的治疗方法。

IF 4.1 2区医学

Current Reviews in Musculoskeletal Medicine Pub Date : 2023-07-01 DOI: 10.1007/s12178-023-09841-3

Oladimeji Ranti Babalola, Adebukola Adedoyin Babalola, Kehinde Adesola Alatishe

{"title":"Approaches to Septic Arthritis of the Knee Post Anterior Cruciate Ligament Reconstruction.","authors":"Oladimeji Ranti Babalola, Adebukola Adedoyin Babalola, Kehinde Adesola Alatishe","doi":"10.1007/s12178-023-09841-3","DOIUrl":"https://doi.org/10.1007/s12178-023-09841-3","url":null,"abstract":"Purpose of review: Septic arthritis of the knee following anterior cruciate ligament reconstruction is a rare but potentially deleterious complication. The main approach to the management of this potentially devastating complication in recent years has involved a more aggressive attempt at preventing graft contamination during surgery with the adoption of the pre-soaking of the graft in broad-spectrum antibiotic solution, and early and adequate treatment of established cases of knee sepsis, with or without retention of the graft. However, what constitutes an early and adequate initial treatment may be a challenging decision for the surgeon to make in certain instances.Recent findings: Graft pre-soaking in vancomycin has been noted to significantly reduce the incidence of septic arthritis of the knee following anterior cruciate ligament reconstruction. Other studies have recorded similar satisfactory results with graft pre-soaking in gentamycin. In established cases of infection, irrigation and debridement with either graft retention or graft excision with delayed re-construction of the anterior cruciate ligament have both given satisfactory results in well-selected patients. Septic arthritis of the knee following anterior cruciate ligament reconstruction can be prevented by careful patient selection, use of prophylactic antibiotics, strict asepsis during surgery, and graft pre-soaking in antibiotic solution. The choice of antibiotic solution for graft pre-soaking is influenced by the surgeon's preference, tissue penetrance, effect on graft tensile strength, local bio-gram of the micro-organisms, and the sensitivity pattern. The treatment option in established cases would depend on the stage of infection, state of the graft, and the extent of bony involvement.","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":"16 7","pages":"274-283"},"PeriodicalIF":4.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10356700/pdf/12178_2023_Article_9841.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9903324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0