Annals of Joint最新文献_第8页

Anterior cruciate ligament injury prevention 预防前交叉韧带损伤

IF 0.4 4区医学

Annals of Joint Pub Date : 2021-01-01 DOI: 10.21037/AOJ-2020-SRI-08

Hannah Bradsell, R. Frank

{"title":"Anterior cruciate ligament injury prevention","authors":"Hannah Bradsell, R. Frank","doi":"10.21037/AOJ-2020-SRI-08","DOIUrl":"https://doi.org/10.21037/AOJ-2020-SRI-08","url":null,"abstract":": Anterior cruciate ligament injuries are a prominent issue in the field of sports medicine, especially for the female athlete. Extensive research has been performed that acknowledges the disparity in anterior cruciate ligament injury rates between male and female athletes and the high prevalence of risk factors specific to females. The underlying causes of anterior cruciate ligament injuries are widespread and are important to consider when approaching injury prevention. For example, prevention techniques aim to correct neuromuscular imbalances and improve biomechanical deficits, which are some of the most significant risk factors leading to these injuries. While there is a lack of opportunity for intervention related to anatomical and hormonal risks, awareness of their influence on injury mechanisms remains an important factor in clinical decision-making. In pursuit of addressing the risks of this injury, several prevention programs have been established that have been shown to successfully reduce anterior cruciate ligament injury rates when properly executed. The most effective programs include early intervention with continuous training and are multicomponent programs including various targeted exercises to modify associated risk factors. Unfortunately, despite the development of these readily available programs, anterior cruciate ligament injury rates remain high due to insufficient implementation of these methods. Recognizing the efficacy and feasibility of utilizing prevention strategies and continuing to develop effective techniques remain of utmost importance to reduce the incidence of this substantial injury among athletes.","PeriodicalId":44459,"journal":{"name":"Annals of Joint","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48618572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Charcot’s foot reconstruction with removal of the navicular and cuboid bones plus arthrodesis of the medial and mid columns using two solid intramedullary fusion bolts—a case report 用两个实心髓内融合螺栓去除舟骨和长方体骨加内侧柱和中柱关节融合术重建Charcot足一例

IF 0.4 4区医学

Annals of Joint Pub Date : 2020-12-31 DOI: 10.21037/AOJ-20-93

J. Mónico, Pedro M. Matos, P. Costa, Maria Pia Monjardino, Jorge Faísca, F. Fonseca, J. Mariano

{"title":"Charcot’s foot reconstruction with removal of the navicular and cuboid bones plus arthrodesis of the medial and mid columns using two solid intramedullary fusion bolts—a case report","authors":"J. Mónico, Pedro M. Matos, P. Costa, Maria Pia Monjardino, Jorge Faísca, F. Fonseca, J. Mariano","doi":"10.21037/AOJ-20-93","DOIUrl":"https://doi.org/10.21037/AOJ-20-93","url":null,"abstract":"Charcot neuroarthropathy is a progressive chronic destructive arthropathy which can result in severe foot deformity, recurrent plantar ulceration, osteomyelitis and, ultimately, foot amputation. Treating a Charcot’s foot and preserving or restoring foot’s anatomy can be challenging. Several treatment methods have been previously described but they are associated with high rates of failure or adverse events. We report a clinical case of a 47-year-old patient with Charcot’s foot. Clinical examination and convectional radiography revealed a rocker bottom deformity with plantar ulceration. Plantar ulceration was addressed first with medical treatment, followed by surgical reconstruction and arthrodesis of the foot. In our case, we describe the advantages of complementing surgical treatment with medical treatment using a cast immobilization. Additionally, we describe our surgical reconstruction method with removal of the navicular and cuboid bones plus arthrodesis of the medial and mid columns, using two solid intramedullary fusion bolts, and stabilization of the lateral column with one Kirschner wire. We were able to successfully reconstruct foot’s anatomy and achieve a stable foot arthrodesis. During 12-month follow-up, no adverse medical events or screws breakdown were recorded. The patient is able to wear shoes again and walk in full weight bearing without limitations. Charcot’s foot surgical reconstruction should be done in non-acute inflammatory phase and achieve foot arthrodesis with rotational stability. Extended fixation of the medial and mid foot columns, with intramedullary solid fusion bolts, is mandatory to build a stable construct. Bone graft augmentation and full contact plastered boot in the first 3 postoperative months can provide additional stability.","PeriodicalId":44459,"journal":{"name":"Annals of Joint","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43098089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation and management of patellar instability 髌骨不稳定的评估和治疗

IF 0.4 4区医学

Annals of Joint Pub Date : 2020-12-04 DOI: 10.21037/AOJ-2020-SRI-09

E. Dennis, S. Gruber, W. Marmor, B. Stein

{"title":"Evaluation and management of patellar instability","authors":"E. Dennis, S. Gruber, W. Marmor, B. Stein","doi":"10.21037/AOJ-2020-SRI-09","DOIUrl":"https://doi.org/10.21037/AOJ-2020-SRI-09","url":null,"abstract":"Patellar instability is a common clinical problem that primarily affects the adolescent and young adult population. The demographic and anatomic risk factors that predispose patients to patellar instability are multifactorial and include young age, female sex, trochlear dysplasia, elevated tibial tubercle to trochlear groove distance (TT-TG), patella alta, femoral and tibial malalignment, ligamentous laxity, and lack of neuromuscular control. There have been substantial efforts to predict which patients who sustain a first-time dislocation will go on to incur additional dislocations. This is particularly important because with each dislocation event, there is a significant risk of injury to the patellofemoral joint including both medial patellofemoral ligament (MPFL) stretch or rupture and damage to the cartilage which can range from simple fissures to full-thickness cartilage defects and osteochondral fractures. Prediction models have demonstrated that amongst first time dislocators, young patients with trochlear dysplasia are at the highest risk for redislocation. The current standard of care for treatment of first-time dislocators without a loose body or osteochondral fracture is nonoperative management. However, recently there has been a focus on implementing a risk-stratified approach to the surgical indications for a first-time dislocator as the highrisk population might be better treated with early surgical stabilization to prevent or reduce their risk of recurrent dislocation and its associated morbidity. Likewise, for patients with recurrent dislocations, it remains to be determined whether an isolated MPFL reconstruction is sufficient for high-risk patients with several poor prognostic risk factors or if bony realignment procedures should be implemented concurrently.","PeriodicalId":44459,"journal":{"name":"Annals of Joint","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49463879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Osteosarcoma mineralization changes on radiographs have moderate correlation to chemotherapy response using bone subtraction methodology. 骨肉瘤在x线片上的矿化变化与骨减影方法的化疗反应有中度相关性。

IF 0.4 4区医学

Annals of Joint Pub Date : 2020-10-01 Epub Date: 2020-10-15 DOI: 10.21037/aoj-20-70

Eric R Henderson, Xiaochun Xu, Brian W Pogue, Kimberley S Samkoe, Megan E Anderson

{"title":"Osteosarcoma mineralization changes on radiographs have moderate correlation to chemotherapy response using bone subtraction methodology.","authors":"Eric R Henderson, Xiaochun Xu, Brian W Pogue, Kimberley S Samkoe, Megan E Anderson","doi":"10.21037/aoj-20-70","DOIUrl":"https://doi.org/10.21037/aoj-20-70","url":null,"abstract":"Background: Survival following a diagnosis of osteosarcoma is correlated strongly with response to chemotherapy. Mineralization changes seen on radiographs have been hypothesized to correlate with chemotherapy response, however, this has never been analyzed using modern techniques.Methods: Retrospective review of radiographs obtained before and after neoadjuvant chemotherapy was performed for 31 patients with high-grade, conventional osteosarcoma. Pre-chemotherapy (PreC) images and post-chemotherapy (PostC) images were co-registered. Tumor luminance measurements were normalized based on the non-tumor bone and then the relative change in tumor mineralization were measured.Results: Mean luminance values for pre-chemotherapy non-tumor-affected bone and tumor were 0.63±0.12 and 0.65±0.12, respectively. Mean values for PostC non-tumor-affected bone were 0.59±0.14 and 0.64±0.10, respectively. Once normalized, osteosarcoma mineralization change showed a statistically significant moderate correlation-Pearson correlation coefficient (ρ) of 0.36 (P=0.038)-with the tumor necrosis value.Conclusions: Moderate, positive correlation was found between osteosarcoma mineralization change during chemotherapy and chemotherapy response. Further work is required to determine if these findings are prognostic by identifying best practice for image analysis and repeating this work with prospectively acquired digital radiographs using uniform technique and phantom normalization.","PeriodicalId":44459,"journal":{"name":"Annals of Joint","volume":"5 ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/de/88/nihms-1813817.PMC9430774.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40343698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

The psychology of the female athlete: how mental health and wellness mediate sports performance, injury and recovery 女运动员的心理：心理健康如何调节运动成绩、损伤和恢复

IF 0.4 4区医学

Annals of Joint Pub Date : 2020-09-06 DOI: 10.21037/AOJ-20-53

C. Herrero, N. Jejurikar, Cordelia Carter

引用次数: 9

Diagnosing prosthetic joint infection: traditional and contemporary techniques 诊断假体关节感染:传统和现代技术

IF 0.4 4区医学

Annals of Joint Pub Date : 2020-08-17 DOI: 10.21037/AOJ-20-78

M. Sarungi, D. Wallace

{"title":"Diagnosing prosthetic joint infection: traditional and contemporary techniques","authors":"M. Sarungi, D. Wallace","doi":"10.21037/AOJ-20-78","DOIUrl":"https://doi.org/10.21037/AOJ-20-78","url":null,"abstract":": Prosthetic joint infection (PJI) has been recognised as a devastating complication for as long as arthroplasty has been performed. Despite this, there is still no universally agreed standard within either PJI literature or clinical practice for the diagnosis of infection following joint arthroplasty. Recently, however, significant efforts have been made by different specialist musculoskeletal societies to move towards this goal. This paper reviews the history of the diagnosis of PJI, examines the current debate on diagnostic criteria and the limitations of a lack of consensus on infection research, clinical practice, and joint registry data. Based on the current situation, we propose that until there is a consensus on existing algorithms for diagnosis, there is need to implement a “minimum standard set of PJI diagnostics” locally by each national orthopaedic/ trauma association (focusing on those tests which are included in every specialist musculoskeletal society’s recommended list). Since there is still variation not only internationally but at national and sometimes at local level regarding standardisation of PJI testing, a smaller number of universally accepted PJI tests which are implemented and professionally monitored by national musculoskeletal societies will likely to result in significant improvement in PJI management in the short term, whilst the debate regarding the best criteria is still ongoing and is likely to continue for some time. 7","PeriodicalId":44459,"journal":{"name":"Annals of Joint","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48235188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The burden of prosthetic joint infection (PJI) 人工关节感染的负担

IF 0.4 4区医学

Annals of Joint Pub Date : 2020-07-09 DOI: 10.21037/AOJ-2020-PJI-11

N. Sandiford, M. Franceschini, D. Kendoff

{"title":"The burden of prosthetic joint infection (PJI)","authors":"N. Sandiford, M. Franceschini, D. Kendoff","doi":"10.21037/AOJ-2020-PJI-11","DOIUrl":"https://doi.org/10.21037/AOJ-2020-PJI-11","url":null,"abstract":"Total hip and knee arthroplasty are clinically and cost effective procedures. The numbers of patients receiving these procedures are estimated to rise by 150–600% for THA and TKA respectively by 2030 (1) in the USA. The trend is similar in Europe (2,3). Along with this trend in hip and knee arthroplasty patients increasingly also have indwelling prostheses of the shoulder, elbow and ankle. Prosthetic joint infection (PJI) is potentially the most significant complication following total joint arthroplasty. It is challenging for the surgeon to manage, physically and mentally disastrous for the patient and the cost to the health care system and society as a whole is high. PJI has an impact on patients, healthcare delivery institutions and society as a whole. It has significant negative impact on patients’ psychological well being (4). The cost of treating PJI is significant. It is estimated that in the US alone the projected spend on the treatment of PJI is $1.62 billion (5). This is despite little improvement in the success rate in terms of eradication of infection (6). For these reasons there has been an increasing focus on the issue of PJI in the medical literature (6). This paper discusses the incidence of PJI as well as the factors which might account for the current trends and the challenges associated with the contemporary management of PJI. The incidence of PJI varies with the joint involved (7,8). Reported incidences following total knee arthroplasty, total hip arthroplasty and total shoulder arthroplasty have been reported to be 0.25% to 2%, 0.5% to 1% and less than 1% respectively (9,10). Between 23–25% of revision TKA procedures and 12–15% revision THA procedures are performed for PJI (11,12). Risk factors for PJI are presented in Table 1 (13). While the incidence remains low the number of patients are likely to increase over time however as the number of arthroplasty procedures performed annually increases. The incidence of PJI varies throughout the literature. As a result existing data needs to be interpreted with caution. Wang 4","PeriodicalId":44459,"journal":{"name":"Annals of Joint","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42200050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8

Calcaneal osteotomies 跟骨截骨术

IF 0.4 4区医学

Annals of Joint Pub Date : 2020-07-01 DOI: 10.21037/aoj.2020.02.02

Dan Prat, Wonyong Lee, Daniel Charles Farber

引用次数: 1

Reverse shoulder arthroplasty for proximal humerus fractures 反向肩关节置换术治疗肱骨近端骨折

IF 0.4 4区医学

Annals of Joint Pub Date : 2020-06-16 DOI: 10.21037/AOJ-20-15

Brian K. Lee, J. Itamura

{"title":"Reverse shoulder arthroplasty for proximal humerus fractures","authors":"Brian K. Lee, J. Itamura","doi":"10.21037/AOJ-20-15","DOIUrl":"https://doi.org/10.21037/AOJ-20-15","url":null,"abstract":"The optimal treatment of complex proximal humerus fractures continues to be debated. While many fractures can be treated nonoperatively, surgical intervention can be indicated to aid in restoring anatomy, allowing earlier range of motion and an improved final outcome. Historically, when surgical fixation of proximal humerus fractures was not possible due to fracture comminution, bone loss, head involvement or soft tissue/rotator cuff injury, hemiarthroplasty of the shoulder was utilized. Results of hemiarthroplasty, however, were unpredictable and largely dependent on the restoration of tuberosities. Reverse shoulder arthroplasty has emerged as a surgical treatment option in such cases, with results less-dependent on tuberosity healing. The design of reverse shoulder arthroplasty and evolution in surgical techniques have yielded results demonstrating it to be a safe option with consistent results in the treatment of these difficult injuries. Studies have shown rotational strength to be improved in cases where the tuberosities heal, and repair techniques as well as implant designs have evolved to optimize tuberosity healing. Complications of reverse shoulder arthroplasty for fracture are similar to those of other indications, including scapular notching, and neurologic injury. Further studies are still needed to assess the long-term validity of the results seen at the short and mid-term.","PeriodicalId":44459,"journal":{"name":"Annals of Joint","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49663774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Patient-derived orthotopic xenograft models for osteosarcoma individualized precision treatment and effective drug discovery 骨肉瘤患者原位异种移植物模型的个体化精确治疗和有效药物发现

IF 0.4 4区医学

Annals of Joint Pub Date : 2020-05-13 DOI: 10.21037/AOJ.2020.02.08

T. Higuchi, K. Igarashi, H. Oshiro, K. Miyake, Norihiko Sugisawa, N. Yamamoto, Katsuhiro Hayashi, H. Kimura, S. Miwa, Z. Duan, F. Hornicek, H. Tsuchiya, R. Hoffman

{"title":"Patient-derived orthotopic xenograft models for osteosarcoma individualized precision treatment and effective drug discovery","authors":"T. Higuchi, K. Igarashi, H. Oshiro, K. Miyake, Norihiko Sugisawa, N. Yamamoto, Katsuhiro Hayashi, H. Kimura, S. Miwa, Z. Duan, F. Hornicek, H. Tsuchiya, R. Hoffman","doi":"10.21037/AOJ.2020.02.08","DOIUrl":"https://doi.org/10.21037/AOJ.2020.02.08","url":null,"abstract":"Osteosarcoma is the most common malignant primary tumor of bone and mainly occurs in young generations. Due to the heterogeneity, rarity, poor response rate to systemic therapy, and metastatic potential of osteosarcoma, individualized precision medicine and novel drug discovery are greatly needed. Toward this goal, we have established the patient-derived orthotopic xenograft (PDOX) mouse model with surgical orthotopic implantation (SOI) for all major cancers. The PDOX models recapitulate human tumors better than subcutaneous-transplanted xenografts including patient-derived xenograft (PDX). Metastasis is observed to a greater extent in PDOX models due to the intact histology and correct-organ tumor microenvironment of the orthotopically implanted tissue. The present report reviews our research group’s experience with the osteosarcoma-PDOX model, and the power of the PDOX models to identify effective therapeutics. We have obtained many promising and surprising results using the osteosarcoma-PDOX model for discovering active approved drugs as well as combinations of them, and experimental therapeutics for individual patients. The patient does not need to suffer from the potential drug toxicity and morbidity of ineffective chemotherapies. In an era of growing promise of new treatment and precision medicine, PDOX models offer a unique opportunity to provide specific and individualized therapy and novel therapeutic options for osteosarcoma patients.","PeriodicalId":44459,"journal":{"name":"Annals of Joint","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48467063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0