Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA最新文献

{"title":"Comparison between Nintendo Wii Fit and conventional rehabilitation on functional performance outcomes after hamstring anterior cruciate ligament reconstruction: prospective, randomized, controlled, double-blind clinical trial.","authors":"Gul Baltaci,&nbsp;Gulcan Harput,&nbsp;Bunyamin Haksever,&nbsp;Burak Ulusoy,&nbsp;Hamza Ozer","doi":"10.1007/s00167-012-2034-2","DOIUrl":"https://doi.org/10.1007/s00167-012-2034-2","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this prospective, randomized, controlled, double-blind clinical trial was to compare the outcomes, including knee strength, balance, coordination, proprioception and response time, of Nintendo Wii Fit with those of conventional rehabilitation on the subjects with anterior cruciate ligament reconstruction.</p><p><strong>Methods: </strong>Thirty volunteer subjects were enrolled in either Wii Fit (n = 15; mean age, 29 ± 7 years) or conventional rehabilitation (n = 15; mean age, 29 ± 6 years) programmes from the first week up to 12th weeks of the operation. Endoscopic reconstruction of a completely ruptured ACL was performed by using graft harvested from hamstrings. Each subject underwent an individual therapeutic programme. Functional examinations included the measurements of the balance using modified star excursion balance test, coordination, proprioception and response time using functional squat system and strength of flexor and extensor muscles of the involved and uninvolved leg using an isokinetic machine.</p><p><strong>Results: </strong>There was no significant difference between Wii Fit and conventional group in terms of isokinetic knee strength at 12th week, and dynamic balance, and functional squat tests including coordination, proprioception and response time at first, 8th and 12th weeks of the rehabilitation.</p><p><strong>Conclusion: </strong>Two different 12-week-physiotherapy programmes following ACL reconstruction have the same affect on muscle strength, dynamic balance and functional performance values in both groups. We considered that the practice of Wii Fit activities like conventional rehabilitation could also address physical therapy goals, which included improving visual-perceptual processing, coordination, proprioception and functional mobility.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":"880-7"},"PeriodicalIF":3.8,"publicationDate":"2013-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00167-012-2034-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40192098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the tibial slope in sustaining and treating anterior cruciate ligament injuries.","authors":"Matthias J Feucht,&nbsp;Craig S Mauro,&nbsp;Peter U Brucker,&nbsp;Andreas B Imhoff,&nbsp;Stefan Hinterwimmer","doi":"10.1007/s00167-012-1941-6","DOIUrl":"https://doi.org/10.1007/s00167-012-1941-6","url":null,"abstract":"<p><strong>Purpose: </strong>A steep tibial slope may contribute to anterior cruciate ligament (ACL)-injuries, a higher degree of instability in the case of ACL insufficiency, and recurrent instability after ACL reconstruction. A better understanding of the significance of the tibial slope could improve the development of ACL injury screening and prevention programmes, might serve as a basis for individually adapted rehabilitation programmes after ACL reconstruction and could clarify the role of slope-decreasing osteotomies in the treatment of ACL insufficiency. This article summarizes and discusses the current published literature on these topics.</p><p><strong>Methods: </strong>A comprehensive review of the MEDLINE database was carried out to identify relevant articles using multiple different keywords (e.g. 'tibial slope', 'anterior cruciate ligament', 'osteotomy', and 'knee instability'). The reference lists of the reviewed articles were searched for additional relevant articles.</p><p><strong>Results: </strong>In cadaveric studies, an artificially increased tibial slope produced an anterior shift of the tibia relative to the femur. While mathematical models additionally demonstrated increased strain in the ACL, cadaveric studies have not confirmed these findings. There is some evidence that a steep tibial slope represents a risk factor for non-contact ACL injuries. MRI-based studies indicate that a steep slope of the lateral tibial plateau might specifically be responsible for this injury mechanism. The influence of the tibial slope on outcomes after ACL reconstruction and the role of slope-decreasing osteotomies in the treatment of ACL insufficiency remain unclear.</p><p><strong>Conclusion: </strong>The role of the tibial slope in sustaining and treating ACL injuries is not well understood. Characterizing the tibial plateau surface with a single slope measurement represents an insufficient approximation of its three-dimensionality, and the biomechanical impact of the tibial slope likely is more complex than previously appreciated.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":"134-45"},"PeriodicalIF":3.8,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00167-012-1941-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40144528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a simulated pivot shift test: a biomechanical study.","authors":"Lars Engebretsen,&nbsp;Coen A Wijdicks,&nbsp;Colin J Anderson,&nbsp;Benjamin Westerhaus,&nbsp;Robert F LaPrade","doi":"10.1007/s00167-011-1744-1","DOIUrl":"https://doi.org/10.1007/s00167-011-1744-1","url":null,"abstract":"<p><strong>Purpose: </strong>Double-bundle anterior cruciate reconstructions have led to an increased interest in quantifying anterolateral rotatory stability. The application of combined internal rotation and valgus torques to the knee can more nearly recreate the anterolateral subluxation that occurs in the pivot shift test in vitro compared to coupled internal rotation torque and anterior tibial loads.</p><p><strong>Methods: </strong>Twelve non-paired cadaveric knees were biomechanically tested with the ACL intact and sectioned. For each test state, six-degree-of-freedom positional data were collected for two simulated pivot shift loads consisting of a 5-Nm internal rotation torque coupled with either a 10-Nm valgus torque or an 88 N anterior tibial load at 0°, 20°, 30°, 60°, and 90° of knee flexion.</p><p><strong>Results: </strong>The coupled internal rotation and valgus torques produced a significant increase in anterolateral subluxation between the ACL intact and sectioned states at all tested angles except 90º (5.9 ± 0.4 mm at 0°, 4.3 ± 0.6 mm at 20°, 3.5 ± 0.6 mm at 30°, 2.1 ± 0.6 mm at 60°). The coupled internal rotation and an anterior tibial load produced significant increases between the ACL intact and sectioned states at all tested angles except 30º (5.4 ± 0.5 mm at 0°, 3.7 ± 0.5 mm at 20°, 2.1 ± 0.8 mm at 60°, 1.4 ± 0.3 mm at 90°).</p><p><strong>Conclusions: </strong>We found that the coupled internal rotation and valgus torques best recreated the anterolateral subluxation that occurs in the pivot shift in vitro. This study describes an anterolateral subluxation test for ACL integrity in the laboratory setting.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":"698-702"},"PeriodicalIF":3.8,"publicationDate":"2012-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00167-011-1744-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40131693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-surgical management of early knee osteoarthritis.","authors":"Elizaveta Kon,&nbsp;Giuseppe Filardo,&nbsp;Matej Drobnic,&nbsp;Henning Madry,&nbsp;Mislav Jelic,&nbsp;Niek van Dijk,&nbsp;Stefano Della Villa","doi":"10.1007/s00167-011-1713-8","DOIUrl":"https://doi.org/10.1007/s00167-011-1713-8","url":null,"abstract":"<p><p>Conservative approach is usually the first choice for the management of the knee degeneration processes, especially in the phase of the disease recognized as early osteoarthritis (OA) with no clear lesions or associated abnormalities requiring to be addressed surgically. A wide spectrum of treatments is available, from non-pharmacological modalities to dietary supplements and pharmacological therapies, as well as minimally invasive procedures involving injections of various substances aiming to restore joint homeostasis and provide clinical improvement and possibly a disease-modifying effect. Numerous pharmaceuticals have been proposed, but since no therapy has shown all the characteristic of an ideal treatment, and side effects have been reported at both systemic and local level, the use of pharmacological agents should be considered with caution by assessing the risk/benefit ratio of the drugs prescribed. Both patients and physicians should have realistic outcome goals in pharmacological treatment, which should be considered together with other conservative measures. A combination of these therapeutic options is a more preferable scenario, in particular considering the evidence available for non-pharmacological management. In fact, exercise is an effective conservative approach, even if long-term effectiveness and optimal dose and administration modalities still need to be clarified. Finally, physical therapies are emerging as viable treatment options, and novel biological approaches are under study. Further studies to increase the limited medical evidence on conservative treatments, optimizing results, application modalities, indications, and focusing on early OA will be necessary in the future. Level of evidence IV.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":"436-49"},"PeriodicalIF":3.8,"publicationDate":"2012-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00167-011-1713-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40115078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What are the factors of residual pain after uncomplicated TKA?","authors":"Michel P Bonnin,&nbsp;Luca Basiglini,&nbsp;H A Pooler Archbold","doi":"10.1007/s00167-011-1549-2","DOIUrl":"https://doi.org/10.1007/s00167-011-1549-2","url":null,"abstract":"<p><strong>Purpose: </strong>Residual pain during activities of daily living and/or at rest is a major cause of a patient's dissatisfaction after total knee arthroplasty (TKA). The management of a painful TKA, which has no obvious clinical or radiological explanation, requires further investigation with more sensitive imaging modalities (CT scan and bone scan) and hematological tests. It is often challenging for the physician to determine what level of pain warrants these more complex and expensive medical examinations. A precise knowledge of the natural history of postoperative pain following TKA is therefore of fundamental importance.</p><p><strong>Methods: </strong>We reviewed the literature and highlighted the studies that investigated the evolution of pain after uncomplicated TKAs and the impact of demographic and psychosocial variables on a postoperative painful TKA.</p><p><strong>Results: </strong>Factors that are associated with a more painful knee include female sex, a younger age at the time of surgery, and a higher than normal depressive or anxiety state. In particular, the Pain Catastrophizing Scale (PCS), a scale that quantifies a patient's negative or exaggerated orientation to pain, appears to significantly influence a patient's outcome after TKA.</p><p><strong>Conclusion: </strong>The identification of these high-risk patients is critical so that a surgeon can provide detailed preoperative education in order to give these patients a realistic expectation of their possible satisfaction following TKA.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":"1411-7"},"PeriodicalIF":3.8,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00167-011-1549-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40095670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Follow-up of ACL reconstructions.","authors":"Ejnar Eriksson","doi":"10.1007/s00167-005-0650-9","DOIUrl":"https://doi.org/10.1007/s00167-005-0650-9","url":null,"abstract":"","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":"247"},"PeriodicalIF":3.8,"publicationDate":"2005-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00167-005-0650-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25009822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of provider volume on resource utilization for surgical procedures of the knee.","authors":"Nitin Jain,&nbsp;Ricardo Pietrobon,&nbsp;Ulrich Guller,&nbsp;Anoop Shankar,&nbsp;Ajit S Ahluwalia,&nbsp;Laurence D Higgins","doi":"10.1007/s00167-004-0516-6","DOIUrl":"https://doi.org/10.1007/s00167-004-0516-6","url":null,"abstract":"<p><p>Operating-room time and patient disposition on discharge are important determinants of healthcare resource utilization and cost. We examined the relation between these determinants and hospital/surgeon volume for anterior cruciate ligament (ACL) reconstruction and meniscectomy procedures. Patients undergoing ACL reconstruction (18,390 cases) and meniscectomy (123,012 cases) were extracted from the State Ambulatory Surgery Databases for the years 1997-2000. Surgeon and hospital volume were divided into low-, intermediate-, and high-volume categories. Multivariate logistic regression models were used to estimate the adjusted association between surgeon and hospital volume and patient discharge status and operating-room time. Patients undergoing ACL reconstruction or meniscectomy performed by low-volume surgeons were significantly more likely to be non-routinely discharged as compared to high-volume surgeons (adjusted odds ratio 3.5, 95% confidence interval 1.7-7.2 for ACL reconstruction; adjusted odds ratio 2.0, 95% confidence interval 1.6-2.3 for meniscectomy). The mean operating-room time for performing ACL reconstruction or meniscectomy was significantly higher in low- and intermediate-volume surgeons and hospitals as compared to high-volume surgeons and hospitals (p < or = 0.001). High-volume providers utilize healthcare resources more efficiently. Our findings may help surgeons and hospitals in optimizing resource utilization and cost for routinely-performed ambulatory surgery procedures.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":"302-12"},"PeriodicalIF":3.8,"publicationDate":"2005-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00167-004-0516-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25093443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The infrapatellar fat pad: anatomy and clinical correlations.","authors":"J Gallagher,&nbsp;P Tierney,&nbsp;P Murray,&nbsp;M O'Brien","doi":"10.1007/s00167-004-0592-7","DOIUrl":"https://doi.org/10.1007/s00167-004-0592-7","url":null,"abstract":"<p><p>This study examined the anatomy of the infrapatellar fat pad (IFP) in relation to knee pathology and surgical approaches. Eight embalmed knees were dissected via semicircular parapatellar incisions and each IFP was examined. Their volume, shape and constituent features were recorded. They were found in all knees and were constant in shape, consisting of a central body with medial and lateral extensions. The ligamentum mucosum was found inferior to the central body in all eight knees, while a fat tag was located superior to the central body in seven cases. Two clefts were consistently found on the posterior aspect of the IFP, a horizontal cleft below the ligamentum mucosum in six knees and a vertical cleft above, in seven cases. Our study found that the IFP is a constant structure in the knee joint, which may play a number of roles in knee joint function and pathology. Its significance in knee surgery is discussed.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":"268-72"},"PeriodicalIF":3.8,"publicationDate":"2005-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00167-004-0592-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25098117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative evaluation of femoral tunnel position in ACL reconstruction: plain radiography versus computed tomography.","authors":"Christian Hoser,&nbsp;Katja Tecklenburg,&nbsp;Karl Heinz Kuenzel,&nbsp;Christian Fink","doi":"10.1007/s00167-004-0548-y","DOIUrl":"https://doi.org/10.1007/s00167-004-0548-y","url":null,"abstract":"<p><p>Inaccurate femoral tunnel placement has been identified as one of the most frequent errors in failed anterior cruciate ligament reconstructions. Most surgeons evaluate the femoral tunnel position on plain radiographs but in a lot of cases it is difficult to detect the femoral tunnel. The goal of this study was to compare plain digital radiographs and multiplanar computed tomography (CT) scans for the evaluation of femoral tunnel position. We examined 50 patients 24-60 months postoperatively, following an arthroscopically-assisted anterior cruciate ligament reconstruction with central third bone-patellar tendon-bone graft. Endobutton fixation was used on the femoral side and titanium interference screws on the tibial side. Standard antero-posterior and lateral X-rays and a CT scan were obtained from each patient. Sagittal and frontal reconstructions of the CT scan were used for the evaluation. We measured the height of the center of the tunnel in the notch in the frontal plane, and the position of the tunnel along Blumensaat's line (BL) in the lateral plane. Measurements are reported as percentages of total notch height and of the length of BL. On plain X-rays the tunnel was invisible in 46 cases in the anterior-posterior plane and in eight cases on the lateral plane. The average position in the frontal plane was 89.8%, and in the lateral plane 38.6%. In the CT scans, measurements were able to be done in 48 patients. The frontal-plane position averaged 90.5% and the lateral-plane position 34.1%. Pearson's correlation coefficient for the values in the lateral plane for CT and X-rays was low at 0.22, with p>0.05. In our group of 50 patients we were able to detect the femoral tunnel on both plains of standard X-rays in only four patients, whereas it was possible to take accurate measurements in 48 patients on reconstructed CT scans. We advocate the use of CT technology for the evaluation of femoral position whenever precise measurements are needed.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":"256-62"},"PeriodicalIF":3.8,"publicationDate":"2005-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00167-004-0548-y","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24933410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chondral injury due to migration of a Mitek RapidLoc meniscal repair implant after successful meniscal repair: a case report.","authors":"J Gliatis,&nbsp;A Kouzelis,&nbsp;A Panagopoulos,&nbsp;E Lambiris","doi":"10.1007/s00167-004-0558-9","DOIUrl":"https://doi.org/10.1007/s00167-004-0558-9","url":null,"abstract":"<p><p>A case of chondral lesion of the medial femoral condyle caused by a bioabsorbable Mitek RapidLoc meniscal repair implant is presented. Meniscal repair was quite successful, but migration of one of the implanted fixation devices resulted in chondral damage, 12 months postoperatively. All orthopaedic surgeons using these new devices should be aware of the possibility of chondral damage of the adjacent femoral condyles.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":"280-2"},"PeriodicalIF":3.8,"publicationDate":"2005-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00167-004-0558-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25093441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}