PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Joint Instability”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources
PubMed2001

Thermal capsulorrhaphy for acute or chronic shoulder instability.

During the past two decades, arthroscopic procedures have been replacing traditional, more invasive orthopedic surgical procedures. As technology becomes more advanced, the opportunity to provide a greater number of minimally invasive surgical interventions continues to improve. Thermal modification of joint capsule and ligamentus tissues, a recent introduction to medical science, has been investigated extensively during the past six years. Arthroscopic thermal capsulorrhaphy is one such procedure, and it is performed on individuals with a history of joint instability. These patients now can be treated surgically without large incisions and significant shoulder joint trauma. The thermal unit in both monopolar and bipolar models has similar properties to those of the basic electrosurgical unit. Relatively low-temperature heat is directed to the supportive structures of the shoulder joint causing the tissues to expand. This tightens a previously stretched and attenuated shoulder capsule.

Arthroscopy↗
PubMed1985

Secondary reconstruction of the anterior cruciate ligament (ACL) in competitive athletes.

A follow-up study of 325 patients with surgical repair of ligamentous lesions from 1971 to 1977 demonstrated 88% good results in a group treated by one operation. Only 66% of patients who had had two or more operations had good results. High-performance athletes may regain a reasonably good level of function if knee joint instability is limited to anterior cruciate ligament instability. Superimposed injury causing rotatory instability significantly reduces the incidence of good recovery of function even if repaired by the best known surgical procedures. Function sufficient for noncontact, nonviolent sports is often possible. A poor prognosis for long-term joint function is attributable to chondromalacia and accompanying proliferative synovitis. The earlier a ligamentous lesion is repaired, the better the prognosis.

Athletic Injuries↗
PubMed1998

Impingement after total knee arthroplasty caused by cement extrusion and proximal tibiofibular instability.

A 57-year-old patient with rheumatoid arthritis showed posterolateral impingement after total knee arthroplasty. The radiographs showed bone cement extrusion posterolateral to the tibial tray. Arthrotomy through a posterolateral approach revealed that the impingement was caused not only by cement extrusion against the fibular head but also by proximal tibiofibular joint instability. It was speculated that rheumatoid arthritis had caused proximal tibiofibular instability, active knee motion had caused fibular head shift by tension of biceps femoris and the fibular head had been impinged on the extruded cement. In cementing the tibial tray, especially in a rheumatoid patient, it is of paramount importance to take caution against posterolateral cement extrusion in order to minimize the risk of fibular head impingement during total knee arthroplasty.

Arthritis, Rheumatoid↗
PubMedDate not supplied

Painful conditions of the acromioclavicular joint.

The acromioclavicular (AC) joint may be affected by a number of pathologic processes, most commonly osteoarthritis, posttraumatic arthritis, and distal clavicle osteolysis. The correct diagnosis of a problem can usually be deduced from a thorough history, physical examination, and radiologic evaluation. Asymptomatic AC joint degeneration is frequent and does not always correlate with the presence of symptoms. Selective lidocaine injection enhances diagnostic accuracy and may correlate with surgical outcome. Nonoperative treatment is helpful for most patients, although those with osteolysis may have to modify their activities. In appropriately selected patients, open or arthroscopic distal clavicle resection is necessary to relieve symptoms. Recent biomechanical and clinical data emphasize the importance of capsular preservation and minimization of bone resection; however, the optimal amount of distal clavicle resection remains elusive. Patients with AC joint instability have poor results after distal clavicle resection.

Acromioclavicular Joint↗
PubMed1999

Increased interleukin-1beta production in the synovium of glenohumeral joints with anterior instability.

Macroscopic synovitis of the glenohumeral joint is frequently seen during arthroscopy in patients with anterior instability. Interleukin-1beta is known to be expressed in inflamed tissue, to correlate with the magnitude of inflammation, and to affect articular cartilage in the joint. We hypothesized that chronic synovitis may occur in the glenohumeral joint in patients with anterior instability. The purpose of this study was to examine the expression of interleukin-1beta in the synovium of the glenohumeral joint with anterior instability and to discuss its clinicopathologic significance. Specimens of synovial tissue around the greater tuberosity in the subacromial synovium (as controls) and around the rotator interval in the glenohumeral synovium were obtained from 10 patients who had anterior instability without signs of subacromial impingement. Semiquantitative reverse transcriptase-polymerase chain reaction was used to compare the levels of interleukin-1beta mRNA expression in the glenohumeral joint with those in the subacromial bursa. We also employed immunohistochemistry and in situ reverse transcriptase-polymerase chain reaction to detect the cells producing interleukin-1beta protein and mRNA. The levels of interleukin-1beta mRNA expression were significantly higher in the glenohumeral joint than in the subacromial bursa (p < 0.01). Histology showed nonspecific inflammation in all 10 samples of glenohumeral synovium, whereas no inflammation was seen in seven of 10 samples of subacromial synovium. Immunohistochemistry identified interleukin-1beta protein in the vessels and inflammatory and synovial cells (from lining to sublining layers) in synovium of the glenohumeral joint, whereas immunoreactivity was negative in seven subacromial bursa. The remaining three synovial specimens of subacromial bursa, however, showed positive immunoreactivity that was unremarkable and confined around the vessels. In situ reverse transcriptase-polymerase chain reaction was exclusively performed in the synovial specimens of the glenohumeral joint, which exhibited a positive reaction (in the same kinds of cells as seen with immunohistochemistry) in the lining and sublining layers and to a lesser extent in the stroma. Thus, our data confirmed the increased production of interleukin-1beta in the synovium of the glenohumeral joint in patients with anterior instability, suggesting the presence of chronic inflammation at the site. We conclude that this chronic synovitis may be partly associated with the development of dislocation arthropathy in the long term.

Acromion↗
PubMed1992

Wrist arthrodesis by intramedullary rod fixation: a valuable technique.

Arthrodesis of the wrist with intramedullary rod fixation is a simple technique that provides the opportunity for performing concomitant procedures. Iliac bone graft usually is not required with this technique, as the intramedullary rod is a load-sharing construct that allows compression at the fusion site and facilitates union. Rod removal usually is optional, and the long intramedullary beam effect of the rod can function as an internal splint if fibrous or hypoplastic union occurs. Early mobilization is possible, sometimes with only minimal splinting. The results with use of this technique over a ten year period of time in ten wrists (nine patients) with endstage radiocarpal joint instability are reported.

Adult↗
PubMed2000

The use of a polypropylene mesh for treatment of ruptured collateral ligaments of the equine metatarsophalangeal joint: a report of two cases.

The prognosis of ruptured collateral ligaments of the metacarpophalangeal or metatarsophalangeal joint in horses is usually considered to be poor, especially for future athletic performance. The main problem is the development, due to joint instability, of osteoarthritis, which may result in persistent lameness. In this paper a surgical technique is described in which joint stabilisation is realised by using a polypropylene mesh as a substitute for the ruptured ligaments, with the subsequent application of a cast for 7 weeks. The technique was successfully performed in 2 horses with ruptured lateral collateral ligaments of a metatarsophalangeal joint. Fifteen months after surgery both horses resumed exercise. Performance could be classified as fair in one case and good in the other. It is concluded that the preliminary results obtained with this surgical technique to stabilise ruptured collateral ligaments of the fetlock joint are promising.

Animals↗
PubMed1992

Traumatic disruption of the triangular fibrocartilage complex. Pathoanatomy.

The surgical pathology in 42 cases of traumatic triangular fibrocartilage complex (TFCC) disruption comprised a spectrum of injury resulting in five basic stages of increasingly severe ulnar wrist instability. In all cases, detachment of the articular disk from its ulnar insertion was the principal cause of distal radioulnar joint instability; in 28 (67%), concomitant injury to the adjacent extensor carpi ulnaris sheath, the ulnocarpal ligaments, or the peritriquetral ligaments compounded the instability. Thus, rather than an isolated event, peripheral disruption of the disk often proved the major constituent of multicomponent lesions--lesions consistently suitable for repair. In this series of destabilizing TFCC disruption requiring operative treatment, awareness that some injuries selectively affect the articular disk, whereas others compromise wider zones of wrist anatomy, was essential to successful surgery.

Adolescent↗
PubMed2005

[Anatomy, biomechanics, and pathophysiology of instability of the glenohumeral joint].

The stability of the shoulder is dependent on both static and dynamic anatomic restraints. In most cases, there must be insufficiency of more than one restraint for the shoulder joint to become instable. Although the role of these restraints is largely known in maintaining shoulder stability, our information on their interactions is insufficient. This article reviews the anatomy and biomechanics of the shoulder and conditions causing instability of the glenohumeral joint.

Biomechanical Phenomena↗
PubMed1992

Stabilization of the distal ulna by transfer of the pronator quadratus origin.

Surgical and nonsurgical treatment of distal radioulnar joint instability has characteristically been unsatisfactory. This present paper presents a surgical method involving the removal and transfer of the origin of the pronator quadratus to a more dorsal position, which effectively gives a dynamic stabilization to the joint. Temporary internal immobilization is performed with a transverse Kirschner wire that is removed at four weeks, and graded physical therapy is started at that time.

Bone Wires↗