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 361 records · Page 20Linked to original sources

PubMed2001

[External femorotibial transfixation in femoral fracture with joint involvement in a child].

Long bone fractures combined with joint injuries run a high risk of destabilising the articulations. Remaining joints incongruence can lead to early arthosis especially in cases of severe injuries or not achieved anatomical reduction. A number of osteosynthesis methods are available for anatomical repair of the articular facet. This report presents a seven years old boy with an open comminuted fracture of the distal femur and consecutive joint instability, treated with a Transfixation (Orthofix) of the knee joint. The functional results suggest this method as an alternative treatment.

Child↗

PubMed1996

Avulsion fractures of the volar aspect of triquetral bone of the wrist: a subtle sign of carpal ligament injury.

OBJECTIVE: We report five examples of a triquetral fracture pattern not previously described to our knowledge. These fractures from the volar aspect of the triquetral bone are important because they are easily missed with conventional wrist radiographs and yet are associated with significant ligament injuries and carpal instability. MATERIALS AND METHODS: Five volar triquetral avulsion fractures occurred in young men (20-28 years old) during falls while playing sports. The initial evaluation consisted of a three-view radiographic series. Subsequently, an instability series was obtained in each case. Four patients were also evaluated by stress videofluoroscopy and arthrography, one by CT, and four by MR imaging. RESULTS: None of the five fractures was recognized on radiographs obtained in the emergency room. Each fracture was identified on an instability series and involved the radial aspect of the volar surface of the triquetral bone. All four wrists evaluated by stress videofluoroscopy showed lunatotriquetral joint instability. One also showed instability of the scapholunate joint. All four wrists evaluated by arthrography showed tears of the lunatotriquetral ligament and three had an associated tear of the scapholunate ligament. MR examination of four wrists showed a volar capsular ligament attached to the avulsion fracture fragment in each wrist. Two of the patients were treated by arthroscopic debridement and three were treated by prolonged splinting. All five patients had persistent pain and carpal instability of variable severity at least 1 year after injury. CONCLUSION: This avulsion fracture of the radial aspect of the volar triquetral bone is a subtle, easily missed sign of a significant injury of the perilunate ligaments. When this fracture is identified, we recommend further evaluation for associated ligament injury and carpal instability.

Adult↗

PubMed2005

Hinged elbow external fixators: indications and uses.

Hinged external fixation of the elbow joint can play an important role in managing complicated fracture-dislocations, joint instability after extensive contracture release, and distraction interposition arthroplasty. Application of these devices requires accurate alignment of the fixator axis with the anatomic axis of the elbow. The primary therapeutic goal is to allow joint motion while protecting the healing ligaments. Common complications include pin loosening, injury to adjacent neurovascular structures, cellulitis, and loss of reduction. Although reported data are limited, this technique is a useful adjunct in patients with complex elbow instability.

Contracture↗

PubMed1979

Neonatal hip instability. Reason for failure of early abduction treatment.

A series of nine children with hip joint instability in 17 hips, diagnosed neonatally, is presented. Seven had bilateral idiopathic instability and two instability secondary to arthrogryposis, one of them bilateral. After reduction seven of the children (14 hips) were treated with abduction devices, which in all cases did not lead to stability in one or both hips. In these cases arthrography revealed that closed reduction was impossible due to narrowing of the joint capsule (hour-glass shape) and the interposition of a capsular fold including the acetabular labrum. The same types of changes were seen within 1 or 2 months after birth in three hips which had had no abduction treatment before arthrography. At open reduction of 11 hips it was found that the narrowing of the capsule was caused by the tendons of the iliopsoas and rectus femoris muscles. Excision of the capsular fold (labrum) was not necessary. The femoral head was deformed and anteverted. Failure of conservative treatment can be due either to incomplete reduction or to inadequate immobilization. Our analysis has shown that the most probable reason is incomplete reduction due to interposition. An obstacle to reduction should be suspected if abduction is restricted at birth, if primary reduction is difficult and the position difficult to maintain or if instability persists after 8 weeks of treatment. On the basis of our material the incidence of such an impediment to reduction was 0.08 per thousand births in the region studied during a 5-year period.

Acetabulum↗

PubMed2005

Osteoarticular allograft reconstruction of the distal radius after bone tumour resection.

Resection of the distal end of the radius is indicated in the treatment of locally aggressive primary benign and malignant bone tumours. The aim of this study was to evaluate the technique of osteoarticular allograft reconstruction of this bone defect. We analysed 12 patients retrospectively with a minimum follow-up of 2 years (range 26-145 months, median 52 months). Three patients had a malignant tumour and nine had a giant cell tumour. The patients ages ranged from 13 to 65 years. The mean resected length of the radius was 6.6 (range 4-14)cm. Non-union of the osteotomy line was diagnosed 6 months after surgery in one case and needed bone grafting. Distal radio-ulnar joint instability was observed in eight cases. Subchondral bone alterations and joint narrowing were present in all cases but were painful in only one patient. The mean range of motion was 51 degrees of flexion and 37 degrees of extension.

Adolescent↗

PubMedDate not supplied

Holmium:YAG laser-assisted capsular shift in a canine model: intraarticular pressure and histologic observations.

The purpose of this study was to determine the initial effects of Holmium:YAG laser energy on the shoulder joint capsule. A new surgical procedure to correct shoulder joint instability uses Holmium:YAG laser energy to cause "shrinkage" of joint capsular tissues. To date there has been no information concerning an intraoperative measurable end point for the application of laser energy at surgery or the resultant depth and degree of tissue alteration. Seven greyhound dogs were used in this study. Preoperative intraarticular pressures (IAP) were measured on entry and after injection of 10 ml of solution. Laser energy was applied to the cranial medial glenohumeral ligament and joint capsule of all right shoulders with arthroscopic visualization. The unoperated left shoulders served as the control group. Six weeks after surgery pressure measurements were performed on both shoulders. A "second look" arthroscopy was performed on the shoulders. After euthanasia was performed, the anterior capsular tissues were harvested from both shoulders for histologic examination. The specimens were inspected by three blinded examiners. After 6 weeks the postoperative laser-treated IAP were higher than the same joint preoperative IAP in four of six dogs for both static nondistension and 10 ml distension measurements. At this same interval the marked tissue damage of the treated capsule was easily discerned by blinded observers. On histologic evaluation the laser-treated capsule showed synovitis and pericapsular tissue reactivity. The depth of the injury was beyond the joint capsule into the pericapsular tissue. It was not possible to determine the end point of the capsular "shrinkage" operation by combined pressure/volume intraoperative measurements. There was no uniform joint capsule compliance at 6 weeks. The histologic changes were extensive in both magnitude and depth. Future studies in this animal should include decreased laser energy plus other means of monitoring the intraoperative effects of laser use.

Animals↗

PubMed2004

The role of biomechanics and inflammation in cartilage injury and repair.

Osteoarthritis is a painful and debilitating disease characterized by progressive degenerative changes in the articular cartilage and other joint tissues. Biomechanical factors play a critical role in the initiation and progression of this disease, as evidenced by clinical and animal studies of alterations in the mechanical environment of the joint caused by trauma, joint instability, disuse, or obesity. The onset of these changes after joint injury generally has been termed posttraumatic arthritis and can be accelerated by factors such as a displaced articular fracture. Within this context, there is considerable evidence that interactions between biomechanical factors and proinflammatory mediators are involved in the progression of cartilage degeneration in posttraumatic arthritis. In vivo studies have shown increased concentrations of inflammatory cytokines and mediators in the joint in mechanically induced models of osteoarthritis. In vitro explant studies confirm that mechanical load is a potent regulator of matrix metabolism, cell viability, and the production of proinflammatory mediators such as nitric oxide and prostaglandin E2. Knowledge of the interaction of inflammatory and biomechanical factors in regulating cartilage metabolism would be beneficial to an understanding of the etiopathogenesis of posttraumatic osteoarthritis and in the improvement of therapies for joint injury.

Animals↗

PubMed1995

Joint failure in erosive osteoarthritis of the hands.

Erosive osteoarthritis (EOA), the type of hand osteoarthritis characterized by faster destructive changes, may be suspected clinically because of phlogistic presentation especially in DIP and in PIP joints. Scintiscan may be useful in early diagnosis, but the final diagnosis of EOA is always radiological, and depends upon the presence of central erosions. The inflammatory and crystal-induced origin of EOA is sometimes stressed in the literature, but despite the phlogistic course of the disease there is evidence against EOA being a primitive synovitis, the most cogent point being the cellular content of synovial fluid. The pathogenetic hypothesis that we propose is of a chondral primitive disorder, with synovitis causing further chondral erosion, subchondral bone damage, and finally joint instability or fibrous and bone ankylosis with severe impairment of joint function.

Animals↗

PubMed1996

The relation between cartilage damage and osteophyte size in a murine model for osteoarthritis in the knee.

The aim of this study was to investigate the relationship between location and size of osteophytes and cartilage loss in an instability-induced experimental model for osteoarthritis. Osteoarthritis was induced in murine knee joints by injection of highly purified bacterial collagenase, causing joint instability. The size of the osteophytes and the cartilage loss were measured at different locations in the joint using image analysis on histological sections of total kees. Cartilage damage did not occur without osteophytes. Osteophytes were located on both medial and lateral sides, independent of the location of cartilage damage, but the size of the osteophytes was related to the amount of cartilage damage on the corresponding side. Cartilage loss on the lateral tibial plateau correlated well with the size of lateral osteophytes, in particular with the osteophyte at the margin of the lateral tibial plateau. Cartilage loss on the medial tibial plateau appeared to have a good correlation with the size of medial osteophytes, which was most pronounced for the osteophyte on the medial margin of the tibial plateau. This side-specific correlation between cartilage damage and osteophyte formation suggests compartmentalization of the osteoarthritic process.

Animals↗

PubMedDate not supplied

Extra-articular stabilization of the knee joint for anterior instability.

The results after one year or longer were evaluated in 76 patients with extra-articular reconstruction for functionally disabling anterior instability of the knee joint. The reconstruction was performed by a modification of the Ellison procedure for treatment of anterolateral rotatory instability. The various superimposed components of knee instability were managed by a variety of methods. Postoperatively,objective stability correlated well with subjective improvement. Patients with 2+ or greater anterior instability preoperatively had disappointing results in both subjective symptoms and objective signs. although extra-articular reconstruction may be sufficient for lesser grades of functionally disabling instability, knees with grade 2-3+ instability may require direct anterior cruciate ligament reconstruction in addition to the extra-articular surgical procedure.

Evaluation Studies as Topic↗

PubMed1979

Experimental knee instability: early mechanical property changes in articular cartilage in a rabbit model.

Utilizing a knee joint instability model for traumatic osteoarthritis, quantitative measurements of the biomechanical properties of the articular cartilage demonstrate that the cartilage deforms and that the deformation rapidly occurs within 24 hours of injury. These changes in mechanical properties may be a more sensitive indicator of early degenerative changes in articular cartilage than the ordinary histological measurements.

Animals↗

PubMed2003

Ligamentous and capsular restraints to experimental posterior elbow joint dislocation.

Pathological external forearm rotation (PEFR) relates to posterolateral elbow joint instability, and is considered a possible requisite step in a simple posterior elbow joint dislocation. The aim of this study was to evaluate the capsuloligamentous restraint to PEFR. In all, 18 elbow joint specimens were examined in a joint analysis system developed for experimental elbow dislocation. Sequential cutting of capsule and ligaments followed by stability testing provided specific data relating to each capsuloligamentous structure. The primary stabilizers against PEFR in the extended elbow were the anterior capsule and the lateral collateral ligament complex (LCLC), whereas in the flexed elbow the anterior capsule did not have a stabilizing effect. In flexed joint positions, the LCLC seems to be the only immediate stabilizer against PEFR, and thereby against posterolateral instability and possibly against posterior dislocation. The medial collateral ligament did not have any immediate stabilizing effect, but it prevented the final step of the posterior dislocation.

Aged↗

PubMed1990

Separate centre of ossification of the lateral malleolus with instability of the ankle joint.

Four cases of recurrent instability of the ankle joint are reported. The instability was associated with a separate centre of ossification of the lateral malleolus and abnormal movement between the ossicle and the distal fibula. All patients were successfully treated by surgery: two underwent internal fixation and ligamentous reconstruction and two, ligamentous reconstruction after removal of the ossicle.

Adult↗

PubMed2005

Anatomic reconstruction of the distal radioulnar ligaments: long-term results.

Chronic post-traumatic dynamic distal radioulnar joint instability following rupture of the distal radioulnar ligaments may cause disabling and progressive ulnar-sided wrist symptoms. We use a free tendon graft to anatomically reconstruct both dorsal and palmar distal radioulnar ligaments simultaneously. Nine patients who underwent this procedure between 1990 and 1997 were assessed using a modified Mayo Wrist Score. Following surgery, average wrist scores improved from 66 (95% CI, +/-3.0) to 92 (95% CI, 92+/-6.9) and were maintained in the long term (average score, 87 at 9 years). Joint stability was restored and maintained in seven of the nine patients, but two developed recurrent instability. Pain, grip strength and function were better following surgery in the short and long term. Range of supination and pronation decreased slightly from an average of 169 degrees pre-operatively to 155 degrees (90% of normal) in the long term. Long-term radiographs show no distal radioulnar or ulnocarpal joint osteoarthritis.

Adult↗

PubMed1984

[Arguments for surgical treatment of severe sprains of the external lateral ligament of the tibiotarsal joint].

Chronic instability of the ankle joint is a frequent long-term result of treatment of severe sprains. This is due to repeated strains, and may lead to true disability in some cases. It would appear necessary, therefore, when a certain angle of varus, the subject of debate, is exceeded to perform ligamentary suture of the external lateral ligament of the tibiotarsal joint. This procedure, which is simple to carry out, is free from complications and provides constantly good results, should be preferred to orthopedic treatment as confirmed by data described in the conclusion to this article.

Adolescent↗

PubMed2002

Rehabilitation following thermal-assisted capsular shrinkage of the glenohumeral joint: current concepts.

Glenohumeral joint instability is a common pathology observed in the orthopedic and sports medicine settings. Overhead athletes often exhibit a certain degree of acquired laxity that can lead to various pathologies. Unfavorable results often observed with traditional open procedures to correct instability in the overhead athlete have led to the development of arthroscopic thermal-assisted capsular shrinkage (TACS). TACS is not commonly used as an isolated procedure in overhead athletes; various procedures are often performed concomitantly. The overall outcome greatly depends on a postoperative rehabilitation program that must be assessed and adjusted frequently based on several factors. Knowledge of the basic science of TACS as well as emphasis on dynamic stabilization, proprioception, and neuromuscular control are vital to the rehabilitation program for overhead athletes. The purpose of this paper is to discuss the basic science and clinical application of thermal-assisted capsular shrinkage of the glenohumeral joint as well as the postoperative rehabilitation for the overhead athlete and the patient with congenital laxity and related multidirectional instability.

Adult↗

PubMedDate not supplied

[The value of arthroscopy for diagnosis of instability of the shoulder joint].

As a glenohumeral instability is defined each case of transient recurrent and permanent decentration of the joint. We propose to differentiate primary and secondary glenohumeral instabilities. Arthroscopical diagnostic is helpful to classify the luxation and subluxation and for verify transient instabilities. In cases clinically snapping phenomena were noticed, arthroscopic findings were documented. A relation between those phenomena and arthroscopic findings is discussed.

Arthroscopy↗

PubMed1985

Driller wrist (vibratory arthropathy).

Driller wrist is an occupational disease with pathophysiologic changes resulting from recurrent use of vibratory tools. The entity includes the clinical finding of Raynaud phenomena with or without associated bone changes in the wrist. Osseous involvement is usually mild and is associated with cystic changes of the carpals and occasionally other structures. Two cases are reported, one with typical cystic abnormalities and the other with more severe disease which progressed to joint instability.

Humans↗