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Results for “Joint Instability”

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At least 379 records · Page 21Linked to original sources

PubMed2000

[Differential diagnosis and therapy of post-traumatic limited forearm rotation].

Limited forearm rotation is an extremely disabling condition for patients. For forearm function, simultaneous rotation in the proximal and distal radioulnar joint is necessary, being connected by the radius and ulnar shaft. Any malalignment of these bony components as well as injuries to the stabilizing soft tissues will lead to an impaired function of the forearm joint. The combination of bony malalignment and joint instability is possible and must be recognized. Any chronic incongruency of the joints will lead to secondary arthrosis that allows only salvage procedures. Therefore, the underlying pathology of restricted forearm motion must be recognized and the original anatomy restored. Using clinical examples, the possible posttraumatic reasons for disturbed forearm rotation and the principle of anatomical reconstruction are presented.

Diagnosis, Differential↗

PubMedDate not supplied

Evaluation of fibular head transposition for repair of experimental cranial cruciate ligament injury in dogs.

Unilateral cranial cruciate ligament excision and fibular head transposition (FHT) were performed on 30 adult dogs. Vertical ground reaction forces were determined using force plate data before and after surgery. Cranial drawer motion, tibial rotation, and varus-valgus motion were measured at monthly intervals. Radiographic, gross, and histological examinations of the stifle joints that had been operated on were performed 3 weeks, 4 months, and 10 months after surgery. A scoring system was used to evaluate lameness, osteophyte formation, and meniscal damage. Rank correlation coefficients were calculated between variables tested in pairs. Cranial drawer motion and abnormal tibial rotation were present in all of the joints that had been operated on. Peak vertical force and associated impulse were not restored during the study time period. Meniscal damage was noted in 25% of the dogs at month 4 and in 50% of the dogs at month 10. Progressive gross and histological deterioration of the articular cartilage was observed in all joints. Positive correlations were noted between the degree of stifle joint instability and meniscal injury or radiographic changes. FHT did not control cranial drawer motion and rotational instability, was not successful in restoring limb function, and did not prevent joint degeneration, especially meniscal damage.

Animals↗

PubMed1995

Dynamic orthopaedic brace in the treatment of ankle sprains.

Ankle sprains may lead to disabling sequelae such as joint instability and persistent pain. Immobilization with plaster cast may give rise to joint stiffness and muscle atrophy. Twenty patients with acute inversion sprains of the ankle were treated with a "dynamic" orthopaedic brace after a 10-day plaster immobilization. A control group, consisting of 10 subjects, received a weight-bearing short-leg plaster cast for 25 days. A clinical evaluation and an instrumental isokinetic investigation (Cybex) were performed as scheduled. The clinical findings suggest an earlier and more comprehensive functional recovery in the group receiving the "dynamic" brace compared to the casted group. The isokinetic test revealed a statistically significantly better performance for most parameters in the brace group especially regarding the ankle joint invertors.

Adult↗

PubMed1982

Experimental osteoarthritis in the rabbit. A study of 133xenon washout rates from the synovial cavity.

Synovial perfusion in 6 rabbit knees, with experimentally induced osteoarthritis (joint instability), was studied by recording the initial 133Xe washout rates from the joint space. The unstable osteoarthritic knee was compared with the contralateral sham operated control knee at intervals of 6 to 96 weeks postoperatively. Within the first half year the ratio between the 133Xe washout rates in the osteoarthritic and control joints was significantly increased. These findings were supported by the increased blood flow to the joint region, visualized by scintigraphy of osteoarthritic rabbits given 99mTc-microspheres intracardially. However, methodological sources of error do not allow any conclusions regarding the much less increased 133Xe washout rates found in advanced osteoarthritis. The initially increased synovial blood flow coincided with the existence of joint effusion and the early development of osteophytes, all conditions supposed to be a consequence of posttraumatic synovitis. Attention is drawn to these pathogenic phenomena in studies dealing with the initial changes in experimental models of osteoarthritis and to a possible etiological significance.

Animals↗

PubMed1999

Pain in persons with post-polio. The Swedish version of the Multidimensional Pain Inventory (MPI).

Increasing muscular atrophy and joint instability in the post-polio syndrome (PPS) leads to muscle and joint pain. The aim of this study was to describe how persons with post-polio syndrome (PPS) perceive their pain and how the pain affects their everyday lives. The Multidimensional Pain Inventory (MPI-S) was used together with supplementary questions concerning location and verbal description of the pain. The study group comprised 37 persons with PPS who had had pain for an average of 19 years. Most commonly reported was pain from the joints of the extremities, followed by pain from the lower back. The verbal description suggests that pain is a palpable health problem for this study group. The results of the MPI-S show that women had the most pain and that the younger the persons are, the more the pain involves negative stress experiences. Activities such as outdoor work, social and other activities away from home involve difficulties, according to the results. The study group could manage their pain, experienced social support, and especially women managed to carry out household chores despite their pain. The MPI-S demonstrates acceptable reliability for this study group.

Activities of Daily Living↗

PubMed1994

[The effects of anterior cruciate ligament resection and subsequent running training on muscles around the knee joint in rat].

The purpose of this study was to evaluate the effects of running training on the muscles in rat after resection of the anterior cruciate ligament (ACL). The biochemical and histochemical changes were analyzed in the muscles around the knee joint from which the ACL was dissected, and the rats were subsequently forced to undergo endurance running. After ACL resection, the wet weights of all muscles around the knee joint decreased but an increase was found in the number of slow-twitch fibers, especially in the vastus lateralis and vastus medialis muscles. The activities of glycolytic and oxidative enzymes in all muscles tended to decrease following resection. Rats which had undergone ACL resection were put through training in the form of appropriate endurance running, causing significant increases in the wet weights of all muscles, except for the vastus medialis, and a decrease in the number of slow-twitch fibers in the vastus medialis. In addition, all the enzyme activities tended to decrease following training. Therefore, the influences of ACL resection and subsequent running training were clearly demonstrated in the vastus medialis muscle. These changes may have been caused by joint instability and sensory reflex dysfunction by deafferentation from the ACL mechanoreceptor (joint-ligament receptor). To maintain knee muscle function, stability of the joint and restoration of the skeletomotor system from the ACL and the muscles around the knee joint is necessary.

Animals↗

PubMed1991

[Surgical treatment of anterior instability of the shoulder joint].

In the article are presented data on the operative treatment of 52 patients (54 operations) with anterior instability of the arm joints. Patients have been distributed into 4 groups depending upon the character of intra-articular damages, revealed in the process of arthrotomy. Each group of patients was subjected to adequate operative intervention, based upon Bankart's method. The authors proceeded from the principle that the arm joint instability treatment should be aimed at removal of intra-articular damages. There have been restored integrity of the damaged cartilage cushion and the joint capsule, the capsule plasty and blocking of the anteroinferior joint sinus. The treatment tactics of the kind allowed to achieve the maximum stability of the arm joint and prevent postoperative recurrencies. Long-term results have been studied with 41 patient, no recurrencies have been noted. The operated limb function has been restored with the majority of the patients.

Arthrodesis↗

PubMed1995

[Pure dislocations of the tibio-talar joint. Apropos of 9 cases].

PURPOSE OF THE STUDY: The authors relate nine cases of pure traumatic dislocation of the tibio talar joint and propose to evaluate the clinical and radiological results at a long term follow-up (mean 12 years). MATERIAL AND METHODS: The series included 9 patients (7 men and 2 women) the average age was 33,2 years. The injury was a road traffic accident in 5 cases. Pure dislocation variety of the ankle joint was medial and posteromedial in 6 cases. Open skin injury was found in 7 cases. The mean follow-up was 12 years (5-19 years). 6 patients were reviewed by the same surgeon, 6 patients were examined clinically and with ankle X-rays. All patients except one were treated by reduction, immobilization with a plaster cast for 6 to 8 weeks. The joint was examined radiographically to detect the presence of tibio talar diastasis and degenerative arthritis. RESULTS: At term we had two very good results and 3 good results (no pain or pain occasionally). We have found in 5 cases a degenerative arthritis to the ankle joint (joint narrowing <50 per cent in 3 cases, > to 50 per cent in 2 cases). No joint instability was noted at revision. DISCUSSION: Pure traumatic dislocation of the tibio talar joint is a rare injury. Medial and posteromedial variety are not frequent. Immediate gravity is dominated by vascular and septic complications and long term result by degenerative arthritis. CONCLUSION: The authors think that closed dislocations need orthopedic treatment (closed reduction and immobilization with a plaster cast for 6 weeks), on the other hand, open dislocation need surgical treatment (reduction, ligamentous reconstruction and immobilization in a plaster cast for 6 weeks).

Adult↗

PubMed1996

Rapid destructive arthritis of the shoulder.

Rapid destructive arthritis of the shoulder, although uncommon, has received much attention in the recent medical literature. It has been described by several authors under varied names: hemorrhagic shoulder of the elderly, Milwaukee shoulder syndrome, rapid destructive arthritis of the shoulder, apatite-associated destructive arthritis and idiopathic destructive arthritis of the shoulder. This particular form of arthritis affects mainly elderly patients, predominantly women, with limited pain, rotator cuff tear, joint instability, voluminous mildly inflammatory, blood-stained effusion, basic calcium phosphate crystals, and marked joint and bone destruction.

Age Factors↗

PubMed1981

Palmaris longus-tenodesis for hyperextension of the thumb metacarpophalangeal joint.

Hyperextension of the thumb metacarpophalangeal joint may be congenital or result from an injury to the volar ligamentary system. The usual complaints are local pain, joint instability and weakness of the pinch and grip. The present paper describes a simple method of correcting this instability by using a palmaris longus-tenodesis as a hyperextension checkrein for the joint.

Adolescent↗

PubMed1980

Mechanism of carpal injuries.

The mechanism responsible for carpal injuries has been elusive. Direct results of the inability to identify the mechanism include a confusing system of classification and a lack of a rational plan of treatment for the many fractures and fracture-dislocations that occur about the carpus. The mechanism of injury determined experimentally was 3-dimensional, including extension, ulnar deviation, and intercarpal supination. The resultant spatial vector in conjunction with the magnitude and duration of loading determined the combination of injuries produced. Carpal dislocations resulted from a force vector that emphasized ulnar deviation and intercarpal supination. Scaphoid fractures were produced by a vector that emphasized extension and were fractured by the dorsal rim of the radius. The degrees of carpal instability produced experimentally were divided into four stages, depending upon the amount of ligamentous damage and joint instability. Stage I (scapholunate instability) was the most stable and Stage IV (lunate dislocation) was least stable. Scaphoid fractures started on the palmar surface and propagated dorsally. Type I fractures had an intact dorsal soft-tissue hinge and fracture stability could be created by flexion. Types II and III scaphoid fractures were associated with significant perilunar instability (PLI) and were classified as fracture-dislocations.

Adult↗

PubMed1988

Intrinsic muscle advancement to treat chronic palmar instability of the metacarpophalangeal joint of the thumb.

Chronic palmar instability of the metacarpophalangeal joint of the thumb can result in a significant disability. Grasp, particularly pinch, is painful and weak because the thumb goes into hyperextension. Stabilization of the metacarpophalangeal joint can be achieved by distal advancement of the conjoined tendon of the abductor pollicis brevis and lateral fibers of the flexor pollicis brevis.

Adolescent↗

PubMed1996

Distal radioulnar joint injuries associated with fractures of the distal radius.

The most common cause of residual wrist disability after fractures of the distal radius is the distal radioulnar joint. The 3 basic conditions that produce radioulnar pain and limitation of forearm rotation are instability, joint incongruency, and ulnocarpal abutment. The last 2 entities initiate irreversible cartilage damage that eventually leads to degenerative joint disease. Early recognition and management in the acute stage aim at the anatomic reconstruction of the distal radioulnar joint including bone, joint surfaces, and ligaments in an effort to reduce the incidence of painful sequelae and functional deficit. This article provides a description and the treatment options of the distal radioulnar joint lesions that occur in association with fractures of the distal radius, and the results obtained with open and arthroscopic techniques. Both acute and chronic disorders are analyzed, and a prognostic and treatment oriented classification is presented Furthermore, the pathoanatomy and management of chronic distal radioulnar joint derangement after fracture of the distal radius are reviewed briefly.

Adult↗

PubMed1996

The effect of removal of the medical collateral ligament on subchondral bone and cartilage in the growing rat knee joint.

The growing knee joint in immature rats was chosen as a model to study quantitatively bone apposition and thickness of articular cartilage after surgical removal of the medial collateral ligament. In 32 rats, subchondral bone apposition was assessed by measuring double tetracycline labelling, and the thickness of calcified and uncalcified articular cartilage was measured by image analysis. The results indicate that there was a significant increase in subchondral bone growth after removal of the medial collateral ligament, but no change in thickness of the calcified and uncalcified zones of the articular cartilage in the medial knee compartment. Further, despite an obvious increase in valgus laxity on manual examination, there were no signs of articular cartilage degeneration in any animal. The study shows that traumatic injury to ligaments and joint instability during the growing period may influence the development of subchondral bone in the knee joint.

Animals↗

PubMed1993

Arthritis of the subtalar joint associated with sustentaculum tali facet configuration.

The articular facets of the sustentaculum tali have a variety of configurations that are generally viewed as nonmetric traits of little functional significance. Bruckner (1987), in contrast, has hypothesised that sustentaculum tali facet variations are functionally important because they influence subtalar joint stability. To test this hypothesis, 191 calcanei were analysed for correlations between sustentaculum tali facet morphology and osteoarthritis of the subtalar joint. Calcanei with 2 separate sustentaculum tali facets had a lower frequency of arthritic changes associated with joint instability than calcanei with other facet configurations. This finding supports Bruckner's hypothesis that subtalar joint facet configuration is a factor in foot mobility.

Adult↗

PubMed1993

[Therapeutic muscle training].

The needs and motives for a therapeutically oriented muscle training programme are quite varied. The attainment of the maximum possible muscle strength is not the decisive goal, but instead the achievement of motoric function permitting optimal performance during daily physical activities, supporting active participation in sports during leisure time, compensating for deficits in the musculo-skeletal system and counteracting a series of disturbances and limitations in general health. The following goals fall into the realm of a therapeutic muscle training programme: maintenance as well as improvement of muscle function--stabilization of the joints--increase in joint mobility--maintenance of the function of the total skeletal system--support of kinesthetics and body consciousness--promotion of emotional stability--prophylaxis of injury--improvement of the preconditions for total body training. From the above goals the following indications for a therapeutic muscle training programme can be deduced: maintenance of muscle strength and joint function during lack of physical activity and in advanced age--muscle building subsequent to periods of immobilization after injuries and surgery affecting the musculo-skeletal system--stabilization of the joint-muscle system in degenerative joint and spinal diseases, joint instability and hypermobility--treatment of muscular dysbalance, muscular insufficiency, postural abnormalities and weaknesses--mobilization of joints--prophylaxis and therapy of osteoporosis--calesthenics during pregnancy--therapy of urinary incontinence--adjuvant therapy for psychiatric disorders--part of a total body training regimen aimed at physical fitness and general health care.

Humans↗

PubMed1999

Metatarsal neck osteotomy with rigid internal fixation for the treatment of lesser toe metatarsophalangeal joint pathology.

Metatarsalgia associated with metatarsophalangeal (MTP) joint instability and/or plantar callosity formation is a difficult problem to treat. During a 15-month period, we performed 50 osteotomies of the metatarsal neck with rigid internal fixation in 47 feet of 42 patients. Three patients were excluded from the study, leaving 47 osteotomies in 44 feet of 39 patients for review. There were 6 men and 33 women, with a mean age of 57 years. In addition to lesser MTP joint pain with or without instability, the majority of patients had first ray pathologic condition, which was also addressed at the time of surgery. All but one of the osteotomies were united radiologically at 6 weeks. The mean shortening was 4.1 mm (range, 2-12 mm), and the mean follow-up was 9 months. There were no cases of malunion, nonunion, or avascular necrosis. At follow-up, 33 patients were asymptomatic. Eight patients (nine feet) had a degree of persisting pain at follow-up (seven mild and two moderate), but the source of this pain was only the metatarsal or MTP joint that was operated on in three cases. In this article, we describe the indications, the technique, and the results of the osteotomy.

Adolescent↗

PubMed1977

Determination of sagittal instability of the knee joint.

For measuring sagittal instability in the knee joint a radiologic method has been developed which requires no complicated equipment, is easy to apply, and is relatively insensitive to the sources of error commonly associated with determination of sagittal instability, such as difference of flexion angle and changes in the projection. Measurements are made between reference points located in the femur and the tibia. The reproducibility of the method is high enough to make it suitable for testing instability before and after reconstructive surgery. By the use of constructed reference points sagittal instability can be distinguished from rotational instability.

Humans↗