PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “LIGAMENTS, ARTICULAR”

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 379 records · Page 21Linked to original sources
PubMed2005

Distal radioulnar joint instability in distal radius fractures: the role of sigmoid notch and triangular fibrocartilage complex revisited.

The stabilising effects of various structures of the distal radioulnar joint (DRUJ) have been heavily debated. This biomechanical cadaveric study examined the effects of the volar and dorsal lips of the sigmoid notch and the volar and dorsal aspects of the triangular fibrocartilage complex (TFCC) on DRUJ stability. Sequential fractures of the distal radius and sectioning of the TFCC were performed followed by measurements of ulnar translation with the forearm in pronation, neutral and supination. A dorsal lunate facet fracture created instability in pronation. Lunate facet fractures alone did not create instability in other forearm positions. Sectioning of the volar TFCC after loss of the dorsal TFCC by a dorsal lunate facet fracture caused DRUJ instability with the forearm in neutral position. Sectioning of the dorsal TFCC after loss of the volar TFCC due to a volar lunate facet fracture created instability in neutral and pronated positions.

Biomechanical Phenomena↗
PubMed1998

Results of revision total knee arthroplasty in the face of significant bone deficiency.

The successful approach to the failed knee with bone deficiency is dependent upon thorough planning prior to surgery in order to have the resources available in terms of adequate bone allograft and suitable revision implants. The approximate size of bone stock deficiency can be calculated from preoperative radiographs and similarly ligamentous incompetence can often be diagnosed clinically prior to surgery. Smaller defects of up to 1 to 1.5 cm in depth and localized in the main to a single side of the tibial plateau or to a single femoral condyle can be dealt with using smaller grafts that may be local autograft or allograft, or modular wedges. Larger tibial defects can be compensated for using conventional revision systems by thicker polyethylene and augmented baseplates, but once the flexion-extension gap reaches approximately 40 mm this is no longer possible and structural graft or customized componentry becomes necessary. Femoral defects larger than about 1 cm that cannot be made up by augments necessitate grafting. The need to use a large proximal tibial allograft also may dictate the operative approach used to expose the joint, especially in the situation of a multiply-operated tight knee. In such cases the use of a quadriceps turndown may be more advisable than the use of a tibial tubercle osteotomy as the osteotomy may well not have an adequate bed to heal to following the reconstruction. Several series have reported cases of patellar tendon avulsion and the clinical results following this complication usually are not satisfactory. Preoperatively it is important to identify, if possible, the case that is likely to require a more extended approach because of a tight soft tissue envelope. The reports of results of series of revision total knee arthroplasty in the setting of significant bone loss are at present confined to short-term followup. The clinical results of these series are satisfactory at this early point in time, but decision regarding the durability of reconstructions requiring major structural allografting awaits longer-term study. Of concern is the devastating complication of infection following such revision surgery, the risk of which is amplified in the setting of prior infection. In addition, the long-term viability of major structural grafts in the setting of loading is uncertain as the risk of graft collapse in the process of incorporation is not known. Notwithstanding these concerns, major grafting is sometimes the only recourse to achieve satisfactory revision of a failed arthroplasty. The use of such major grafts is therefore cautiously supported and because of the risks inherent in such surgery we believe that such surgery should be carried out in the setting of specialist interest units.

Arthroplasty, Replacement, Knee↗
PubMed2000

Treatment of combined anterior cruciate ligament-posterior cruciate ligament-lateral side injuries of the knee.

ACL-PCL-posterolateral corner injuries most frequently are seen in multiple trauma patients but do occur in the athletic injury population. Acute three-ligament-injured knees may have been tibiofemoral dislocations with spontaneous reduction in the field. Careful documentation of the neurovascular status is essential in these cases to avoid the complications associated with limb ischemia. Systematic evaluation of these patients with history, physical examination, imaging studies, examination under anesthesia, and diagnostic arthroscopy will aid in the correct diagnosis and treatment plan formulation. Arthroscopically assisted, combined ACL-PCL-posterolateral complex reconstructions, using strong graft material, and performed in a timely fashion, have provided consistent and predictable results with few complications.

Anterior Cruciate Ligament↗
PubMed2002

Trivalent reconstruction for posterolateral and lateral knee instability.

Chronic posterolateral rotatory and lateral instability of the knee is approached from multiple anatomic and functional points of view. Traditional surgical techniques provide one-directional stabilization using autologous tendon transplantation and the split-tendon biceps procedure. Both of these resolve the lateral opening of the joint but do not secure the rest of the anatomic structures that are very important, such as the arcuate ligament and the capsule. This new approach to solving an old problem acts by tightening the fibular collateral ligament, arcuate ligament, the capsule (partially), and biceps tendon in 1 step by performing an oblique fibular-head osteotomy and pulling down these structures with good results. We report 2 cases in which this technique was used. The first was a 26-year-old man who hit the dashboard in an automobile accident and presented 1 week later with posterolateral instability associated with a tear of the posterior cruciate ligament. The second was a case of pure chronic lateral instability of the knee in a 32-year-old man who sustained a fall that caused a rupture of his lateral collateral ligament. This was repaired using a trivalent reconstruction at 3 months. Both patients successfully achieved good stability after reconstruction.

Accidental Falls↗
PubMed1998

Quantitative analysis of collagen fibrils of human cruciate and meniscofemoral ligaments.

The ultrastructural anatomy of collagen fibril diameters in the cruciate and meniscofemoral ligaments, from four young human cadaver knees (mean age, 20 years, range, 17-22 years) was studied using transmission electron microscopy. Samples were harvested from the proximal, middle, and distal regions of the anterior and posterior cruciate ligaments, and the meniscofemoral ligament. Photomicrographs were taken and assessed quantitatively using image analysis software to determine the collagen fibril diameters and eccentricities, and the percentage of total cross sectional area occupied by collagen. The collagen fibril diameter for the anterior cruciate ligament was found to be largest in the distal region but it decreased as it moved proximally. The posterior cruciate ligament had an opposite trend because it decreased from the proximal to the distal region. For the meniscofemoral ligament, the fibrils of the middle region were larger than those of the proximal and distal regions. The percentage of total cross sectional area occupied by collagen, however, did not vary significantly between regions. Fibril eccentricity also varied little between ligament or location. The variability observed in fibril diameters may account for the different mechanical properties of the ligaments.

Adolescent↗
PubMed2006

Multiple-image radiography for human soft tissue.

Conventional radiography only provides a measure of the X-ray attenuation caused by an object; thus, it is insensitive to other inherent informative effects, such as refraction. Furthermore, conventional radiographs are degraded by X-ray scatter that can obscure important details of the object being imaged. The novel X-ray technology diffraction-enhanced imaging (DEI) has recently allowed the visualization of nearly scatter-free images displaying both attenuation and refraction properties. A new method termed multiple-image radiography (MIR) is a significant improvement over DEI, corrects errors in DEI, is more robust to noise and produces an additional image that is entirely new to medical imaging. This new image, which portrays ultra-small-angle X-ray scattering (USAXS) conveys the presence of microstructure in the object, thus differentiating homogeneous tissues from tissues that are irregular on a scale of micrometres. The aim of this study was to examine the use of MIR for evaluation of soft tissue, and in particular to conduct a preliminary investigation of the USAXS image, which has not previously been used in tissue imaging.

Arthrography↗
PubMed2002

Painted black.

Explore the source record for details and available documents.

Aged↗
PubMedDate not supplied

Efficacy of lateral retinacular release for painful bipartite patella.

We treated painful bipartite patella with a modified lateral retinacular release technique in 15 patients (16 knees). Bony union of the separated fragment and the patella was obtained in 15 of 16 knees within 8 months of surgery. Sustained traction acting on the patella laterally and proximally is presumed to cause the pain. The surgical technique to reduce this force proved effective not only in relieving the pain but also in achieving bony union. Painful bipartite patella can lead to excessive lateral pressure syndrome or patellar compression syndrome, these complications can be effectively treated by this surgical technique. In contrast to conventional treatments, such as excision of smaller fragments or osteosynthesis to achieve bony union, the modified lateral retinacular release technique is easy to perform and provides an effective means for relieving patellofemoral pain and achieving bony union.

Adolescent↗
PubMed1992

Fractures associated with patellar ligament grafts in cruciate ligament surgery.

We reviewed retrospectively 490 patellar ligament reconstructions for cruciate ligament injuries performed from 1980 to 1990. There were six cases of patellar splitting and three displaced patellar fractures in donor knees. The fissure fractures all occurred during the removal of the patellar bone block. The displaced fractures were sustained during early rehabilitation, and in two of the three patients, involved the normal contralateral knee. The major reasons for this complication were imprecise saw cuts, spreading osteotomies, and the use of a too large patellar bone block. When a trapezoidal bone block is used to self-lock in the femoral tunnel, this should preferably be taken from the tibia. Special care is needed in rehabilitation when the graft has been taken from the contralateral knee.

Adult↗
PubMed1979

Knee disarticulation versus above-knee amputation.

If below-knee amputation is impossible, knee disarticulation should be considered before above-knee amputation, regardless of age and etiology. Knee disarticulation which leaves the femur and patella untoched offers many advantages. The surgical technique is simple and non-traumatic since no bone or muscle tissue is to be dissected. The thigh muscles are completely preserved and thus there is no muscular imbalance. The stump permits total end bearing and its bulbous shape permits easy and firm attachment of the prosthesis. A specially designed double-wall socket and various types of knee joints are presented. Modern prostheses are superior to above-knee prostheses with regard to function, comfort and cosmesis. Results of 72 patients of all age groups are presented and discussed.

Adolescent↗
PubMed2000

[Osteo-articular ultrasonography of the hip and the knee].

Experience in the field of musculoskeletal diseases and advanced technology of medical sonographers allow increasing accuracy in US investigations of most lesions of both hip and knee superficial tendons. In this field, US is more and more widely replacing other imaging modalities, including MR imaging. Ultrasonography may now be used also for articular diseases purpose, including joint effusion, synovitis, intraarticular loose bodies, ligamentous injuries, articular cysts, as well as for certain osseous lesions like stress or insufficiency fractures of superficial bones. However, ultrasonography has still to be evaluated for these latter indications.

Hip Joint↗
PubMed2003

The meniscofemoral ligaments: secondary restraints to the posterior drawer. Analysis of anteroposterior and rotary laxity in the intact and posterior-cruciate-deficient knee.

We have tested the hypothesis that the meniscofemoral ligaments make a significant contribution to resisting anteroposterior and rotatory laxity of the posterior-cruciate-ligament-deficient knee. Eight cadaver human knees were tested for anteroposterior and rotatory laxity in a materials-testing machine. The posterior cruciate ligament (PCL) was then divided, followed by division of the meniscofemoral ligaments (MFLs). Laxity results were obtained for intact, PCL-deficient, and PCL-MFL-deficient knees. Division of the MFLs in the PCL-deficient knee increased posterior laxity between 15 degrees and 90 degrees of flexion. Force-displacement measurements showed that the MFLs contributed 28% to the total force resisting posterior drawer at 90 degrees of flexion in the intact knee, and 70.1% in the PCL-deficient knee. There was no effect on rotatory laxity. This is the first study which shows a function for the MFLs as secondary restraints to posterior tibial translation. The integrity of these structures should be assessed during both imaging and arthroscopic studies of PCL-injured knees since this may affect the diagnosis and management of such injuries.

Biomechanical Phenomena↗