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At least 721 records · Page 40Linked to original sources
PubMed2001

Computer-assisted design of the sagittal shapes of a ligament-compatible total ankle replacement.

The poor results of total ankle replacement have been attributed to the inability of designers to restore adequately the critical mutual function of the ligaments and the articular surfaces. The purpose of this study was to design sagittal shapes of the articular surfaces for a new ankle prosthesis to be compatible with the geometry of the retained ligamentous structures. Several ligament-compatible pairs of articular surfaces were tested using a computerised version of a four-bar linkage model. The kinematics of the ankle when replaced by non-conforming two-component and by fully conforming three-component designs with either flat, concave or convex tibial surfaces were assessed by the model. A ligament-compatible convex-tibia fully-congruent three-component prosthesis showed the best features. The three-component prosthesis allows complete congruence over the entire range of flexion. A convex shape for the tibial arc was preferred because of the better degree of entrapment of the meniscal bearing. A 5 cm convex-tibia arc radius gave 2 mm entrapment together with 9.8 mm of tibial bone cut. Ligament elongation imposed by full congruence of the articular surfaces was less than 0.03% of the original length. The original patterns of joint kinematics and ligament tensioning are closely restored in the joint replaced by the proposed prosthesis.

Ankle Joint↗
PubMed1997

Imaging of the knee. Current status.

This article reviews the variety of imaging modalities that are currently being used to evaluate the knee. Nuclear scintigraphy is discussed with emphasis on prosthesis abnormalities. Sonography is discussed with regard to the evaluation of popliteal masses. The uses of computed tomography, especially in the evaluation of the tibial plateau fracture, are discussed, and the role of fluoroscopy, computed tomography, and sonography in image-guided needle procedures are reviewed. Emphasis is placed on the role of MR imaging in knee imaging, with attention to internal derangements, bursal and capsular pathology, and other assorted intra- and extra-articular disorders. The focus of this article is to review the wealth of information that may be obtained by using these imaging modalities.

Arthrography↗
PubMed1981

[Fractures of the anterolateral tubercle of the distal tibial epiphysis in adolescence (author's transl)].

The authors have observed this type of fracture in 5 adolescents. They describe the etiology and the mechanism of trauma by internal rotation of the tibia combined with eversion of the foot. These fractures create a tibio-fibular diastasis and disrupt the articular surface. It is concluded that conservative treatment is not satisfactory and that the bone fragments should be fixed accurately by screwing, using an anterolateral approach.

Adolescent↗
PubMed1987

[Anatomy and biomechanics of the meniscus of the knee joint].

The menisci enlarge the weight-bearing surface to an extension twice of the pure contact surface between the femur condyles and the tibia plateau. Furthermore they widen the range of the articular resultant force. Consequently, the balancing muscular forces can be implemented more economically. The menisci are adapted to their functional stressing: circular tension is resisted by circularly arranged collagen fiber bundles. Split lines, however, show a more complex arrangement.

Biomechanical Phenomena↗
PubMed1998

Morphologic changes in the elastic fibers of the temporomandibular joint after experimental disc perforation in the rabbit.

PURPOSE: Elastic fibers in the attachment regions of the temporomandibular joint (TMJ) are considered important in the movements of the disc during jaw motion. This study was designed to determine whether there are change in the elastic fibers of the TMJ when the disc is perforated for a long period. MATERIALS AND METHODS: Each TMJ of five rabbits was surgically exposed, and a mediolateral perforation was made in the center of the articulating region of the disc with a scalpel. Five untreated and three sham-operated rabbits were used as controls. The TMJs were removed after 10 months and processed for histochemical demonstration of elastic fibers. RESULTS: Osteoarthritic changes and a significant decrease in number of the elastic fibers in the anterior-inferior attachment and posterior-inferior attachment of the TMJ disc were observed after disc perforation. Conversely, elastic fibers appeared in the fibrous tissue on the resorbed bone of the articular eminence. CONCLUSIONS: Experimental disc perforation changes the distribution and density of the elastic fiber in the TMJ as well as causes osteoarthritis. A knowledge of these facts may improve our understanding of perforation of the disc.

Animals↗
PubMed1976

Changes in 35S-sulphate uptake in different tissues in the knee and hip regions of rabbits during immobilization, remobilization the development of osteoarthritis.

In order to observe phenomena accompanying the development of osteoarthritis of the rabbit knee, consistently appearing within 4-6 weeks as a consequence ofimmobilization of this joint, studies on 35S-sulphate (Na2 35SO4) uptake were carried out. The investigation suggests that immobilization of the knee leads within 2-4 weeks to increased sulphate uptake in bone, cartilage and ligaments in the knee region and in the hip (not immobilized) of the same leg. The first marked changes in 35S-sulphate uptake were found in the ligaments and the articular cartilage as early as after 4 days of immobilization.

Animals↗
PubMed1997

[Luno-triquetral angle and dislocation of the wrist].

The mediocarpal force, determined by the distal articular surface of both, lunate and triquetral bones, abuts against the double bolt, composed of the scaphoid and the radial styloid process. An important wrist trauma can rupture this bolt and cause a proximal and lateral translation of the distal carpal row. This situation may present under 3 forms: fracture of the scaphoid bone and midcarpal dissociation; fracture of the radial styloid process with scapholunate dissociation; scapholunate dissociation, associated with a dorsal radiotriquetral ligament rupture and medial translation of the lunotriquetral block. Experimental and clinical illustration of this process, discussion and treatment.

Carpal Bones↗
PubMed1985

Arthroscopic evaluation of the injured athlete's knee.

In summary, arthroscopic evaluation of the athlete's knee joint provides a highly accurate means of diagnosing intra-articular lesions. It provides valuable information regarding treatment and prognosis. In addition, if arthroscopic surgical treatment is possible, even greater benefits in regard to more rapid return to full athletic activity will be possible.

Arthroscopy↗
PubMed1989

[Intra-articular finger fractures in children].

From 1982 to 1984 140 patients with fractures of the fingers were admitted to the department of surgery of the University Children's Hospital. Only 28 patients (21.5%) suffered from intraarticular fractures. Three 3/12 years later, 10 patients (35.7%) presented functional trouble or suffered from pain. Only 2 of the 15 conservatively treated patients had trouble. On the other hand, 8 children out of the 13 operatively treated patients presented an unsatisfactory result. Localisation, type of fracture and kind of treatment are analysed. We prefer as a rule conservative treatment excepting fractures of type Salter III and IV, osseous ruptures of the ulnar collateral ligament of the thumb and dislocated fractures. We suggest splinting with 0.6 mm K-wires.

Adolescent↗
PubMed1977

Etiology, pathogenesis and classifications of knee fractures.

Fractures of the knee include fractures of the lower end of the femur, upper end of tibia, and patella. The term articular fractures has been avoided in this text because it would exclude supracondylar fractures of the femur, fractures of the tibial spines, and epiphyseal separations in which the articular surfaces remain uninjured. By agreement with the other rapporteurs to this Congress, we excluded from our review separation of the apophysis of the tibial tubercle, fractures of the tibial spines, and osteochondral lesions.

Accidents, Traffic↗
PubMed2002

Comparison of analgesic effects of intra-articular tenoxicam and morphine in anterior cruciate ligament reconstruction.

This study compared the analgesic effect of intra-articular injection of tenoxicam with that of morphine on postoperative pain after anterior cruciate ligament (ACL) reconstruction. Forty-two patients undergoing arthroscopically ACL reconstructions using hamstring tendons underwent the same anesthetic protocol. The patients were randomized to receive 25 ml normal saline, 20 mg tenoxicam in 25 ml normal saline, or 2 mg morphine in 25 ml normal saline. Postoperative pain was assessed using a visual analogue scale and measuring analgesic requirements. We found both that both intra-articular tenoxicam and intra-articular morphine provided better analgesia than that in the control group. Although pain scores were similar between tenoxicam and morphine groups 30 min postoperative, the analgesic requirements in with tenoxicam were significantly lower than those with morphine group 3-6 h postoperatively.

Adult↗
PubMed2001

Unbiased evaluation of the arthroscopic extra-articular technique for Bankart repair: a clinical and radiographic study with a 2- to 5-year follow-up.

This study performed an unbiased reexamination of patients who at least 2 years previously had undergone an arthroscopic extra-articular Bankart repair and prospectively evaluated the development of degenerative changes in the shoulder. Two unbiased observers who had never seen the patients before and had in no way been involved in the treatment of the patients were given unlimited access to the patients' files, surgical reports, and radiographs. Of the 80 patients 72 (90%) attended the follow-up 42.5 months (24-66) after the index procedure. Failures in terms of stability (redislocations and subluxations) were recorded in 14% of the patients. The Rowe score was 97 points (51-100), the Constant score was 94 (56-100) in injured shoulders and 97 points (80-100) in noninjured shoulders (P = 0.002). A return to the preinjury level of activity was recorded in 73% of the patients. There was a significant increase in degenerative changes between the pre- and postoperative radiographic assessments (P < 0.0001). At 2- to 5-year follow-up therefore the extra-articular arthroscopic Bankart repair resulted in stable and well-functioning shoulders in a high percentage of patients. However, the signs of radiographic degenerative changes increased between the preoperative assessments and the 2- to 5-year follow-up.

Arthroscopy↗
PubMed2003

Arthroscopic-assisted reduction with bilateral buttress plate fixation of complex tibial plateau fractures.

PURPOSE: Our aim was to determine the outcome of arthroscopic-assisted reduction with bilateral buttress plate fixation for the treatment of closed complex tibial plateau fractures. TYPE OF STUDY: Case series. METHODS: 18 consecutive patients (12 men, 6 women) with complex tibial plateau fractures were enrolled in this prospective study. All patients underwent arthroscopic-assisted bilateral buttress plate fixation of closed complex tibial plateau fractures. The average age at operation was 35 years (range, 23 to 45 years). The follow-up period ranged from 39 to 69 months, with an average of 48 months. Using the Schatzker classification, there were 11 type V and 7 type VI fractures. The clinical and radiological outcomes were determined according to Rasmussen's system. RESULTS: All of the 18 fractures united. Overall, 4 (22%) patients were rated as excellent, 12 (67%) good, and 2 (11%) fair. Secondary osteoarthritis appeared in 3 injured knees (16.7%). One patient had a wound dehiscence (3 cm long) of the medial incision. Condylar joint surface depression was noted in 3 patients without functional instability. Two patients had valgus alignment between 10 degrees and 15 degrees. Two patients had the paresthesia over the lateral calf. There were no complications directly associated with arthroscopy in any of the 18 patients. No deep vein thrombosis, infection, or knee stiffness was found at final follow-up. CONCLUSIONS: Arthroscopic-assisted reduction with bilateral buttress plate fixation for complex tibial plateau fractures allows accurate fracture reduction, diagnosis, and treatment of associated intra-articular lesions, and less dissection than open reduction internal fixation.

Adult↗
PubMed1989

Double-blind assessment of the value of magnetic resonance imaging in the diagnosis of anterior cruciate and meniscal lesions.

A prospective double-blind study was undertaken to evaluate the usefulness of magnetic resonance imaging in the accurate interpretation of pathological intra-articular changes in the knee. Forty-seven patients who were scheduled to have arthroscopy and three patients who wer to have arthrotomy volunteered for magnetic resonance imaging preoperatively. The radiologists had no clinical or roentgenographic information about the patients before the evaluation of the magnetic resonance images, and the radiologists' interpretations were unknown to the surgeon before the arthroscopy or arthrotomy was done. Our important observations were limited to the findings in the menisci and in the anterior cruciate ligament. Magnetic resonance imaging had a positive predictive value of 75 per cent, a negative predictive value of 90 per cent, a sensitivity of 83 per cent, and a specificity of 84 per cent for pathological findings in the menisci. For complete tears of the anterior cruciate ligament, the positive predictive value was 74 per cent; the negative predictive value, 70 per cent; the sensitivity, 61 per cent; and the specificity, 82 per cent. We believe that magnetic resonance imaging, when combined with clinical and roentgenographic examination, provides the most accurate non-invasive source of information that is currently available for pathological findings in the menisci and in the anterior cruciate ligament.

Adolescent↗
PubMed2006

The elephant knee joint: morphological and biomechanical considerations.

Elephant limbs display unique morphological features which are related mainly to supporting the enormous body weight of the animal. In elephants, the knee joint plays important roles in weight bearing and locomotion, but anatomical data are sparse and lacking in functional analyses. In addition, the knee joint is affected frequently by arthrosis. Here we examined structures of the knee joint by means of standard anatomical techniques in eight African (Loxodonta africana) and three Asian elephants (Elephas maximus). Furthermore, we performed radiography in five African and two Asian elephants and magnetic resonance imaging (MRI) in one African elephant. Macerated bones of 11 individuals (four African, seven Asian elephants) were measured with a pair of callipers to give standardized measurements of the articular parts. In one Asian and three African elephants, kinematic and functional analyses were carried out using a digitizer and according to the helical axis concept. Some peculiarities of healthy and arthrotic knee joints of elephants were compared with human knees. In contrast to those of other quadruped mammals, the knee joint of elephants displays an extended resting position. The femorotibial joint of elephants shows a high grade of congruency and the menisci are extremely narrow and thin. The four-bar mechanism of the cruciate ligaments exists also in the elephant. The main motion of the knee joint is extension-flexion with a range of motion of 142 degrees . In elephants, arthrotic alterations of the knee joint can lead to injury or loss of the cranial (anterior) cruciate ligament.

Animals↗
PubMed2002

Radiologic case study. Glenolabral articular disruption (GLAD) lesion.

Glenolabral articular disruption lesions are an unusual source of anterior shoulder instability and pain. They may be difficult to diagnose clinically and often require surgical repair. Magnetic resonance arthrography is superior to other imaging techniques, including conventional MRI, in the evaluation of shoulder instability.

Adolescent↗
PubMed1987

Trapeziometacarpal osteoarthritis. Staging as a rationale for treatment.

Painful arthrosis of the basal joints of the thumb covers a spectrum of arthritic disease. The painful hypermobile thumb with articular cartilage preserved requires an entirely different type of treatment than does the similarly painful basal joint, which has stiffness and degeneration of more than one facet of the trapezium. By careful radiographic evaluation of the trapezial articulations, particularly in the lateral projection, a reasonable set of radiographic guidelines for staging of the degenerative process can be provided. One must be prepared to adjust this preoperative staging should direct inspection of the articular surfaces at surgery indicate more damage than perceived on the radiograph. Once the ultimate staging of the disease has been established, the means of treatment is considerably simplified and the multiple procedures that have been proposed for "basal joint arthritis" can be applied more accurately.

Arthroplasty↗