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Sample records for acute knee dislocations

  1. Traumatic Knee Dislocation with Acute Artery Injury

    Hüseyin Şahin1; Mustafa Uzkeser2; Ayhan Aköz; et al.

    2014-01-01

    Traumatic knee dislocation is very rare injury in patients presenting to the emergency room. The complications associated with knee dislocation such as amputation of extremities and die is required emergency response. We discussed a case, that he has only knee dislocation and popliteal artery injury and mortal as soon as possible.

  2. Acute Concomitant Anterior Cruciate Ligament and Patellar Tendon Tears in a Non-dislocated Knee

    Robert D Wissman

    2012-01-01

    Full Text Available Anterior cruciate ligament (ACL tears are common and may occur in isolation or with other internal derangements of the joint. Tears of the patellar tendon (PT occur less frequently and are rarely associated with intra-articular pathology. Acute combined tears of both the ACL and PT are known complications of high-energy traumatic knee dislocations. We present a case of an acute concomitant ACL and PT tears in a low-energy non-dislocated knee. To our knowledge, this injury has only been described in a limited number of case reports in the orthopedic literature. We present the imaging findings of this combined injury and discuss the importance of magnetic resonance (MR in diagnosis.

  3. Acute traumatic patellar dislocation.

    Duthon, V B

    2015-02-01

    Inaugural traumatic patellar dislocation is most often due to trauma sustained during physical or sports activity. Two-thirds of acute patellar dislocations occur in young active patients (less than 20 years old). Non-contact knee sprain in flexion and valgus is the leading mechanism in patellar dislocation, accounting for as many as 93% of all cases. The strong displacement of the patella tears the medial stabilizing structures, and notably the medial patellofemoral ligament (MPFL), which is almost always injured in acute patellar dislocation, most frequently at its femoral attachment. Lateral patellar glide can be assessed with the knee in extension or 20° flexion. Displacement by more than 50% of the patellar width is considered abnormal and may induce apprehension. Plain X-ray and CT are mandatory to diagnose bony risk factors for patellar dislocation, such as trochlear dysplasia or increased tibial tubercle-trochlear groove distance (TT-TG), and plan correction. MRI gives information on cartilage and capsulo-ligamentous status for treatment planning: free bodies or osteochondral fracture have to be treated surgically. If patellar dislocation occurs in an anatomically normal knee and osteochondral fracture is ruled out on MRI, non-operative treatment is usually recommended. PMID:25592052

  4. Multiligamentous injuries and knee dislocations.

    Gimber, Lana H; Scalcione, Luke R; Rowan, Andrew; Hardy, Jolene C; Melville, David M; Taljanovic, Mihra S

    2015-11-01

    Complex capsular ligamentous structures contribute to stability of the knee joint. Simultaneous injury of two or more knee ligaments, aside from concurrent tears involving the anterior cruciate and medial collateral ligaments, is considered to be associated with femorotibial knee dislocations. Proximal tibiofibular joint dislocations are not always easily recognized and may be overlooked or missed. Patellofemoral dislocations can be transient with MR imaging sometimes required to reach the diagnosis. In this article, the authors describe the mechanism of injury, ligamentous disruptions, imaging, and treatment options of various types of knee dislocations including injuries of the femorotibial, proximal tibiofibular, and patellofemoral joints. PMID:26002747

  5. Radiographic Assessment of Anatomic Risk Factors Associated with Acute, Lateral Patellar Dislocation in the Immature Knee

    Thai Trinh; Andrew Mundy; Matthew Beran; Kevin Klingele

    2016-01-01

    Acute patellar dislocation remains a common injury in both adult and pediatric patients. Non-operative management has been advocated for patients without a history of recurrent instability. Although pathologic thresholds for consideration of operative management have previously been reported in adults, it is largely unknown in children. A retrospective review of all skeletally immature patients diagnosed with acute lateral patellar dislocation who had MRI imaging were included for analysis. A...

  6. Radiographic Assessment of Anatomic Risk Factors Associated with Acute, Lateral Patellar Dislocation in the Immature Knee

    Thai Trinh

    2016-04-01

    Full Text Available Acute patellar dislocation remains a common injury in both adult and pediatric patients. Non-operative management has been advocated for patients without a history of recurrent instability. Although pathologic thresholds for consideration of operative management have previously been reported in adults, it is largely unknown in children. A retrospective review of all skeletally immature patients diagnosed with acute lateral patellar dislocation who had MRI imaging were included for analysis. An age-based control group was also identified. Six radiographic measurements were compared: lateral trochlear inclination (LTI, trochlear facet asymmetry (TFA, trochlear depth (TD, tibial tuberosity–trochlear groove (TT–TG, sulcus angle (SA and patellar height ratio. A total of 178 patients were included for analysis (study: n = 108, control: n = 70. The mean age of patients in the study and control groups was 13.7 and 12.1 years respectively (p ≤ 0.001. Study group patients had significant differences in all radiographic measurements including a decreased LTI (p < 0.001, increased TFA (p < 0.001 and SA (p < 0.001. The mean trochlear depth was 3.4 mm and 5.6 mm for patients in the study and control groups respectively (p < 0.001. Study group patients had an increased patellar height ratio (p < 0.001 and TT–TG distance (p < 0.001. Morphologic abnormalities may predispose skeletally immature patients to an increased risk of acute lateral patellar instability.

  7. Extensor Mechanism Disruption in Knee Dislocation.

    O'Malley, Michael; Reardon, Patrick; Pareek, Ayoosh; Krych, Aaron; Levy, Bruce A; Stuart, Michael J

    2016-05-01

    Disruption of the knee extensor mechanism is a challenging injury with no clear consensus on optimal treatment. Although rare in the setting of knee dislocations, these injuries should not be overlooked. Acute, complete rupture of either the quadriceps or patellar tendon necessitates primary repair with or without augmentation. Surgical management may also be required in the setting of a partial tear if a significant extensor lag is present or nonoperative treatment has failed. Tendon augmentation is used during primary repair if the native tissue is inadequate or after a failed primary repair. The purpose of this study is to evaluate extensor mechanism disruption incidence, injury patterns, associated injuries, and surgical options, including a novel tendon augmentation technique. This procedure consists of primary patellar or quadriceps tendon repair with semitendinosus autograft augmentation utilizing a distal or proximal patellar socket. Advantages of repair with tendon augmentation include accelerated rehabilitation, decreased risk of patellar fracture from transverse or longitudinal bone tunnels, and less hardware complications. We recommend consideration of this technique for selected cases of acute extensor mechanism disruption in the setting of tibiofemoral dislocation. PMID:26636488

  8. Knee Dislocation in the Morbidly Obese Patient.

    Carr, James Bradley; Werner, Brian Christopher; Miller, Mark D; Gwathmey, Frank Winston

    2016-05-01

    Though a relatively rare orthopedic injury, knee dislocation in the morbidly obese population has been increasingly reported in the literature. These injuries are often referred to as "ultralow-velocity knee dislocations" since they commonly occur after a seemingly trivial injury, such as a ground level fall. As a result, these injuries are often underappreciated and initially misdiagnosed. Even though these injuries are low-velocity, they should still be regarded as a high energy injury because of the large amount of mass contributing to the dislocating force. Knee dislocations in the morbidly obese are associated with a particularly high rate of neurovascular injury. A timely and accurate diagnosis is crucial to avoid serious limb-threatening complications, including the need for amputation. Therefore, evaluating physicians should maintain a high suspicion for a knee dislocation in any morbidly obese patient who presents with knee pain following a seemingly innocuous injury. Management of these injuries is controversial. Associated vascular injuries must be identified promptly and appropriately managed by a vascular surgery team. There is no consensus on the ideal orthopedic treatment of knee dislocations in the morbidly obese patient. Operative treatment can be fraught with complications, including a higher rate of neurovascular injury, increased surgical complications, and poor subjective patient outcome scores compared with nonobese patients sustaining a high-velocity knee dislocation. It is paramount that treating physicians are familiar with the unique challenges of treating knee dislocations in the morbidly obese patient when discussing risks and benefits of treatment options. This article presents a review of the existing literature on knee dislocations in the morbidly obese population, including diagnosis, management, and outcomes. PMID:26838970

  9. Bioabsorbable Pins for Treatment of Osteochondral Fractures of the Knee after Acute Patella Dislocation in Children and Young Adolescents

    A. Gkiokas

    2012-01-01

    Full Text Available A retrospective study was performed on the use of bioabsorbable pins in the fixation of osteochondral fractures (OCFs after traumatic patellar dislocation in children. Eighteen children (13 females, 5 males aged 11 to 15 years (mean age 13.1 years with osteochondral fracture (OCF of the knee joint were treated at the authors’ institution. Followup ranged from 22 months to 5 years. Diagnosis was verified by X-ray and magnetic resonance imaging (MRI of the knee and patella. In seven patients the osteochondral fragment was detached from the patella and in 11 it was detached from the lateral femoral condyle. All patients were subjected to open reduction and fixation of the lesion with bioabsorbable pins. Postoperatively, the knee was immobilized in a cast and all patients were mobilized applying a standardized protocol. Bone consolidation was successful in 17 of the 18 patients. Bioabsorbable pins reliably fix OCF in children and adolescents, demonstrating a high incidence of consolidation of the detached osteochondral fragment in short- and middle-term followup without requiring further operative procedures.

  10. REHABILITATION FOLLOWING KNEE DISLOCATION WITH LATERAL SIDE INJURY: IMPLEMENTATION OF THE KNEE SYMMETRY MODEL

    Kinzer, Angie; Jenkins, Walter; Urch, Scott E.; Shelbourne, K. Donald

    2010-01-01

    Rehabilitation following lateral side knee ligament repair or reconstruction has traditionally utilized a conservative approach. An article outlining a new concept in rehabilitation following ACL reconstruction called the Knee Symmetry Model was recently published13. The Knee Symmetry Model can also be applied to rehabilitation of other knee pathologies including a knee dislocation with a lateral side injury.

  11. An Unexpected Complication of Hip Arthroplasty: Knee Dislocation

    Serdar Yilmaz

    2015-01-01

    Full Text Available An increasing number of patients with hip fracture have been seen with osteoporosis associated with osteoarthritis. Although knee dislocation is related to high-energy trauma, low-grade injuries can also lead to knee dislocation which is defined as “ultra-low velocity dislocation.” The case reported here is of an 82-year-old patient who presented with a left intertrochanteric hip fracture. Partial arthroplasty was planned because of osteoporosis. In the course of surgery, degenerative arthritic knee was dislocated during the hip reduction maneuver with the application of long traction. The neurovascular examination was intact, but the knee was grossly unstable and was dislocated even in a brace; thus a hinged knee prosthesis was applied nine days after surgery. The patient was mobilized with crutches after the knee prosthesis but exercise tolerance was diminished. In conclusion, it should be emphasized that overtraction must be avoided during the hip reduction maneuver in patients with advanced osteoarthritic knee.

  12. Posterolateral dislocation of the knee: Recognizing an uncommon entity.

    Woon, Colin Yl; Hutchinson, Mark R

    2016-06-18

    Posterolateral dislocations of the knee are rare injuries. Early recognition and emergent open reduction is crucial. A 48-year-old Caucasian male presented with right knee pain and limb swelling 3 d after sustaining a twisting injury in the bathroom. Examination revealed the pathognomonic anteromedial "pucker" sign. Ankle-brachial indices were greater than 1.0 and symmetrical. Radiographs showed a posterolateral dislocation of the right knee. He underwent emergency open reduction without an attempt at closed reduction. Attempts at closed reduction of posterolateral dislocations of the knee are usually impossible because of incarceration of medial soft tissue in the intercondylar notch and may only to delay surgical management and increase the risk of skin necrosis. Magnetic resonance imaging is not crucial in the preoperative period and can lead to delays of up to 24 h. Instead, open reduction should be performed once vascular compromise is excluded. PMID:27335816

  13. Posterolateral dislocation of the knee: Recognizing an uncommon entity

    Woon, Colin YL; Hutchinson, Mark R

    2016-01-01

    Posterolateral dislocations of the knee are rare injuries. Early recognition and emergent open reduction is crucial. A 48-year-old Caucasian male presented with right knee pain and limb swelling 3 d after sustaining a twisting injury in the bathroom. Examination revealed the pathognomonic anteromedial “pucker” sign. Ankle-brachial indices were greater than 1.0 and symmetrical. Radiographs showed a posterolateral dislocation of the right knee. He underwent emergency open reduction without an attempt at closed reduction. Attempts at closed reduction of posterolateral dislocations of the knee are usually impossible because of incarceration of medial soft tissue in the intercondylar notch and may only to delay surgical management and increase the risk of skin necrosis. Magnetic resonance imaging is not crucial in the preoperative period and can lead to delays of up to 24 h. Instead, open reduction should be performed once vascular compromise is excluded. PMID:27335816

  14. Lateral dislocation of the knee joint after total knee arthroplasty: a case report

    Ugutmen, Ender; Ozkan, Korhan; Unay, Koray; Mahirogullari, Mahir; Eceviz, Engin; Taser, Omer

    2008-01-01

    Background Total knee arthroplasty (TKA) is a successful therapy for functional improvement and pain relief in advanced symptomatic degeneration of the knee joint. But it can be associated with many complications, one of which is instability. Case presentation A 70-year-old woman was referred to our hospital because of right knee dislocation after TKA was performed on her right knee due to severe varus deformity and flexion contracture. This instability was caused by persistent MCL tightness ...

  15. Magnetic resonance findings in knee dislocation: pictorial essay

    The role of MRI in the preoperative assessment of knee dislocation is well documented. e present our experience with a series of images graphically displaying the spectrum of abnormalities associated with these injuries. These images were derived from a local internal audit reviewing the preoperative MRI and correlating this with the surgical findings. Twenty-two cases between April 1997 and April 1999 were reviewed. Traumatic dislocation of the knee is rare, although many believe it is often unrecognized because of spontaneous reduction.' The injury may present as (i) frank dislocation; (ii) a knee that is dislocated while under anaesthesia; or (iii) a pattern of soft-tissue injury which suggests dislocation. Dislocation is described by the position of the tibia relative to the femur and may be anterior, posterior, lateral, medial or rotatory. Conservative management has traditionally been advocated and in this setting clinical examination and plain radiographs are adequate. Because of the trend toward increased surgical intervention, however, the more accurate characterization of soft-tissue injuries provided by MRI aids the planning of ligamentous reconstruction and the operative approach. Copyright (1999) Blackwell Science Pty Ltd

  16. Dislocation following total knee arthroplasty: A report of six cases

    Villanueva Manuel

    2010-01-01

    Full Text Available Background: Dislocation following total knee arthroplasty (TKA is the worst form of instability. The incidence is from 0.15 to 0.5%. We report six cases of TKA dislocation and analyze the patterns of dislocation and the factors related to each of them. Materials and Methods: Six patients with dislocation of knee following TKA are reported. The causes for the dislocations were an imbalance of the flexion gap (n=4, an inadequate selection of implants (n=1, malrotation of components (n=1 leading to incompetence of the extensor mechanism, or rupture of the medial collateral ligament (MCC. The patients presented complained of pain, giving way episodes, joint effusion and difficulty in climbing stairs. Five patients suffered posterior dislocation while one anterior dislocation. An urgent closed reduction of dislocation was performed under general anaesthesia in all patients. All patients were operated for residual instability by revision arthroplasty after a period of conservative treatment. Results: One patient had deep infection and knee was arthrodesed. Two patients have a minimal residual lag for active extension, including a patient with a previous patellectomy. Result was considered excellent or good in four cases and fair in one, without residual instability. Five out of six patients in our series had a cruciate retaining (CR TKA designs: four were revised to a posterior stabilized (PS TKA and one to a rotating hinge design because of the presence of a ruptured MCL. Conclusion: Further episodes of dislocation or instability will be prevented by identifying and treating major causes of instability. The increase in the level of constraint and correction of previous technical mistakes is mandatory.

  17. Periprosthetic fracture-dislocation in a loosened total knee replacement treated by knee arthrodesis

    We present a patient who was operated four years before performing a total knee replacement. She fell down resulting a periprosthetic femoral fracture and a prosthetic dislocation. After evaluating different treatments, we decided to do prosthetic removal and a knee arthrodesis using an intramedullar nail. The femoral fracture was fixed with wire cerclages. Knee arthrodesis is a procedure uses as a last option for the treatment of infected or loosed arthroplasties. In our case it was difficult to consider any other reconstructive procedure due to the association of fracture, dislocation and loosening. The evolution has been satisfactory with good functional result and without pain

  18. Dislocations

    Dislocations are joint injuries that force the ends of your bones out of position. The cause is often a fall or a blow, sometimes from playing a contact sport. You can dislocate your ankles, knees, shoulders, hips, elbows and jaw. You can also dislocate your finger and toe joints. Dislocated joints often ...

  19. A RARE CASE OF IPSILATERAL HIP AND KNEE DISLOCATION

    Deepak

    2015-06-01

    Full Text Available High velocity road traffic accidents leads to complicated lower limb injuries. Such injuries demand highly experienced surgeon and are associated with high morbidity and mortality. Hip or knee dislocations are two different orthopaedic emergencies. Concomitant fracture dislocation of the hip and knee is rare and very few cases have been reported in the literature. A 45 year old man with history of fall from motorcycle came to the casualty. He had ipsilateral hip and knee dislocation. Immediately patient was shifted to operation theatre and closed reduction was performed under general anaesthesia. Reduction was confirmed under fluoroscopy and post-operative x-rays were taken. The functional results were excellent. After 2 months patient made an uncomplicated recovery and had satisfactory functional outcome with right hip having 110⁰ flexion and right knee flexes to 120⁰.There was no neurological deficit. The urgency, that the treating surgeon shows in managing these injuries, significantly affects the prognosis and outcome finally achieved by these patients (golden period in reducing the hip joint has been described to be 6 hours.

  20. Imaging following acute knee trauma.

    Kijowski, R; Roemer, F; Englund, M; Tiderius, C J; Swärd, P; Frobell, R B

    2014-10-01

    Joint injury has been recognized as a potent risk factor for the onset of osteoarthritis. The vast majority of studies using imaging technology for longitudinal assessment of patients following joint injury have focused on the injured knee joint, specifically in patients with anterior cruciate ligament injury and meniscus tears where a high risk for rapid onset of post-traumatic osteoarthritis is well known. Although there are many imaging modalities under constant development, magnetic resonance (MR) imaging is the most important instrument for longitudinal monitoring after joint injury. MR imaging is sensitive for detecting early cartilage degeneration and can evaluate other joint structures including the menisci, bone marrow, tendons, and ligaments which can be sources of pain following acute injury. In this review, focusing on imaging following acute knee trauma, several studies were identified with promising short-term results of osseous and soft tissue changes after joint injury. However, studies connecting these promising short-term results to the development of osteoarthritis were limited which is likely due to the long follow-up periods needed to document the radiographic and clinical onset of the disease. Thus, it is recommended that additional high quality longitudinal studies with extended follow-up periods be performed to further investigate the long-term consequences of the early osseous and soft tissue changes identified on MR imaging after acute knee trauma. PMID:25278054

  1. Lateral dislocation of the knee joint after total knee arthroplasty: a case report

    Ugutmen, Ender; Ozkan, Korhan; Unay, Koray; Mahirogullari, Mahir; Eceviz, Engin; Taser, Omer

    2008-01-01

    Background Total knee arthroplasty (TKA) is a successful therapy for functional improvement and pain relief in advanced symptomatic degeneration of the knee joint. But it can be associated with many complications, one of which is instability. Case presentation A 70-year-old woman was referred to our hospital because of right knee dislocation after TKA was performed on her right knee due to severe varus deformity and flexion contracture. This instability was caused by persistent MCL tightness and iatrogenic lateral collateral, arcuate ligament, and popliteus tendon injury. The torn lateral collateral ligament and arcuate ligament were sutured with no. 2 non-absorbable (Ethibond) sutures with plication of the posterolateral knee capsule. A deep-dish liner was inserted to optimize soft tissue tension. Conclusion This is a very severe complication, and surgeons must be cautious about ligament balancing and soft tissue resection during TKA for severe varus and valgus deformities. PMID:18687153

  2. Non-Traumatic Anterior Dislocation of a Total Knee Replacement Associated with Neurovascular Injury

    Aderinto, Joseph; Gross, Allan E.; Rittenhouse, Bryan

    2009-01-01

    Prosthetic total knee replacements rarely dislocate. When dislocation does occur, it is usually in a posterior direction in association with a posterior stabilised, cruciate-sacrificing prosthesis. Neurovascular injury is unusual. In this report, we describe a case of anterior dislocation of a cruciate-retaining total knee replacement in a 67-year-old woman. The dislocation occurred in the absence of overt trauma and resulted in severe neurovascular injury.

  3. Posterolateral dislocation of the knee joints:analysis of 9 cases

    顾敏琪; 邓磊; 刘沂

    2004-01-01

    Objective: To analyze the traumatic pathological characteristics of posterolateral dislocation of knee joints and its treatment.Methods: Nine cases of posterolateral dislocation of knee joint, 5 cases of fresh injuries (the fresh injury group) and 4 cases of old injuries ( the old injury group) were reviewed and analyzed. In the fresh injury group 4 cases failed in close reduction due to "buttonholing" through the medial joint, among them 3 cases underwent repair of the damaged ligaments. In the old injury group 2 cases underwent ACL and MCL repair only in acute stage, but re-dislocated. Of the rest 2 cases 1 was associated with peroneal nerve injury and the other was not treated in acute stage. One case was associated with comminuted fracture of the tibial condyle and popliteal artery injury. Open reduction was performed in 3 cases. One case was fixed with 2-crossed pin and another was fixed with one pin through the tibial and femoral condyle and second pin with olecranization fixation. Plaster immobilization for 6-8 weeks respectively was required. In the old injury group in 1 case ACL and PCL repair ( Augustine method ) and posterolateral structure were performed and olecranization fixation and plaster immobilization for 6 weeks was needed.Arthrodesis of the knee was done for the patient with comminuted fracture of the tibial condyle and popliteal artery injury.Results: All the cases were followed up for 1-23 years ( average 6 years). Knee stability in 4 cases with repair of the ligaments was improved, although PDT showed ( + ) with different degrees. The results of the patients treated with ligamentous reconstruction were much better than those of the patients without any repair. Conclusions: Well understanding of the traumatic pathological characteristics, repair of the damaged ligaments, augmentation of olecranization fixation and postoperative immobilization for 6 weeks are the key points of successful treatment.

  4. The Arcuate Sign: A Marker of Potential Knee Dislocation? A Report of Two Cases

    Crimmins, Jason T.; Wissman, Robert D.

    2015-01-01

    The arcuate sign is a well described finding of fibular head avulsion at the insertion site of the arcuate complex. It has been associated with posterolateral corner knee injury and resulting instability. The authors report two patients presenting with the arcuate sign following knee dislocation, which has not been previously described. As unrecognized spontaneously reduced knee dislocation often results in significant morbidity, the authors propose that the arcuate sign should raise clinical...

  5. A non-contact complete knee dislocation with popliteal artery disruption, a rare martial arts injury

    Viswanath, Y; Rogers, I

    1999-01-01

    Complete knee dislocation is a rare injury and an associated incidence of popliteal artery damage ranges from 16-60% of cases. It occurs commonly in road traffic accidents and in high velocity trauma where significant contact remains as the usual mode of injury. We describe a rare case of non-contact knee dislocation with popliteal artery injury sustained while practising Aikido, a type of martial art. This patient successfully underwent closed reduction of the knee with an emergency vein byp...

  6. Atraumatic patellar prosthesis dislocation with patellar tendon injury following a total knee arthroplasty: a case report

    Singh Alka; Singh Yashwant; Singh Pankaj; Singh Vinay; Javed Sadaf; Abdunabi Murad

    2010-01-01

    Abstract Introduction Total knee arthroplasty is a well-established procedure with gratifying results. There is no consensus in the literature whether to routinely resurface the patella while performing total knee arthroplasty or not. Although an extremely rare occurrence in clinical practice, patellar prosthesis dislocation is a possible complication resulting from total knee arthroplasty. Case presentation We report a rare case of atraumatic spontaneous dislocation of patellar prosthesis in...

  7. Posterior Dislocation of the Hinge-Post Extension in a Rotating Hinge Total Knee Prosthesis

    Givenchy Manzano

    2013-01-01

    Full Text Available The rotating hinge knee prosthesis is a popular intervention in patients lacking stability with highly constrained total knee arthroplasty. Despite improvements in design, nonmechanical and mechanical complications continue to be a problem. Dislocation of the hinge has been widely described, mainly due to the component fracture. Few reports describe isolated dislocation of the rotating stem. We report a case of isolated disengagement of the rotating hinge mechanism, due to severe flexion gap imbalance, leading to subsequent posterior dislocation of the hinge and anterior knee dislocation, in a patient with a history of multiple total knee arthroplasty revisions. This case suggests the importance of the soft tissue balancing, the adequate patellar tracking, and use of a long cylindrical, minimally tapered rotating stem in hinge arthroplasty to minimize hinge dislocation.

  8. Spontaneous Relocation of a Posterior Dislocation of Mobile Bearing in a Medial Unicompartmental Knee Replacement

    Hussein Noureddine; Jaimes Aird; Paul Latimer

    2012-01-01

    We describe a case of spontaneous relocation of a posterior dislocation of the mobile bearing in a medial unicompartmental knee replacement, prior to surgical intervention. We are unaware of any similar cases in the published literature. This paper highlights some clinical issues around this type of dislocation.

  9. Spontaneous Relocation of a Posterior Dislocation of Mobile Bearing in a Medial Unicompartmental Knee Replacement

    Noureddine, Hussein; Aird, Jaimes; Latimer, Paul

    2012-01-01

    We describe a case of spontaneous relocation of a posterior dislocation of the mobile bearing in a medial unicompartmental knee replacement, prior to surgical intervention. We are unaware of any similar cases in the published literature. This paper highlights some clinical issues around this type of dislocation. PMID:23259116

  10. Open posterior dislocation of the knee with rupture of the patellar tendon and a tibial plateau fracture

    Mohammed Fahd Amar; Badr Chbani; Oussama Ammoumri; Amine Marzouki; Fawzi Boutayeb

    2010-01-01

    Knee dislocations are rare injuries. They represent a severe soft tissue injury following high-energy blunt trauma. We report a case of open posterior knee dislocation with rupture of the patellar tendon and a fracture of the tibial plateau. The treatment was surgical and consisted of reduction of the knee dislocation, fixation of the tibial plateau fracture by lag screws, and transosseous sutures for the patellar tendon protected by a patellotibial cerclage. The result was successful with fu...

  11. Knee dislocation: descriptive study of injuries Luxação do joelho: estudo descritivo das lesões

    Fabiano Kupczik; Marlus Eduardo Gunia Schiavon; Lucas de Almeida Vieira; Daniel Pundek Tenius; Rodrigo Caldonazzo Fávaro

    2013-01-01

    OBJECTIVE: Describe the ligamentous and associated injuries that occur in the traumatic knee dislocation, relating them to the mechanisms of trauma and to identify patterns of injuries. METHODS: Twenty three knee dislocations were described in the period between March 2010 and March 2011. After the diagnosis of the lesions, the reduction and transarticular external fixation of the dislocated knees were done. At the second moment, the patients were evaluated with physical examination under...

  12. Atraumatic patellar prosthesis dislocation with patellar tendon injury following a total knee arthroplasty: a case report

    Singh Alka

    2010-01-01

    Full Text Available Abstract Introduction Total knee arthroplasty is a well-established procedure with gratifying results. There is no consensus in the literature whether to routinely resurface the patella while performing total knee arthroplasty or not. Although an extremely rare occurrence in clinical practice, patellar prosthesis dislocation is a possible complication resulting from total knee arthroplasty. Case presentation We report a rare case of atraumatic spontaneous dislocation of patellar prosthesis in a 63-year-old Caucasian man of British origin with patellar tendon injury. The patient was treated successfully through a revision of the patellar component and tendon repair. In two years follow-up the patient is asymptomatic with no sign of loosening of his patellar prosthesis. Conclusions A thorough understanding of knee biomechanics is imperative in performing total knee arthroplasty in order to achieve a better functional outcome and to prevent early prosthetic failure.

  13. Primary traumatic patellar dislocation

    Tsai Chun-Hao

    2012-06-01

    Full Text Available Abstract Acute traumatic patellar dislocation is a common injury in the active and young adult populations. MRI of the knee is recommended in all patients who present with acute patellar dislocation. Numerous operative and non-operative methods have been described to treat the injuries; however, the ideal management of the acute traumatic patellar dislocation in young adults is still in debate. This article is intended to review the studies to the subjects of epidemiology, initial examination and management.

  14. Emergency arthroscopic debridement and reduction associated with the second stage ligament reconstruction for the treatement of acute posterolateral rotatory dislocation of knee%急诊关节镜下清创复位联合二期韧带重建治疗急性膝关节后外侧旋转脱位

    何锐; 杨柳; 郭林; 陈光兴; 段小军; 戴刚

    2012-01-01

      Objective To discuss the curative effect of emergency arthroscopic debridement and reduction associated with the second stage anterior cruciate ligament (ACL) reconstruction for acute posterolateral rotatory dislocation of knee. Methods The retrospective study involved 3 patients with acute posterolateral rotarory dislocation treated in Southwest Hospital of Third Military Medical University from September 2007 to August 2008. Emergency arthroscopy was taken to reduce the knee and debride articular cavity. One case with medial collateral ligment (MCL) rupture was repaired and another 2 cases with MCL partialy injury accepted conservative treatment of hinge knee orthosis until natural healing. Three months later, ACL reconstruction with LARS artificial ligament were performed for all patients. The range of motion (ROM) of knee and Lysholm scores were observed during the follow-up. Results The mean duration of follow-up was 15 months. No anterior knee instability had happened. Results of anterior drawer test and talar tilt test were negative, no heteropic ossification was found in 3 patients, the ROM were 0°-130° , 0°-120° and 0°-130° in 3 months after reconstruction surgery, and the Lysholm score were 91 point, 98 point and 94 point in 12 months afier reconstruction. Conclusion Emergency arthroscopic reduction and debridement associated with standard ACL reconstruction results in good curative outcomes for acute posterolateral rotatory dislocation of knee.%  目的总结急诊关节镜下复位清创联合二期韧带重建手术在急性膝关节后外侧旋转脱位治疗中的效果.方法回顾性分析2007年9月至2008年8月第三军医大学西南医院收治的3例急性膝关节后外侧旋转脱位患者的临床资料,3例患者均急诊行关节镜手术清创+复位治疗,其中1例内侧副韧带(MCL)Ⅲ度损伤患者行MCL修补缝合术;2例MCLⅡ度损伤患者佩戴铰链支具保守治疗.术后3个月,3例患者接受LARS人

  15. Unilateral Congenital Knee and Hip Dislocation with Bilateral Clubfoot – A rare Packaging disorder

    Mukesh Tiwari

    2013-04-01

    Full Text Available ntroduction: Reduced intrauterine space gives rise to ‘packaging disorder’ which may involve joint dislocations or contractures. We present an unique case where mutiple joints were dislocated involving left congenital knee dislocation (CDK, bilateral congenital hip dislocation (CDH and congenital talipes equino varus (CTEVdeformities. Case Report: A preterm baby boy born to mother with diagnosed oligohydramios presented with left CDK bilateral DDH and CTEV. The knee dislocation was treated first with gradual streaching and weekly above knee cast. At 7th week good flexion was achieved at both knees and abduction splint for DDH (using double diaper with ponseti cast for CTEV was done. At one year follow up all joints were reduced and maintained well with baby able to stand with support. Conclusion: Packaging disorders may present with multiple dislocations and deformities. Early intervention with serial casting and manipulation minimises disability and prevents ambulatory problems. In our case there was a good response to manipulation and serial casting. This differs from cases with inherent pathology like arthrogryposis where response to treatment is not so good. Keywords: Congenital genu recurvatum, Develpmental dysplasia hip, CTEV, Clubfoot, serial manipulation, packaging disorders

  16. Recurrent locked knee caused by an impaction fracture following inferior patellar dislocation: a case report

    Sutcliffe William

    2011-08-01

    Full Text Available Abstract Introduction Locked knee caused by inferior patellar dislocation is considered rare in elderly patients. It was originally thought that, in the osteoarthritic knee, osteophytes on the pole of the patella become entrapped in the inter-condylar notch, which is managed by performing closed reduction and immobilization in a knee splint for three to four weeks. We present an unusual case of a locked knee with an impaction fracture. To the best of our knowledge, there have been no previous reports of such impaction fractures managed with arthroscopy. Case presentation We present an unusual case of an 88-year-old Caucasian woman with moderate arthritis who had a locked knee caused by an impaction fracture of the patella into the lateral femoral condyle. In this case report, we describe the need for arthroscopic surgery to prevent relocking of the knee in these patients. Conclusions This case report emphasizes the need for careful assessment of locked knees in elderly patients. Impaction fractures should be considered in all rare cases of patellar dislocation, and we advocate arthroscopic assessment of the articular cartilage in these patients. This is an important consideration, as the population demographics change and such impaction fractures may become more common in patients with degeneration in the knees.

  17. The iliotibial band in acute knee trauma: patterns of injury on MR imaging

    Mansour, Ramy; Yoong, Philip; McKean, David; Teh, James L. [Oxford University Hospitals NHS Trust, Department of Radiology, Nuffield Orthopaedic Centre, Oxford (United Kingdom)

    2014-10-15

    To delineate the spectrum of knee injuries associated with sprains and tears of the distal iliotibial band (ITB). A retrospective review of 200 random MRI scans undertaken for acute knee trauma was performed. Scans were excluded if there was a history of injury over 4 weeks from the time of the scan, septic arthritis, inflammatory arthropathy, previous knee surgery, or significant artefact. In each scan, the ITB was scored as normal, minor sprain (grade 1), severe sprain (grade 2), and torn (grade 3). The menisci, ligaments, and tendons of each knee were also assessed. The mean age was 27.4 years (range, 9-69 years) and 71.5 % (n = 143) of the patients were male. The ITB was injured in 115 cases (57.5 %). The next most common soft tissue structure injured was the anterior cruciate ligament (ACL) in 53.5 % of cases (n = 107). Grade 1 ITB injury was seen in 90 of these 115 cases (45 %), grade 2 injury in 20 cases, and grade 3 injury in only five cases. There is a significant association between ITB injury and ACL rupture (p < 0.05), as well as acute patellar dislocation (p < 0.05). There were ten cases of significant posterolateral corner injury, and all were associated with ITB injury, including four ITB tears. Only two cases of isolated ITB injury were seen (1 %). ITB injury is common in acute knee trauma and is associated with significant internal derangement of the knee, especially cruciate ligament rupture, posterolateral corner injury, and patellar dislocation. (orig.)

  18. The iliotibial band in acute knee trauma: patterns of injury on MR imaging

    To delineate the spectrum of knee injuries associated with sprains and tears of the distal iliotibial band (ITB). A retrospective review of 200 random MRI scans undertaken for acute knee trauma was performed. Scans were excluded if there was a history of injury over 4 weeks from the time of the scan, septic arthritis, inflammatory arthropathy, previous knee surgery, or significant artefact. In each scan, the ITB was scored as normal, minor sprain (grade 1), severe sprain (grade 2), and torn (grade 3). The menisci, ligaments, and tendons of each knee were also assessed. The mean age was 27.4 years (range, 9-69 years) and 71.5 % (n = 143) of the patients were male. The ITB was injured in 115 cases (57.5 %). The next most common soft tissue structure injured was the anterior cruciate ligament (ACL) in 53.5 % of cases (n = 107). Grade 1 ITB injury was seen in 90 of these 115 cases (45 %), grade 2 injury in 20 cases, and grade 3 injury in only five cases. There is a significant association between ITB injury and ACL rupture (p < 0.05), as well as acute patellar dislocation (p < 0.05). There were ten cases of significant posterolateral corner injury, and all were associated with ITB injury, including four ITB tears. Only two cases of isolated ITB injury were seen (1 %). ITB injury is common in acute knee trauma and is associated with significant internal derangement of the knee, especially cruciate ligament rupture, posterolateral corner injury, and patellar dislocation. (orig.)

  19. Usefulness of the skyline view in the assessment of acute knee trauma in children

    We report a retrospective analysis of all cases of acute knee injuries in children presenting to the Winnipeg Children's Hospital, University of Manitoba, between Jan. 1, 1994, and Jan. 1, 1995. The mechanism of injury was recorded and all 3 radiographic views (i.e., anterioposterior, lateral and skyline) were available for 171 of 256 total cases. We found a significant association between mechanism of injury and visualization of damage on skyline view radiographs (p < 0.01). The skyline view showed damage in only 1 of the 158 cases involving direct or indirect injury not involving subluxation or dislocation. However, damage was visualized on skyline view radiographs in 7 (54%) of the 13 cases that included a history of subluxation or dislocation. We conclude that in acute knee trauma in children, a skyline view radiograph of the patella should be obtained only when the mechanism of injury includes subluxation or dislocation. When the mechanism does not suggest subluxation or dislocation, the skyline view is unlikely to reveal damage; it adds unnecessary radiation, cost and possible added discomfort for the child. (author)

  20. Knee dislocations: a magnetic resonance imaging study correlated with clinical and operative findings

    Our objectives were to determine retrospectively the prevalence, patients' demographics, mechanism of injury, combination of torn ligaments, associated intra-articular and extra-articular injuries, fractures, bone bruises, femoral-tibial alignment and neurovascular complications of knee dislocations as evaluated by magnetic resonance (MR) imaging. From 17,698 consecutive knee examinations by magnetic resonance imaging (MRI) over a 6-year period, 20 patients with knee dislocations were identified. The medical records of these patients were subsequently reviewed for relevant clinical history, management and operative findings. The prevalence of knee dislocations was 0.11% [95% confidence interval (95% CI) 0.06-0.16]. There were 16 male patients and four female patients, with ages ranging from 15 years to 76 years (mean 31 years). Fifteen patients had low-velocity injuries (75%), of which 11 were amateur sports related and four were from falls. Four patients (20%) had suffered high-velocity trauma (motor vehicle accidents). One patient had no history available. Anatomic alignment was present at imaging in 16 patients (80%). Eighteen patients had three-ligament tears, two had four-ligament tears. The four-ligament tears occurred with low-velocity injuries. The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) were torn in every patient; the lateral collateral ligament (LCL) was torn in 50%, and the medial collateral ligament (MCL) in 60%. Intra-articular injuries included meniscal tears (five in four patients), fractures (eight in seven patients), bone bruises (15 patients), and patellar retinaculum tears (eight partial, two complete). The most common extra-articular injury was a complete biceps femoris tendon tear (five, 25%). There were two popliteal tendon tears and one iliotibial band tear. One patient had received a vascular injury following a motor vehicle accident (MVA) and had been treated prior to undergoing MRI. Bone bruises (unrelated to

  1. Knee dislocations: a magnetic resonance imaging study correlated with clinical and operative findings

    Bui, Kimmie L. [Cleveland Clinic, Department of Radiology, Cleveland, OH (United States); Cleveland Clinic, Department of Radiology, HB6, Cleveland, OH (United States); Ilaslan, Hakan; Sundaram, Murali [Cleveland Clinic, Department of Radiology, Cleveland, OH (United States); Parker, Richard D. [Cleveland Clinic, Department of Orthopaedics, Cleveland, OH (United States)

    2008-07-15

    Our objectives were to determine retrospectively the prevalence, patients' demographics, mechanism of injury, combination of torn ligaments, associated intra-articular and extra-articular injuries, fractures, bone bruises, femoral-tibial alignment and neurovascular complications of knee dislocations as evaluated by magnetic resonance (MR) imaging. From 17,698 consecutive knee examinations by magnetic resonance imaging (MRI) over a 6-year period, 20 patients with knee dislocations were identified. The medical records of these patients were subsequently reviewed for relevant clinical history, management and operative findings. The prevalence of knee dislocations was 0.11% [95% confidence interval (95% CI) 0.06-0.16]. There were 16 male patients and four female patients, with ages ranging from 15 years to 76 years (mean 31 years). Fifteen patients had low-velocity injuries (75%), of which 11 were amateur sports related and four were from falls. Four patients (20%) had suffered high-velocity trauma (motor vehicle accidents). One patient had no history available. Anatomic alignment was present at imaging in 16 patients (80%). Eighteen patients had three-ligament tears, two had four-ligament tears. The four-ligament tears occurred with low-velocity injuries. The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) were torn in every patient; the lateral collateral ligament (LCL) was torn in 50%, and the medial collateral ligament (MCL) in 60%. Intra-articular injuries included meniscal tears (five in four patients), fractures (eight in seven patients), bone bruises (15 patients), and patellar retinaculum tears (eight partial, two complete). The most common extra-articular injury was a complete biceps femoris tendon tear (five, 25%). There were two popliteal tendon tears and one iliotibial band tear. One patient had received a vascular injury following a motor vehicle accident (MVA) and had been treated prior to undergoing MRI. Bone bruises

  2. [Acute perilunar dislocations: algorithm for treatment].

    Towfigh, H

    2001-01-01

    In most cases, perilunar dislocations of the wrist are caused by high speed accidents. Usually these injuries occur by a fall on the dorsiflexed superextension of the hand. The instability caused by injuries of various erticular structures (ligament, bone) show various developmental stages. Clinical symptoms are reduced and painful movement, instability of the carpus, snapping and swelling. The diagnosis is established by X-ray, cinematography, arthrography MRT or CT. Perilunar instability with or without associated fractures and particularly de Quervain must be reduced and treated operatively including suture of the ligament and stabilization of the fracture. PMID:11824286

  3. Knee Luxation - Surgical treatment in acute cases

    Introduction: Traumatic luxation of the knee is an infrequent pathology with low number of reported cases. That implies a true challenge for the orthopedic surgeon due to its great of presentation. Objective: Establish a scheme of surgical management for this complex injury. Methodology: Observational study with different kinds of cases of patients from Universitario Del Valle Hospital and from the Imbanaco Medical Center. These surgeries occurred from December of 1999 to February of the 2003. Patients: 16. Age average: 31 years old. Age group: 13 to 64 years. Sex: 14 male and 2 female. Luxation Types: 15 closed and 1 exposed. Procedures: Correction of the extra-capsular structures and reintegration of the crossed ligaments in cases of avulsion using an acute management approach. In the two last patients, it was performed a simultaneous reconstruction of the crossed posterior and anterior with an auto-graft followed by patients monitoring from 12 to 50 months. The most common luxation type was KDIII L according to anatomical classification. A patient with vascular injury, two with external popliteo ciatic nerve injury and one broken patellar tendon, the results were evaluated according to the scale of Lysholm, IKDC and For Special Surgery. Conclusions: The acute management of the extra-articular structures gives the best results; therefore, if the surgeon does not have enough experience, this procedure should be to left for secondary reconstruction when the patient has normal arch of mobility

  4. Utilization and cost of a new model of care for managing acute knee injuries: the Calgary acute knee injury clinic

    Lau Breda HF; Lafave Mark R; Mohtadi Nicholas G; Butterwick Dale J

    2012-01-01

    Abstract Background Musculoskeletal disorders (MSDs) affect a large proportion of the Canadian population and present a huge problem that continues to strain primary healthcare resources. Currently, the Canadian healthcare system depicts a clinical care pathway for MSDs that is inefficient and ineffective. Therefore, a new inter-disciplinary team-based model of care for managing acute knee injuries was developed in Calgary, Alberta, Canada: the Calgary Acute Knee Injury Clinic (C-AKIC). The g...

  5. A modified surgical technique for reconstruction of an acute acromioclavicular joint dislocation

    Marchie Anthony

    2009-01-01

    Full Text Available We report a modified surgical technique for reconstruction of coracoclavicular and acromioclavicular ligaments after acute dislocation of acromioclavicular joint using suture anchors. We have repaired 3 consecutive type III acromioclavicular dislocations with good results. This technique is simple and safe and allows anatomical reconstruction of the ligaments in acute dislocations.

  6. Endobutton technique for the treatment of acute acromioclavicular joint dislocations

    Raif Özden

    2014-06-01

    Full Text Available Objective: Acromioclavicular (AC joint dislocation is a common injury frequently affecting young athletes. The aim of this study is to evaluate postoperative functional results in cases diagnosed with acute AC joint dislocation stabilized with endobutton system. Methods: This fixation procedure has been applied on 10 patients. Indications of the technique included: a grade V AC joint dislocation (7 patients, and grade III AC joint dislocation (3 patient according to Rockwood classification. The coracoclavicular (CC interval and AC joint were reduced using two endobuttons. One endobutton was fitted on the clavicle and the second was placed at the undersurface of the coracoid. Outcomes were assessed with the Constant shoulder score and visual analog pain scale. Results: All the patients had powerful intraoperative fixation. Immediately after surgery, and 6 weeks, and 1 year postoperative radiographs showed adequate reduction of the CC distance and the AC joint. The mean Constant shoulder score was 89 (88–92 in the injured shoulder and 90 (88–93 in the uninjured shoulder. There was no statically significant difference between the injured and normal shoulder in terms of Constant shoulder score and there was no complication during the process. Conclusion: This technique is a safe and effective method for providing fixation for the AC joint.

  7. The acutely ACL injured knee assessed by MRI

    Frobell, R B; Roos, H P; Roos, E M;

    2008-01-01

    OBJECTIVES: To map by magnetic resonance imaging (MRI) and quantitative MRI (qMRI) concomitant fractures and meniscal injuries, and location and volume of traumatic bone marrow lesions (BMLs) in the acutely anterior cruciate ligament (ACL) injured knee. To relate BML location and volume to cortical...... depression fractures, meniscal injuries and patient characteristics. METHODS: One hundred and twenty-one subjects (26% women, mean age 26 years) with an ACL rupture to a previously un-injured knee were studied using a 1.5T MR imager within 3 weeks from trauma. Meniscal injuries and fractures were classified...... by type, size and location. BML location and volume were quantified using a multi-spectral image data set analyzed by computer software, edited by an expert radiologist. RESULTS: Fractures were found in 73 (60%) knees. In 67 (92%) of these knees at least one cortical depression fracture was found...

  8. The external rotation method for reduction of acute anterior shoulder dislocations

    Marinelli, Mario; de Palma, Luigi

    2009-01-01

    Background Shoulder dislocations account for almost 50% of all joint dislocations, and are most commonly anterior (90–98%) and occur due to trauma. This prospective study was conducted to report our experiences of using the external rotation method (ERM) in the reduction of acute anterior shoulder dislocation. Materials and methods Between August 2006 and April 2007, ERM was applied to 31 patients who presented with traumatic anterior shoulder dislocation to the Emergency Department of our Ho...

  9. Patellar Dislocations and Reduction Procedure.

    Ramponi, Denise

    2016-01-01

    Acute patellar dislocations are a common injury occurring in adolescents involved in sports and dancing activities. This injury usually occurs when the knee is in full extension and sustains a valgus stress on the knee. The medial patellofemoral ligament is the medial restraint that assists in stabilizing the patella from lateral dislocations. The patella usually dislocates laterally and is usually not difficult to reduce after patient evaluation and prereduction radiographs. After postreduction radiographs confirm proper position of the patella postreduction and the absence of fractures, the patient is usually treated conservatively with initial immobilization, orthopedic referral, and physical therapy. PMID:27139130

  10. Dislocations

    Representations of main geometrical properties of dislocations, their interaction between each other and with a free surface are given. Mechanisms of dislocation formation and movements in different crystal lattices and their role in material strain hardening are considered. Grain boundaries and twin ones are described as dislocation rows imposed on each other

  11. Utilization and cost of a new model of care for managing acute knee injuries: the Calgary acute knee injury clinic

    Lau Breda HF

    2012-12-01

    Full Text Available Abstract Background Musculoskeletal disorders (MSDs affect a large proportion of the Canadian population and present a huge problem that continues to strain primary healthcare resources. Currently, the Canadian healthcare system depicts a clinical care pathway for MSDs that is inefficient and ineffective. Therefore, a new inter-disciplinary team-based model of care for managing acute knee injuries was developed in Calgary, Alberta, Canada: the Calgary Acute Knee Injury Clinic (C-AKIC. The goal of this paper is to evaluate and report on the appropriateness, efficiency, and effectiveness of the C-AKIC through healthcare utilization and costs associated with acute knee injuries. Methods This quasi-experimental study measured and evaluated cost and utilization associated with specific healthcare services for patients presenting with acute knee injuries. The goal was to compare patients receiving care from two clinical care pathways: the existing pathway (i.e. comparison group and a new model, the C-AKIC (i.e. experimental group. This was accomplished through the use of a Healthcare Access and Patient Satisfaction Questionnaire (HAPSQ. Results Data from 138 questionnaires were analyzed in the experimental group and 136 in the comparison group. A post-hoc analysis determined that both groups were statistically similar in socio-demographic characteristics. With respect to utilization, patients receiving care through the C-AKIC used significantly less resources. Overall, patients receiving care through the C-AKIC incurred 37% of the cost of patients with knee injuries in the comparison group and significantly incurred less costs when compared to the comparison group. The total aggregate average cost for the C-AKIC group was $2,549.59 compared to $6,954.33 for the comparison group (p Conclusions The Calgary Acute Knee Injury Clinic was able to manage and treat knee injured patients for less cost than the existing state of healthcare delivery. The

  12. Common peroneal nerve injuries in knee dislocations: results with one-stage nerve repair and tibialis posterior tendon transfer

    Garozzo, D.; Ferraresi, S.; Buffatti, P.

    2002-01-01

    We report our experience in the treatment of common peroneal nerve (CPN) palsy following knee dislocations: a twelve-year surgical series of 26 patients presenting with a traumatic injury of the lateral sciatic nerve and no spontaneous recovery is reviewed. From 1988 to 1991, we performed nerve surgery alone on 3 patients. Their results were highly disappointing and in none did we observe muscle recovery. Since 1991 nerve surgery was associated with a palliative procedure for 23 patients. Alt...

  13. Dislocation

    ... Alternative Names Joint dislocation Images Radial head injury Dislocation of the hip Shoulder joint References Boss SE, Mehta A, Maddow C, ... Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also ... Browse the Encyclopedia A.D.A.M., Inc. ...

  14. Ipsilateral fracture dislocations of the hip and knee joints with contralateral open fracture of the leg: a rare case and its management principles

    Sen Ramesh Kumar

    2011-06-01

    Full Text Available 【Abstract】This paper discussed the injury mecha- nism and management of a patient who had concomitant ipsilateral hip and knee dislocations and contralateral open leg fracture. A 32-year-old man presented with ipsilateral fracture- dislocations of the left hip (Pipkin’s type IV and knee (Moore II joints and contralateral open fracture of the leg bones after a car accident. After emergency resuscitative measures, the hip joint was reduced and Pipkin’s fracture was fixed using Ganz approach with lag screws; knee joint was reduced closely and tibial plateau fracture was stabi- lized with lateral buttress plate and a transarticular span- ning fixator. The open fracture on the other leg was de- brided and fixed with an external fixator. There was no insta- bility in both joints after fixation when he was examined under anesthesia. The fractures united after 3 months and the patient had no residual instability of hip and knee. There was no clinical or radiological evidence of osteonecrosis in the hip joint after 6 months. At one-year follow-up, he had satisfactory functional outcome with almost normal range of motion at both joints. Ipsilateral hip and knee dislocations are rare injuries and more caution is needed for early diagnosis. A timely appro- priate intervention can provide good functional outcome to the patient in this situation. Key words: Hip dislocation; Knee dislocation; Fractures, bone

  15. Management of acute dislocation of the temporomandibular joint in dental practice.

    McGoldrick, David M

    2010-12-01

    Acute dislocation of the temporomandibular joint is a situation that, although rare, may present to the dentist in practice at any time. A number of activities, such as removal of a tooth, may cause dislocation. The event is painful and distressing for the patient, their family and the dental team. Prompt management minimises discomfort, distress and long-term morbidity to the patient. We describe the aetiology of acute dislocation and outline a number of techniques that will aid the clinican in dealing with this event.

  16. Clinical and radiological outcomes after management of traumatic knee dislocation by open single stage complete reconstruction/repair

    Lorez Lukas G

    2010-05-01

    Full Text Available Abstract Background The purpose of our study was to analyze the clinical and radiological long-term outcomes of surgically treated traumatic knee dislocations and determine prognostic factors for outcome. Methods Retrospective consecutive series of patients treated surgically for traumatic knee dislocation with reconstruction/refixation of the anterior (ACL and posterior cruciate ligaments (PCL and primary complete repair of collaterals and posteromedial and posteromedial corner structures. 68 patients were evaluated clinically (IKDC score, SF36 health survey, Lysholm score, Knee Society score, Tegner score, visual analogue scale - VAS pain and satisfaction, Cooper test and radiologically (weight bearing and stress radiographs with a mean follow up of 12 ± 8 years. Instrumented anterior-posterior translation was measured (Rolimeter, KT-1000. Pearson correlation and stepwise regression analysis was used. Results 82% of patients (n = 56 returned to their previous work. At final follow-up 6 patients (9% suffered from pain VAS > 3. The mean side-to-side difference of anterior/posterior translation (KT-1000, 134N was 1.6 ± 1.6 mm and 2.6 ± 1.4 mm. Valgus and varus stress testing in 30° flexion was 40 days were significantly associated with worse outcome (p Conclusions Early complete reconstruction can achieve good functional results and patient satisfaction with overall restoration of sports and working capacity. Negative predictive factors for outcome were injury pattern, type of surgical procedure and timing of surgery.

  17. Patellar Tendinosis: Acute Patellar Tendon Rupture and Jumper's Knee.

    Depalma, Michael James; Perkins, Robert Harrison

    2004-05-01

    Patellar tendinopathy (jumper's knee) may affect athletes who engage in explosive lower-limb movements. An eccentric contraction of the quadriceps when landing after a jump may lead to acute patellar tendon rupture, the end-stage of patellar tendinopathy. Plain x-rays will usually confirm the diagnosis. Treatment centers around reducing the stress placed on the patellar tendon. Postoperative functional restoration and preventive measures must address biomechanic abnormalities that may predispose patients to disruptive patellar tendon strain. As this case report shows, counseling patients who have early-stage tendinopathy on appropriate flexibility and plyometric exercises may prevent more serious damage. PMID:20086412

  18. MRI for the initial evaluation of acute wrist, knee, and ankle trauma

    J.J. Nikken (Jeroen)

    2003-01-01

    textabstractIn this thesis we study the application of MRI in acute trauma of wrist, knee, and ankle, evaluating its potentials, its effects, and its costs. Our aim was to use MRI in all patients with acute trauma of wrist, knee, and ankle, without increasing the overall costs to society, potentiall

  19. Costs and effectiveness of a brief MRI examination of patients with acute knee injury

    E.H.G. Oei (Edwin); J.J. Nikken (Jeroen); A.Z. Ginai (Abida); G.P. Krestin (Gabriel); J.A.N. Verhaar (Jan); A.B. van Vugt (Arie); M.G.M. Hunink (Myriam)

    2009-01-01

    textabstractThe aim of this study was to assess the costs and effectiveness of selective short magnetic resonance imaging (MRI) in patients with acute knee injury. A model was developed to evaluate the selective use of MRI in patients with acute knee injury and no fracture on radiography based on th

  20. Knee dislocation: descriptive study of injuries Luxação do joelho: estudo descritivo das lesões

    Fabiano Kupczik

    2013-04-01

    Full Text Available OBJECTIVE: Describe the ligamentous and associated injuries that occur in the traumatic knee dislocation, relating them to the mechanisms of trauma and to identify patterns of injuries. METHODS: Twenty three knee dislocations were described in the period between March 2010 and March 2011. After the diagnosis of the lesions, the reduction and transarticular external fixation of the dislocated knees were done. At the second moment, the patients were evaluated with physical examination under anesthesia and the surgical exploration of peripheral lesions was perfomed by a surgeon of the knee surgery group of this institution.The patients data with the description of the injuries were found and registered. RESULTS: 65% of patients were male, the average age was 35 years and the most common mechanism of trauma was the motorcycle accident (60%. The lesion of the anterior cruciate ligament (ACL occurred in 75% of the cases, and the lesion of posterior cruciate ligament (PCL in 95%. The medial peripheral injuries happened in 65% of the dislocations, and the lateral lesions in 40%. The most common dislocations were classified as KDI (25% and as KDIIIm (25%. The arterial injury was present in 15% of the cases, and the nervous injury where registered in one patient (5%. At the initial radiographic evaluation, 45% of the dislocations presented reduced. CONCLUSION: The characteristics of the knee dislocations described showed a great range of variability demonstrating that an individualized evaluation of each case is mandatory. The surgeon should be able to recognize and choose the correct treatment to these lesions. OBJETIVO: Descrever as lesões ligamentares e associadas ocorridas nas luxações traumáticas do joelho, relacioná-las aos mecanismos de trauma e identificar padrões de lesões. MÉTODOS: Foram descritas 23 luxações do joelho entre março de 2010 e março de 2011. Após o diagnóstico das lesões, foi procedida a redução e fixação externa

  1. Multidetector computed tomography evaluation of bony fragments and donor sites in acute patellar dislocation

    Peltola, Erno K.; Koskinen, Seppo K. (Dept. of Radiology, Helsinki Medical Imaging Center, Helsinki Univ. Hospital, Toeoeloe Trauma Center, Helsinki (Finland)), e-mail: erno.peltola@fimnet.fi

    2011-02-15

    Background: Patellar dislocation is frequently associated with bony fragments that are difficult to see on radiographs. MRI or MDCT are often used to rule out or characterize these bony fragments. Purpose: To assess the use of MDCT for locating bony fragments and donor sites in patients with acute patellar dislocation, and to test whether sizes and quantity of bony fragments differ between first-time dislocations and recurrent dislocations. Material and Methods: Retrospective data from two hospitals during a 96-month period were collected, and a total of 46 patients (mean age 27 years, range 9-69 years) that had sustained an acute patellar dislocation (22 first-time, 24 recurrent) were identified. Size, location and donor site of bony fragments were evaluated on MDCT images. Surgical correlation was available for 22 of 46 patients. Results: On MDCT images, the likely donor site could be identified in 62 of 71 (87%) bony fragments. Of the bony fragments that were seen on MDCT images, 40 of 68 (59%) were not seen on AP and lateral views of the conventional radiographs. There was no significant difference in size of bony fragments between first-time or recurrent dislocators (p 0.77). The average number of bony fragments were 2.1 and 1.0 in first-time and recurrent dislocators, respectively. The location and donor site of bony fragments was similar between two patients groups. Conclusion: MDCT is a suitable imaging method to locate bony fragments and donor sites. The number of bony fragments seems to be higher in first-time dislocators than recurrent dislocators, otherwise findings between the two patient groups were similar

  2. Hemarthrosis of the knees following streptokinase therapy for acute myocardial infarction

    Pimenta Eduardo

    2003-01-01

    Full Text Available A sixty-four-year-old male patient was studied who had acute coronary syndrome with ST segment elevation experienced bilateral hemarthrosis of the knees after administration of streptokinase and acetylsalicylic acid.

  3. Arthroscopically Assisted Treatment of Acute Dislocations of the Acromioclavicular Joint

    Braun, Sepp; Beitzel, Knut; Buchmann, Stefan; Imhoff, Andreas B.

    2015-01-01

    Arthroscopically assisted treatments for dislocations of the acromioclavicular joint combine the advantages of exact and visually controlled coracoid tunnel placement with the possibility of simultaneous treatment of concomitant injuries. The clinical results of previous arthroscopically assisted techniques have been favorable at midterm and long-term follow-up. The presented surgical technique combines the advantages of arthroscopically positioned coracoclavicular stabilization with an additional suture cord cerclage of the acromioclavicular joint capsule for improved horizontal stability. PMID:26870646

  4. Value of multidetector spiral CT in diagnosis of acute thoracolumbar spinal fracture and fracture-dislocation

    龚静山; 徐坚民

    2004-01-01

    Objective:To investigate the diagnostic value of multidetector spiral CT (MSCT) in acute thoracolumbar spinal fracture and fracture-dislocation.Methods: CT imaging files of 152 consecutive traumatic patients with thoracolumbar fractures were retrospectively reviewed. MSCT scannings were performed with a collimation of 3-5 mm and a pitch of 5.5. The postprocessing included sagittal and coronal multiplannar reconstruction, and 3-D reconstruction.Result: There were 88 cases of compression fracture, 54 cases of burst fracture and 10 cases of fracasdislocation. Transverse images of MSCT could visualize all fractures directly and determine whether spinal canal was intact. Postprocessing image was helpful in depicting the displacement of fragment and orientation of dislocation.Conclusions: MSCT plays an important role in diagnosis and management of acute thoracolumbar spinal fracture and fracture-dislocation.

  5. Low-Cost Alternative External Rotation Shoulder Brace and Review of Treatment in Acute Shoulder Dislocations

    Lacy, Kyle

    2015-01-01

    Full Text Available Traumatic dislocations of the shoulder commonly present to emergency departments (EDs. Immediate closed reduction of both anterior and posterior glenohumeral dislocations is recommended and is frequently performed in the ED. Recurrence of dislocation is common, as anteroinferior labral tears (Bankart lesions are present in many anterior shoulder dislocations.14,15,18,23 Immobilization of the shoulder following closed reduction is therefore recommended; previous studies support the use of immobilization with the shoulder in a position of external rotation, for both anterior and posterior shoulder dislocations.7-11,19 In this study, we present a technique for assembling a low-cost external rotation shoulder brace using materials found in most hospitals: cotton roll, stockinette, and shoulder immobilizers. This brace is particularly suited for the uninsured patient, who lacks the financial resources to pay for a pre-fabricated brace out of pocket. We also performed a cost analysis for our low-cost external rotation shoulder brace, and a cost comparison with pre-fabricated brand name braces. At our institution, the total materials cost for our brace was $19.15. The cost of a pre-fabricated shoulder brace at our institution is $150 with markup, which is reimbursed on average at $50.40 according to our hospital billing data. The low-cost external rotation shoulder brace is therefore a more affordable option for the uninsured patient presenting with acute shoulder dislocation. [West J Emerg Med. 2015;16(1:114–120.

  6. Knee Injuries

    ... of the knee. Sometimes fluid collects around the knee (this is called effusion ). Fractures and Dislocations A fracture is a cracked, broken, or shattered bone and is usually diagnosed by an X-ray. You may have trouble ... off to the side of the knee joint by twisting or some kind of impact. ...

  7. Ipsilateral fracture dislocations of the hip and knee joints with contralateral open fracture of the leg: a rare case and its management principles

    Ramesh Kumar Sen; Sujit Kumar Tripathy; Vibhu Krishnan; Tarun Goyal; Vanyambadi Jagadeesh

    2011-01-01

    This paper discussed the injury mechanism and management of a patient who had concomitant ipsilateral hip and knee dislocations and contralateral open leg fracture.A 32-year-old man presented with ipsilateral fracturedislocations of the left hip (Pipkin's type Ⅳ) and knee (Moore Ⅱ)joints and contralateral open fracture of the leg bones after a car accident. After emergency resuscitative measures, the hip joint was reduced and Pipkin's fracture was fixed using Ganz approach with lag screws; knee joint was reduced closely and tibial plateau fracture was stabilized with lateral buttress plate and a transarticular spanning fixator. The open fracture on the other leg was debrided and fixed with an external fixator. There was no instability in both joints after fixation when he was examined under anesthesia. The fractures united after 3 months and the patient had no residual instability of hip and knee. There was no clinical or radiological evidence of osteonecrosis in the hip joint after 6 months. At one-year follow-up, he had satisfactory functional outcome with almost normal range of motion at both joints.Ipsilateral hip and knee dislocations are rare injuries and more caution is needed for early diagnosis. A timely appropriate intervention can provide good functional outcome to the patient in this situation.

  8. Haemodynamics in acute arthritis of the knee in puppies

    Bünger, C; Hjermind, J; Harving, S;

    1984-01-01

    simultaneous intra-articular and intraosseous pressure recordings were performed in seven other dogs. The intra-articular pressure was elevated in all arthritic knees. Hyperaemia was found in the knee-joint capsule and distal femoral metaphysis, whereas juxta-articular epiphyseal blood flow rates were not...

  9. Diagnosis and Management of Acute Knee Ligament Injuries

    Hastings, David E.

    1990-01-01

    Knee ligament injuries are a common problem, especially in the athletic age group. The most common knee ligament injury is the so-called isolated anterior cruciate ligament tear. This is also the injury most likely to be missed. Isolated collateral ligament tears are generally managed non-operatively, but combined collateral and cruciate tears should be surgically repaired. “Isolated” anterior cruciate tears are generally repaired in the younger active athlete but are managed by hamstring exe...

  10. 关节镜辅助治疗急性髌骨脱位%ARTHROSCOPICALLY ASSISTED TREATMENT FOR ACUTE PATELLAR DISLOCATION

    唐恒涛; 苏训同; 王义隽; 金大地; 赵亮

    2011-01-01

    目的 探讨关节镜辅助下外侧支持带松解、内侧支持带紧缩治疗急性髌骨脱何的疗效.方法 2006年4月-2009年3月,应用关节镜辅助下改良髌外侧支持带松解、内侧支持带紧缩治疗急性髌骨脱位22例25膝.男5例,女17例;年龄14~34岁,平均23.6岁.均突发于屈膝活动过程中.左侧11膝,右侧14膝.出现症状至入院时间为1~10 d,平均5.9 d.患者均为外侧脱位,其中14例脱位后自行复位,8例入院时仍呈脱位状态,给予手法闭合复位.检查示膝关节脱位恐惧试验均为阳性,被动活动受限,其中15例浮髌试验阳性.结果 术后切口均Ⅰ期愈合.22例均获随访,随访时间12~36个月,平均17个月.术后3个月内,12膝出现髌骨内侧皮肤穿刺处凹陷,10膝出现髌骨外侧疼痛,15膝出现髌骨内侧紧绷牵拉感,经理疗康复后均逐渐自行消失或好转.随访期间无复发性髌骨脱位.术后1年膝关节Lysholm评分为(96.6±4.5)分,高于术前的(67.3±5.7)分,差异有统计学意义(t=3.241,P=0.003);疼痛视觉模拟评分(VAS)为(1.8±0.4)分,低于术前的(6.5±0.5)分,差异有统计学意义(t=2.154,P=0.040).术后1年患膝功能采用Insall评分标准,获优18膝,良5膝,可2膝,优良率92%.结论 关节镜辅助下外侧支持带松解、内侧支持带紧缩治疗急性髌骨脱位,创伤小,恢复快,早期临床疗效满意.%Objective To evaluate an improving operative procedure and the clinical results of arthroscopically assisted treatment for acute patellar dislocation. Methods Between April 2006 and March 2009, 22 patients (25 knees) with primary acute complete dislocation of the patella underwent an improving arthroscopic operation, rdease of lateral retinaculum and suture of medial capsule and retinaculum structure. There were 5 males and 17 females with an average age of 23.6 years (range, 14-34 years). Three patients had bilateral procedure. Eleven left knees and 14 right knees were involved. The

  11. SIDELINE MANAGEMENT OF ACUTE DISLOCATION OF THE GLENOHUMERAL JOINT‐ A UNIQUE APPROACH TO ATHLETE SELF‐REDUCTION

    Smith, Danny; Hoogenboom, Barbara

    2013-01-01

    The acute anterior dislocation of the glenohumeral joint (GHJ) poses a challenge to sports medicine providers at all levels and in all settings. This macrotraumatic injury occurs in athletes who participate in a wide variety of sports, most typically as a result of contact or collision mechanisms. Quick and effective relocation of the GHJ is an important skill for on the sideline or on the field management of this type of dislocation when appropriate and allowable by facility protocol. This c...

  12. Knee pain

    ... time, overuse, or injury. Dislocation of the kneecap Fracture of the kneecap or other bones Iliotibial band syndrome . Injury to the thick band that runs from your hip to the outside of your knee. Pain in the front of your knee around ...

  13. Popliteal artery injury following traumatic knee joint dislocation in a 14-year-old boy: A case report and review of the literature

    Cvetković Slobodan

    2014-01-01

    Full Text Available Introduction. Posterior knee joint dislocation associated with injury of the popliteal artery in children is an extremely rare condition. Rapid diagnosis and treatment are essential for limb salvage and function. Case report. We reported a 14-year-old boy who suffered traumatic displacement of the right knee and contusion of the popliteal artery during motorcycle accident. The diagnosis was confirmed using Doppler and duplex ultrasonography and digital substraction transfemoral arteriography. The urgent surgical procedure was performed using posterior approach to the popliteal artery. During the surgical exploration, rupture of the posterior cruciate ligament associated with thrombosed popliteal artery have been found. The damaged popliteal artery was resected and replaced with autologous saphenous vein graft. The last stage of the procedure was a transosseous femoral fixation of posterior circuate ligament. A 3-year-follow-up after the surgery demonstrated intact arterial perfusion and very good function of the knee with a minimal difference as compared with the contralateral knee. Conclusion. Combined orthopedic and vascular injuries are very rare in children. They require combined treatment. [Projekat Ministarstva nauke Republike Srbije, br. 175008

  14. Management of Acute Combined ACL-Medial and Posteromedial Instability of the Knee.

    Medvecky, Michael J; Tomaszewski, Paul

    2015-06-01

    Medial collateral ligament (MCL) injuries are the most common ligamentous injury of the knee. The extent of injury can range from a minor first-degree (1-degree) sprain to an extensive third-degree (3-degree) sprain that can propagate across the knee, rupturing one or both cruciate ligaments, and result in a knee subluxation or dislocation. A common pattern involves the combined anterior cruciate ligament (ACL) and MCL injury that is the focus of this chapter. The vast majority of these combined medial-sided injuries are treated nonoperatively with delayed reconstruction of the ACL injury in athletically active individuals. The MCL and associated medial structures are carefully assessed on physical examination, and classification of injury is based upon abnormal limits of joint motion. In vitro cadaveric biomechanical testing has given us a better understanding of ligament deficiency and altered joint motion. Consistency in terminology is necessary for proper classification of injury and reproducible categorization of injury patterns to be able to compare both nonoperative and operative treatment of various injury patterns. PMID:25932883

  15. Prevention of acute knee injuries in adolescent female football players: cluster randomised controlled trial

    Walden, Markus; Atroshi, Isam; Magnusson, Henrik; Wagner, Philippe; Hagglund, Martin

    2012-01-01

    Objective To evaluate the effectiveness of neuromuscular training in reducing the rate of acute knee injury in adolescent female football players. less thanbrgreater than less thanbrgreater thanDesign Stratified cluster randomised controlled trial with clubs as the unit of randomisation. less thanbrgreater than less thanbrgreater thanSetting 230 Swedish football clubs (121 in the intervention group, 109 in the control group) were followed for one season (2009, seven months). less thanbrgreate...

  16. Report of a pregnant lady with bilateral elbow dislocation caused by acute fall injury

    Koh Shao Hui

    2015-01-01

    Simultaneous bilateral posterior elbow dislocations occur rarely with only 14 cases being reported in the literature so far. Of these cases, none occurred in a patient who was pregnant. No cases of bilateral elbow dislocation with a distal radial fracture-dislocation have also been described. A case of a pregnant patient presenting with bilateral elbow dislocation, right wrist fracture-dislocation is reported here and the issues involved in managing such a case are discussed.

  17. Costs and effectiveness of a brief MRI examination of patients with acute knee injury

    Oei, Edwin H.G. [Erasmus MC, University Medical Center Rotterdam, Department of Radiology, GE Rotterdam (Netherlands)]|[Erasmus MC, University Medical Center Rotterdam, Department of Epidemiology and Biostatistics, GE Rotterdam (Netherlands)]|[Erasmus MC, University Medical Center Rotterdam, Department of Radiology, CE Rotterdam (Netherlands); Nikken, Jeroen J. [Erasmus MC, University Medical Center Rotterdam, Department of Radiology, GE Rotterdam (Netherlands)]|[Erasmus MC, University Medical Center Rotterdam, Department of Epidemiology and Biostatistics, GE Rotterdam (Netherlands)]|[Sint Franciscus Gasthuis, Kleiweg 500, Department of Radiology, PM Rotterdam (Netherlands); Ginai, Abida Z.; Krestin, Gabriel P. [Erasmus MC, University Medical Center Rotterdam, Department of Radiology, GE Rotterdam (Netherlands)]|[Erasmus MC, University Medical Center Rotterdam, Department of Radiology, CE Rotterdam (Netherlands); Verhaar, Jan A.N. [Erasmus MC, University Medical Center Rotterdam, Department of Orthopaedic Surgery, GE Rotterdam (Netherlands)]|[Erasmus MC, University Medical Center Rotterdam, Department of Orthopaedic Surgery, CE Rotterdam (Netherlands); Vugt, Arie B. van [Erasmus MC, University Medical Center Rotterdam, Department of Traumatology, GE Rotterdam (Netherlands)]|[UMC St Radboud, Department of Traumatology, P.O. Box 9101, HB Nijmegen (Netherlands); Hunink, M.G.M. [Erasmus MC, University Medical Center Rotterdam, Department of Radiology, GE Rotterdam (Netherlands)]|[Erasmus MC, University Medical Center Rotterdam, Department of Epidemiology and Biostatistics, GE Rotterdam (Netherlands)

    2009-02-15

    The aim of this study was to assess the costs and effectiveness of selective short magnetic resonance imaging (MRI) in patients with acute knee injury. A model was developed to evaluate the selective use of MRI in patients with acute knee injury and no fracture on radiography based on the results of a trial in which 208 patients were randomized between radiography only and radiography plus MRI. We analyzed medical (diagnostic and therapeutic) costs, quality of life, duration of diagnostic workup, number of additional diagnostic examinations, time absent from work, and time to convalescence during a 6-month follow-up period. Quality of life was lowest (EuroQol at 6 weeks 0.61 (95% CI 0.54-0.67)); duration of diagnostic workup, absence from work, and time to convalescence were longest; and the number of diagnostic examinations was largest with radiography only. These outcomes were more favorable for both MRI strategies (EuroQol at 6 weeks 0.72 (95% CI 0.67-0.77) for both). Mean total costs were 2,593 euros (95% CI 1,815-3,372) with radiography only, 2,116 euros (95% CI 1,488-2,743) with radiography plus MRI, and 1,973 euros (95% CI 1,401-2,543) with selective MRI. The results suggest that selective use of a short MRI examination saves costs and potentially increases effectiveness in patients with acute knee injury without a fracture on radiography. (orig.)

  18. Acute Knee Trauma: Analysis of Multidetector Computed Tomography Findings and Comparison with Conventional Radiography

    Mustonen, A.O.T. [Helsinki Univ. Central Hospital (Finland). Dept. of Radiology; Koskinen, S.K. [Research Inst. of Military Medicine, Helsinki (Finland); Kiuru, M.J. [ORTON Orthopaedic Hospital, Helsinki (Finland)

    2005-12-01

    Purpose: To evaluate the multidetector computed tomography (MDCT) findings of acute knee trauma and to compare radiography with MDCT in patients referred ta level 1 trauma center. Material and Methods: During a 5-year period, a total of 415 MDCT examinations were performed on 409 patients with acute knee trauma to reveal complex fracture anatomy or rule out a fracture. MDCT and primary radiographs were re-evaluated with respect to fracture location and trauma mechanism. Tibial plateau fractures were further analyzed depending on anatomical location: anterior-medial, anterior-lateral, posterior-lateral, and posterior-medial regions. Maximal depression of the tibial articular surface was measured. Findings on the primary knee radiographs were compared with MDCT findings. Results: Of the 409 patients, 356 (87%) had a knee fracture. A total of 451 fractures were found in all anatomic regions: distal femur ( n = 49), proximal tibia ( n 307), patella ( n = 23), and proximal fibula ( n = 72). Primary radiographs were available in 316 (76%) cases. Of these, 225 (71%) had MDCT in order to reveal the fracture anatomy better, and 91 (29%) had a subsequent MDCT after negative plain radiographs. Overall sensitivity of radiography was 83%, while negative predictive value was 49%. On radiography, tibial plateau articular depression was underestimated in all regions except when the fracture consisted of the whole half of the anterior or posterior plateau. The three main injury mechanisms were traffic accident, a simple fall, and sport. In 49 cases (15%), primary radiographs were suboptimal due to positioning. Conclusion: In severely injured patients, diagnostically sufficient radiographs are difficult to obtain, and therefore a negative radiograph is not reliable in ruling out a fracture. In these patients, MDCT is a fast and accurate examination and is also recommended in patients with tibial plateau fractures or complex knee injuries in order to evaluate the fracture adequately.

  19. The popliteal fibular ligament in acute knee trauma: patterns of injury on MR imaging

    McKean, D.; Thomee, E.; Grant, D.; Teh, J.L.; Mansour, R. [Oxford University Hospitals NHS Trust, Nuffield Orthopaedic Centre, Headington, Oxford (United Kingdom); Yoong, P. [Royal Berkshire NHS Foundation Trust, Royal Berkshire Hospital, Reading (United Kingdom); Yanny, S. [Buckinghamshire Healthcare NHS Trust, Stoke Mandeville Hospital, Aylesbury (United Kingdom)

    2015-10-15

    To describe the patterns of injury associated with injury to the popliteofibular ligament injury. A retrospective review was performed of 180 MRI scans undertaken for acute knee trauma. Scans were excluded if the time of injury was over 4 weeks from the time of the scan, or if there was a history of septic arthritis, inflammatory arthropathy, previous knee surgery, or significant artefact. An agreed criterion for assessing the structures of the posterolateral ligamentous complex was defined and in each scan, the popliteofibular ligament (PFL) was scored as normal or injured. The menisci, ligaments, and tendons of each knee were also assessed. The mean age was 25.7 years (range, 9-65 years) and 72.2 % (n = 130) patients were male. The PFL was injured in 36 cases (20 %). There is a significant association between PFL injury and ACL rupture (p = 0.0001), ITB injury (p = 0.0001), PCL injury (p = 0.0373), in addition to associations with injury to other posterolateral corner structures including the lateral collateral ligament (p = 0.0001), biceps femoris tendon (p = 0.0014), and popliteus tendon (p = 0.0014). Of our series of PFL injuries, nine cases (25 %) were associated with further injuries of posterolateral corner structures and in 27 cases (75 %) the PFL was the only posterolateral corner structure torn. PFL injury is not uncommon in acute knee trauma and is associated with significant internal derangement of the knee, especially anterior cruciate ligament rupture, ITB sprain, and injury to other structures within the posterolateral corner. (orig.)

  20. Acute Knee Trauma: Analysis of Multidetector Computed Tomography Findings and Comparison with Conventional Radiography

    Purpose: To evaluate the multidetector computed tomography (MDCT) findings of acute knee trauma and to compare radiography with MDCT in patients referred ta level 1 trauma center. Material and Methods: During a 5-year period, a total of 415 MDCT examinations were performed on 409 patients with acute knee trauma to reveal complex fracture anatomy or rule out a fracture. MDCT and primary radiographs were re-evaluated with respect to fracture location and trauma mechanism. Tibial plateau fractures were further analyzed depending on anatomical location: anterior-medial, anterior-lateral, posterior-lateral, and posterior-medial regions. Maximal depression of the tibial articular surface was measured. Findings on the primary knee radiographs were compared with MDCT findings. Results: Of the 409 patients, 356 (87%) had a knee fracture. A total of 451 fractures were found in all anatomic regions: distal femur ( n = 49), proximal tibia ( n 307), patella ( n = 23), and proximal fibula ( n = 72). Primary radiographs were available in 316 (76%) cases. Of these, 225 (71%) had MDCT in order to reveal the fracture anatomy better, and 91 (29%) had a subsequent MDCT after negative plain radiographs. Overall sensitivity of radiography was 83%, while negative predictive value was 49%. On radiography, tibial plateau articular depression was underestimated in all regions except when the fracture consisted of the whole half of the anterior or posterior plateau. The three main injury mechanisms were traffic accident, a simple fall, and sport. In 49 cases (15%), primary radiographs were suboptimal due to positioning. Conclusion: In severely injured patients, diagnostically sufficient radiographs are difficult to obtain, and therefore a negative radiograph is not reliable in ruling out a fracture. In these patients, MDCT is a fast and accurate examination and is also recommended in patients with tibial plateau fractures or complex knee injuries in order to evaluate the fracture adequately

  1. The popliteal fibular ligament in acute knee trauma: patterns of injury on MR imaging

    To describe the patterns of injury associated with injury to the popliteofibular ligament injury. A retrospective review was performed of 180 MRI scans undertaken for acute knee trauma. Scans were excluded if the time of injury was over 4 weeks from the time of the scan, or if there was a history of septic arthritis, inflammatory arthropathy, previous knee surgery, or significant artefact. An agreed criterion for assessing the structures of the posterolateral ligamentous complex was defined and in each scan, the popliteofibular ligament (PFL) was scored as normal or injured. The menisci, ligaments, and tendons of each knee were also assessed. The mean age was 25.7 years (range, 9-65 years) and 72.2 % (n = 130) patients were male. The PFL was injured in 36 cases (20 %). There is a significant association between PFL injury and ACL rupture (p = 0.0001), ITB injury (p = 0.0001), PCL injury (p = 0.0373), in addition to associations with injury to other posterolateral corner structures including the lateral collateral ligament (p = 0.0001), biceps femoris tendon (p = 0.0014), and popliteus tendon (p = 0.0014). Of our series of PFL injuries, nine cases (25 %) were associated with further injuries of posterolateral corner structures and in 27 cases (75 %) the PFL was the only posterolateral corner structure torn. PFL injury is not uncommon in acute knee trauma and is associated with significant internal derangement of the knee, especially anterior cruciate ligament rupture, ITB sprain, and injury to other structures within the posterolateral corner. (orig.)

  2. The effect of music on pain and acute confusion in older adults undergoing hip and knee surgery.

    McCaffrey, Ruth; Locsin, Rozzano

    2006-01-01

    The purpose of this study was to examine the effects of music listening in older adults following hip or knee surgery. Acute confusion and pain after surgery can increase length of stay and reduce function. Study results demonstrate a reduction in acute confusion and pain and improved ambulation and higher satisfaction scores in older adults who listened to music. PMID:16974175

  3. Low-Cost Alternative External Rotation Shoulder Brace and Review of Treatment in Acute Shoulder Dislocations

    Lacy, Kyle; Cooke, Chris; Cooke, Pat; Schupbach, Justin; Vaidya, Rahul

    2015-01-01

    Traumatic dislocations of the shoulder commonly present to emergency departments (EDs). Immediate closed reduction of both anterior and posterior glenohumeral dislocations is recommended and is frequently performed in the ED. Recurrence of dislocation is common, as anteroinferior labral tears (Bankart lesions) are present in many anterior shoulder dislocations.14,15,18,23 Immobilization of the shoulder following closed reduction is therefore recommended; previous studies support the use of im...

  4. Does marathon running cause acute lesions of the knee? Evaluation with magnetic resonance imaging

    An investigation was conducted into whether running a marathon causes acute alterations in menisci, cartilage, bone marrow, ligaments, or joint effusions, which could be evaluated by magnetic resonance imaging (MRI). Twenty-two non-professional marathon runners underwent MRI of the knee before and immediately after running a marathon. Lesions of menisci and cartilage (five-point scale), bone marrow, ligaments (three-point scale), joint effusion, and additional findings were evaluated and a total score was assessed. Before the marathon, grade 1 lesions of the menisci were found in eight runners, and grade 2 lesions in five runners. After the marathon, an upgrading from a meniscal lesion grade 1 to grade 2 was observed in one runner. Before the marathon, grade 1 cartilage lesions were found in three runners, and grade 2 lesions in one runner, all of which remained unchanged after the marathon. Before and after the marathon, unchanged bone marrow edema was present in three runners and unchanged anterior cruciate ligament lesions (grade 1) were seen in two runners. Joint effusions were present in 13 runners in the pre-run scans, slightly increased in four runners after the marathon, and newly occurred in one runner after the marathon. A total score comprising all knee lesions in each runner showed an increase after the marathon in two runners, whereas no runner showed an improvement of the radiological findings (Wilcoxon signed-rank test, P>0.05). The evaluation of lesions of the knee with MRI shows that marathon running does not cause severe, acute lesions of cartilage, ligaments, or bone marrow of the knee in well-trained runners. Only subtle changes, such as joint effusions or increased intrameniscal signal alterations, were imaged after running a marathon. (orig.)

  5. Bone bruise in acute traumatic patellar dislocation: volumetric magnetic resonance imaging analysis with follow-up mean of 12 months

    Paakkala, Antti; Paakkala, Timo [Tampere University Hospital, Department of Radiology, Tampere (Finland); Sillanpaeae, Petri; Maeenpaeae, Heikki [Tampere University Hospital, Department of Orthopaedics and Traumatology, Tampere (Finland); Huhtala, Heini [University of Tampere, School of Public Health, Tampere (Finland)

    2010-07-15

    The aim of the study was to assess volumetric analysis of bone bruises in acute primary traumatic patellar dislocation by magnetic resonance imaging (MRI) and resolving resolution of bruises in follow-up MRI. MRI was performed in 23 cases. A follow-up examination was done at a mean of 12 months after dislocation. Volumes of patellar and femur bruises for every patient were evaluated separately by two musculoskeletal radiologists, and mean values of the bruises were assessed. Other MRI findings were evaluated, together with agreement by consensus. Bone bruise volumes were compared with other MR findings. In the acute study 100% of patients showed bruising of the lateral femoral condyle and 96% bruising of the patella. The bruise was located at the medial femoral condyle in 30% and at the patellar median ridge in 74% of patients. The median volume of the femoral bruise was 25,831 mm{sup 3} and of the patellar bruise 2,832 mm{sup 3}. At the follow-up study 22% of patients showed bruising of the lateral femoral condyle and 39% bruising of the patella, the median volumes of the bruises being 5,062 mm{sup 3} and 1,380 mm{sup 3}, respectively. Larger patellar bruise volume correlated with larger femur bruise volume in the acute (r=0.389, P=0.074) and the follow-up (r=1.000, P<0.01) studies. Other MRI findings did not correlate significantly with bone bruise volumes. Bone bruising is the commonest finding in cases of acute patellar dislocation, being seen even 1 year after trauma and indicating significant bone trabecular injury in the patellofemoral joint. A large bruise volume may be associated with subsequent chondral lesion progression at the patella. We concluded that the measurement of bone bruise volume in patients with acute patellar dislocation is a reproducible method but requires further studies to evaluate its clinical use. (orig.)

  6. Epidemiological survey of orthopedic joint dislocations based on nationwide insurance data in Taiwan, 2000-2005

    Yang Nan-Ping

    2011-11-01

    Full Text Available Abstract Background The epidemiology of acute orthopedic dislocations is poorly understood. A nationwide database provides a valuable resource for examining this issue in the Taiwanese population. Methods A 6-year retrospective cohort study of 1,000,000 randomly-sampled beneficiaries from the year 2005 was used as the original population. Based on the hospitalized and ambulatory data, the concomitant ICD9-CM diagnosis codes and treatment codes were evaluated and classified into 8 and 3 major categories, respectively. The cases matching both inclusive criteria of dislocation-related diagnosis codes and treatment codes were defined as incident cases. Results During 2000-2005, the estimated annual incidence (per 100,000 population of total orthopedic dislocations in Taiwan was 42.1 (95%CI: 38.1-46.1. The major cause of these orthopedic dislocations was traffic accidents (57.4%, followed by accident falls (27.5%. The annual incidence dislocation by location was shoulder, 15.3; elbow, 7.7; wrist, 3.5; finger, 4.6; hip, 5.2; knee, 1.4; ankle, 2.0; and foot, 2.4. Approximately 16% of shoulder dislocations occurred with other concomitant fractures, compared with 17%, 53%, 16%, 76% and 52%, respectively, of dislocated elbow, wrist, hip, knee, and ankle cases. Including both simple and complex dislocated cases, the mean medical cost was US$612 for treatment of a shoulder dislocation, $504 for the elbow, $1,232 for the wrist, $1,103 for the hip, $1,888 for the knee, and $1,248 for the ankle. Conclusions In Taiwan, three-quarters of all orthopedic dislocations were of the upper limbs. The most common complex fracture-dislocation was of the knee, followed by the wrist and the ankle. Those usually needed a treatment combined with open reduction of fractures and resulted in a higher direct medical expenditure.

  7. Dual-energy computed tomography of cruciate ligament injuries in acute knee trauma

    To examine dual-energy computed tomography (DECT) in evaluating cruciate ligament injuries. More specifically, the purpose was to assess the optimal keV level in DECT gemstone spectral imaging (GSI) images and to examine the usefulness of collagen-specific color mapping and dual-energy bone removal in the evaluation of cruciate ligaments and the popliteus tendon. At a level 1 trauma center, a 29-month period of emergency department DECT examinations for acute knee trauma was reviewed by two radiologists for presence of cruciate ligament injuries, visualization of the popliteus tendon and the optimal keV level in GSI images. Three different evaluating protocols (GSI, bone removal and collagen-specific color mapping) were rated. Subsequent MRI served as a reference standard for intraarticular injuries. A total of 18 patients who had an acute knee trauma, DECT and MRI were found. On MRI, six patients had an ACL rupture. DECT's sensitivity and specificity to detect ACL rupture were 79 % and 100 %, respectively. The DECT vs. MRI intra- and interobserver proportions of agreement for ACL rupture were excellent or good (kappa values 0.72-0.87). Only one patient had a PCL rupture. In GSI images, the optimal keV level was 63 keV. GSI of 40-140 keV was considered to be the best evaluation protocol in the majority of cases. DECT is a usable method to evaluate ACL in acute knee trauma patients with rather good sensitivity and high specificity. GSI is generally a better evaluation protocol than bone removal or collagen-specific color mapping in the evaluation of cruciate ligaments and popliteus tendon. (orig.)

  8. Dual-energy computed tomography of cruciate ligament injuries in acute knee trauma

    Peltola, Erno K. [Helsinki University Hospital, Toeoeloe Trauma Center, Department of Radiology, Helsinki Medical Imaging Center, Helsinki (Finland); Koskinen, Seppo K. [Karolinska Universitetssjukhuset, Department of Clinical Science, Intervention and Technology (CLINTEC), Stockholm (Sweden)

    2015-09-15

    To examine dual-energy computed tomography (DECT) in evaluating cruciate ligament injuries. More specifically, the purpose was to assess the optimal keV level in DECT gemstone spectral imaging (GSI) images and to examine the usefulness of collagen-specific color mapping and dual-energy bone removal in the evaluation of cruciate ligaments and the popliteus tendon. At a level 1 trauma center, a 29-month period of emergency department DECT examinations for acute knee trauma was reviewed by two radiologists for presence of cruciate ligament injuries, visualization of the popliteus tendon and the optimal keV level in GSI images. Three different evaluating protocols (GSI, bone removal and collagen-specific color mapping) were rated. Subsequent MRI served as a reference standard for intraarticular injuries. A total of 18 patients who had an acute knee trauma, DECT and MRI were found. On MRI, six patients had an ACL rupture. DECT's sensitivity and specificity to detect ACL rupture were 79 % and 100 %, respectively. The DECT vs. MRI intra- and interobserver proportions of agreement for ACL rupture were excellent or good (kappa values 0.72-0.87). Only one patient had a PCL rupture. In GSI images, the optimal keV level was 63 keV. GSI of 40-140 keV was considered to be the best evaluation protocol in the majority of cases. DECT is a usable method to evaluate ACL in acute knee trauma patients with rather good sensitivity and high specificity. GSI is generally a better evaluation protocol than bone removal or collagen-specific color mapping in the evaluation of cruciate ligaments and popliteus tendon. (orig.)

  9. Long-term osseous sequelae after acute trauma of the knee joint evaluated by MRI

    To evaluate the frequency and location and to determine the long-term MR changes in patients with edema-like bone marrow abnormalities after acute knee trauma.Design and patients. A cohort of 176 consecutive patients in a 29 month period with acute injury of the knee joint was examined with MRI. Forty-nine patients with bone marrow edema-like signal alteration on the initial MR examination were re-evaluated with MRI after a minimum of 2 years (mean 44 months). Signal alterations and contour abnormalities on the initial and follow-up MR examinations were classified. The volume of the edema was also measured.Results. There was a prevalence of post-traumatic edema-like signal changes of 72% in 176 patients. In the follow-up group (n=49) the initial MR examination showed 80 areas of signal change with a mean volume of 15.5 cm3 (range 0.25-175 cm3). Thirty-five (44%) were signal changes without other bony or cartilaginous injuries, 19 (24%) were subchondral impaction fractures and 26 (33%) were osteochondral or chondral fractures. Sixty-nine percent of the lesions were located in the lateral, and 29% in the medial joint compartment. Three percent were patellar lesions. In seven of the 49 patients (14%) eight signal changes were seen on the follow-up MR examination. Six lesions were located in the same anatomic area as on the initial MR examination, and two new lesions had developed. The volume of the bone marrow edema was smaller in all persisting lesions (mean volume 2.26 cm3, range 0.3-4.8 cm3). Deterioration of the subchondral impaction, chondral/osteochondral fracture or lesions resembling osteonecrosis were not found in any patient.Conclusions. The majority of acute post-traumatic marrow signal changes are found in the lateral compartment and do not show additional osseous or chondral alterations. After a minimum of 2 years acute post-traumatic bone marrow edema-like signal alterations vanish in the majority of patients. Even more severe articular surface injuries

  10. Magnetic resonance imaging of bone bruising in the acutely injured knee--short-term outcome

    AIM: To investigate the short-term outcome and associated injuries of bone bruising in the acutely injured knee. METHOD AND MATERIALS: Thirty patients (age range 17-39 years, mean 28 years) with bone bruising identified on magnetic resonance imaging (MRI) after an acute knee injury were rescanned 12-14 weeks post-injury. The volume of bone bruising was measured on coronal STIR (short TI inversion recovery) images and correlation made with the presence and type of ligamentous and osteochondral injuries. RESULTS: All bone bruises were present on repeat MRI. Twenty of the 30 patients (67%) had associated anterior cruciate ligament (ACL) injuries, seven of the 30 (23%) had collateral ligament injuries and three of the 30 (10%) had no associated ligamentous injuries. Greater than 50% reduction in bone bruise volume was demonstrated at repeat scanning in 24 of the 30 patients (80%) and less than 50% in five of the 30 patients (17%). One patient showed an increase in volume of bone bruising at follow-up. There was no correlation between initial size or size reduction of bone bruising and the presence/absence or type of associated injuries. In 21 patients the bone bruises resolved from the periphery, whilst eight patients showed bone bruises that resolved towards the joint margin, all of whom had associated osteochondral injuries. Of the 30 patients, 17 showed bone bruising that extended to the joint margin, 10 of whom had associated osteochondral injuries on MRI. On clinical review some degree of knee pain was still present in all but one of the patients reviewed. The single patient who reported complete resolution of symptoms was one of the three patients with isolated bone bruising CONCLUSION: Bone bruises persist for at least 12-14 weeks, which is longer than previously quoted. Two discrete patterns of bone bruise resolution have been demonstrated. The size and persistence of bone bruising is not related to the presence or absence or type of associated ligamentous

  11. Magnetic resonance imaging of bone bruising in the acutely injured knee--short-term outcome

    Davies, N.H.; Niall, D.; King, L.J.; Lavelle, J.; Healy, J.C. E-mail: j.healy@ic.ac.uk

    2004-05-01

    AIM: To investigate the short-term outcome and associated injuries of bone bruising in the acutely injured knee. METHOD AND MATERIALS: Thirty patients (age range 17-39 years, mean 28 years) with bone bruising identified on magnetic resonance imaging (MRI) after an acute knee injury were rescanned 12-14 weeks post-injury. The volume of bone bruising was measured on coronal STIR (short TI inversion recovery) images and correlation made with the presence and type of ligamentous and osteochondral injuries. RESULTS: All bone bruises were present on repeat MRI. Twenty of the 30 patients (67%) had associated anterior cruciate ligament (ACL) injuries, seven of the 30 (23%) had collateral ligament injuries and three of the 30 (10%) had no associated ligamentous injuries. Greater than 50% reduction in bone bruise volume was demonstrated at repeat scanning in 24 of the 30 patients (80%) and less than 50% in five of the 30 patients (17%). One patient showed an increase in volume of bone bruising at follow-up. There was no correlation between initial size or size reduction of bone bruising and the presence/absence or type of associated injuries. In 21 patients the bone bruises resolved from the periphery, whilst eight patients showed bone bruises that resolved towards the joint margin, all of whom had associated osteochondral injuries. Of the 30 patients, 17 showed bone bruising that extended to the joint margin, 10 of whom had associated osteochondral injuries on MRI. On clinical review some degree of knee pain was still present in all but one of the patients reviewed. The single patient who reported complete resolution of symptoms was one of the three patients with isolated bone bruising CONCLUSION: Bone bruises persist for at least 12-14 weeks, which is longer than previously quoted. Two discrete patterns of bone bruise resolution have been demonstrated. The size and persistence of bone bruising is not related to the presence or absence or type of associated ligamentous

  12. Surgical treatment of a chronically fixed lateral patella dislocation in an adolescent patient

    Xinning Li

    2013-06-01

    Full Text Available Acute patellar dislocation or subluxation is a common cause for knee injuries in the United States and accounts for 2% to 3% of all injuries. Up to 49% of patients will have recurrent subluxations or dislocations. Importance of both soft tissue\t(predominantly,\tthe medial patellofemoral ligament, MPFL, which is responsible for 60% of the resistance to lateral dislocation and bony constraint of femoral trochlea in preventing subluxation and dislocation is well documented. Acute patella dislocation will require closed reduction and management typically consist of conservative or surgical treatment depending on the symptoms and recurrence of instability. Most patients are diagnosed and treated in a timely manner. We present a 15 years old male with a missed traumatic lateral patella dislocation during childhood. The patient presented as an adolescent with a chronically fixed lateral patella dislocation and was management with surgery. The key steps in the surgical reconstruction of this patient required first mobilizing the patella with a lateral retinacular release and V-Y lengthening of the shortened or contracted quadriceps tendon. Then a combination of MPFL reconstruction using the semi-tendinosis autograft, tibial tubercle osteotomy with anterio-medialization, and lateral facetectomy was performed. At the one-year follow-up, our patient had improved knee range of motion and decrease in pain. Chronically fixed lateral dislocated patella is a rare and complex problem to manage in older patients that will require a thorough work-up and appropriate surgical planning along with reconstruction.

  13. MRI findings of juvenile acute pure cartilage fracture of the knee joint

    Objective: To study the MRI manifestation of juvenile acute pule cartilage fracture of the knee joint. Methods: The MRI changes of cartilage, subcartilage low signal line and subcartilage bone were analysed retrospectively in 26 juvenile patients with acute pure cartilage fracture confirmed by arthroscopy. Sagittal and coronal MRI scanning were performed in 26 patients. Using fast low angle shot fat saturation T1-weighted image (FLASH-FS-T1WI) sequences, spin echo T1-weighted image (SE-TWI) and fast imaging with steady-state precession three dimensional fat saturation T2-weighted image(FISP-3D -FS- T2WI) sequences in sagittal plane, SE-T1WI and multi echo data image combination T2-weighted imaging (MEDIC or ME-T2WI) in coronal plane. Using ME-T2WI sequence, axial plane MRI scanning in 5 patients. Results: Twenty-seven sites of 26 patients include 8 patella, 7 femoral medial condyle, 11 femoral lateral condyle and l tibial plateau. Three types pure cartilage fracture were observed, totally defect of the cartilage in 7 sites (include 3 patella, 2 femoral medial condyle, 1 femoral lateral condyle and 1 tibial plateau), fissuring fracture in 3 sites (include 2 femoral medial and 1 femoral lateral condyles), superficial defect of the cartilage in 17 sites (include 5 patella, 3 femoral medial and 9 femoral lateral condyle). Corpus liberum was found in 21 patients' knee joints by arthroscopy, but only 3 cases by MRI. Bone bruise was detected, and subcartilage low signal lines were normal. Conclusion: Using FLASH-FS- T1WI, SE-T1WI, FISP-3D-FS-T2WI and ME-T2WI sequences, sagittal and coronal MRI scanning in femoral and tibial plateau pure cartilage fractures, and using ME-T2WI sequence axial scanning in patellar cartilage fractures may show the position, extension and types of the acute pure cartilage fracture of the knee joint. MRI is the best non-invasive method for studying cartilage fracture. (authors)

  14. Clinical and Arthroscopic Findings of Acute Anterior Cruciate Ligament Tears of the Knee

    Kenji Shirakura

    1995-01-01

    Full Text Available Clinical, arthrographic, and arthroscopic findings in 53 patients with acutely torn anterior cruciate ligaments (ACLs were documented. Arthroscopy and instability tests under anesthesia were performed on all patients within 2 weeks after the initial injury. Twenty-three patients complained of extension blocks, and localized tenderness on the medial side was revealed in 26 patients at the initial examination. Aspiration from joints exhibited hemarthrosis in 52 patients. Arthroscopy revealed ACL ruptures in all patients. Four Segond's fractures, 26 meniscus tears (8 medial and 18 lateral, 1 osteochondral fracture, and 19 medial collateral ligament ruptures were revealed. Arthroscopy detected only 1 of the 5 ruptures of the posteromedial corner of the medial meniscus, which were noted on arthrography. Three ACL stumps were protruding among the femorotibial joint, which seemed to be restricting full extension. Statistical analysis showed that tenderness on the medial side was not revealed more frequently in knees with medial collateral ligament injuries than in the others. The volume of aspirated fluids in knees with no leakage in arthrography significantly increased over those with leakages (p < 0.05. Diagnosis of ACL injuries should be completed by clinical, arthrographic, and arthroscopic examinations.

  15. Clinical Effect of Acute Complete Acromioclavicular Joint Dislocation Treated with Micro-Movable and Anatomical Acromioclavicular Plate

    Qingjun Liu, Jianyun Miao, Bin Lin, Zhimin Guo

    2012-01-01

    Full Text Available Objectives: We evaluated the long-term clinical results of acute complete acromioclavicular dislocations treated with micro-movable and anatomical acromioclavicular plate.Methods: Open reduction and internal fixation was performed using the MAAP in 16 patients (10 males, 6 females; mean age 36 years; range16 to 63 years with acute complete acromioclavicular joint dislocation. Radiographic evaluations were routinely conducted every 3 weeks until 3 months postoperatively. The MAAP were removed under local anesthesia after 3 months postoperatively. We evaluated the functional results by using the constant scoring system and radiological results in the last follow-up time. The mean follow up was 26 months (range 16 to 38 months.Results: The mean Constant score was 94 (range, 78 to 100. The results were excellent in 12 patients (75.0%, good in 3 patients (18.8% and satisfactory in 1patient (6.2%. Three patients with scores of 80 to 90 had mild pain during activity, but have not affected the shoulder range of motion. One patient has both some pain and limited range of motion of shoulder joint. All patients but one have returned to their preoperative work without any limitations. Compared to the contralateral side, radiography showed anatomical reposition in the vertical plane in 14 cases, slight loss of reduction in 2 older patients.Conclusion: We recommend the MAAP fixation for surgical treatment of acute complete acromioclavicular joint dislocation as it could provide satisfactory shoulder functions and clinical results, with lower complication rate. However, it is necessary to continue to observe the clinical effects of this fixation technique.

  16. Anterior knee pain

    ... or playing soccer). You have flat feet. Anterior knee pain is more common in: People who are overweight People who have had a dislocation, fracture, or other injury to the kneecap Runners, jumpers, ...

  17. Preventing Knee Injuries

    ... to tearing. Growth Plate Injuries, Fractures, and Dislocations Knee fractures rarely occur in childhood sports, but with any ... is the bump on the front of the knee where the patellar tendon attaches. Fractures to the growth plate in this area often ...

  18. Acute arterial occlusion in the midpiece of femoral artery following total knee arthroplasty: Report of one case

    Rui He; Liu Yang

    2016-01-01

    Acute arterial occlusion is a rare complication following total knee arthroplasty (TKA).The incidence as reported previously is from 0.03% to 0.17%;however,the sequelae can be disastrous because of its potential threat to limb loss.We report a case of acute arterial occlusion in the midpiece of femoral artery following TKA occurred 40 min postoperatively.The occlusion site existed at the midpiece of femoral artery is uncommon.Arterial circulation of the lower limb could not be restored by the thrombolysis and thrombectomy treatments performed within 11 h after TKA.In the end,amputation had to be carried out.In the treatment of acute arterial occlusion following TKA with a tourniquet,it is important to fully consider that arteriosclerosis may induce atheromatous plaque disruption,which might be the reason for acute arterial occlusion.

  19. Traumatic knee extension deficit (the locked knee)

    Helmark, I C; Neergaard, K; Krogsgaard, M R

    2007-01-01

    In the present study we investigated the validity of magnetic resonance imaging (MRI) and arthroscopy in knees with acute, traumatic extension deficit (the "locked knee"), and evaluated whether arthroscopy of knees with no mechanical pathology could be avoided by MRI evaluation. The study consist......-handle lesion and one pathological synovial plica). MRI of the knee with acute, traumatic extension deficit is in the acute or subacute phase a safe method to identify the patients that have a mechanical reason for locking and therefore can benefit from arthroscopic treatment....

  20. EFFECTIVENESS OF TRAUMATIC DISLOCATION OF KNEE JOINT COMBINED WITH MULTIPLE LIGAMENT INJURIES TREATED BY STAGES%分期治疗外伤性膝关节脱位合并多韧带损伤的疗效观察

    陈志伟; 刘春磊; 杨乐忠; 戴祝; 曹盛俊

    2011-01-01

    目的 观察分期治疗外性伤膝关节脱位合并多韧带损伤的临床疗效. 方法 2005年6月-2008年11月,收治13例外伤性膝关节脱位合并多韧带损伤患者.男9例,女4例;年龄18~54岁,平均30.7岁.致伤原因:运动伤8例,交通事故伤2例,高处哈落伤2例,扭伤1例.左侧3例,右侧10例.受伤至入院时间6 h~2 d,平均9h.8例前交叉韧带(anterior cruciate ligament,ACL)、后交叉韧带(posterior cruciate ligament,PCL)及内侧副韧带(medial collateral ligament,MCL)损伤,3例ACL、PCL及外侧副韧带(lateral collateral ligament,LCL)损伤,2例ACL、PCL、MCL及LCL损伤.10例外翻应力试验为++~+++,5例内翻应力试验为++~+++;13例前、后抽屉试验均为阳性,Lachman试验为++~+++.一期手术修复PCL、MCL、LCL及半月板,术后固定3~4周后开始功能锻炼,4~6个月后膝关节活动范围良好且存在前方不稳时二期于关节镜下重建ACL. 结果 两次手术后切口均Ⅰ期愈合,无感染及骨筋膜室综合征等并发症发生.患者均获随访,随访时间12~60个月,平均36个月.一期术后4周2例出现关节腔积液,经穿刺抽吸后缓解,其余患者均未出现膝关节不适.二期术后3个月1例外翻应力试验++,1例为+;1例内翻应力试验为+;1例Lachman试验++,1例为+;其余患者各试验均为阴性.二期术后12个月患膝关节屈曲达100~135°,平均123.4°;伸直达0~4°,平均2.3°.根据Lysholm膝关节功能评分标准评定:获优9例,良2例,可2例,优良率84.6%. 结论 分期治疗外伤性膝关节脱位合并多韧带损伤可获得较好的临床效果.%Objective To observe the effectiveness of traumatic dislocation of the knee joint combined with multiple ligament injuries treated by stages. Methods Between June 2005 and November 2008, 13 cases of traumatic dislocation of the knee joint combined with multiple ligament injuries were treated by stages, including 9 males and 4 females with an average age of 30

  1. Pain and knee function in relation to degree of bone bruise after acute anterior cruciate ligament rupture

    Szkopek, K; Warming, Torsten; Neergaard, K;

    2012-01-01

    imaging (MRI) scan was performed shortly after the injury, and at 2 weeks, 1 month and 2 months. The patients reported the level of pain every day and filled in a Knee injury and Osteoarthritis Outcome Score sheet in connection with MRI. For every MRI of the knee, volume of bone bruise was calculated, and...... intensity was visually graded. Our study showed a reduction of the pain to 50% approximately 2 weeks after the injury, at which time the bone bruise was at maximum. There was a significant relationship between pain and the volume and intensity of the bone bruise in the medial tibia condyle, as well as pain...... and the bone bruise volume of the lateral femoral condyle. Patients with bone bruise of the medial tibia and patients with meniscal lesions had more pain. It is suggested that pain and decreased function after acute ACL injury most likely is related to soft tissue and cartilage injury and not to bone...

  2. Acute Improvement of Vertical Jump Performance After Isometric Squats Depends on Knee Angle and Vertical Jumping Ability.

    Tsoukos, Athanasios; Bogdanis, Gregory C; Terzis, Gerasimos; Veligekas, Panagiotis

    2016-08-01

    Tsoukos, A, Bogdanis, GC, Terzis, G, and Veligekas, P. Acute improvement of vertical jump performance after isometric squats depends on knee angle and vertical jumping ability. J Strength Cond Res 30(8): 2250-2257, 2016-This study examined the acute effects of maximum isometric squats at 2 different knee angles (90 or 140°) on countermovement jump (CMJ) performance in power athletes. Fourteen national-level male track and field power athletes completed 3 main trials (2 experimental and 1 control) in a randomized and counterbalanced order 1 week apart. Countermovement jump performance was evaluated using a force-plate before and 15 seconds, 3, 6, 9, and 12 minutes after 3 sets of 3 seconds maximum isometric contractions with 1-minute rest in between, from a squat position with knee angle set at 90 or 140°. Countermovement jump performance was improved compared with baseline only in the 140° condition by 3.8 ± 1.2% on the 12th minute of recovery (p = 0.027), whereas there was no change in CMJ height in the 90° condition. In the control condition, there was a decrease in CMJ performance over time, reaching -3.6 ± 1.2% (p = 0.049) after 12 minutes of recovery. To determine the possible effects of baseline jump performance on subsequent CMJ performance, subjects were divided into 2 groups ("high jumpers" and "low jumpers"). The baseline CMJ values of "high jumpers" and "low jumpers" differed significantly (CMJ: 45.1 ± 2.2 vs. 37.1 ± 3.9 cm, respectively, p = 0.001). Countermovement jump was increased only in the "high jumpers" group by 5.4 ± 1.4% (p = 0.001) and 7.4 ± 1.2% (p = 0.001) at the knee angles of 90 and 140°, respectively. This improvement was larger at the 140° angle (p = 0.049). Knee angle during isometric squats and vertical jumping ability are important determinants of the acute CMJ performance increase observed after a conditioning activity. PMID:26808841

  3. Medial patellofemoral ligament injury patterns and associated pathology in lateral patella dislocation: an MRI study

    Guerrero Patrick

    2009-07-01

    Full Text Available Abstract Background Lateral Patella dislocations are common injuries seen in the active and young adult populations. Our study focus was to evaluate medial patellofemoral ligament (MPFL injury patterns and associated knee pathology using Magnetic Resonance Imaging studies. Methods MRI studies taken at one imaging site between January, 2007 to January, 2008 with the final diagnosis of patella dislocation were screened for this study. Of the 324 cases that were found, 195 patients with lateral patellar dislocation traumatic enough to cause bone bruises on the lateral femoral trochlea and the medial facet of the patella were selected for this study. The MRI images were reviewed by three independent observers for location and type of MPFL injury, osteochondral defects, loose bodies, MCL and meniscus tears. The data was analyzed as a single cohort and by gender. Results This study consisted of 127 males and 68 females; mean age of 23 yrs. Tear of the MPFL at the patellar attachment occurred in 93/195 knees (47%, at the femoral attachment in 50/195 knees (26%, and at both the femoral and patella attachment sites in 26/195 knees (13%. Attenuation of the MPFL without rupture occurred in 26/195 knees (13%. Associated findings included loose bodies in 23/195 (13%, meniscus tears 41/195 (21%, patella avulsion/fracture in 14/195 (7%, medial collateral ligament sprains/tears in 37/195 (19% and osteochondral lesions in 96/195 knees (49%. Statistical analysis showed females had significantly more associated meniscus tears than the males (27% vs. 17%, p = 0.04. Although not statistically significant, osteochondral lesions were seen more in male patients with acute patella dislocation (52% vs. 42%, p = 0.08. Conclusion Patients who present with lateral patella dislocation with the classic bone bruise pattern seen on MRI will likely rupture the MPFL at the patellar side. Females are more likely to have an associated meniscal tear than males; however, more males

  4. Conservative treatment of acute knee osteoarthritis: A review of the Cochrane Library

    Emerito Carlos Rodriguez-Merchan

    2016-05-01

    Conclusions: Five main strategies for the conservative treatment of knee osteoarthritis exist that must be used before indicating surgical treatment: medical treatment, physical medicine and rehabilitation, intra-articular injections, acupuncture, and self-management education programs.

  5. The Effects of NMDA Antagonists on Neuronal Activity in Cat Spinal Cord Evoked by Acute Inflammation in the Knee Joint.

    Schaible, Hans-Georg; Grubb, Blair D.; Neugebauer, Volker; Oppmann, Maria

    1991-01-01

    In alpha-chloralose-anaesthetized, spinalized cats we examined the effects of NMDA antagonists on the discharges of 71 spinal neurons which had afferent input from the knee joint. These neurons were rendered hyperexcitable by acute arthritis in the knee induced by kaolin and carrageenan. They were located in the deep dorsal and ventral horn and some of them had ascending axons. The N-methyl-d-aspartate (NMDA) antagonists ketamine and d-2-amino-5-phosphonovalerate (AP5), were administered ionophoretically, and ketamine was also administered intravenously. In some of the experiments the antagonists were tested against the agonists NMDA and quisqualate. The effects of the NMDA antagonists consisted of a significant reduction in the resting activity of neurons and/or the responses of the same neurons to mechanical stimulation of the inflamed knee. Intravenous ketamine was most effective in suppressing the resting and mechanically evoked activity in 25 of 26 neurons tested. Ionophoretically applied ketamine had a suppressive effect in 11 of 21 neurons, and AP5 decreased activity in 17 of 24 cells. The reduction in the resting and/or the mechanically evoked discharges was achieved with doses of the antagonists which suppressed the responses to NMDA but not those to quisqualate. These results suggest that NMDA receptors are involved in the enhanced responses and basal activity of spinal neurons induced by inflammation in the periphery. PMID:12106256

  6. Knee morphometric risk factors for acute anterior cruciate ligament injury in skeletally immature patients

    Shaw, K. Aaron; Dunoski, Brian; Mardis, Neil; Pacicca, Donna

    2015-01-01

    Study design Retrospective, case–control. Purpose Knee morphometric risk factors for noncontact anterior cruciate ligament (ACL) injury have been a popular topic with skeletally mature patients. Little research has focused on the skeletally immature, with conflicting conclusions. This study performs a comprehensive analysis of identified parameters thought to predispose to ACL injury in a skeletally immature cohort. Methods A retrospective review of pediatric patients undergoing knee magnetic...

  7. MRI evaluation of osteonecrosis in knee joints after intravenous administration of corticosteroids in patients with severe acute respiratory syndrome

    Objective: To evaluate MRI features of osteonecrosis in knee joints after intravenous administration of exogenous corticosteroids in patients with severe acute respiratory syndrome (SARS). Methods: MRI was done in 18 patients (medical staff from 4 hospitals) suffered from SARS and treated with intravenous use of exogenous corticosteroids in hip joints and knee joints to indicate the findings and characteristics of osteonecrosis as well as their relation with hormone amount. Results: Eleven patients showed lesions of osteonecrosis in knee joints with bilateral in 7 and unilateral in 4, and 3 patients were complicated with avascular necrosis in bilateral femoral heads. Among the 38 lesions in knee joints, 34 lesions were located in medial condylu, lateral condylus and shaft of femur, and 4 in medial condylus or lateral condylus of tibia. Large-middle lesions showed geographic focus of typically heterogeneous signal (low or intermediate signal intensity on T1WI and high or intermediate signal intensity T2WI) within the marrow that was surrounded by characteristic low signal intensity, serpentine border on T1, T2WI. This border showed a classic double-line sign on T2WI in 4 lesions. Small lesions showed low signal intensity on T1 and low or high signal intensity on T2WI. Subchondral avascular necrosis in middle-upper femoral heads showed intermediate signal intensity on T1 weighted images and high or complicated signal intensity on T2WI encircled with characteristic low signal intensity, serpentine border on T1 and T2WI. This border showed a classic double-line sign on T2 weighted images in avascular necrosis of bilateral femoral heads in 1 case. Conclusion: In these cases, osteonecrosis in knee joints was more than in femoral heads in patients with SARS after intravenous use of exogenous corticosteroids, mostly located in medial condylus, lateral condylus and shaft of femur as well as in medial condylus or lateral condylus of tibia. So, MRI should be early done in

  8. Minimally Invasive Total Knee Arthroplasty

    Full Text Available ... actually rotate and dislocate, if you would, and cause problems that direction. This, at least, will not ... to correct those deformities that we will then cause enough instability that will require a knee that ...

  9. Total Knee Replacement for Women

    Full Text Available ... that and successfully. But there are some cost issues between cements and cementless implants that have to ... to spin out you can have can dislocation issues. So mobile-bearing knees require absolutely perfect balancing ...

  10. Acute onset of intracranial subdural hemorrhage five days after spinal anesthesia for knee arthroscopic surgery: a case report

    Hagino Tetsuo

    2012-03-01

    Full Text Available Abstract Introduction Spinal anesthesia is a widely used general purpose anesthesia. However, serious complications, such as intracranial subdural hemorrhage, can rarely occur. Case presentation We report the case of a 73-year-old Japanese woman who had acute onset of intracranial subdural hemorrhage five days after spinal anesthesia for knee arthroscopic surgery. Conclusion This case highlights the need to pay attention to acute intracranial subdural hemorrhage as a complication after spinal anesthesia. If the headache persists even in a supine position or nausea occurs abruptly, computed tomography or magnetic resonance imaging of the brain should be conducted. An intracranial subdural hematoma may have a serious outcome and is an important differential diagnosis for headache after spinal anesthesia.

  11. Effects of Group-Based Exercise on Range of Motion, Muscle Strength, Functional Ability, and Pain During the Acute Phase After Total Knee Arthroplasty: A Controlled Clinical Trial.

    Hiyama, Yoshinori; Kamitani, Tsukasa; Wada, Osamu; Mizuno, Kiyonori; Yamada, Minoru

    2016-09-01

    Study Design Prospective observational study including a historical control group. Background The extent to which group-based exercise (G-EXE) improves knee range of motion (ROM), quadriceps strength, and gait ability is similar to that of individualized exercise (I-EXE) at 6 weeks and 8 months after total knee arthroplasty (TKA). However, the benefits of G-EXE for patients during the acute recovery phase after TKA remain unclear. Objective To determine the effects of G-EXE during the acute recovery phase after TKA on knee ROM, quadriceps strength, functional ability, and knee pain. Methods Two hundred thirty-one patients participated in G-EXE in addition to regular ambulation and activities-of-daily-living exercises twice daily during the hospital stay. Outcomes were compared to those of a retrospectively identified, historical control group (I-EXE group [n = 206]) that included patients who performed exercises identical to those performed by the G-EXE group. The outcomes included knee ROM, quadriceps strength, pain intensity, and timed up-and-go test score at 1 month before surgery and at discharge. Analyses were adjusted for age, body mass index, sex, length of hospital stay, and preoperative values. Results Changes in ROM of knee flexion and extension (PSports Phys Ther 2016;46(9):742-748. Epub 5 Aug 2016. doi:10.2519/jospt.2016.6409. PMID:27494052

  12. Retrowalking as an adjunct to conventional treatment versus conventional treatment alone on pain and disability in patients with acute exacerbation of chronic knee osteoarthritis: A randomized clinical trial

    Gauri Arun Gondhalekar

    2013-01-01

    Full Text Available Background: Increased external knee adduction moment during walking alters the joint biomechanics; which causes symptoms in chronic knee osteoarthritis patients. Aims: To assess additional effects of Retro-walking over conventional treatment on pain and disability in patients with acute exacerbation of chronic knee osteoarthritis. Materials and Methods: Thirty chronic knee osteoarthritis patients were randomly assigned into 2 groups. Group ′A′ (7 men, 8 women received conventional treatment. Group ′B′ (8 men, 7 women received conventional treatment and Retro-walking. Pain, assessed through visual analogue scale (VAS, and Western Ontario and McMaster Universities Arthritis Index (WOMAC were the primary outcomes and knee range of motion (ROM, hip abductor and extensor strength were secondary outcomes; measured pre-intervention, after 1 week and after 3 weeks of intervention. Results: Two factors analysis of variance for repeated measures was used for all outcomes. At the end of 3 weeks; WOMAC score showed highly significant difference within ( P < 0.0001 and significant difference between groups ( P = 0.040 also by Time × group interaction ( P = 0.024, VAS showed highly significant difference within groups ( P < 0.0001. Knee ROM showed significant difference within groups. Hip abductor and extensor strength showed significant difference by Time × group interaction ( P < 0.05. Conclusion: Retrowalking is an effective adjunct to conventional treatment in decreasing disability in patients with knee osteoarthritis.

  13. Lisfranc fracture-dislocation precipitating acute Charcot arthopathy in a neuropathic diabetic foot: a case report

    Yeoh, Joey; Muir, Kenneth Ross; Dissanayake, Ajith Munasinghe; Tzu-Chieh, Wendy Yu

    2008-01-01

    The Lisfranc injury is relatively uncommon yet remains popular in the literature due to its variable causative mechanisms and subtleties in radiographic features despite its potential for disabling long term outcomes if treatment is inadequate, inappropriate or delayed. These injuries are especially pertinent in diabetic patients, especially those with neuropathy, since they are more common, can lead to Charcot neuropathic joint, ulcers and have different causative mechanisms compared to the general population. We describe the case of a neuropathic diabetic patient who presented with a Lisfranc injury which precipitated the development of acute Charcot arthropathy in the right foot. The case serves to illustrate several salient points about the Lisfranc joint and related injuries in diabetic patients. PMID:18973700

  14. Effect of acute dietary nitrate intake on maximal knee extensor speed and power in healthy men and women.

    Coggan, Andrew R; Leibowitz, Joshua L; Kadkhodayan, Ana; Thomas, Deepak P; Ramamurthy, Sujata; Spearie, Catherine Anderson; Waller, Suzanne; Farmer, Marsha; Peterson, Linda R

    2015-08-01

    Nitric oxide (NO) has been demonstrated to enhance the maximal shortening velocity and maximal power of rodent muscle. Dietary nitrate (NO3(-)) intake has been demonstrated to increase NO bioavailability in humans. We therefore hypothesized that acute dietary NO3(-) intake (in the form of a concentrated beetroot juice (BRJ) supplement) would improve muscle speed and power in humans. To test this hypothesis, healthy men and women (n = 12; age = 22-50 y) were studied using a randomized, double-blind, placebo-controlled crossover design. After an overnight fast, subjects ingested 140 mL of BRJ either containing or devoid of 11.2 mmol of NO3(-). After 2 h, knee extensor contractile function was assessed using a Biodex 4 isokinetic dynamometer. Breath NO levels were also measured periodically using a Niox Mino analyzer as a biomarker of whole-body NO production. No significant changes in breath NO were observed in the placebo trial, whereas breath NO rose by 61% (P < 0.001; effect size = 1.19) after dietary NO3(-) intake. This was accompanied by a 4% (P < 0.01; effect size = 0.74) increase in peak knee extensor power at the highest angular velocity tested (i.e., 6.28 rad/s). Calculated maximal knee extensor power was therefore greater (i.e., 7.90 ± 0.59 vs. 7.44 ± 0.53 W/kg; P < 0.05; effect size = 0.63) after dietary NO3(-) intake, as was the calculated maximal velocity (i.e., 14.5 ± 0.9 vs. 13.1 ± 0.8 rad/s; P < 0.05; effect size = 0.67). No differences in muscle function were observed during 50 consecutive knee extensions performed at 3.14 rad/s. We conclude that acute dietary NO3(-) intake increases whole-body NO production and muscle speed and power in healthy men and women. PMID:25199856

  15. Acute non-traumatic marrow edema syndrome in the knee: MRI findings at presentation, correlation with spinal DEXA and outcome

    Karantanas, Apostolos H. [Department of Radiology, University of Crete, Heraklion 711 10 Greece (Greece)], E-mail: apolsen@yahoo.com; Drakonaki, Elena [Department of Radiology, University of Crete, Heraklion 711 10 Greece (Greece); Karachalios, Theophilos [Department of Orthopaedic Surgery, University of Thessaly, Larissa 411 10 Greece (Greece); Korompilias, Anastasios V. [Department of Orthopaedic Surgery, University of Ioannina, Ioannina 451 10 (Greece); Malizos, Konstantinos [Department of Orthopaedic Surgery, University of Thessaly, Larissa 411 10 Greece (Greece)

    2008-07-15

    Purpose: The aim of the study was to present the MRI findings of non-traumatic edema-like lesions presented acutely in the adult knee and to correlate them with the 3-year outcome and the bone mineral density (BMD) in the spine. Materials and methods: Ninety-eight patients (40 men, 58 women, mean age 60.1 {+-} 11 years, age range 27-82 years), were followed up clinically as well as with MR imaging, when indicated, for at least 3 years. Patients were classified according to presentation in 3 groups (A: bone marrow edema (BME), B: BME and subchondral fracture, C: BME and articular collapse) and according to outcome in 2 groups (A: reversible BME, B: articular collapse). BMD measurements of the spine were carried out in males over 70 and females over 60 years old using DEXA. Results: The isolated BME pattern was observed in 64.3% (Group A), subchondral fractures without articular collapse in 11.2% (Group B) and articular collapse in 24.5% (Group C). Significant differences were found among the 3 groups at presentation, regarding the age, sex, BMD, affected area and duration of symptoms prior to imaging (p < 0.05). Localization of the lesions in the weight-bearing areas of the knee was shown in 100% of C, in 90.9% of B and in 50.8% of A. The duration of symptoms prior to imaging was longer in C (7.6 {+-} 2.8 m) than in A (2.5 {+-} 1.7 m) and B (4.0 {+-} 3.2 m) (p < 0.05). Group B progressed to articular collapse in 45.5%, the rest demonstrating a favourable outcome. Group C showed clinical improvement in 75% and persistent symptoms that required knee arthroplasty in 25% of cases. Articular collapse was the final outcome in 29.6% and transient BME in 70.4% of patients. These two groups showed significant differences regarding the age (p {approx} 0), sex (p = 0.002), low BMD (p = 0.004), affected area (p {approx} 0), presence of subchondral sparing (p {approx} 0), duration of symptoms prior to imaging (p {approx} 0), time from onset of symptoms to the final outcome (p

  16. The acutely ACL injured knee assessed by MRI: changes in joint fluid, bone marrow lesions, and cartilage during the first year

    Frobell, R B; Le Graverand, M-P; Buck, R;

    2008-01-01

    OBJECTIVES: To investigate changes in the knee during the first year after acute rupture of the anterior cruciate ligament (ACL) of volumes of joint fluid (JF), bone marrow lesions (BMLs), and cartilage volume (VC), and cartilage thickness (ThCcAB) and cartilage surface area (AC). To identify...

  17. Acute Effects of Kinesio Taping on Knee Extensor Peak Torque and Stretch Reflex in Healthy Adults.

    Yeung, Simon S; Yeung, Ella W

    2016-01-01

    Kinesio Tex tape (KT) is used to prevent and treat sports-related injuries and to enhance muscle performance. It has been proposed that the direction of taping may either facilitate or inhibit the muscle by having different effects on cutaneous receptors that modulate excitability of the motor neurons. This study had 2 goals. First, we wished to determine if KT application affects muscle performance and if the method of application facilitates or inhibits muscle performance. This was assessed by measuring isokinetic knee extension peak torque in the knee extensor. Second, we assessed neurological effects of taping on the excitability of the motor neurons by measuring the reflex latency and action potential by electromyography (EMG) in the patellar reflex. The study was a single-blind, placebo-controlled crossover trial with 28 healthy volunteers with no history of knee injuries. Participants received facilitative KT treatment, inhibitory KT treatment, or Hypafix taping of the knee extensor. There were significant differences in the peak torque between 3 treatments (F(2,54) = 4.873, P taping applications. The findings suggest that the direction of KT application over the muscle has specific effects on muscle performance. Given the magnitude of effect is small, interpretation of clinical significance should be considered with caution. The underlying mechanism warrants further investigation. PMID:26825916

  18. Conservative treatment of acute knee osteoarthritis:A review of the Cochrane Library

    2016-01-01

    Objective: To analyze conservative treatment of knee pain in patients with osteoarthritis. Methods: A Cochrane Library search related to knee osteoartritis was analyzed. Five main strategies for the conservative treatment of knee osteoartritis have been reviewed:medical treatment, physical medicine and rehabilitation, intra-articular injections, and acupuncture. Results: Regarding medical treatment, non-steroidal antiinflammatory drugs (ibuprofen, diclofenac, arthrotec, celecoxib, naproxen, rofecoxib) were superior to acetaminophen. The benefits of tramadol or tramadol/paracetamol, non-tramadol opioids, glucosamine, diacerine, and doxycicline were small. Herbal topical treatment with preparations from medical plants seemed to improve pain. Concerning oral herbal therapy, Piascidine ad extracts of Boswellia serrata had a short-term effect on osteoarthritis symptoms. Regarding physical medicine and rehabilitation, there was limited evidence that a brace had additional beneficial effect compared with medical treatment alone. Land-based therapeutic exercise and aquatic exercise had at least a small short term benefit. Thera-peutic ultrasound may be beneficial (low quality of evidence). The effectiveness of transcutaneous electrostimulation for pain relief has not been demonstrated. Electrical stimulation therapy may provide significant improvements. Regarding intra-articular in-jections, viscosupplementation seemed to be an effective treatment for pain relief in the short-term (months). The short-term (weeks) benefit of intra-articular corticosteroids in the management of knee osteoarthritis has been demonstrated. The benefits of acupuncture were small. Self-management education programs resulted in no or small benefits on pain relief. Conclusions: Five main strategies for the conservative treatment of knee osteoarthritis exist that must be used before indicating surgical treatment:medical treatment, physical medicine and rehabilitation, intra-articular injections

  19. Physical Examination and Imaging of the Acute Multiple Ligament Knee Injury

    Manske, Robert C.; Prohaska, Daniel

    2008-01-01

    Examination and evaluation of the patient a with multiple ligament injured knee is a complicated process and best done in a methodical, comprehensive fashion with a particular emphasis placed on assessment of supporting soft tissues. Tissues that can be damaged during this devastating injury include bones, ligaments, meniscus, articular cartilage, and neurovascular structures. Uses of diagnostic imaging and the physical examination process will be described in this article.

  20. 关节镜下喙锁韧带增强术治疗肩锁关节脱位%Arthroscopic treatment of acute acromioclavicular joint dislocations by coracoacromial ligament augmentation and suture

    皇甫小桥; 赵金忠; 何耀华; 杨星光; 刘旭东; 刘闻欣; 王海明

    2013-01-01

    ,nine patients with acute AC joint dislocation type Ⅲ and three patients with type V were treated arthroscopically to augment the reconstructed CC ligaments (conoid ligament and trapezoid ligament ) by the suture plate (ASCULAP Company, Germany,B′Braun)used to reconstruct ligaments of knee joint.Patients were pre and postoperatively evaluated with X-ray examinations,American Shoulder and Elbow Surgeons′Form (ASES)and Constant-Murley Score (CMS).Results All 1 2 patients were followed up for at least 1 2 months (range,1 2 to 1 8 months).The average ASES score significantly increased from 28.7 preoperatively to 86.9 postoperatively, and the mean CMS score from 24 to 91,respectively.X-ray data showed a good reduction of the AC joint in the treated group.9 1 .7% of patients (1 1 patients)obtained an obvious therapeutic effect after operation. 83.3% of patients (10 patients)returned to their pre-injury level of athletics.Acromioclavicular subluxation was only found in one case.Discussion AC joint dislocation usually appears in youth and adults with obvious traumatic history,and often results from the direct violence on the adducted shoulder.The stable structure of AC joint is achieved by the connection between the scapula and the clavicle,and the integrity of the sternoclavicular articulation and the scapulothoracic joint.According to the injury level of acromioclavicular stability,AC joint injuries can be classified into six types by Rockwood,type Ⅲ、Ⅳ、Ⅴ、Ⅵ should be fixed through operation for its disruption of stable structures.The goal of surgical procedure on AC joint dislocation is to reconstruct its anatomy and function. Activity of AC joint and its postoperative rehabilitation training will be inevitably affected by any operation of strict limitation on its flexibility. Arthroscopically assisted augmentation of reconstructed CC ligaments with the suture plate button technique is an effective method in treating AC joint dislocation,which restores its

  1. Traumatic chylous knee effusion.

    Reginato, A J; Feldman, E; Rabinowitz, J L

    1985-01-01

    A 47-year-old patient presented with a chylous knee effusion and traumatic infected skin lacerations. The diagnosis of septic arthritis was considered because of purulent looking joint fluid, spuriously high synovial fluid white cell count, and signs of acute knee synovitis. Synovial fluid lipid analysis showed increased total lipids due to high concentration of neutral lipids, mainly triglycerides, and repeated knee radiographs showed a small fracture of the tibial spine. Joint trauma with s...

  2. Acromioclavicular dislocation: postoperative evaluation of the coracoclavicular ligaments using magnetic resonance☆

    Faria, Rafael Salomon Silva; Ribeiro, Fabiano Rebouças; Amin, Bruno de Oliveira; Tenor Junior, Antonio Carlos; da Costa, Miguel Pereira; Filardi Filho, Cantídio Salvador; Batista, Cleber Gonçalves; Brasil Filho, Rômulo

    2015-01-01

    Objective To radiologically evaluate the healing of the coracoclavicular ligaments after surgical treatment for acromioclavicular dislocation. Methods Ten patients who had undergone surgical treatment for acromioclavicular dislocation via a posterosuperior route at least one year earlier were invited to return for radiological assessment using magnetic resonance. This evaluation was done by means of analogy with the scale described in the literature for studying the healing of the anterior cruciate ligament of the knee and for measuring the healed coracoclavicular ligaments. Results A scar structure of fibrous appearance had formed in 100% of the cases. In 50% of the cases, the images of this structure had a good appearance, while the other 50% were deficient. Conclusion Late postoperative evaluation using magnetic resonance, on patients who had been treated for acute acromioclavicular dislocation using a posterosuperior route in the shoulder, showed that the coracoclavicular ligaments had healed in 100% of the cases, but that this healing was deficient in 50%. PMID:26229916

  3. Intra-articular lignocaine versus intravenous analgesia with or without sedation for manual reduction of acute anterior shoulder dislocation in adults.

    Wakai, Abel

    2012-01-31

    BACKGROUND: There is conflicting evidence regarding the use of intra-articular lignocaine injection for the closed manual reduction of acute anterior shoulder dislocations. A systematic review may help cohere the conflicting evidence. OBJECTIVES: To compare the clinical efficacy and safety of intra-articular lignocaine and intravenous analgesia (with or without sedation) for reduction of acute anterior shoulder dislocation. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 1), MEDLINE (1950 to March 2010), and EMBASE (1980 to March 2010). We searched Current Controlled Trials metaRegister of Clinical Trials (compiled by Current Science) (March 2010). We imposed no language restriction. SELECTION CRITERIA: Randomized controlled trials comparing intra-articular lignocaine (IAL) with intravenous analgesia with or without sedation (IVAS) in adults aged 18 years and over for reduction of acute anterior shoulder dislocation. DATA COLLECTION AND ANALYSIS: Two authors independently assessed trial quality and extracted data. Where possible, data were pooled and relative risks (RR) and mean differences (MD), each with 95% confidence intervals (CI), were computed using the Cochrane Review Manager statistical package (RevMan). MAIN RESULTS: Of 1041 publications obtained from the search strategy, we examined nine studies. Four studies were excluded, and five studies with 211 participants were eligible for inclusion. There was no difference in the immediate success rate of IAL when compared with IVAS in the closed manual reduction of acute anterior shoulder dislocation (RR 0.95; 95% CI 0.83 to 1.10). There were significantly fewer adverse effects associated with IAL compared with IVAS (RR 0.16; 95% CI 0.06 to 0.43). The mean time spent in the emergency department was significantly less with IAL compared with IVAS (MD 109.46 minutes; 95% CI 84.60 to 134.32). One trial reported significantly less time for

  4. Advances in the research of the diagnosis and treatment of vascular and nerve injury in the knee dislocation with multiple ligament injuries%膝关节脱位合并多发韧带损伤患者血管神经损伤诊治的研究进展

    孙正宇; 李箭

    2015-01-01

    Objective To explore advances in the research of knee dislocation ( KD ) with vascular and nerve injury and to provide theoretical reference for the clinic. Methods Literature of the diagnosis and treatment of KD with vascular and nerve injury at home and abroad was extensively reviewed and analyzed. Results Currently, emergency surgery of repair and revascularization was needed in KD with vascular and nerve injury, while most nerve injury could be treated with conservative treatment or delayed surgery. Fast and accurate assessment was essential for the determination of treatment options and prognosis. Conclusions Knee dislocation ( KD ) with vascular and nerve injury can severely affect the lower limb functions. Comprehensive and systematic evaluation and imaging examination are needed to put forward reasonable treatment options due to complex conditions and rapid progress. At present, there is no academic consensus on the treatment of neurovascular injury, and therefore individualized treatment need to be developed.

  5. Runner's Knee

    ... Without Pain? Jumper's Knee Knee Injuries Anterior Cruciate Ligament (ACL) Injuries Knee Injury: Caroline's Story Medial Collateral Ligament (MCL) Injuries Sports and Exercise Safety Repetitive Stress Injuries Bursitis ...

  6. Neglected Traumatic Locked Anterior Shoulder Fracture-Dislocation

    Er, Mehmet Serhan; Eroglu, Mehmet; Erten, Recep Abdullah; Metineren, Hasan; Altinel, Levent

    2015-01-01

    Anterior shoulder dislocations are the most common major joint dislocations encountered in the emergency departments and fractures of proximal humerus can accompany with dislocations. Although the treatment of acute isolated traumatic anterior shoulder dislocation is generally simple, the treatment of neglected fracture-dislocations becomes more complicated. In this report, a 22-year-old male patient who had posttraumatic locked, shoulder fracture-dislocation is presented. Open reduction and ...

  7. Subtalar dislocation

    Over a period of three years we have seen nine patients with subtalar dislocation, all of whom sustained violent trauma to the region of the ankle and hind foot. All but one patient were males. Clinically a subtalar dislocation resembles a complicated fracture dislocation of the ankle but a definitive diagnosis can only be made radiographically. The mechanism of injury and radiographic features of this injury are discussed. (orig.)

  8. Subtalar dislocation

    El-Khoury, G.Y.; Yousefzadeh, D.K.; Mulligan, G.M.; Moore, T.E.

    1982-05-01

    Over a period of three years we have seen nine patients with subtalar dislocation, all of whom sustained violent trauma to the region of the ankle and hind foot. All but one patient were males. Clinically a subtalar dislocation resembles a complicated fracture dislocation of the ankle but a definitive diagnosis can only be made radiographically. The mechanism of injury and radiographic features of this injury are discussed.

  9. 膝部急性隐匿性骨损伤的MRI评价%Evaluation of acute occult bone injuries of the knee with MRI

    郑少锐; 李润根

    2011-01-01

    Objective : To evaluate MRI in the diagnosis of acute occult bone injury of the knee. Methods : The MR images of 113 patients mct the criteria acute occuit bone injuries of knee. Mink's knee occult bone injury classification was used for the study. Results : Of the 113 patients.there were bone contusion (71 cases) ,bone cartilage injury (25 cases) and occult fracture ( 15 cases) , stress fracture ( 2 cases). MRI manifestations of these injuries varied , yet the signal characteristics were more consistent and were better shown on T1 WI and STIR. Conclusion: MRI is superior to radiography and CT in the diagnosis of acute occult bone injury of knee,which is a reliable technique in clinical practice.%目的:评价MRI对膝部急性隐匿性骨损伤的诊断价值.方法:回顾性分析113例符合纳入条件的急性膝部创伤患者的MRI图像,采用Mink膝部隐匿性骨损伤分类方法进行观察.结果:骨挫伤71例,骨软骨损伤25例,隐匿骨折15例,应力骨折2例.这些损伤的MRI表现形态各异,信号特点较为一致,以T1WI和STIR显示较好.结论:MRI在膝部急性隐匿性骨损伤检查中,较X线、CT检查具有明显优势和可靠的临床应用价值.

  10. Are radiographs needed when MR imaging is performed for non-acute knee symptoms in patients younger than 45 years of age?

    Braak, Bert P.M. ter; Vincken, Patrice W.J.; Erkel, Arian R. van; Bloem, Johan L. [Leiden University Medical Center, Department of Radiology, P.O. Box 9600, Leiden (Netherlands); Bloem, Rolf M. [Leiden University Medical Center, Department of Orthopaedic Surgery, Leiden (Netherlands); Napoleon, L.J.; Coene, M.N. [HAGA Hospital, Department of Orthopaedic Surgery, The Hague (Netherlands); Luijt, Peter A. van [Leiden University Medical Center, Department of Traumatology, Leiden (Netherlands); Lange, Sam de [Medical Center Haaglanden, Department of Orthopaedic Surgery, The Hague (Netherlands); Department of Orthopaedic Surgery, Delft (Netherlands)

    2007-12-15

    The objective was to determine the value of radiographs in young adults with non-acute knee symptoms who are scheduled for magnetic resonance imaging (MRI). Nine hundred and sixty-one consecutive patients aged between 16 and 45 years with knee symptoms of at least 4 weeks' duration were prospectively included in three participating hospitals. After applying exclusion criteria, 798 patients remained. Exclusion criteria were previous knee surgery (including arthroscopy) or MRI, history of rheumatoid arthritis, clinical diagnosis of retropatellar chondromalacia, contra-indication for MRI and recent trauma. We identified two groups: group A with no history of trauma (n = 332), and group B with an old (>4 weeks) history of trauma (n = 466). Patients had a standardized history taken, and underwent a physical exam, antero-posterior (AP) and lateral radiographs and MRI. We evaluated the radiographs and MRI for osseous lesions, articular surface lesions, fractures, osteoarthritis, loose bodies, bone marrow edema and incidental findings. Subsequently, patients with osseous abnormalities (Kellgren grade 1 and 2 excluded) on radiographs and a matched control group was evaluated again using MRI without radiographs. Median duration of symptoms was 20 weeks. In group A, radiographs showed 36 osseous abnormalities in 332 patients (10.8%). Only 13 of these, all Kellgren grade 1 osteoarthritis, were not confirmed on MRI. MRI showed 72 (21.7%) additional abnormalities not confirmed on radiographs. In group B, radiographs showed 40 osseous abnormalities (8.6%) in 466 patients. Only 15 of these, all Kellgren grade 1 osteoarthritis, were not confirmed on MRI. MRI showed 194 (41.6%) additional abnormalities not confirmed on radiographs. The second evaluation of MRI without radiographs in 34 patients was identical to the first MRI evaluation. Common lesions were significantly more often diagnosed with MRI than with radiographs. Radiographs should not be obtained routinely when MRI is

  11. Isolated Proximal Tibiofibular Dislocation during Soccer

    Casey Chiu

    2015-01-01

    Full Text Available Proximal tibiofibular dislocations are rarely encountered in the Emergency Department (ED. We present a case involving a man presenting to the ED with left knee pain after making a sharp left turn on the soccer field. His physical exam was only remarkable for tenderness over the lateral fibular head. His X-rays showed subtle abnormalities of the tibiofibular joint. The dislocation was reduced and the patient was discharged from the ED with orthopedic follow-up.

  12. Knee pain

    ... the bones of the knee Infection in the knee joint Injuries and overuse Bursitis . Inflammation from repeated pressure ... felt on the inside or outside of the knee joint. Strain or sprain . Minor injuries to the ligaments ...

  13. Effect of knee joint icing on knee extension strength and knee pain early after total knee arthroplasty: a randomized cross-over study

    Holm, Bente; Husted, Henrik; Kehlet, Henrik;

    2012-01-01

    Objective: To investigate the acute effect of knee joint icing on knee extension strength and knee pain in patients shortly after total knee arthroplasty.Design: A prospective, single-blinded, randomized, cross-over study.Setting: A fast-track orthopaedic arthroplasty unit at a university hospital.......Participants: Twenty patients (mean age 66 years; 10 women) scheduled for primary unilateral total knee arthroplasty.Interventions: The patients were treated on two days (day 7 and day 10) postoperatively. On one day they received 30 minutes of knee icing (active treatment) and on the other day they received 30...... minutes of elbow icing (control treatment). The order of treatments was randomized.Main outcome measures: Maximal knee extension strength (primary outcome), knee pain at rest and knee pain during the maximal knee extensions were measured 2-5 minutes before and 2-5 minutes after both treatments by an...

  14. Overuse Knee Injuries in Athletes

    Miroslav Kezunović

    2013-01-01

    According to many statistics over 55% of all sports-related injuries are incurred in the knee joint (active sportsmen and recreationists). The statistics definitely differ, depending on type of sport and specific movements habitually performed in a particular sport. Therefore, in addition to acute knee injuries overuse syndromes are common in the knee area also due to specificities of patellofemoral joint just because specific diseases like „jumper's knee“ and „runner's knee“ are related to c...

  15. Atlantoaxial dislocation

    Vijendra K Jain

    2012-01-01

    Full Text Available Atlanto-axial dislocations (AADs may be classified into four varieties depending upon the direction and plane of the dislocation i.e. anteroposterior, rotatory, central, and mixed dislocations. However, from the surgical point of view these are divided into two categories i.e. reducible (RAADs and irreducible (IAADs. Posterior fusion is the treatment of choice for RAAD. Transarticular screw fixation with sub-laminar wiring is the most stable& method of posterior fusion. Often, IAAD is due to inadequate extension in dynamic X-ray study which may also be due to spasm of muscles. If the anatomy at the occipito-atlanto-axial region {O-C1-C2; O: occiput, C1: atlas, C2: axis} is normal on X-ray, the dislocation should be reducible. In case congenital anomalies at O-C1-C2 and IAAD are seen on flexion/extension studies of the cervical spine, the C1-C2 joints should be seen in computerized tomography scan (CT. If the C1-C2 joint facet surfaces are normal, the AAD should be reducible by cervical traction or during surgery by mobilizing the joints. The entity termed "dolichoodontoid" does not exist. It is invariably C2-C3 (C3- third cervical vertebra fusion which gives an appearance of dolichoodontoid on plain X-ray or on mid-saggital section of magnetic resonance imaging (MRI or CT scan. The central dislocation and axial invagination should not be confused with basilar invagination. Transoral odontoidectomy alone is never sufficient in cases of congenital IAAD, adequate generous three-dimensional decompression while protecting the underlying neural structures should be achieved. Chronic post-traumatic IAAD are usually Type II odontoid fractures which get malunited or nonunited with pseudoarthrosis in dislocated position. All these dislocations can be reduced by transoral removal of the offending bone, callous and fibrous tissue.

  16. A COMPARATIVE STUDY BETWEEN THE EFFICACY OF NMES AND QUADRICEPS ISOMETRIC EXERCISES VERSUS TENS AND QUADRICEPS ISOMETRIC EXERCISES IN PATIENTS SUFFERING FROM ACUTE KNEE OSTEOARTHRITIS

    Shivakumar

    2014-04-01

    Full Text Available BACKGROUND AND OBJECTIVES: Knee osteoarthritis (OA is a painful and degenerative joint disease, the pain, joint stiffness associated with this condition have a dramatic impact on physical mobility and function. This study was done to assess the effectiveness of NMES and Quadriceps isometric exercises versus TENS and Quadriceps isometric exercises in patients suffering from acute Knee Osteoarthritis. METHODS: All the subjects were clinically diagnosed by orthopaedician with acute knee osteoarthritis were screened after finding their suitability as per the inclusion and exclusion criteria and were requested to participate in the study. Participants in the study were briefed about the nature of the study and their intervention. After briefing them about the study, their informed written consent was taken. 60 Acute knee osteoarthritis patients were randomly divided into two groups with n= 30 each group, Group A- received Neuromuscular electrical stimulation (NMES and Quadriceps isometric exercises, where Group B- received Transcutaneous electrical nerve stimulation and Quadriceps isometric exercises. The treatment was given 5 days a week. The total treatment duration was for 4 weeks. OUTCOME MEASURES: The patients were evaluated at the beginning of the intervention program, and again at the beginning of treatment of day1, day 15 and 4th week. All the patients were requested to come for a follow up measurement after 4 week of treatment program. All the patients were assessed for pain and functional outcome by taking their VAS and WOMAC score. RESULTS: Group A which received Neuromuscular electrical stimulation (NMES and Quadriceps isometric exercises showed great improvements from baseline to 4th week on pain intensity and functional outcome assessed using VAS and WOMAC respectively. Group B showed slight improvements from baseline to 4th week till the treatment was given to them but showed mild reduction of pain and improve functional outcome after

  17. The epidemiology of shoulder dislocations in Oslo

    Liavaag, S; Svenningsen, S; Reikerås, O.; Enger, M; Fjalestad, T; Pripp, A H; Brox, J I

    2011-01-01

    There are few previous studies on the incidence of shoulder dislocation in the general population. The aim of the study was to report the incidence of acute shoulder dislocations in the capital of Norway (Oslo) in 2009. Patients of all ages living in Oslo, sustaining a dislocation of the glenohumeral joint, were identified using electronic diagnosis registers, patient protocols, radiological registers of the hospitals, and the Norwegian Patient Register (NPR). The overall incidence rate was 5...

  18. Acute Effects of Foot Rotation in Healthy Adults during Running on Knee Moments and Lateral-Medial Shear Force.

    Valenzuela, Kevin A; Lynn, Scott K; Noffal, Guillermo J; Brown, Lee E

    2016-03-01

    As runners age, the likelihood of developing osteoarthritis (OA) significantly increases as 10% of people 55+ have symptomatic knee OA while 70% of people 65+ have radiographic signs of knee OA. The lateral-medial shear force (LMF) and knee adduction moment (KAM) during gait have been associated with cartilage loading which can lead to OA. Foot rotation during gait has been shown to alter the LMF and KAM, however it has not been investigated in running. The purpose of this study was to investigate changes in the KAM and LMF with foot rotation during running. Twenty participants volunteered and performed five running trials in three randomized conditions (normal foot position [NORM], external rotation [EXT], and internal rotation [INT]) at a running speed of 3.35m·s(-1) on a 20 meter runway. Kinematic and kinetic data were gathered using a 9-camera motion capture system and a force plate, respectively. Repeated measures ANOVAs determined differences between conditions. The KAM and LMF were lower in both EXT and INT conditions compared to the NORM, but there were no differences between EXT and INT conditions. The decreases in KAM and LMF in the EXT condition were expected and concur with past research in other activities. The reductions in the INT condition were unexpected and contradict the literature. This may indicate that participants are making mechanical compensations at other joints to reduce the KAM and LMF in this abnormal internal foot rotation condition. Key pointsExternal rotation of the foot during running reduced the loads on the medial compartment of the kneeInternal rotation of the foot also reduced the medial loads, but is a more unnatural interventionExternal and internal rotation reduced the shear forces on the knee, which may help slow the degeneration of knee joint cartilage. PMID:26957926

  19. A COMPARATIVE STUDY ON THE EFFECTIVENESS OF DICLOFENAC SODIUM PHONOPHORESIS WITH EXERCISES VERSUS TOPICAL DICLOFENAC SODIUM WITH EXERCISES IN ACUTE OSTEOARTHRITIS OF KNEE

    Sharath

    2014-07-01

    Full Text Available BACKGROUND AND OBJECTIVES: Osteoarthritis is a most common cause of Knee pain. The pain and discomfort associated with this condition have a dramatic impact on physical mobility and function. This study was done to assess the effectiveness of Diclofenac sodium phonophoresis with exercise versus Topical Diclofenac Sodium application with exercise in patients with acute osteoarthritis of knee. METHODS: All the subjects clinically diagnosed by orthopedician with acute osteoarthritis of knee were screened after finding their suitability as per the inclusion and exclusion criteria and were requested to participate in the study. Participants in the study were briefed about the nature of the study and their intervention. After briefing them about the study, their informed written consent was taken. 60 osteoarthritis knee patients were randomly divided into two groups with n= 30 each group, Group 1- received diclofenac sodium phonophoresis over medial aspects of the knee joint in supine position with the dosage of 1.5Watt/cm2 at 1 MHz for 5 min per session followed by supervised exercises prescribed as 3 sets a day with 10 repetitions in each set for a period of 10 consecutive days, where Group 2- received topical diclofenac sodium Gel [4g] application to the affected knee, 4 times daily [29], followed by supervised exercises taught and prescribed as 3 sets a day with 10 repetitions in each set. OUTCOME MEASURES: The patients were evaluated at the beginning of the intervention program i.e. day 1, day 5 and day 10. All the patients were requested to come for a follow up after 1 week of treatment program and were evaluated. All the patients were assessed for pain and physical function by taking their VAS and WOMAC respectively. RESULTS: Both group A and group B showed statistically significant improvements in pain experienced as assessed by VAS and in the assessment of WOMAC. Group A had a mean ± SD of 7.67±1.15 on Day 1 which decreased to 2.13± 0

  20. The Effect of Gabapentin on Acute Postoperative Pain in Patients Undergoing Total Knee Arthroplasty: A Meta-Analysis.

    Zhai, Lifeng; Song, Zhoufeng; Liu, Kang

    2016-05-01

    The purpose of this systematic review and meta-analysis of randomized controlled trials (RCTs) and non-RCTs was to evaluate the efficacy and safety of gabapentin versus placebo for pain control after total knee arthroplasty (TKA).In December 2015, a systematic computer-based search was conducted in the Medline, Embase, PubMed, Cochrane Controlled Trials Register (CENTRAL), Web of Science, Google, and Chinese Wanfang databases. This systematic review and meta-analysis were performed according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement criteria. The primary endpoint was the visual analogue scale (VAS) score after TKA with rest or mobilization at 24 and 48 hours, representing the efficacy of pain control after TKA. Cumulative morphine consumption via patient controlled anesthesia (PCA) was also assessed to determine the morphine-spare effect. Complications such as dizziness, pruritus, vomiting, nausea, and sedation were also compiled to assess the safety of gabapentin. Stata 12.0 software was used for the meta-analysis. After testing for publication bias and heterogeneity across studies, the data were aggregated for random-effects modeling whenever necessary.Six studies involving 769 patients met the inclusion criteria. Our meta-analysis revealed that gabapentin resulted in superior pain relief compared to the control group in terms of VAS score with rest at 24 hours (mean difference [MD] = -3.47; 95% confidence interval [CI] -6.16 to -0.77; P = 0.012) and at 48 hours postoperatively (MD = -2.25; 95% CI -4.21 to -0.30; P = 0.024). There was no statistically significant difference between the groups with respect to the VAS score at 24 hours postoperatively (MD = 1.05; 95% CI -3.31 to 5.42; P = 0.636) or at 48 hours (MD = 1.71; 95% CI -0.74 to 4.15; P = 0.171). These results indicated that the perioperative administration of gabapentin decreases the cumulative morphine

  1. Congenital dislocation of the patella – clinical case☆

    Miguel Sá, Pedro; Raposo, Filipa; Santos Carvalho, Manuel; Alegrete, Nuno; Coutinho, Jorge; Costa, Gilberto

    2015-01-01

    Congenital patellar dislocation is a rare condition in which the patella is permanently dislocated and cannot be reduced manually. The patella develops normally as a sesamoid bone of the femur. This congenital dislocation results from failure of the internal rotation of the myotome that forms the femur, quadriceps muscle and extensor apparatus. It usually manifests immediately after birth, although in some rare cases, the diagnosis may be delayed until adolescence or adulthood. Early diagnosis is important, thereby allowing surgical correction and avoiding late sequelae, including early degenerative changes in the knee. A case of permanent dislocation of the patella is presented here, in a female child aged seven years. PMID:26962496

  2. O ultra-som na artropatia hemofílica subaguda do joelho Ultrasound in knee sub-acute hemophilic arthropathy

    Luiz Mario Bellegard

    2006-01-01

    Full Text Available São apresentados 4 casos de Artropatia Hemofílica Subaguda de Joelho em seus aspectos clínicos, radiográficos e ultra-sonográficos. A radiografia tem alterações discretas nas fases iniciais da Artropatia Hemofílica (AH. São enfatizados os aspectos do ultra-som, que proporcionou imagem direta da membrana sinovial no recesso capsular anterior do joelho. Discutimos a possibilidade de utilização da ultra-sonografia como marcador de atividade inflamatória.Here we present 4 cases of Knee Sub-Acute Hemophilic Arthropathy according to clinical, X-ray and ultrasound aspects. The X-ray images show subtle changes in the early phases of Hemophilic Arthropathy (HA. Ultrasound aspects are emphasized, which provided direct image of the synovial membrane at the knee anterior capsular recess. We discuss the potential ultrasound use as a marker of inflammatory activity.

  3. Bilateral anterior shoulder dislocation

    Meena, Sanjay; Saini, Pramod; Singh, Vivek; Kumar, Ramakant; Trikha, Vivek

    2013-01-01

    Shoulder dislocations are the most common major joint dislocations encountered in the emergency departments. Bilateral shoulder dislocations are rare and of these, bilateral posterior shoulder dislocations are more prevalent than bilateral anterior shoulder dislocations. Bilateral anterior shoulder dislocation is very rare. We present a case of 24-year-old male who sustained bilateral anterior shoulder dislocation following minor trauma, with associated greater tuberosity fracture on one side...

  4. Knee Problems

    ... in Chinese 繁體中文 ) What Are Knee Problems? (in Korean 한국어 ) What Are Knee Problems? (in Vietnamese bằng ... the knee. Ultrasound. A technique that uses sound waves to produce images of the soft tissue structures ...

  5. Acute spontaneous atraumatic bilateral anterior dislocation of the shoulder joint with Hill-Sachs lesions: first reported case and review of literature

    Manoharan, Gopikanthan; Singh, Rohit; Ahmed, Bessam; Kathuria, Vinod

    2014-01-01

    The anatomy of the shoulder joint comprises a relatively large humeral head with a shallow glenoid cavity allowing a remarkable range of motion at the expense of inherent instability. Despite anterior shoulder dislocations being the most common type encountered, bilateral dislocations are rare and almost always posterior. The aetiology is usually direct or indirect trauma related to sports, seizures, electric shock or electroconvulsive therapy. We present the first reported case of atraumatic...

  6. Five-year follow-up of knee joint cartilage thickness changes after acute anterior cruciate ligament rupture

    Eckstein, F; Wirth, W; Lohmander, Stefan;

    2015-01-01

    focus. Maximal subregional cartilage thickness loss (OV1) and gain (OV16), independent of its specific location in individual knees, was the secondary analytic focus. Results: Overall femorotibial cartilage thickness increased by 31 micrometers per year over 5 years [95% confidence interval 18...... cartilage loss (OV1) and thickening (OV16) were both significantly greater (p<0.001) during the earlier than during the later interval (-115 vs. -54 [OV1], and +116 vs. +69 micrometers [OV16]). Conclusion: Cartilage thickening was observed over five years following ACL injury, particularly in the medial...

  7. Medial subtalar dislocation: Case report

    Manojlović Radovan

    2010-01-01

    Full Text Available Introduction. Subtalar dislocation (SI is a term that refers to an injury in which there is dislocation of the talonavicular and talocalcanear joint, although the tibiotalar joint is intact. Case Outline. A case of medial subtalar dislocation as a result of basketball injury, so-called 'basketball foot', is presented. Closed reposition in i.v. anaesthesia was performed with the patient in supine position and a knee flexed at 90 degrees. Longitudinal manual traction in line of deformity was carried out in plantar flexion. The reposition continued with abduction and eversion simultaneously increasing dorsiflexion. It was made in the first attempt and completed instantly. Rehabilitation was initiated after 5 weeks of immobilization. One year after the injury, the functional outcome was excellent with full range of motion and the patient was symptom-free. For better interpretation of roentgenogram, bone model of subtalar dislocation was made using the cadaver bone. Conclusion. Although the treatment of such injury is usually successful, diagnosis can be difficult because it is a rare injury, and moreover, X-ray of the injury can be confusing due to superposition of bones. Radiograms revealed superposition of the calcaneus, tarsal and metatarsal bones which was radiographically visualized in the anterior-posterior projection as one osseous block inward from the talus, and on the lateral view as in an osteal block below the tibial bone. Prompt recognition of these injuries followed by proper, delicately closed reduction under anaesthesia is crucial for achieving a good functional result in case of medial subtalar dislocation.

  8. Acute Postexercise Time Course Responses of Hypertrophic vs. Power-Endurance Squat Exercise Protocols on Maximal and Rapid Torque of the Knee Extensors.

    Conchola, Eric C; Thiele, Ryan M; Palmer, Ty B; Smith, Doug B; Thompson, Brennan J

    2015-05-01

    The aim of this study was to examine the effects of a medium-intensity high-volume vs. explosive squat protocol on the postexercise time course responses of maximal and rapid strength of the knee extensors. Seventeen resistance-trained men (mean ± SD: age = 22.0 ± 2.6 years) performed maximal voluntary contractions (MVCs) of the knee extensors before and after performing a squat workout using either a low-intensity fast velocity (LIFV) (5 × 16 at 40% 1 repetition maximum) or a traditional high-intensity slow velocity (TISV) (5 × 8 at 80% 1RM) exercise protocol. For each MVC, peak torque (PT), peak rate of torque development (RTDpeak), absolute (RTDabs), and relative RTD (RTDnorm) at early (0-50 milliseconds) and late (100-200 milliseconds) phases of muscle contraction were examined at pre- (Pre) and post-exercise at 0, 7, 15, and 30 (Post0...30) minutes. There were no intensity × time interactions for any variables (p = 0.098-0.832). Peak torque was greater at Pre than Post0 and Post7 (p = 0.001-0.016) but was not greater than Post15 and Post30 (p = 0.010-0.189). RTDpeak and early absolute RTD (RTD50abs) were greater at Pre than all postexercise time phases (p = 0.001-0.050); however, later absolute RTD (RTD100-200abs) was only greater at Pre than Post0 and Post30 (p = 0.013-0.048). Early relative RTD (RTD50norm) was only higher at Pre compared with Post0 (p = 0.023), whereas no differences were observed for later relative RTD (RTD100-200norm) (p = 0.920-0.990). Low-intensity fast velocity and TISV squat protocols both yielded acute decreases in maximal and rapid strength capacities following free-weight squats, with rapid strength showing slower recovery characteristics than maximal strength. PMID:25774625

  9. Patellar dislocation with genu valgum treated by DFO.

    Kwon, Jae Ho; Kim, Jong In; Seo, Dong-Hyun; Kang, Kyung-Woon; Nam, Ji Ho; Nha, Kyung-Wook

    2013-06-01

    Congenital habitual patellar dislocation is a rare condition of the knee where the patella dislocates during flexion and relocates during extension. The congenital form is permanent, irreducible, and presents at birth. It is characterized by a short quadriceps and a major patellofemoral dysplasia and short height. This article presents a rare case of a 27-year-old woman with recurring bilateral habitual dislocation of the patella after a failed previous proximal and distal realignment procedure. Clinical examinations of both knees revealed genu valgus knees and lateral joint pain that recurred after several previous operations. Radiographs of both knees showed patellar dislocation and genu valgum associated with patellofemoral dysplasia and osteoarthritis of the lateral compartment. Long-leg standing radiographs showed an anatomic tibiofemoral angle of right 13° and left 6° valgus and a mechanical tibiofemoral angle of right 8° and left 2° valgus and weight-bearing line of 65% on the right and 48% on the left. The authors performed a distal femoral closing wedging osteotomy to correct the valgus deformity, and then percutaneous lateral release and medial reefing were performed to stabilize the patellas of both knees simultaneously. PMID:23746026

  10. In-game Management of Common Joint Dislocations

    Skelley, Nathan W.; McCormick, Jeremy J; Smith, Matthew V.

    2014-01-01

    Context: Sideline management of sports-related joint dislocations often places the treating medical professional in a challenging position. These injuries frequently require prompt evaluation, diagnosis, reduction, and postreduction management before they can be evaluated at a medical facility. Our objective is to review the mechanism, evaluation, reduction, and postreduction management of sports-related dislocations to the shoulder, elbow, finger, knee, patella, and ankle joints. Evidence Ac...

  11. Dislocation of the proximal tibiofibular joint

    Milankov Miroslav

    2013-01-01

    Full Text Available Introduction. Dislocation of the proximal tibiofibular joint is a rare injury. It occurs during a sports activity that includes rough twisting movements of the bent knee. The role of the proximal tibiofibular joint is to reduce torsional loads to the ankle, to distribute the bending moment of the outer side of tibia, and transfer the vertical load while standing. In the literature there is no larger series; only several cases of the proximal tibiofibular joint dislocation treated by different methods have been published so far. Case Report. A 23-year-old male soccer player sustained an injury after he had joined the game without previous warming-up. He fell on his right side because of a sudden change of direction while his foot was fixed to the base. He felt a severe pain and had a sensation as if something had snapped in his right knee. Pain and swelling at the head of fibula were found by physical examination, which, however, did not reveal any pain, swelling and instability of the ankle or peroneal nerve palsy. The x-ray showed anterolateral dislocation of the proximal tibiofibular joint, Ogden type II. Since manual reposition in general anesthesia failed, open reduction internal fixation was performed and proximal tibiofibular joint was transfixed with a screw. After the wound closure, the above-the-knee plaster cast was applied. The screw was extracted six weeks later, full weight bearing was allowed and he started with physical therapy. Four months after the injury he returned to sports activities. On the follow- up one year after the injury he had the full range of motion of the knee, no complains, and continued with active soccer playing. X-ray showed no signs of arthrosis of the proximal tibiofibular joint. Conclusion. The proximal tibiofibular joint dislocation may be the cause of the chronic pain of the knee so it has to be taken into account when making differential diagnosis in case of the pain at the lateral side of the knee. The

  12. Anterior knee pain

    Anterior knee pain is a common complain in all ages athletes. It may be caused by a large variety of injuries. There is a continuum of diagnoses and most of the disorders are closely related. Repeated minor trauma and overuse play an important role for the development of lesions in Hoffa's pad, extensor mechanism, lateral and medial restrain structures or cartilage surface, however usually an increase or change of activity is referred. Although the direct relation of cartilage lesions, especially chondral, and pain is a subject of debate these lesions may be responsible of early osteoarthrosis and can determine athlete's prognosis. The anatomy and biomechanics of patellofemoral joint is complex and symptoms are often unspecific. Transient patellar dislocation has MR distinct features that provide evidence of prior dislocation and rules our complication. However, anterior knee pain more often is related to overuse and repeated minor trauma. Patella and quadriceps tendon have been also implicated in anterior knee pain, as well as lateral or medial restraint structures and Hoffa's pad. US and MR are excellent tools for the diagnosis of superficial tendons, the advantage of MR is that permits to rule out other sources of intraarticular derangements. Due to the complex anatomy and biomechanic of patellofemoral joint maltracking is not fully understood; plain films and CT allow the study of malalignment, new CT and MR kinematic studies have promising results but further studies are needed. Our purpose here is to describe how imaging techniques can be helpful in precisely defining the origin of the patient's complaint and thus improve understanding and management of these injuries

  13. [A woman with a locked knee].

    Boersma, A R; van Raay, J J A M

    2015-01-01

    A 25-year-old female presented with locking of the left knee after an assertiveness training. The MRI scan showed a bucket-handle tear of the medial meniscus. The medial meniscus was dislocated into the intercondylar fossa, in which the image of a second posterior cruciate ligament (PCL) was simulated. This is also called a 'double PCL sign'. PMID:26959734

  14. Imaging features of traumatic dislocation of the lumbosacral joint associated with disc herniation

    Tohme-Noun, C.; Krainik, A.; Menu, Y. [Department of Radiology, Hopital Beaujon, AP HP, Universite Paris 7, Faculte de Medecine Bichat-Beaujon, Paris (France); Rillardon, L.; Guigui, P. [Department of Orthopedic Surgery, Hopital Beaujon, AP HP, Universite Paris 7, Faculte de Medecine Bichat-Beaujon, Paris (France); Feydy, A. [Department of Radiology, Hopital Beaujon, AP HP, Universite Paris 7, Faculte de Medecine Bichat-Beaujon, Paris (France); Department of Radiology, Hopital Beaujon, 100 avenue du General Leclerc, 92118, Clichy (France)

    2003-06-01

    Bilateral facet dislocation of the lumbosacral joint is an uncommon injury. We report on the imaging findings in a patient who had an acute disc herniation associated with a bilateral traumatic lumbosacral dislocation. (orig.)

  15. Imaging features of traumatic dislocation of the lumbosacral joint associated with disc herniation

    Bilateral facet dislocation of the lumbosacral joint is an uncommon injury. We report on the imaging findings in a patient who had an acute disc herniation associated with a bilateral traumatic lumbosacral dislocation. (orig.)

  16. Spontaneous osteonecrosis of the knee

    Spontaneous osteonecrosis of the knee presents with acute onset of severe, pain in elderly patients, usually female and usually without a history of trauma. Originally described as idiopathic osteonecrosis, the exact etiology is still debated. Evidence suggests that an acute fracture occurs as a result of chronic stress or minor trauma to a weakened subchondral bone plate. The imaging characteristics on MR reflect the age of the lesion and the symptoms. More appropriate terminology may be ' subchondral insufficiency fracture of the knee' or 'focal subchondral osteonecrosis'

  17. Spontaneous osteonecrosis of the knee

    Kattapuram, Taj M. [Department of Radiology, Massachusetts General Hospital (United States); Kattapuram, Susan V. [Department of Radiology, Massachusetts General Hospital (United States)], E-mail: skattapuram@partners.org

    2008-07-15

    Spontaneous osteonecrosis of the knee presents with acute onset of severe, pain in elderly patients, usually female and usually without a history of trauma. Originally described as idiopathic osteonecrosis, the exact etiology is still debated. Evidence suggests that an acute fracture occurs as a result of chronic stress or minor trauma to a weakened subchondral bone plate. The imaging characteristics on MR reflect the age of the lesion and the symptoms. More appropriate terminology may be ' subchondral insufficiency fracture of the knee' or 'focal subchondral osteonecrosis'.

  18. Tratamento artroscópico da luxação acromioclavicular aguda com âncoras Arthroscopic treatment of acute acromioclavicular joint dislocation using suture anchors

    Leonardo Muntada Cavinatto

    2011-01-01

    Full Text Available OBJETIVO: Apresentar os resultados clínicos e radiográficos de uma série de casos com diagnóstico de Luxação Acromioclavicular (LAC Aguda, tratados através da fixação coracoclavicular com âncoras por via artroscópica. MÉTODO: Vinte pacientes apresentando LAC com menos de 30 dias de evolução foram operados pela técnica da estabilização coracoclavicular com âncoras por via artroscópica. Duas âncoras metálicas com dois fios cada, foram inseridas no coracóide. Os fios foram amarrados sobre a clavícula passando por túneis transósseos claviculares. Para a avaliação radiográfica, foi utilizada a medida comparativa da distância coracoclavicular com o lado contralateral e a avaliação funcional através dos escores de Constant e UCLA o seguimento foi de seis meses. RESULTADO: Dos vinte casos inicialmente selecionados, seis necessitaram de novo procedimento cirúrgico e foram excluídos do estudo. Dos quatorze pacientes restantes, apenas dois mantiveram redução da articulação acromioclavicular, enquanto os demais apresentaram algum grau de desvio no decorrer da evolução. Desconsiderando os pacientes excluídos, os escores de Constant e UCLA tiveram média 94,79 (82-100 e, 32,64 (26-35, respectivamente. CONCLUSÃO: A técnica apresentou um alto índice de perda da redução ao longo da evolução de seis meses. A avaliação funcional apresentou resultado satisfatório com escore médio elevado de Evidência: Nível de Evidência: Nível III, estudo retrospectivo.OBJECTIVE: To present the clinical and radiographic results of a case series of patients with acute acromioclavicular dislocation (AAD treated by arthroscopic coracoclavicular fixation with suture anchors. METHOD: Twenty patients with AAD with less than 30 days since the injury were submitted to a coracoclavicular stabilization procedure using 2 suture anchors placed at the base of the coracoid process. Each suture anchor was connected to 2 strands of No.2

  19. Knee arthroscopy

    ... remove it. Torn or damaged anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL) Torn or damaged ... in the knee Blood clot in the leg Injury to a blood vessel or nerve Infection in ...

  20. Knee Injuries and Disorders

    Your knee joint is made up of bone, cartilage, ligaments and fluid. Muscles and tendons help the knee joint move. When any of these structures is hurt or diseased, you have knee problems. Knee problems can cause pain and difficulty ...

  1. Imaging patellar complications after knee arthroplasty

    Melloni, Pietro [Unitat de Imatge d' Alta Tecnologia, Centre Diagnostic, Corporacio Parc Tauli, Universitat Autonoma de Barcelona, Sabadell (Barcelona) (Spain)], E-mail: pmelloni@cspt.es; Valls, Rafael; Veintemillas, Maite [Unitat de Imatge d' Alta Tecnologia, Centre Diagnostic, Corporacio Parc Tauli, Universitat Autonoma de Barcelona, Sabadell (Barcelona) (Spain)

    2008-03-15

    The purpose of this study is to describe complications affecting the patella in patients with total or partial knee arthroplasty. We respectively analysed plain-film radiographs, as well as ultrasound images when acquired, in a consecutive series of 1272 patients. The mean interval from knee replacement to patellar complications was 5 years and 7 months (range, 5 months to 14 years). The complications described include fracture, instability, dislocation or luxation, necrosis of the patella, infection of the patella, erosion of the patella, patellar impingement on the prosthesis and patellar or quadricipital tendon tear. We discuss the pathological imaging findings in the patella and their differential diagnosis after knee arthroplasty. Patellar complications after knee arthroplasty are uncommon but often potentially serious.

  2. Dislocated shoulder - aftercare

    Shoulder dislocation - aftercare; Shoulder subluxation - aftercare; Shoulder reduction - aftercare ... Horn AE, Ufberg JW. Management of common dislocations. In: ... Extremity 6th ed. Philadelphia, PA: ElsevierMosby; 2011:chap 92.

  3. Dislocated shoulder - aftercare

    Shoulder dislocation - aftercare; Shoulder subluxation - aftercare; Shoulder reduction - aftercare ... You most likely dislocated your shoulder from a sports injury or accident, such as a fall. You have likely injured (stretched or torn) some of the muscles, ...

  4. Use of radiographic projections of knee

    Cockshott, W.P.; Burrows, D.A.; Ferrier, M.; Racoveanu, N.T.

    1985-02-01

    A study to determine the routine radiography practice for the investigation of acute trauma cases and those with suspected arthritis of the knee was carried out by questionnaires sent to radiologists in 41 countries. The role of radiology in the investigation of chondromalacia patellae was also ascertained. Some of the reasons for the diversities of practice are discussed. The necessity for further views of the knee to supplement the two standard projections was assessed for various diagnostic entities. It became clear that if occult fractures were not to be missed, patients with knee effusions following acute trauma required additional views if a lesion was not shown by the anteroposterior (AP) and lateral views. In contrast, two views of the knee sufficed for examination of most entities affecting the knee.

  5. Traumatic Elbow Dislocations

    Iordens, Gijs

    2014-01-01

    markdownabstractThe elbow is the second most common major joint to dislocate after the shoulder in the adult population. Its stability is highly dependent on a complex interaction between bony articulations, capsuloligamentous structures and dynamic muscle restraints. Dislocations are traditionally classified by the presence (complex dislocations) or absence (simple dislocations) of associated fractures and by the direction of the displacement of the forearm relative to the humerus. The gener...

  6. The SIGN nail for knee fusion: technique and clinical results

    Anderson Duane Ray

    2016-01-01

    Full Text Available Purpose: Evaluate the efficacy of using the SIGN nail for instrumented knee fusion. Methods: Six consecutive patients (seven knees, three males with an average age of 30.5 years (range, 18–50 years underwent a knee arthrodesis with SIGN nail (mean follow-up 10.7 months; range, 8–14 months. Diagnoses included tuberculosis (two knees, congenital knee dislocation in two knees (one patient, bacterial septic arthritis (one knee, malunited spontaneous fusion (one knee, and severe gout with 90° flexion contracture (one knee. The nail was inserted through an anteromedial entry point on the femur and full weightbearing was permitted immediately. Results: All knees had clinical and radiographic evidence of fusion at final follow-up and none required further surgery. Four of six patients ambulated without assistive device, and all patients reported improved overall physical function. There were no post-operative complications. Conclusion: The technique described utilizing the SIGN nail is both safe and effective for knee arthrodesis and useful for austere environments with limited fluoroscopy and implant options.

  7. Dor lateral no joelho do atleta: um raro caso de luxação do tendão do bíceps femoral Lateral pain in an athlete's knee: a rare case of dislocation of the femoral biceps tendon

    Aires Duarte Junior

    2012-01-01

    Full Text Available A luxação do tendão do bíceps femoral é uma condição rara, descrita na literatura clinicamente com uma dor lateral do joelho e inicialmente relatada como uma inserção anômala da cabeça longa do bíceps femoral. Depois se verificou que a causa é uma mobilidade anormal do tendão sobre a proeminência da cabeça da fíbula em determinados ângulos de flexão do joelho. O objetivo deste relato de caso raro é descrever e discutir sobre o quadro de dor lateral no joelho num atleta de natação que iniciou a subluxação do bíceps femoral durante a prática esportiva, que o incapacitava de realizar provas e torneios. O caso é discutido frente à literatura levantada, à provável etiologia traumática de repetição que levou a essa condição, além do tratamento cirúrgico que foi realizado, obtendo excelente resultado e retorno a prática esportiva habitual.Dislocation of the femoral biceps tendon is rare and is described clinically in the literature as a lateral pain in the knee. It was initially reported as an anomalous insertion of the long head of the femoral biceps. Subsequently, it was found to be caused by abnormal mobility of the tendon over the prominence of the fibu lar head at certain angles of knee flexion. The objective of the present report was to describe and discuss a condition of lateral knee pain in a swimmer who started to present subluxation of the femoral biceps during sports practice, which incapacitated him from taking part in trials and competitions. The case is dis cussed in the light of the literature surveyed; the likelihood that the etiology for the trauma leading to this condition was repeti tion; and the surgical treatment instituted, which led to excellent results and the patient's return to his habitual sports practice.

  8. Human aggrecanase generated synovial fluid fragment levels are elevated directly after knee injuries due to proteolysis both in the inter globular and chondroitin sulfate domains

    Struglics, A; Hansson, M; Lohmander, Stefan

    2011-01-01

    To examine different aggrecanase generated fragments in synovial fluid (SF) from patients with acute and chronic knee injuries and from knee healthy subjects.......To examine different aggrecanase generated fragments in synovial fluid (SF) from patients with acute and chronic knee injuries and from knee healthy subjects....

  9. The gauge theory of dislocations: A nonuniformly moving screw dislocation

    Lazar, Markus, E-mail: lazar@fkp.tu-darmstadt.d [Emmy Noether Research Group, Department of Physics, Darmstadt University of Technology, Hochschulstr. 6, D-64289 Darmstadt (Germany); Department of Physics, Michigan Technological University, Houghton, MI 49931 (United States)

    2010-07-05

    We investigate the nonuniform motion of a straight screw dislocation in infinite media in the framework of the translational gauge theory of dislocations. The equations of motion are derived for an arbitrarily moving screw dislocation. The fields of the elastic velocity, elastic distortion, dislocation density and dislocation current surrounding the arbitrarily moving screw dislocation are derived explicitly in the form of integral representations. We calculate the radiation fields and the fields depending on the dislocation velocities.

  10. Dislocation of the fibular head in an unusual sports injury: a case report

    Ahmad Riaz

    2008-05-01

    Full Text Available Abstract Introduction One of the primary functions of the proximal tibiofibular joint is slight rotation to accommodate rotational stress at the ankle. Proximal tibiofibular joint dislocation is a rare injury and accounts for less than 1% of all knee injuries. This dislocation has been reported in patients who had been engaged in football, ballet dancing, equestrian jumping, parachuting and snowboarding. Case presentation A 20-year-old man was injured whilst playing football. He felt a pop in the right knee and was subsequently unable to bear weight on it. The range of movement in his knee joint was limited. Anterior-posterior and lateral X-rays of the knee revealed anterolateral dislocation of the proximal tibiofibular joint. Comparison views confirmed the anterolateral dislocation. He had a failed manipulation under anaesthesia and the joint needed an open reduction in which the fibular head was levered back into place. Operative findings revealed a horizontal type of joint. Conclusion An exceedingly rare dislocation of a horizontal type of proximal tibiofibular joint was presented following a football injury. This dislocation was irreducible by a closed method.

  11. Dislocation Formation in Alloys

    Minami, Akihiko; Onuki, Akira

    2006-05-01

    An interaction between dislocations and phase transitions is studied by a phase field model both in two and three dimensional systems. Our theory is a simple extension of the traditional linear elastic theory, and the elastic energy is a periodic function of local strains which is reflecting the periodicity of crystals. We find that the dislocations are spontaneously formed by quenching. Dislocations are formed from the interface of binary alloys, and slips are preferentially gliding into the soft metals. In three dimensional systems, formation of dislocations under applied strain is studied in two phase state. We find that the dislocation loops are created from the surface of hard metals. We also studied the phase separation above the coexisting temperature which is called as the Cottrell atmosphere. Clouds of metals cannot catch up with the motion of dislocations at highly strained state.

  12. Dislocation-dynamics method

    Dislocation-Dynamics (DD) technique is identified as the method able to model the evolution of material plastic properties as a function of the microstructural transformation predicted at the atomic scale. Indeed, it is the only simulation method capable of taking into account the collective behaviour of a large number of dislocations inside a realistic microstructure. DD simulations are based on the elastic dislocation theory following rules inherent to the dislocation core structure often call 'local rules'. All the data necessary to establish the local rules for DD have to come directly from experiment or alternatively from simulations carried out at the atomic scale such as molecular dynamics or ab initio calculations. However, no precise information on the interaction between two dislocations or between dislocations and defects induced by irradiation are available for nuclear fuels. Therefore, in this article the DD technique will be presented and some examples are given of what can be achieved with it. (author)

  13. Collective behavior of dislocations

    Deformation of a crystal involves the motion of dislocations. Since dislocations interact, a short range and at long range, it is basic to understanding plasticity to establish if dislocations move singly or collectively. If deformation involves the collective motion of dislocations how does it manifest itself or equivalently how can it be measured? While a variety of techniques measure the positions of single dislocations before and after a stress is applied to a crystal, giving an average dislocation velocity, these techniques do not related directly to what happens during deformation, that is the collective behavior of dislocations. The mobile dislocation density is measured as follows: Lead-10% indium crystals are deformed at 4.2K, while in a magnetic field in the range Hc1 c2 where Hc1 is the lower critical field, H the applied field and Hc2 the upper critical field. During deformation changes n the flux are observed; the changes in flux are proportional to the mobile dislocation density. These changes in flux show the following characteristics: When the deformation process changes from elastic to plastic deformation there is a pronounced increase in flux noise, well above the background noise level. In addition superposed on this noise are pronounced bursts of magnetic flux, corresponding to dislocation bursts or avalanches of dislocations. A number of checks establish that these pulses are solely related to dislocations. These include the fact that they are not reproducible in terms of time from test to test, ruling out systematic instabilities in the circuit. Also, they occur when the crystal is unloaded and then reloaded at times, after plasticity is reinitiated, which are inconsistent with any time constant of the circuit. Finally, the measuring circuit shows no instabilities or ringing in this frequency range

  14. Homogenization of dislocation dynamics

    In this paper we consider the dynamics of dislocations with the same Burgers vector, contained in the same glide plane, and moving in a material with periodic obstacles. We study two cases: i) the particular case of parallel straight dislocations and ii) the general case of curved dislocations. In each case, we perform rigorously the homogenization of the dynamics and predict the corresponding effective macroscopic elasto-visco-plastic flow rule.

  15. Homogenization of dislocation dynamics

    El Hajj, Ahmad; Ibrahim, Hassan; Monneau, Regis, E-mail: elhajj@cermics.enpc.fr, E-mail: ibrahim@cermics.enpc.fr, E-mail: monneau@cermics.enpc.fr [CERMICS, ENPC, 6 and 8 avenue Blaise Pascal, Cite Descartes, Champs sur Marne, 77455 Marne-la-Valle Cedex 2 (France)

    2009-07-15

    In this paper we consider the dynamics of dislocations with the same Burgers vector, contained in the same glide plane, and moving in a material with periodic obstacles. We study two cases: i) the particular case of parallel straight dislocations and ii) the general case of curved dislocations. In each case, we perform rigorously the homogenization of the dynamics and predict the corresponding effective macroscopic elasto-visco-plastic flow rule.

  16. Unique aspects of downhill ski injuries part 2: diagnosis and acute management of specific injuries.

    Buck, P G; Sophocles, A M; Beckenbaugh, R D

    1982-04-01

    As in many sports, a wide spectrum of injuries is seen in skiing (Table 1). This includes injuries to the upper and lower extremities as well as miscellaneous injuries and medical problems (frostbite, hypothermia, and high altitude effects). Six relatively unique injuries in skiing will be presented in detail. The discussion will focus on the acute management of these injuries: subluxing peroneal tendons, fibular stress fractures, tibial shaft fractures (spiral, transverse), medical compartment knee injuries, anterior shoulder dislocations with associated greater tuberosity fractures, and gamekeeper's thumb. PMID:24822536

  17. Do normal hips dislocate?

    Alshameeri, Zeiad; Rehm, Andreas

    2014-11-01

    There have been a small number of case reports describing late normal-hip dislocations in children who were later diagnosed with developmental dysplasia of the hip. Here, we contest the assumption that normal hips can dislocate. We argue that (as in our case) the ultrasound scans in all published case reports on late dislocated normal hips did not show results that were entirely normal and therefore, so far, there has been no convincing evidence of a dislocation of a normal hip. We also want to highlight the importance of meticulous ultrasound and clinical assessments of high-risk children by an experienced orthopaedic surgeon. PMID:25144883

  18. Bilateral recurrent discloation of the patella associated with below knee amputation: A case report

    Lenka Prasanna

    2005-02-01

    Full Text Available Abstract Background Recurrent dislocation of the patella in patients with below knee amputation is a known entity. Abnormally high-riding patella (patella alta and medial patellofemoral ligament insufficiency in these patients predisposes them to patellar instability. The established treatment of this problem is surgical realignment. Case presentation A 25 year old male patient with bilateral below knee amputation presented with bilateral recurrent dislocation of the patella while walking on knees on uneven ground. Clinical and radiographic studies showed patella alta. A simple shoe modification was used to treat this patient. Conclusions A simple shoe modification can be used to treat such a condition which is otherwise treated surgically.

  19. 手术治疗急性无骨折脱位型颈髓损伤的回顾性分析%Retrospective analysis of treatment of acute cervical spinal cord injury without fracture and dislocation by surgery

    祁文; 唐晓菊; 刘汝专; 潘汉升

    2011-01-01

    [目的] 分析前路和后路内固定治疗急性无骨折脱位型颈髓损伤的临床治疗效果.[方法]对56例急性无骨折脱位型颈髓损伤的患者进行颈椎前路减压、植骨及颈椎前路带锁钢板内固定术或后路减压侧块钢板螺钉内固定术.术后定期X线片观察损伤节段的稳定性和融合情况以及有无内置物并发症,以JOA评分判定脊髓功能恢复情况.[结果]56例获得随访,时间13 ~48个月.平均26个月.56例患者均损伤节段稳定,植骨愈合良好,无内置物并发症,脊髓功能JOA评分平均提高5.78分,取得满意疗效;前路术式与后路术式在改善脊髓功能方面无明显差异(P>0.05).[结论]颈椎前路和后路术式治疗无骨折脱位型颈髓损伤,能使损伤节段获得即刻、坚强的稳定,解除颈髓压迫,为颈髓功能的恢复提供了有利条件.%[Objective] To observe the results of the treatment of acute cervical spinal cord injury without fracture and dislocation by the anterior plate internal fixation the posterior lateral mass plate fixation. [ Method ] Fifty-six cases of acute cervical spinal cord injury without fracture and dislocation were treated by anterior decompression,bone graft,and cervical spine plate fixation, or posterior extensive laminectomy decompression and lateral mass plate fixation. The stability and fusion of the injured segments and the complications of the hardware were observed on the X-ray film postoperatively. The function of the spinal cord was evaluated with JOA scores. [ Result] Fifty-six cases were followed up from 13 to 48 months (average 26 months). The injured segments were stable, the bone grafting fused completely, and the complications of the hardware were not observed. The function of the spinal cord improved by 5. 78 scores. The clinical outcomes were excellent. There were not difference on improving spinal cord function between the anterior plate internal fixation and the posterior lateral mass

  20. Knee pain (image)

    ... front of the knee can be due to bursitis, arthritis, or softening of the patella cartilage as ... knee. Overall knee pain can be due to bursitis, arthritis, tears in the ligaments, osteoarthritis of the ...

  1. Anterior knee pain

    Patellofemoral syndrome; Chondromalacia patella; Runner's knee; Patellar tendinitis; Jumper's knee ... or playing soccer). You have flat feet. Anterior knee pain is more ... skiers, bicyclists, and soccer players who exercise often ...

  2. Knee arthroscopy - discharge

    ... this page: //medlineplus.gov/ency/patientinstructions/000199.htm Knee arthroscopy - discharge To use the sharing features on ... had surgery to check for problems in your knee (knee arthroscopy). You may have been checked for: ...

  3. Knee microfracture surgery

    Cartilage regeneration - knee ... Three types of anesthesia may be used for knee arthroscopy surgery: Medicine to relax you, and shots of painkillers to numb the knee Spinal (regional) anesthesia General anesthesia (you will be ...

  4. Multiple-ligament injured knee

    SUN Lei; NING Zhi-jie; ZHANG Hui; TIAN Min; NING Tin-min

    2006-01-01

    Objective: To explore the clinical characteristic of the multiple-ligament injured knee and evaluate the protocol,technique and outcome of treatment for the multipleligament injured knee.Methods: From October 2001 to March 2005, 9 knees with combined anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) tears in 9 patients were identified with clinical and arthroscopic examinations. Of them, 5 knees were combined with ruptures of posteromedial corner (PMC) and medial collateral ligament (MCL), 4 with disruptions of posterolateral corner ( PLC), 2 with popliteal vascular injuries and 1 with peroneal nerve injuries. Six patients were hospitalized in acute phase of trauma, 2 received repairs of popliteal artery and 4 had repairs of PMC and MCL. Reconstructions of ACL and PCL with autografts under arthroscope were performed in all patients at 4 to 10 weeks after trauma,including reconstruction of PLC with the posterior half of biceps femoris tendon tenodesis in 4 patients and reconstructions of PMC and MCL with femoral fascia in 1 patient.Results: No severe complications occurred at early stage after operation in the 9 patients. All of them were followed up for 10-39 months with an average of 23. 00 months ± 9.46 months. Lysholm score was 70-95 with an average of 85.00 ± 8.29. International Knee Documentation Committee (IKDC) score was from severely abnormal (Grade D) in 9 knees at initial examination to normal (Grade A) in 2 knees, nearly normal (Grade B ) in 6 knees and abnormal in 1 knee at the last follow-up. Of the 9 patients, 7 returned to the same activity level before injury and 2 were under the level.Conclusions: The multiple-ligament injured knee with severe instability is usually combined with other important structure damages. Therefore, careful assessment and treatment of the combined injuries are essential. Reconstructions of ACL and PCL under arthroscope, combined with repairs or reconstructions of the extraarticular ligaments

  5. Traumatic Elbow Dislocations

    G.I.T. Iordens (Gijs)

    2014-01-01

    markdownabstractThe elbow is the second most common major joint to dislocate after the shoulder in the adult population. Its stability is highly dependent on a complex interaction between bony articulations, capsuloligamentous structures and dynamic muscle restraints. Dislocations are traditionally

  6. Dislocations in yttrium orthovanadate

    Eakins, D. E.; LeBret, J. B.; Norton, M. G.; Bahr, D. F.

    2004-06-01

    Dislocation structures in single crystals of yttrium orthovanadate have been identified by transmission electron microscopy. Electron diffraction was used to predict possible Burgers vectors for the dislocations. Results suggest vectors of the type {1}/{2}[1 1 1] or {1}/{4}[0 2 1] . Arguments for the likelihood of each possible vector have been presented.

  7. Recurrent dislocation of the patella accompanying hypotrochlea of the femur and malalignment of the patella

    Horikawa, Akira; Kodama, Hiroyuki; Miyakoshi, Naohisa; Yamada, Shin; Miyamoto, Seiya

    2011-01-01

    This case report describes a rare case of recurrent dislocation of the patella which was accompanied with trochlear dysplasia and malalignment of the patella in a 15-year-old girl. She complained of hemoarthrosis and recurrent patellar dislocation in the early knee flexion phase. Plain radiography and computed tomography (CT) showed patellar malalignment (quadriceps angle 20°) and severe dysplasia of the trochlea of the femur (sulcus angle 170°). Surgery was performed, consisting of trochleop...

  8. A Combined Procedure For Irreducible Dislocation Of Patella In Children With Ligamentous Laxity: A Preliminary Report

    Inan, Muharrem; Sarikaya, Ilker; Seker, Ali; Beng, Kubilay

    2015-01-01

    Objectives: Irreducible patellar dislocation accompanying ligamentous laxity is rarely seen in pediatric patients. Most common complaints due to this condition are inability to walk, delayed walking and difficulties with orthotics. The purpose of this retrospective study is to describe a novel surgical technique to treat dislocated patella in patients with symptomatic ligamentous laxity. Patients and Methods: Fourteen knees of nine patients operated by a single surgeon between 2009-2012 were ...

  9. Patella Dislocation with Vertical Axis Rotation: The “Dorsal Fin” Patella

    Gamble, David; Carrothers, Andrew D.; Khanduja, Vikas

    2015-01-01

    A 44-year-old woman presented following minor trauma to her right knee. While dancing she externally rotated around a planted foot and felt sudden pain in her right knee. She presented with her knee locked in extension with a “dorsal fin” appearance of the soft tissues tented over the patella. This was diagnosed as a rare case of an intraarticular patella dislocation, which was rotated 90 degrees about the vertical axis. Closed reduction in the emergency room was unsuccessful but was achieved in theatre under general anaesthetic with muscle relaxation. Postreduction arthroscopy demonstrated that no osteochondral or soft tissue damage to the knee had been sustained. In patients presenting with a knee locked in extension with tenting of skin over the patella (the “dorsal fin” appearance), intra-articular patella dislocation should be suspected. Attempts to reduce vertical patella dislocations under sedation with excessive force or repeatedly without success should be avoided to prevent unnecessary damage to the patellofemoral joint. In this clinical situation we recommend closed reduction under general anaesthetic followed by immediate knee arthroscopy under the same anaesthetic to ensure that there is no chondral damage to the patella or femoral trochlea and to rule out an osteochondral fracture. PMID:25883819

  10. Patella Dislocation with Vertical Axis Rotation: The “Dorsal Fin” Patella

    David Gamble

    2015-01-01

    Full Text Available A 44-year-old woman presented following minor trauma to her right knee. While dancing she externally rotated around a planted foot and felt sudden pain in her right knee. She presented with her knee locked in extension with a “dorsal fin” appearance of the soft tissues tented over the patella. This was diagnosed as a rare case of an intraarticular patella dislocation, which was rotated 90 degrees about the vertical axis. Closed reduction in the emergency room was unsuccessful but was achieved in theatre under general anaesthetic with muscle relaxation. Postreduction arthroscopy demonstrated that no osteochondral or soft tissue damage to the knee had been sustained. In patients presenting with a knee locked in extension with tenting of skin over the patella (the “dorsal fin” appearance, intra-articular patella dislocation should be suspected. Attempts to reduce vertical patella dislocations under sedation with excessive force or repeatedly without success should be avoided to prevent unnecessary damage to the patellofemoral joint. In this clinical situation we recommend closed reduction under general anaesthetic followed by immediate knee arthroscopy under the same anaesthetic to ensure that there is no chondral damage to the patella or femoral trochlea and to rule out an osteochondral fracture.

  11. Luxatio erecta: Inferior glenohumeral dislocation

    Baba Asif; Bhat Javid; Paljor S; Mir Naseer; Majid Suhail

    2007-01-01

    Inferior dislocation of the shoulder, also called luxatio erecta, is a rare form of the otherwise common shoulder dislocation. It accounts for less than 0.5% of all shoulder dislocations. A case involving the inferior dislocation of the shoulder is reported. A brief review of the presentation and management of the condition is described.

  12. Luxatio erecta: Inferior glenohumeral dislocation

    Baba Asif

    2007-01-01

    Full Text Available Inferior dislocation of the shoulder, also called luxatio erecta, is a rare form of the otherwise common shoulder dislocation. It accounts for less than 0.5% of all shoulder dislocations. A case involving the inferior dislocation of the shoulder is reported. A brief review of the presentation and management of the condition is described.

  13. GPU accelerated dislocation dynamics

    Ferroni, Francesco; Tarleton, Edmund; Fitzgerald, Steven

    2014-09-01

    In this paper we analyze the computational bottlenecks in discrete dislocation dynamics modeling (associated with segment-segment interactions as well as the treatment of free surfaces), discuss the parallelization and optimization strategies, and demonstrate the effectiveness of Graphical Processing Unit (GPU) computation in accelerating dislocation dynamics simulations and expanding their scope. Individual algorithmic benchmark tests as well as an example large simulation of a thin film are presented.

  14. Dynamic posterior stabilization of shoulder hemiarthroplasty in long-standing neglected posterior dislocation of the glenohumeral joint

    Shyam Kumar A; Oakley Jeremy; Wootton Jamie

    2008-01-01

    Posterior dislocations of the shoulder are rare. They account for less than 3% of all shoulder dislocations. The treatment of neglected bilateral posterior dislocation of the shoulder is controversial. We present a novel operative technique to stabilize a shoulder hemiarthroplasty that we used in the treatment of a chronic posterior dislocation of a shoulder with an acute four-part fracture of the proximal humerus.

  15. Dynamic posterior stabilization of shoulder hemiarthroplasty in long-standing neglected posterior dislocation of the glenohumeral joint

    Shyam Kumar A

    2008-01-01

    Full Text Available Posterior dislocations of the shoulder are rare. They account for less than 3% of all shoulder dislocations. The treatment of neglected bilateral posterior dislocation of the shoulder is controversial. We present a novel operative technique to stabilize a shoulder hemiarthroplasty that we used in the treatment of a chronic posterior dislocation of a shoulder with an acute four-part fracture of the proximal humerus.

  16. Statistical characterization of dislocation ensembles

    El-Azab, A; Deng, J; Tang, M

    2006-05-17

    We outline a method to study the spatial and orientation statistics of dynamical dislocation systems by modeling the dislocations as a stochastic fiber process. Statistical measures have been introduced for the density, velocity, and flux of dislocations, and the connection between these measures and the dislocation state and plastic distortion rate in the crystal is explained. A dislocation dynamics simulation model has been used to extract numerical data to study the evolution of these statistical measures numerically in a body-centered cubic crystal under deformation. The orientation distribution of the dislocation density, velocity and dislocation flux, as well as the dislocation correlations have been computed. The importance of the statistical measures introduced here in building continuum models of dislocation systems is highlighted.

  17. Dislocation Dynamics During Plastic Deformation

    Messerschmidt, Ulrich

    2010-01-01

    The book gives an overview of the dynamic behavior of dislocations and its relation to plastic deformation. It introduces the general properties of dislocations and treats the dislocation dynamics in some detail. Finally, examples are described of the processes in different classes of materials, i.e. semiconductors, ceramics, metals, intermetallic materials, and quasicrystals. The processes are illustrated by many electron micrographs of dislocations under stress and by video clips taken during in situ straining experiments in a high-voltage electron microscope showing moving dislocations. Thus, the users of the book also obtain an immediate impression and understanding of dislocation dynamics.

  18. Intraoperative Low-Dose Ketamine Infusion Reduces Acute Postoperative Pain Following Total Knee Replacement Surgery: A Prospective, Randomized Double-Blind Placebo-Controlled Trial

    Objective: To evaluate the effect of intraoperative low-dose ketamine with general anesthesia on postoperative pain after total knee replacement surgery. Study Design: A randomized, double-blind comparative study. Place and Duration of Study: Ankara Numune Training and Research Hospital, Turkey, from January and June 2011. Methodology: Sixty adults undergoing total knee arthroplasty were enrolled in this study. The patients were randomly allocated into two groups of equal size to receive either racemic ketamine infusion (6.25 g/kg/minute) or the same volume of saline. A visual analogue scale (VAS) was used to measure each patient's level of pain at 1, 3, 6, 12, and 24 hours after surgery. Time to first analgesic request, postoperative morphine consumption and the incidence of side effects were also recorded. Results: Low-dose ketamine infusion prolonged the time to first analgesic request. It also reduced postoperative cumulative morphine consumption at 1, 3, 6, 12, and 24 hours postsurgery (p < 0.001). Postoperative VAS scores were also significantly lower in the ketamine group than placebo, at all observation times. Incidences of side effects were similar in both study groups. Conclusion: Intraoperative continuous low-dose ketamine infusion reduced pain and postoperative analgesic consumption without affecting the incidence of side effects. (author)

  19. POSTERIOR STERNOCLAVICULAR JOINT DISLOCATION IN A DIVISION I FOOTBALL PLAYER: A CASE REPORT

    Cruz, Mario F.; Erdeljac, Joe; Williams, Richard(Institut für Theoretische Physik, Justus-Liebig–Universität Giessen, 35392 Giessen, Germany); Brown, Mike; Bolgla, Lori

    2015-01-01

    Posterior dislocation of the sterno‐clavicular (SC) joint is a rare injury in athletes. It normally occurs in high collision sports such as American football or rugby. Acute posterior dislocations of the SC joint can be life‐threatening as the posteriorly displaced clavicle can cause damage to vital vascular and respiratory structures such as the aortic arch, the carotid and subclavian arteries, and the trachea. The potential severity of a posterior SC joint dislocation provides multiple chal...

  20. Dislocation-dislocation and dislocation-twin reactions in nanocrystalline Al by molecular-dynamics simulation.

    Yamakov, V.; Wolf, D.; Phillpot, S. R.; Gleiter, H.; Materials Science Division; Forschungszentrum Karlsruhe

    2003-08-15

    We use massively parallel molecular dynamics simulations of polycrystal plasticity to elucidate the intricate dislocation dynamics that evolves during the process of deformation of columnar nanocrystalline Al microstructures of grain size between 30 and 100 nm. We analyze in detail the mechanisms of dislocation-dislocation and dislocation-twin boundary reactions that take place under sufficiently high stress. These reactions are shown to lead to the formation of complex twin networks, i.e. structures of coherent twin boundaries connected by stair-rod dislocations. Consistent with recent experimental observations, these twin networks may cause dislocation pile-ups and thus give rise to strain hardening.

  1. Loss of knee-extension strength is related to knee swelling after total knee arthroplasty

    Holm, Bente; Kristensen, Morten T; Bencke, Jesper;

    2010-01-01

    To examine whether changes in knee-extension strength and functional performance are related to knee swelling after total knee arthroplasty (TKA).......To examine whether changes in knee-extension strength and functional performance are related to knee swelling after total knee arthroplasty (TKA)....

  2. Total Knee Replacement

    ... following total knee replacement include unlimited walking, swimming, golf, driving, light hiking, biking, ballroom dancing, and other ... to the final success of your surgery. To learn more about the full value of total knee ...

  3. Osteotomy of the knee

    ... is not affected unless you have had a knee injury in the past. Osteotomy surgery works by shifting ... M. Editorial team. Related MedlinePlus Health Topics Arthritis Knee Injuries and Disorders Browse the Encyclopedia A.D.A. ...

  4. Knee MRI scan

    Abnormal results may be due to a sprain or tear of the ligaments in the knee area. Abnormal results may also be due to: Arthritis of the knee Avascular necrosis (also called osteonecrosis) Bone tumor or cancer Broken bone ...

  5. Partial knee replacement - slideshow

    ... page: //medlineplus.gov/ency/presentations/100225.htm Partial knee replacement - series To use the sharing features on ... A.M. Editorial team. Related MedlinePlus Health Topics Knee Replacement A.D.A.M., Inc. is accredited ...

  6. Knee braces - unloading

    ... most people talk about the arthritis in their knees, they are referring to a type of arthritis ... is caused by wear and tear inside your knee joints. Cartilage, the firm, rubbery tissue that cushions ...

  7. Knee joint replacement - slideshow

    ... this page: //medlineplus.gov/ency/presentations/100088.htm Knee joint replacement - series To use the sharing features ... 4 out of 4 Normal anatomy Overview The knee is a complex joint. It contains the distal ...

  8. Knee arthroscopy - slideshow

    ... this page: //medlineplus.gov/ency/presentations/100117.htm Knee arthroscopy - series To use the sharing features on ... 5 out of 5 Normal anatomy Overview The knee is a complex joint made up of the ...

  9. Supersonic Dislocation Bursts in Silicon

    Hahn, E. N.; Zhao, S.; Bringa, E. M.; Meyers, M. A.

    2016-06-01

    Dislocations are the primary agents of permanent deformation in crystalline solids. Since the theoretical prediction of supersonic dislocations over half a century ago, there is a dearth of experimental evidence supporting their existence. Here we use non-equilibrium molecular dynamics simulations of shocked silicon to reveal transient supersonic partial dislocation motion at approximately 15 km/s, faster than any previous in-silico observation. Homogeneous dislocation nucleation occurs near the shock front and supersonic dislocation motion lasts just fractions of picoseconds before the dislocations catch the shock front and decelerate back to the elastic wave speed. Applying a modified analytical equation for dislocation evolution we successfully predict a dislocation density of 1.5 × 1012 cm‑2 within the shocked volume, in agreement with the present simulations and realistic in regards to prior and on-going recovery experiments in silicon.

  10. Posterior knee pain

    English, S.; Perret, D.

    2010-01-01

    Posterior knee pain is a common patient complaint. There are broad differential diagnoses of posterior knee pain ranging from common causes such as injury to the musculotendinous structures to less common causes such as osteochondroma. A precise understanding of knee anatomy, the physical examination, and of the differential diagnosis is needed to accurately evaluate and treat posterior knee pain. This article provides a review of the anatomy and important aspects of the history and physical ...

  11. Bicompartmental knee arthroplasty

    Sabatini, Luigi; Giachino, Matteo; Risitano, Salvatore; Atzori, Francesco

    2016-01-01

    Total knee arthroplasty (TKA) is the most worldwide practiced surgery for knee osteoarthritis and its efficacy is mightily described by literature. Concerns about the invasiveness of TKA let the introduction of segmental resurfacing of the joint for younger patients with localized osteoarthritis. Bone stock sparing and ligaments preservation are the essence of both unicompartmental knee arthroplasty (UKA) and bicompartmental knee arthroplasty (BKA). Advantages related to BKA are the respect o...

  12. Acute patellofemoral instability in children and adolescents

    ANTINOLFI, PIERLUIGI; BARTOLI, MATTEO; PLACELLA, GIACOMO; SPEZIALI, ANDREA; PACE, VALERIO; DELCOGLIANO, MARCO; MAZZOLA, CLAUDIO

    2016-01-01

    Patellofemoral problems are considered to be among the most frequent causes of knee pain in children and adolescents. Correcting bone abnormalities through specific and targeted interventions is mandatory in skeletally immature patients. Medial patellofemoral ligament (MPFL) reconstruction is the preferred procedure, but there are several important precautionary considerations that the surgeon must take into account. It must always be remembered that MPFL rupture is the result, not the cause, of an altered extensor mechanism; therefore, patellar stabilization with MPFL reconstruction is only the first step to be accomplished in the management of an MPFL rupture. If other anatomical alterations are encountered, alternative/additional surgical procedures should be considered. If MPFL rupture occurs without associated anatomical or functional knee alterations, an appropriate rehabilitation program after MPFL reconstruction should be sufficient to achieve a good outcome. In conclusion, an acute patellar dislocation should be managed conservatively unless there is evidence of osteochondral damage or medial retinaculum lesions. Osseous procedures are contraindicated in children, while MPFL anatomical reconstruction with “physeal sparing” is the primary surgical option. PMID:27386447

  13. Knee joint replacement

    Knee joint replacement is a surgery to replace a knee joint with a man-made joint. The artificial joint is called a prosthesis . ... cartilage and bone are removed from the knee joint. Man-made pieces are then placed in the ...

  14. Actinomycosis of the Knee

    Yusof, Mohd Imran; Yusof, Abdul Halim; Salleh, Md Salzihan Md; HARUN, Azian

    2005-01-01

    We report a case of actinomycosis presenting as a knee swelling in a 34 year-old man. Knee actinomycosis poses a diagnosis challenge to clinicians as it is rare, often mimics knee tuberculosis and culture of the causative microbes is technically difficult. The classic microscopic appearance of this Gram-positive bacteria often forms the basis of diagnosis.

  15. Knee CT scan

    A computed tomography (CT) scan of the knee is a test that uses x-rays to take detailed images of the knee. ... A CT scan can quickly create more detailed pictures of the knee than standard x-rays. The test may be ...

  16. The treatment of the acute acromioclavicular joint dislocation with LARS artificial ligament:a preliminary report%应用LARS人工韧带治疗急性肩锁关节脱位的初步报告

    陈爱民; 鹿楠; 叶添文; 杨鹏; 朱磊; 李菁

    2014-01-01

    Background Currently,the clinical perspectives of surgical treatment for Tossy Ⅲacromioclavicular(AC)joint dislocations are relatively identical.Due to the post-traumatic ruptures of the acromioclavicular ligament and coracoclavicular(CC)ligament which are used to maintain stability of the joint,the clavicle moves backward and upward,and the upper arm and the scapula drops downward for the gravity of the upper arm and the influence of the sternocleidomastoid muscle.Since such complications as reduction difficulties,redislocation after external fixation,pressure ulcers of the skin,and so forth are particularly prone to occur in the conservative therapy,the operative treatment is more inclined to be adopted for the Tossy Ⅲ dislocation of the AC joint.With the single repair and fixation of the CC ligament,redislocation is likely to happen after implant removal because the ruptured ligaments healed as scar tissue.Therefore,this study uses an operative method of reconstructing and augmenting the CC ligament with LARS artificial ligament for the treatment of Tossy Ⅲ AC joint dislocation,and evaluates its clinical effect.Methods From November 2006 to July 2009,8 patients with acute AC joint dislocation of Tossy Ⅲ were admitted into our hospital.Five patients were male and 3 were female,and their ages ranged from 21 to 45.Sides:3 injuries were on the left and 5 were on the right.Seven patients suffered from falling on the ground,and 1 patient was inj ured in a traffic accident.All the patients were treated with LARS artificial ligaments to reconstruct the CC ligament.Constant score and VAS score were adopted in clinical evaluation.Zanca view of the bilateral AC joint and the axillary radiograph of the affected shoulder joint were employed for imaging evaluation.All the patients were simple Tossy Ⅲ dislocation of AC joint with no trauma of other parts and skin breakdown.Regular pre-operative examinations and evaluations were carried out after admission,and LARS

  17. Finite strain discrete dislocation plasticity

    Deshpande, VS; Needleman, A; Van der Giessen, E

    2003-01-01

    A framework for carrying out finite deformation discrete dislocation plasticity calculations is presented. The discrete dislocations are presumed to be adequately represented by the singular linear elastic fields so that the large deformations near dislocation cores are not modeled. The finite defor

  18. Behavior of dislocations in silicon

    Sumino, Koji [Nippon Steel Corp., Chiba Prefecture (Japan)

    1995-08-01

    A review is given of dynamic behavior of dislocations in silicon on the basis of works of the author`s group. Topics taken up are generation, motion and multiplication of dislocations as affected by oxygen impurities and immobilization of dislocations due to impurity reaction.

  19. 关节镜下四骨道双束固定治疗急性肩锁关节Rockwood Ⅴ型脱位%Arthroscopic fixation in the treatment of Rockwood Ⅴ acute acromioclavicular joint dislocation

    陆伟; 王大平; 朱伟民; 欧阳侃; 柳海峰; 彭亮权; 李皓; 冯文哲

    2014-01-01

    Background Treatment methods for acromioclavicular joint dislocation of Rockwood type V are numerous.The commonly used is the open surgery with large trauma (by clavicular hook plate fixation).In recent years,some scholars use clavicle-coracoid screws fixation method under arthroscopy,but the screws need to be removed after 6 weeks; there are also scholars using arthroscopic double Endobutton loops single bundle fixation method with good effect,but they found suture rupture between the Endobutton,redislocation or fracture,bone absorption under the loops in some patients. This article investigates the method of arthroscopic procedure with four-tunnel quadruple double-bundle Endobutton double-bundle fixation via self-designed positioning apparatus in the treatment of acute acromioclavicular joint (ACJ)Rockwood Ⅴ degree dislocations and their short-term therapeutic effect.Methods (1)Patient selection:12 patients (9 male and 3 female)with acute acromioclavicular joint dislocation of Rockwood type V were selected from October 2010 to June 2013. Their average age is 28.2 years.with sports injury in 10 cases and fall injury in 2 cases.All patients received surgical repair within 2 weeks after injury.The operations were performed by the same senior surgeon.(2)Preoperative bone tunnel positioning design:All patients had CT scan in the position of 90°internal rotating of bilateral shoulder joint (palm down).Measure the angle of scapular long axis and coronal section (A)separately,make the line in the coracoid neck parallel to the long axis of scapula (S),and then measure the width of parallel line in the part of coracoid neck (P).The midpoint of the coracoid neck is the center between the two preparatively drilled bone tunnels.Make the cross line vertical to line P,and the bone tunnels are located in the I and II quadrant.The distance between two bone tunnels is 6 mm.(3 )Surgical techniques:According to the data of preoperative measurement of bone tunnel,the self

  20. Phonon-dislocation interaction

    Thermal conductivity measurements on LiF crystals in the temperature range 0.04 to 30 K have demonstrated that, throughout this range, thermal phonons interact with dislocations via a dynamic or resonant process which is highly frequency- and phonon-mode dependent. The results of earlier work are consistent with this interpretation

  1. Closed subtalar dislocation with non-displaced fractures of talus and navicular: a case report and review of the literature

    Fotiadis, Elias; Lyrtzis, Christos; Svarnas, Theodoros; Koimtzis, Miltos; Akritopoulou, Kiriaki; Chalidis, Byron

    2009-01-01

    Closed subtalar dislocations associated with talus and navicular fractures are rare injuries. We report on a case of a 43-year-old builder man with medial subtalar dislocation that was further complicated by minimally displaced talar and navicular fractures. Successful closed reduction under general anesthesia was followed by non-weight bearing and ankle immobilization with a below-knee cast for 6 ;weeks. At 3 years post-injury, the subtalar joint was stable, the foot and ankle mobility was i...

  2. Magnetic Resonance of the Knee

    Magnetic Resonance Imaging (MRI) has been applied to muscoloskeletal pathoanatomy and has proved to be useful in the detection and characterization of knees and 8 normal knees were examined. The images were obtained in the Diagnostic Centre RMRC of Naples on a 0.5 T superconductive magnetic system, using a surface coil and a spin-echo pulse sequence (SE 600/28 ms). The examined limb was immobilized and bent at 8-10 grade, extrarotated for the examination of the anterior cruciate ligament (ACL) only. Images were obtained on a 256x256 matrix and had a 2 or 4-mm thickness. MRI cleary showed all the anatomical structures. The anterior and posterior cruciate ligaments (ACL and PAL) and tha patellar ligament were shown by sagittal SE images through the intercondylar notch; the tibial and fibular collateral ligaments (TCL and FCL) were evaluated on coronal SE images; the articular capsula and menisci on axial transverse SE images. Objective criteria for ACL and PCL tears were: lack of continuity of the signal and change in signal intensity; in meniscal pathology, menisci with small linear regions of increased signal or with grossly truncated shape were interpreted as tears. Preliminary results of this study indicate that MRI together with clinical evaluation may be an useful non-invasive procedure in the assessment of acute injuries of the knee

  3. Nocturnal seizure and simultaneous bilateral shoulder fracture-dislocation.

    Sahbudin, Ilfita; Filer, Andrew

    2016-01-01

    An otherwise fit and well 27-year-old man presented with acute onset unexplained bilateral shoulder pain, and was found to have bilateral shoulder fractures and dislocations on imaging. Although features were atypical, a nocturnal seizure causing the bilateral shoulder fractures was suspected and EEG showed features compatible with epilepsy. PMID:26838296

  4. Preventing knee injuries in adolescent female football players – design of a cluster randomized controlled trial [NCT00894595

    Waldén Markus; Hägglund Martin; Atroshi Isam

    2009-01-01

    Background: Knee injuries in football are common regardless of age, gender or playing level, but adolescent females seem to have the highest risk. The consequences after severe knee injury, for example anterior cruciate ligament (ACL) injury, are well-known, but less is known about knee injury prevention. We have designed a cluster randomized controlled trial (RCT) to evaluate the effect of a warm-up program aimed at preventing acute knee injury in adolescent female football. Methods: In this...

  5. Interaction of dislocation loops with dislocations studied by dislocation dynamics in α-iron

    Shi, X. J.; Dupuy, L.; Devincre, B.; Terentyev, D.; Vincent, L.

    2015-05-01

    Interstitial dislocation loops with Burgers vector of type are formed in α-iron under neutron or heavy ion irradiation. As the density and size of these loops increase with radiation dose and temperature, these defects are thought to play a key role in hardening and subsequent embrittlement of iron-based steels. The aim of the present work is to study the pinning strength of the loops on mobile dislocations. Prior to run massive Dislocation Dynamics (DD) simulations involving experimentally representative array of radiation defects and dislocations, the DD code and its parameterization are validated by comparing the individual loop-dislocation reactions with those obtained from direct atomistic Molecular Dynamics (MD) simulations. Several loop-dislocation reaction mechanisms are successfully reproduced as well as the values of the unpinning stress to detach mobile dislocations from the defects.

  6. Thermodynamically consistent continuum dislocation dynamics

    Hochrainer, Thomas

    2016-03-01

    Dislocation based modeling of plasticity is one of the central challenges at the crossover of materials science and continuum mechanics. Developing a continuum theory of dislocations requires the solution of two long standing problems: (i) to represent dislocation kinematics in terms of a reasonable number of variables and (ii) to derive averaged descriptions of the dislocation dynamics (i.e. material laws) in terms of these variables. The kinematic problem (i) was recently solved through the introduction of continuum dislocation dynamics (CDD), which provides kinematically consistent evolution equations of dislocation alignment tensors, presuming a given average dislocation velocity (Hochrainer, T., 2015, Multipole expansion of continuum dislocations dynamics in terms of alignment tensors. Philos. Mag. 95 (12), 1321-1367). In the current paper we demonstrate how a free energy formulation may be used to solve the dynamic closure problem (ii) in CDD. We do so exemplarily for the lowest order CDD variant for curved dislocations in a single slip situation. In this case, a thermodynamically consistent average dislocation velocity is found to comprise five mesoscopic shear stress contributions. For a postulated free energy expression we identify among these stress contributions a back-stress term and a line-tension term, both of which have already been postulated for CDD. A new stress contribution occurs which is missing in earlier CDD models including the statistical continuum theory of straight parallel edge dislocations (Groma, I., Csikor, F.F., Zaiser, M., 2003. Spatial correlations and higher-order gradient terms in a continuum description of dislocation dynamics. Acta Mater. 51, 1271-1281). Furthermore, two entirely new stress contributions arise from the curvature of dislocations.

  7. Posttraumatic chronic patellar dislocation treated by distal femoral osteotomy and medial patellofemoral ligament reconstruction.

    Purushothaman, Balaji; Agarwal, Amit; Dawson, Matt

    2012-11-01

    Chronic patellar dislocation is a rare condition where the patella remains dislocated throughout knee range of motion during flexion and extension. In adults, the delayed presentation of this condition is often due to symptoms caused by the onset of severe secondary osteoarthritis. To the authors' knowledge, all of the cases reported in the literature have been treated by patellofemoral or total knee replacements depending on patient age and the extent of the arthritis. This article describes a rare case of a 22-year-old woman who sustained a traumatic chronic patellar dislocation for 5 months. Clinical examination revealed a valgus deformity of the left leg secondary to childhood injury and that the patella lay lateral to the lateral femoral condyle throughout flexion and extension. Radiographs of the knee revealed patellar dislocation. Long-leg radiographs of the left leg showed an anatomic tibiofemoral angle of 17° valgus. The anatomical (74°) and mechanical (80°) lateral distal femoral angles were abnormal, whereas the medial proximal tibial angle (87°) was normal, confirming that the valgus deformity was due to the abnormal distal femur. The authors performed a distal femoral osteotomy to correct the valgus deformity. Medial patellofemoral ligament reconstruction using a hamstring autograft was performed to stabilize the patella. PMID:23127463

  8. Superior Dislocation of the Patella in a Young Woman without Osteophytes: A Case Report.

    Kataoka, Tatsunori; Iizawa, Norishige; Takai, Shinro

    2016-01-01

    Superior dislocation of the patella without patellar ligament injury is an extremely rare condition. A review of the English-language literature found only 23 reported cases. In addition, the primary factor for dislocation in most of these cases was considered to be osteophytes in the inferior pole of the patella and the anterior surface of the femoral condyle; only 1 case had no osteophytes. We treated a 19-year-old woman who sustained a painful locking of the left knee after colliding with a friend. Plain radiography and computed tomography showed superior-lateral dislocation of the patella and an interlocking between notches in the inferior pole of the patella and the anterior surface of the femoral condyle. Closed reduction without sedation was performed without difficulty, and the patient was able to walk home without pain. After 1 week, the knee was without problems. The patient had no osteophytes in the knee and had no other common risk factors, such as patella alta, ligamentous laxity, genu recurvatum, and paralytic disorders. After a comparison with previously reported cases of superior patella dislocation, we concluded that the primary factor in the present case might have been a different condition. PMID:26960585

  9. Les dislocations: textes et contextes

    Leonarduzzi, Laetitia; Herry, Nadine

    2005-01-01

    In this paper we analyse the contexts in which left and right dislocations appear. Our corpus is based on written as well as oral discourse, with texts ranging from the year 1884 to 2005. After trying to define both types of dislocation, and seeing how far the definitions can be extended, we notice that the dislocated NP is most of the time definite (90% of our examples). This phenomenon may be explained by the notions of anaphora, deixis and thematisation. Dislocations appear both in oral an...

  10. Design rules for dislocation filters

    The efficacy of strained layer threading dislocation filter structures in single crystal epitaxial layers is evaluated using numerical modeling for (001) face-centred cubic materials, such as GaAs or Si1−xGex, and (0001) hexagonal materials such as GaN. We find that threading dislocation densities decay exponentially as a function of the strain relieved, irrespective of the fraction of threading dislocations that are mobile. Reactions between threading dislocations tend to produce a population that is a balanced mixture of mobile and sessile in (001) cubic materials. In contrast, mobile threading dislocations tend to be lost very rapidly in (0001) GaN, often with little or no reduction in the immobile dislocation density. The capture radius for threading dislocation interactions is estimated to be approximately 40 nm using cross section transmission electron microscopy of dislocation filtering structures in GaAs monolithically grown on Si. We find that the minimum threading dislocation density that can be obtained in any given structure is likely to be limited by kinetic effects to approximately 104–105 cm−2

  11. Design rules for dislocation filters

    Ward, T.; Sánchez, A. M.; Beanland, R., E-mail: r.beanland@warwick.ac.uk [Department of Physics, University of Warwick, Coventry CV4 7AL (United Kingdom); Tang, M.; Wu, J.; Liu, H. [Department of Electronic and Electrical Engineering, University College London, Torrington Place, London WC1E 7JE (United Kingdom); Dunstan, D. J. [School of Physics and Astronomy, Queen Mary University of London, London E1 4NS (United Kingdom)

    2014-08-14

    The efficacy of strained layer threading dislocation filter structures in single crystal epitaxial layers is evaluated using numerical modeling for (001) face-centred cubic materials, such as GaAs or Si{sub 1−x}Ge{sub x}, and (0001) hexagonal materials such as GaN. We find that threading dislocation densities decay exponentially as a function of the strain relieved, irrespective of the fraction of threading dislocations that are mobile. Reactions between threading dislocations tend to produce a population that is a balanced mixture of mobile and sessile in (001) cubic materials. In contrast, mobile threading dislocations tend to be lost very rapidly in (0001) GaN, often with little or no reduction in the immobile dislocation density. The capture radius for threading dislocation interactions is estimated to be approximately 40 nm using cross section transmission electron microscopy of dislocation filtering structures in GaAs monolithically grown on Si. We find that the minimum threading dislocation density that can be obtained in any given structure is likely to be limited by kinetic effects to approximately 10{sup 4}–10{sup 5 }cm{sup −2}.

  12. Dislocation dynamics in nanocrystalline nickel.

    Shan, Z W; Wiezorek, J M K; Stach, E A; Follstaedt, D M; Knapp, J A; Mao, S X

    2007-03-01

    It is believed that the dynamics of dislocation processes during the deformation of nanocrystalline materials can only be visualized by computational simulations. Here we demonstrate that observations of dislocation processes during the deformation of nanocrystalline Ni with grain sizes as small as 10 nm can be achieved by using a combination of in situ tensile straining and high-resolution transmission electron microscopy. Trapped unit lattice dislocations are observed in strained grains as small as 5 nm, but subsequent relaxation leads to dislocation recombination. PMID:17359167

  13. Non-invasive interactive neurostimulation (InterX ™ reduces acute pain in patients following total knee replacement surgery: a randomised, controlled trial

    Taylor Drena M

    2011-08-01

    Full Text Available Abstract Background Adequate post-operative pain relief following total knee replacement (TKR is very important to optimal post-operative recovery. Faster mobilisation and rehabilitation ultimately results in optimum recovery outcomes, but pain is often the limiting factor. This study evaluates the potential clinical benefit of the InterX neurostimulation device on pain reduction and rehabilitative outcome. Methods A clinical trial under the Hywel Dda Clinical Audit Committee to validate the clinical benefit of Non-invasive Interactive Neurostimulation (NIN therapy using the InterX device was performed in patients undergoing TKR. 61 patients were randomised to treatment groups in blocks of two from the Theatre Operation List. The control group received the standard hospital course of pain medication and rehabilitation twice daily for 3 post-op days. The experimental group received 8 sessions of NIN therapy over 3 post-op days in addition to the standard course received by the Control group. Pain and range of motion were collected as the primary study measures. Results Sixty one subjects were enrolled and randomised, but 2 subjects (one/group were excluded due to missing data at Baseline/Final; one subject in the InterX group was excluded due to pre-existing rheumatoid pain conditions confounding the analysis. The experimental group pre- to post-session Verbal Rating Scale for pain (VRS showed that NIN therapy consistently reduced the pain scores by a mean of 2.3 points (SE 0.11. The NIN pre-treatment score at Final was used for the primary ANCOVA comparison, demonstrating a significantly greater cumulative treatment effect of a mean 2.2 (SE 0.49 points pain reduction (p = 0.002. Control subjects only experienced a mean 0.34 (SE 0.49 point decrease in pain. Ninety degrees ROM was required to discharge the patient and this was attained as an average despite the greater Baseline deficit in the InterX group. Eight control patients and three

  14. Annealing of dislocation loops in dislocation dynamics simulations

    We report of 3-dimensional discrete dislocation dynamics (DDD) simulations of dislocation loops coarsening by vacancy bulk diffusion. The calculation is based upon a model which couples the diffusion theory of vacancies to the DDD in order to obtain the climb rate of the dislocation segments. Calculation of isolated loops agrees with experimental observations, i.e. loops shrink or expand, depending on their type and vacancy supersaturation. When an array of dislocation loops of various sizes is considered, and the total number of vacancies in the simulation is maintained constant, the largest dislocations are found to increase in size at the expense of small ones, which disappear in a process known as Ostwald ripening.

  15. Annealing of dislocation loops in dislocation dynamics simulations

    Mordehai, Dan; Clouet, Emmanuel [SRMP, CEA-Saclay, 91191 Gif-sur-Yvette Cedex (France); Fivel, Marc; Verdier, Marc, E-mail: danmord@tx.technion.ac.il [CNRS/SIMAP, INPG, BP 75, 38402 St Martin d' Heres (France)

    2009-07-15

    We report of 3-dimensional discrete dislocation dynamics (DDD) simulations of dislocation loops coarsening by vacancy bulk diffusion. The calculation is based upon a model which couples the diffusion theory of vacancies to the DDD in order to obtain the climb rate of the dislocation segments. Calculation of isolated loops agrees with experimental observations, i.e. loops shrink or expand, depending on their type and vacancy supersaturation. When an array of dislocation loops of various sizes is considered, and the total number of vacancies in the simulation is maintained constant, the largest dislocations are found to increase in size at the expense of small ones, which disappear in a process known as Ostwald ripening.

  16. Recurrent Mandibular Dislocation in Geriatric Patients: Treatment and Prevention by a Simple and Non-invasive Technique

    Chhabra, Shruti; Chhabra, Naveen; Gupta, Prachi

    2013-01-01

    Dislocation is defined as the complete loss of articular relationship between the articular fossa of the temporal bone and the condyle-disk complex. Most common aetiology of dislocation is wide mouth opening, trauma and use of certain drugs. It is classified as acute, chronic and recurrent. Chronic recurrent dislocation of mandible is a distressing condition especially for geriatric patients. Various non-surgical methods of reduction include Hippocratic method, Awang’s gag reflex method, wris...

  17. Revision Knee Surgery

    Full Text Available Revision Knee Surgery Featuring the Zimmer® NexGen® LCCK System. Zimmer, Inc. Indio, California March 31, 2010 Welcome ... the role of the NexGen LCCK Knee Revision System. If we could go to the slides, please. ...

  18. Revision Knee Surgery

    Full Text Available Revision Knee Surgery Featuring the Zimmer® NexGen® LCCK System. Zimmer, Inc. Indio, California March 31, 2010 Welcome to this ... surgery, demonstrating the role of the NexGen LCCK Knee Revision System. If we could go to the ...

  19. Traumatic hip dislocations in children

    Objectives: To evaluate clinical features, treatment and relationship to the time period between dislocation, reduction and early complications of traumatic dislocation of hip in children. Methods: Case series conducted at Jinnah Post Graduate Medical Centre Karachi from July 2005 to August 2009. Children with traumatic hip dislocation up to fifteen years of age who presented in last four years were included in this study. Their clinical information, etiology, associated injuries, duration, method of reduction and early complications are evaluated through emergency room proforma and indoor record. Follow up of patient was updated in outpatient department. Results: We had eight patients, six boys and two girls. Youngest 2.4 years and eldest was 12 years with mean age of 6.2 +- 3.8 years. All presented with posterior hip dislocation. Etiology was road traffic accident in two and history of fall in remaining six patients. Average duration of time between dislocation and reduction was 19 hours range 3-72 hours. Dislocated hips were reduced under General Anaesthesia in two patients and under sedation analgesia in six patients. No complications were noted in eight cases with mean 18.75 +- 13.23 months follows up. Conclusion: Traumatic hip dislocation in children is not rare. Slight trauma causes dislocation in younger age and immediate closed reduction and Immobilization reduces complications. (author

  20. Nature of Dislocations in Silicon

    Hansen, Lars Bruno; Stokbro, Kurt; Lundqvist, Bengt;

    1995-01-01

    Interaction between two partial 90 degrees edge dislocations is studied with atomic-scale simulations using the effective-medium tight-binding method. A large separation between the two dislocations (up to 30 Angstrom), comparable to experimental values, is achieved with a solution of the tight-b...

  1. Bicompartmental knee arthroplasty

    Giachino, Matteo; Risitano, Salvatore; Atzori, Francesco

    2016-01-01

    Total knee arthroplasty (TKA) is the most worldwide practiced surgery for knee osteoarthritis and its efficacy is mightily described by literature. Concerns about the invasiveness of TKA let the introduction of segmental resurfacing of the joint for younger patients with localized osteoarthritis. Bone stock sparing and ligaments preservation are the essence of both unicompartmental knee arthroplasty (UKA) and bicompartmental knee arthroplasty (BKA). Advantages related to BKA are the respect of knee biomechanics, lower complications rates, shorter hospital stay, faster rehabilitation. Moreover, in case of failure of the first implant the conversion to TKA is undemanding and can be compared to a standard prosthesis. Our experience suggest that BKA is a reliable technique in selected cases and especially younger people with higher functional requests can favourably profit from it. Although those results are encouraging, we still need further prospective, randomized, long-term studies to finally assess BKA indications and outcomes. PMID:26855941

  2. Musculoskeletal MR: knee

    Staebler, A.; Glaser, C.; Reiser, M. [Dept. of Diagnostic Radiology, Klinikum Grosshadern, Ludwig-Maximilian Universitaet Muenchen (Germany)

    2000-02-01

    Magnetic resonance imaging is the most sensitive, specific, and accurate noninvasive method for diagnosing internal derangement of the knee. During the past 15 years knowledge of pathologic conditions of the knee had evolved significantly. Beyond the basic principles of imaging knee injuries great impact was made on the understanding of indirect or collateral findings, even in rare diseases. In this article the spectrum of disorders of the knee are reviewed and an overview of the current literature is given. This includes considerations about how to achieve a high-standard MR imaging study of the knee, and principles of imaging anterior cruciate ligament and meniscal tears. A focus is put on distinct diseases including intra-articular and intraosseous ganglion cysts, iliotibial band friction syndrome, transient osteoporosis, osteonecrosis, osteochondritis dissecans, and imaging of the articular cartilage. (orig.)

  3. Musculoskeletal MR: knee

    Magnetic resonance imaging is the most sensitive, specific, and accurate noninvasive method for diagnosing internal derangement of the knee. During the past 15 years knowledge of pathologic conditions of the knee had evolved significantly. Beyond the basic principles of imaging knee injuries great impact was made on the understanding of indirect or collateral findings, even in rare diseases. In this article the spectrum of disorders of the knee are reviewed and an overview of the current literature is given. This includes considerations about how to achieve a high-standard MR imaging study of the knee, and principles of imaging anterior cruciate ligament and meniscal tears. A focus is put on distinct diseases including intra-articular and intraosseous ganglion cysts, iliotibial band friction syndrome, transient osteoporosis, osteonecrosis, osteochondritis dissecans, and imaging of the articular cartilage. (orig.)

  4. Bicompartmental knee arthroplasty.

    Sabatini, Luigi; Giachino, Matteo; Risitano, Salvatore; Atzori, Francesco

    2016-01-01

    Total knee arthroplasty (TKA) is the most worldwide practiced surgery for knee osteoarthritis and its efficacy is mightily described by literature. Concerns about the invasiveness of TKA let the introduction of segmental resurfacing of the joint for younger patients with localized osteoarthritis. Bone stock sparing and ligaments preservation are the essence of both unicompartmental knee arthroplasty (UKA) and bicompartmental knee arthroplasty (BKA). Advantages related to BKA are the respect of knee biomechanics, lower complications rates, shorter hospital stay, faster rehabilitation. Moreover, in case of failure of the first implant the conversion to TKA is undemanding and can be compared to a standard prosthesis. Our experience suggest that BKA is a reliable technique in selected cases and especially younger people with higher functional requests can favourably profit from it. Although those results are encouraging, we still need further prospective, randomized, long-term studies to finally assess BKA indications and outcomes. PMID:26855941

  5. Traumatic Dislodgement of Tibial Polyethylene Insert after a High-Flex Posterior-Stabilized Total Knee Replacement

    Juan Felix Astoul Bonorino; Pablo Ariel Isidoro Slullitel; Gonzalo Rodrigo Kido; Santiago Bongiovanni; Renato Vestri; Lisandro Carbó

    2015-01-01

    Many pathologic entities can produce a painful total knee replacement (TKR) that may lead to potential prosthetic failure. Polyethylene insert dissociation from the tibial baseplate has been described most frequently after mobile-bearing and cruciate-retaining TKRs. However, only 3 tibial insert dislocations in primary fixed-bearing High-Flex posterior-stabilized TKRs have been reported. We present a new case of tibial insert dislocation in a High-Flex model that shares similarities and diffe...

  6. Total Knee Replacement for Women

    Full Text Available ... this knee differ from the high-flex mobile bearing knee?” Well this is not a mobile bearing knee. There is a lot of controversy as to whether or not a mobile-bearing knee provides any significant benefit to the patient. ...

  7. Effect of Angiotensin II on Blood Flow in Acute and Chronically Inflamed Knee Joints of Rabbits: The Role of Nitric Oxide

    Hamid Najafipour

    2009-03-01

    Full Text Available Background: Angiotensin converting enzyme (ACE upregulationin stromal cells of joints affected by rheumatoid arthritismay lead to higher tissue angiotensin II that is a vasoconstrictorand mitogen factor. To date, the role of angiotensin II onregulating blood flow in inflamed joints has not been studied.Methods: Acute and chronic joint inflammation was inducedin rabbits by intra-articular injection of carrageenan and antigen-induced arthritis method, respectively. The ACE level ofsynovial fluid and the response of joint blood flow to angiotensinII, angiotensin II receptor antagonist, and the role ofnitric oxide (NO in modulation of the effects of angiotensin IIon joint blood vessels were examined.Results: The synovial fluid level of ACE was significantly increasedduring the process of inflammation and angiotensin IIincreased joint vascular resistance dose-dependently in both acuteand chronically inflamed joints. The angiotensin 1 receptor antagonistlosartan completely blocked the vasoconstrictor effect ofangiotensin II on joint blood vessels and induced vasodilatation.Nitric oxide synthase inhibitor N-omega -nitro L- argininemethyl ester (L-NAME increased joint vascular resistance andaugmented vascular response of inflamed joints to angiotensin II.Conclusion: Angiotensin II receptors in joint blood vesselsare angiotensin -1 subtype, and inflammation significantlyincreases the activity of synovial fluid ACE. Nitric oxide playsa significant role on regulating joint blood flow and in modulationof angiotensin 1 receptor-mediated vasoconstriction ofinflamed joint blood vessels.

  8. Luxación intra-articular de rótula Intra-articular dislocation of patella

    S. García-Mata

    2006-08-01

    Full Text Available Presentamos el caso de una paciente de 73 años de edad que, tras una caída accidental en las escaleras, sufrió una luxación intra-articular aguda de rótula de la rodilla izquierda. Esta luxación excepcional presentaba incarceración del polo proximal rotuliano en el surco intercondíleo femoral. Se realizó reducción bajo anestesia general debido al dolor y contractura muscular en los intentos de reducción sin anestesia. Realizamos revision quirúrgica que descartó lesiones asociadas del aparato extensor, partes blandas, estructuras articulares y osteofitos. Presentaba artrosis avanzada, sobre todo fémoro-patelar. Tras dos semanas de inmovilización reinició movilidad. No ha presentado recidiva u otro tipo de complicaciones.The case of a patient aged 73 years who, following an accidental fall on a staircase, suffered an acute intraarticular dislocation in the left knee-cap is presented. This exceptional dislocation presented incarceration of the proximal kneecap pole in the femoral intercondylar groove. A reduction was carried out under general anaesthetic due to pain and muscular contraction in the attempts at reduction without anaesthetic. We made a surgical check that ruled out associated lesions to the extensor apparatus, soft parts, joint structures and osteophytes. The patient presented advanced arthrosis, above all femoral-patellar. Following two weeks of immobilisation, the patient restarted mobility. There has been no relapse or other type of complication.

  9. Smooth Pins Reinforcing Static Cement Spacers for Infected Total Knee Arthroplasty Are Not Safe.

    Llado, Roald J; Banerjee, Samik; Khanuja, Harpal S

    2016-05-01

    Prosthetic joint infection is one of the most dreaded complications following elective lower extremity primary total joint arthroplasty, resulting in substantial pain, disability, and health care costs. Both static and articulating antibiotic-impregnated spacers have been used in the management of 2-stage revision for infected total knee arthroplasty, which remains the gold standard for treatment of these infections. Articulating spacers may provide theoretical benefits with regard to improved range of motion after reimplantation secondary to less scar formations and soft tissue contractures. However, static spacers may be necessary to overcome instability associated with substantial bone defects, incompetent extensor mechanisms, and collateral ligament insufficiencies. In these scenarios, static spacers are often reinforced with intramedullary rods or Steinmann pins to provide additional knee stability, improve construct strength, maintain extension, and avoid flexion contractures. This case report describes an extremely rare case of migration of smooth pins through the posterior tibia into the calf following static spacer use in a 48-year-old man. Various mechanical and systemic complications have been reported in up to 50% of patients with the use of polymethyl methacrylate spacer devices, such as acute renal failure, allergic reactions from antibiotic use, stiffness, bone loss, fractures, and dislocations. However, to the best of the authors' knowledge, this complication of hardware migration has not been reported previously in the literature. The authors believe that orthopedic surgeons should consider the use of threaded pin dowels or intramedullary rods to avoid this potential untoward complication. [Orthopedics. 2016; 39(3):e553-e557.]. PMID:27045481

  10. Mid- term results of stryker® scorpio plus mobile bearing total knee arthroplasty

    Kobayashi Hideo

    2012-10-01

    Full Text Available Abstract Background The mobile bearing knee system was introduced to lessen contact stress on the articular bearing surface and reduce polyethylene wear. The purpose of the current study was to investigate the mid-term results of patients undergoing total knee arthroplasties (TKAs using Scorpio Plus Mobile Bearing Knee System (Stryker, Mahwah, NJ, and compare the outcomes between patients with osteoarthritis and osteonecrosis (OA·ON group and patients with rheumatoid arthritis (RA group. Methods Eight males and 58 females were followed up for a period of 4.4- 7.6 years from June 1, 2003 to December 31, 2005. There were 53 knees with osteoarthritis, 17 knees with rheumatoid arthritis, and 6 knees with osteonecrosis. Clinical and radiographic follow- up was done using The Japanese Orthopedic Association knee rating score (JOA score and Knee Society Total Knee Arthroplasty Roentgenographic Evaluation and Scoring System. Results With regard to the JOA score, there was significant improvement in both groups. The postoperative range of motion was between 0.8°and 116.8° in OA·ON group, and between 0.0° and 113.7° in RA group. There were no significant differences with the radiographic evaluation between two groups. Spontaneous dislocation of a polyethylene insert occurred in one patient, and deep infection was occurred in one patient. Conclusion There was significant improvement with regard to the clinical and radiographic results of patients undergoing TKAs using the model. The risk of polyethylene insert dislocation related to the mobile bearing TKA is a cause for concern.

  11. Older Adults without Radiographic Knee Osteoarthritis: Knee Alignment and Knee Range of Motion

    Lissa Fahlman; Emmeline Sangeorzan; Nimisha Chheda; Daphne Lambright

    2014-01-01

    This study describes knee alignment and active knee range of motion (ROM) in a community-based group of 78-year old adults (n = 143) who did not have radiographic evidence of knee osteoarthritis in either knee (KL 0.001) than women with varus or...

  12. To Observe the Clinical Effect of Stimson Reduction Method Cooperate with Zhuang Medicated Thread Moxibustion in Treating Adults with Acute Anterior Dislocation of Shoulder Joint%Stimson复位法配合壮医药线点灸治疗青壮年肩关节前脱位疗效观察

    于小中; 洪定钢; 王效柱

    2013-01-01

    Objective:To observe the clinical effect of Stimson reduction method cooperate with Zhuang medicated thread moxibus-tion in treating adults with acute anterior dislocation of shoulder joint. Methods:36 cases of patients with Stimson reduction method are reset, and cooperate with Zhuang medicated thread moxibustion therapy in the treatment of intraoperative and postoperative. Re-sults:36 patients were all one-time success, with no use of anesthesia, patients were followed up for 6 months, the shoulder joint function of the patients recovered well, the total efficiency was 100%. Conclusion:Using Stimson reduction method cooperate with Zhuang medicated thread moxibustion in treating adults with acute anterior dislocation of shoulder joint is simple and effective, avoiding the use of anesthesia, and worth further clinical application.%  目的:观察Stimson复位法配合壮医药线点灸治疗青壮年急性肩关节前脱位的临床疗效。方法:对36例青壮年急性肩关节前脱位采用Stimson复位法进行复位,并在术中及术后配合患肩壮医药线点灸治疗。结果:36例患者全部一次性复位成功,无一例使用麻醉,随访半年,患者肩关节功能均恢复良好,总有效率100%。结论:采用Stimson复位法配合壮医药线点灸治疗青壮年急性肩关节前脱位操作方法简单,疗效肯定,避免了使用麻醉,值得临床进一步推广应用。

  13. Moving Dislocations in Disordered Alloys.

    Marian, J; Caro, A

    2006-11-18

    Using atomistic simulations of dislocation motion in Ni and Ni-Au alloys we report a detailed study of the mobility function as a function of stress, temperature and alloy composition. We analyze the results in terms of analytic models of phonon radiation and their selection rules for phonon excitation. We find a remarkable agreement between the location of the cusps in the {sigma}-v relation and the velocity of waves propagating in the direction of dislocation motion. We identify and characterize three regimes of dissipation whose boundaries are essentially determined by the direction of motion of the dislocation, rather than by its screw or edge character.

  14. Lower body positive pressure: an emerging technology in the battle against knee osteoarthritis?

    Takacs J

    2013-07-01

    Full Text Available Judit Takacs,1 Judy E Anderson,1,3 Jeff RS Leiter,1,2,4 Peter B MacDonald,2,4 Jason D Peeler1,4 1Department of Human Anatomy and Cell Science, 2Department of Surgery, 3Department of Biological Sciences, University of Manitoba, Winnipeg, Manitoba, Canada; 4Pan Am Clinic, Winnipeg, Manitoba, Canada Background: Knee osteoarthritis (OA is the most prevalent medical condition in individuals over the age of 65 years, and is a progressive joint degenerative condition with no known cure. Research suggests that there is a strong relationship between knee pain and loss of physical function. The resulting lifestyle modifications negatively impact not only disease onset and progression but also overall health, work productivity, and quality of life of the affected individual. Purpose: The goal of this investigation was to examine the feasibility of using an emerging technology called lower body positive pressure (LBPP to simulate weight loss and reduce acute knee pain during treadmill walking exercise in overweight individuals with radiographically confirmed symptomatic knee OA. Design: Prospective case series. Methods: Twenty-two overweight individuals with knee OA completed two 20-minute treadmill walking sessions (one full weight bearing and one LBPP supported at a speed of 3.1 mph, 0% incline. Acute knee pain was assessed using a visual analog scale, and the percentage of LBPP support required to minimize knee pain was evaluated every 5 minutes. Knee Osteoarthritis Outcome Scores were used to quantify knee pain and functional status between walking sessions. The order of testing was randomized, with sessions occurring a minimum of 1 week apart. Results: A mean LBPP of 12.4% of body weight provided participants with significant pain relief during walking, and prevented exacerbation of acute knee pain over the duration of the 20-minute exercise session. Patients felt safe and confident walking with LBPP support on the treadmill, and demonstrated no change

  15. What Are Knee Problems?

    ... Health Information Basics for You and Your Family Sports Injuries, Handout on Health Health Information Knee Problems Find ... for a long time. This sometimes occurs in sports training. Treatment for tendon injuries and disorders includes: Rest Ice Elevation Medicines such ...

  16. Revision Knee Surgery

    Full Text Available ... Tiarina [PH], Angie Weems [PH], and to my right, Roya Royo [PH]. Elise Bond Is our circulator. ... female, five- three, 274 pounds, who had this right knee replacement performed approximately ten years ago. Initially ...

  17. Revision Knee Surgery

    Full Text Available ... and I will ream. Now this was a hybrid knee it looked like on the radiograph; is ... that’s surprising though, we’re almost doing a hybrid cement technique. Where there is no TM or ...

  18. Jumper's Knee (Patellar Tendonitis)

    ... when bending the knee pain in the quadriceps muscle leg or calf weakness Less common symptoms include: balance problems warmth, ... weight-bearing muscle groups like the quadriceps and calf muscles specialized injections to desensitize nerve endings and reduce ...

  19. Revision Knee Surgery

    Full Text Available ... instruments or that allow for abbreviated surgical technique. These instruments allow us to use the LCCK implants, ... the knee. When she presented to me with these X-rays, my first concern was infection because ...

  20. Revision Knee Surgery

    Full Text Available ... LPS flex to LCCK components, to even a rotating hinge knee arthroplasty, and finally, to the segmental ... I think the interface stresses, even with the rotating hinges, are higher, and so I want fixation ...

  1. Revision Knee Surgery

    Full Text Available ... equally bad. Right. So what about you rehab process for this knee? Does it change in any manner to your primary setting? Not really. The pain management protocol that we have here is excellence. The ...

  2. Knee MRI scan

    MRI - knee ... radiologist see certain areas more clearly. During the MRI, the person who operates the machine will watch ... less anxious. Your provider may suggest an "open" MRI, in which the machine is not as close ...

  3. Arthritic Pain Relief through Partial Knee Replacement

    Full Text Available ... the inner aspect of her knee, what we call the medial compartment of her knee, she's got ... only one part of the knee, what we call a compartment of the knee, when one compartment ...

  4. Simultaneous shoulder and elbow dislocation

    Çobanoğlu, Mutlu; Yumrukcal, Feridun; KARATAŞ, Cengiz; Duygun, Fatih

    2014-01-01

    Ipsilateral shoulder and elbow dislocation is very rare and only six articles are present in the literature mentioning this kind of a complex injury. With this presentation we aim to emphasise the importance of assessing the adjacent joints in patients with trauma in order not to miss any accompanying pathologies. We report a case of a 43-year-old female patient with ipsilateral right shoulder and elbow dislocation treated conservatively. The patient reported elbow pain when first admitted to...

  5. Dashboard (in the) knee.

    Patel, M S; Qureshi, A A; Green, T P

    2015-03-01

    We present the case of a 19-year-old individual presenting to an orthopaedic outpatient clinic several months following a dashboard knee injury during a road traffic accident with intermittent mechanical symptoms. Despite unremarkable examination findings and normal magnetic resonance imaging, the patient was identified subsequently as having an intra-articular plastic foreign body consistent with a piece of dashboard on arthroscopic knee assessment, the retrieval of which resulted in a complete resolution of symptoms. PMID:25723676

  6. Reading Knee-Deep

    Jewett, Pamela

    2007-01-01

    Freire told his audience at a seminar at the University of Massachusetts, "You need to read knee-deep in texts, for deeper than surface meanings, and you need to know the words to be able to do it" (quoted in Cleary, 2003). In a children's literature class, fifteen teachers and I traveled along a path that moved us toward reading knee-deep as we…

  7. A new method of arthroscopic reconstruction of the dislocated acromio-clavicular joint.

    Trikha, S. P.; Acton, D.; Wilson, A. J.; Curtis, M. J.

    2004-01-01

    BACKGROUND: Symptomatic total acromio-clavicular joint dislocation (Rockwood et al. types III-VI) may be treated by surgical reconstruction. AIM: To describe an arthroscopically assisted technique to reconstruct anatomically the coraco-clavicular ligaments in acute or chronic (> 6 weeks) acromio-clavicular joint dislocation. METHODS: This new technique involves arthroscopic exposure of the coracoid process. Prior to introducing this technique, cadaveric studies were undertaken. RESULTS: Five ...

  8. Neurovascular complications due to the Hippocrates method for reducing anterior shoulder dislocations

    Regauer, Markus; Polzer, Hans; Mutschler, Wolf

    2014-01-01

    In spite of the fact that the Hippocrates method hardly has been evaluated in a scientific manner and numerous associated iatrogenic complications have been reported, this method remains to be one of the most common techniques for reducing anterior shoulder dislocations. We report the case of a 69-year-old farmer under coumarin anticoagulant therapy who sustained acute first time anterior dislocation of his dominant right shoulder. By using the Hippocrates method with the patient under genera...

  9. Early postoperative albumin level following total knee arthroplasty is associated with acute kidney injury: A retrospective analysis of 1309 consecutive patients based on kidney disease improving global outcomes criteria.

    Kim, Ha-Jung; Koh, Won-Uk; Kim, Sae-Gyeol; Park, Hyeok-Seong; Song, Jun-Gol; Ro, Young-Jin; Yang, Hong-Seuk

    2016-08-01

    Hypoalbuminemia has been reported to be an independent risk factor for acute kidney injury (AKI). However, little is known about the relationship between the albumin level and the incidence of AKI in patients undergoing total knee arthroplasty (TKA). The aim of our study was to assess incidence and risk factors for AKI and to evaluate the relationship between albumin level and AKI following TKA.The study included a retrospective review of medical records of 1309 consecutive patients who underwent TKA between January 2008 and December 2014. The patients were divided into 2 groups according to the lowest serum albumin level within 2 postoperative days (POD2_alb level < 3.0 g/dL vs ≥3.0 g/dL). Multivariate logistic regression analysis was used to assess risk factors for AKI. A comparison of incidence of AKI, hospital stay, and overall mortality in the 2 groups was performed using propensity score analysis.Of 1309 patients, 57 (4.4%) developed AKI based on Kidney Disease Improving Global Outcomes criteria. Factors associated with AKI included age (odds ratio [OR] 1.05; 95% confidence interval [CI] 1.01-1.09; P = 0.030), diabetes (OR 3.12; 95% CI 1.65-5.89; P < 0.001), uric acid (OR 1.51; 95% CI 1.26-1.82; P < 0.001), beta blocker use (OR 2.65; 95% CI 1.48-4.73; P = 0.001), diuretics (OR 16.42; 95% CI 3.08-87.68; P = 0.001), and POD2_alb level < 3.0 g/dL (OR 1.92; 95% CI 1.09-3.37; P = 0.023). After propensity score analysis, POD2_alb level<3.0 g/dL was associated with AKI occurrence (OR 1.82; 95% CI 1.03-3.24, P = 0.041) and longer hospital stay (P = 0.001).In this study, we demonstrated that POD2_alb level<3.0 g/dL was an independent risk factor for AKI and lengthened hospital stay in patients undergoing TKA. PMID:27495094

  10. Calcific tendinitis of biceps femoris: an unusual site and cause for lateral knee pain.

    Chan, Warwick; Chase, Helen Emily; Cahir, John G; Walton, Neil Patrick

    2016-01-01

    A 37-year-old man presented to the acute knee and sports medicine clinic with atraumatic lateral knee pain. He had point tenderness over the lateral aspect of his knee which had not settled with anti-inflammatory medications. Imaging revealed a large opaque lesion lateral to the knee and although there was no clear mechanism, injury to the posterolateral corner was considered. An MRI subsequently revealed a rare case of calcific tendinitis to the biceps femoris tendon insertion. This condition was self-limiting and did not require interventions such as steroid injections. This is the first reported case of calcific tendinitis of biceps femoris as a cause of acute knee pain. PMID:27473032

  11. 应用缝匠肌治疗伸膝功能障碍%The application of sartorius muscle for treatment of extension disorders of knee

    陈秋生; 李松建; 余斌; 陈霞; 朱立新; 杨建成

    2002-01-01

    Objective Sartorius muscle was applied to treat dislocation or subluxation of patella and extension disorder of knee resulted from poliomyelitis,patellectomy and quadriceps femoris injury.Method The distal one third part or two thirds part of sartorius muscle excluded its insertion was freed,then transposed and threaded to the front surface of patella.Result 30 cases(37 knees)with dislocation or subluxation of patella were treated and 25 cases(28 knees)were followed up(mean followed up time 4 years).pain in the patello femeral joint disappeared without any recurrence of dislocation.75 with weak extensor of knee were treated and 50 were followed up for mean 2 years and 1 month.The extensor strength in the patients with poliomyelitis increased from 0.89 preoperatively to 2.76 postoperatively.The joint movement in the patients with extension stiffness of knee increased from 15° preoperatively to 102° postoperatively.The extensor strength in the patients with patellectomy increased by 2 grades postoperatively,which enable the patients to complete the last 10° to 15° extension movement of knee.Conclusion The authors modified the usual surgery methods,by which the results were far from perfect,in treatment of the lateral displacement of patella and advanced a new treatment for the patients with extension stiffness of knee and the patients with weak extensor strength after patellectomy.

  12. Management of dislocated intraocular implants.

    Chan, C K; Agarwal, A; Agarwal, S; Agarwal, A

    2001-12-01

    Implant dislocation may occur in the absence of appropriate capsular or zonular support (PCIOL) (11,35,53) or following traumatic injury to anterior ocular tissues (ACIOL). (11,19,20) Other factors (e.g., advanced patient age, high myopia, previous vitrectomy, pseudoexfoliation syndrome, and certain connective tissue disorders) also may predispose implant dislocation. (9,52) Although reported for all types of IOLs, implant dislocation is becoming more manageable because of the advancement of surgical techniques. A dislocated ACIOL or PCIOL may be explanted, exchanged, or repositioned. (11,48,71) Repositioning the dislocated PCIOL in the ciliary sulcus with modern vitreoretinal techniques provides an optimal environment for visual recovery. (11,71) Implant repositioning techniques generally may be categorized into the external or the internal approaches. (8,11) The former involves external suturing methods for a primary or secondary implant in the absence of adequate capsular or zonular support (15,16,31,42,56,60,61,64,66,73,76) and the latter is achieved through modern pars plana techniques. 8,11,62,69) Recently, several implant repositioning methods gaining increasing acceptance include the scleral loop fixation, (45) the snare approach, (43) the use of the 25-gauge implant forceps, (13) temporary haptic externalization, (8,11,36,71) and the use of perfluorocarbon liquids. (1,28,40,41,44) The temporary haptic externalization method combines the best features of the external and the internal approaches, avoids complex intraocular maneuvers, and allows precise scleral fixation of the dislocated IOL on a consistent basis. (8,11,71) Endoscopy provides the surgeon with optimal viewing of the anterior retropupillary anatomy that is often difficult to appreciate (e.g., capsular-zonular complex, ciliary sulcus, anterior retina, and vitreous base). (6,11) As a result, precise haptic placement is possible during the repositioning process. (6,11) However, a three

  13. Dislocations in Monolayers and Semiconductors.

    Ren, Qiang

    1995-01-01

    Four different aspects of the properties of dislocations in monolayer and semiconductors have been investigated: (i) Using atomic relaxation techniques, dislocation dipoles of various sizes and orientations have been studied for monolayers with the Lennard-Jones potential (LJP) and the nearest-neighbour piecewise linear force (PLF) interactions. In the WP system the lower energy vacancy dipoles have over a wide range of angles an energy which is mainly a function of the vacancy content of the dipole. There is a competition between the elastic forces and the topological constraints which favour a five-fold coordinate vacancy (FCV) at the centre of each core. For the short range PLF system the lattice usually compresses upon the introduction of a dislocation, a consequence of the soft core of the interaction potential, and interstitial dipoles are lower in energy. For the long range LJP system the dislocations are mobile whereas for the PLF system they are pinned. The relevance of these results to existing theories of melting are discussed. (ii) Using generalized stacking-fault (GSF) energies obtained from first-principles density-functional calculations, a zero-temperature model for dislocations in silicon is constructed within the framework of a Peierls-Nabarro (PN) model. Core widths, core energies, PN pinning energies, and stresses are calculated for various possible perfect and imperfect dislocations. Both shuffle and glide sets are considered. 90^circ partials are shown to have a lower Peierls stress (PS) than 30 ^circ partials in accord with experiment. (iii) We have also studied by atomic relaxation techniques the properties of dislocations in silicon, modelled by the empirical potential of Stillinger and Weber. In order to compare with the preceding calculation no reconstruction is allowed. We find no evidence of dissociation in the shuffle dislocations. Within this model shuffle dislocations glide along their slipping planes. On the other hand, glide sets

  14. Total Knee Replacement for Women

    Full Text Available ... get it as close to the knee, the hip, and the ankle being in perfect alignment, and ... there was a long-term results with cemented hips and cemented knees reported in the Swedish registry ...

  15. Minimally Invasive Total Knee Arthroplasty

    Full Text Available ... ligaments well balanced, that almost any knee will work. But if we'll maximize and think about ... and cam design which allow this knee to work will in high flexion without the threat of ...

  16. Total Knee Replacement for Women

    Full Text Available ... The initial setting for the distal femoral resection guide is making these parallel to the posterior condyle. ... does this knee differ from the high-flex mobile bearing knee?” Well this is not a mobile ...

  17. Minimally Invasive Total Knee Arthroplasty

    Full Text Available ... female. The knee is a little -- I would grade it a one plus lax knee but it’s ... and/or rapid aware problems. Heavy hookup, please. Good point. Just make sure you do it well, ...

  18. Minimally Invasive Total Knee Arthroplasty

    Full Text Available ... Institute. We're going to be doing an MIS total knee arthroplasty with the Zimmer mobile bearing ... this point. And there is many recipes for MIS knee surgery as there are surgeons. What’s kind ...

  19. Total Knee Replacement for Women

    Full Text Available ... ll be moderating a Zimmer Gender Solutions total knee, performed by my partner, Dr. Ken Gustke. At ... I’m going to be doing a total knee replacement utilizing the Gender Flex implants on a ...

  20. MedlinePlus: Knee Replacement

    ... Knee Pain and the Weekend Warriors (OR-Live) - Mercy Hospital, Miami, FL, 3/17/2009 Also in ... 2012 Small Incision Total Knee Arthroplasty (OR-Live) - Mercy Hospital, Miami, FL, 3/01/2011 Also in ...

  1. Dislocations and other topological oddities

    Pieranski, Pawel

    2016-03-01

    We will show that the book Dislocations by Jacques Friedel, published half a century ago, can still be recommended, in agreement with the author's intention, as a textbook "for research students at University and for students at engineering schools as well as for research engineers". Indeed, today dislocations are known to occur not only in solid crystals but also in many other systems discovered more recently such as colloidal crystals or liquid crystals having periodic structures. Moreover, the concept of dislocations is an excellent starting point for lectures on topological defects occurring in systems equipped with order parameters resulting from broken symmetries: disclinations in nematic or hexatic liquid crystals, dispirations in chiral smectics or disorientations in lyotropic liquid crystals. The discussion of dislocations in Blue Phases will give us an opportunity to call on mind Sir Charles Frank, friend of Jacques Friedel since his Bristol years, who called these ephemeral mesophases "topological oddities". Being made of networks of disclinations, Blue Phases are similar to Twist Grain Boundary (TGB) smectic phases, which are made of networks of screw dislocations and whose existence was predicted by de Gennes in 1972 on the basis of the analogy between smectics and superconductors. We will stress that the book by Jacques Friedel contains seeds of this analogy.

  2. Getting your home ready - knee or hip surgery

    ... Hip joint replacement Knee arthroscopy Knee joint replacement Knee microfracture surgery Patient Instructions ACL reconstruction - discharge Hip fracture - discharge Hip or knee replacement - after - what to ...

  3. Minimally Invasive Total Knee Arthroplasty

    Full Text Available ... the NexGen® LPS-Flex Mobile and LPS-Mobile Bearing Knees March 5, 2009 Welcome to this "OR ... MIS total knee arthroplasty with the Zimmer mobile bearing knee. We invite all of you who have ...

  4. Prevalent knee pain and sport

    Hahn, Thomas; Foldspang, Anders

    1998-01-01

    weekly hours of participation in competitive gymnastics but negatively with weekly hours of tennis. Constant or recurrent knee pain was positively associated with years of swimming. Absence from sport due to knee pain was positively associated with weekly hours of soccer participation. CONCLUSIONS: Knee...

  5. Minimally Invasive Total Knee Arthroplasty

    Full Text Available ... NexGen® LPS-Flex Mobile and LPS-Mobile Bearing Knees March 5, 2009 Welcome to this "OR Live" ... re going to be doing an MIS total knee arthroplasty with the Zimmer mobile bearing knee. We ...

  6. MR imaging of the knee

    intensity. A complete tear of the anterior cruciate ligament is accompanied by disruption of all of its fibers and an irregular or wavy contour. Anterior cruciate ligament injuries are associated with anterolateral instability that may be manifested as a forward shift of the tibia with respect to the femur (MR drawer sign). The uncovered lateral meniscus sign is positive if a vertical line drawn tangent to the posterior- most cortical margin of the lateral tibial plateau on sagittal MR images intersects any part of the posterior horn of the lateral meniscus. A forward shift of the tibia with respect for the femur may alter the appearance of the smooth curve of the posterior cruciate ligament. In patients with acute tears of the anterior cruciate ligament, bone bruises have been observed most often in the weight-bearing portion of the lateral femoral condyle and in the posterior aspect of the lateral tibial epiphysis. Articular cartilage is a uniquely adapted, highly differentiated tissue that acts as buffer to transmitted forces across the joint, protecting the underlying bone. Unlike other tissues such as muscels and tendons, cartilage has a very limited repair capability, which indicates the obvious need to detect these defects early in the course of the disease. Condral lesions of the knee are a common and important orthopedic problem in both young and old patients. Chondromalacia represents a localized lesion confined to the articular hyaline cartilage. Differentiation from osteoarthritis is not possible by means of histology. Because of the excellent soft-tissue contrast, the ability to visualize directly hyaline cartilage, and the multiplanar capabilities, MRI appears to be the best imaging technique for the evaluation of articular cartilage

  7. Bipolar dislocation of the clavicle

    Wei Jiang

    2012-01-01

    Full Text Available Bipolar dislocation of the clavicle at acromioclavicular and sternoclavicular joint is an uncommon traumatic injury. The conservative treatments adopted in the past is associated with redislocation dysfunction and deformity. A 41 years old lady with bipolar dislocation of right shoulder is treated surgically by open reduction and internal fixation by oblique T-plate at sternoclavicular joint and Kirschner wire stabilization at acromioclavicular joint. The patient showed satisfactory recovery with full range of motion of the right shoulder and normal muscular strength. The case reported in view of rarity and at 2 years followup.

  8. Bipolar dislocation of the clavicle.

    Jiang, Wei; Gao, Shu-Guang; Li, Yu-Sheng; Lei, Guang-Hua

    2012-11-01

    Bipolar dislocation of the clavicle at acromioclavicular and sternoclavicular joint is an uncommon traumatic injury. The conservative treatments adopted in the past is associated with redislocation dysfunction and deformity. A 41 years old lady with bipolar dislocation of right shoulder is treated surgically by open reduction and internal fixation by oblique T-plate at sternoclavicular joint and Kirschner wire stabilization at acromioclavicular joint. The patient showed satisfactory recovery with full range of motion of the right shoulder and normal muscular strength. The case reported in view of rarity and at 2 years followup. PMID:23325981

  9. Does post-operative knee awareness differ between knees in bilateral simultaneous total knee arthroplasty?

    Nielsen, Katrine Abildgaard; Thomsen, Morten Grove; Latifi Yaghin, Roshan;

    2016-01-01

    awareness) with decreasing knee awareness for decreasing tibio-femoral angles. Post-operative alignment did not significantly affect FJS. CONCLUSION: Knee awareness did not differ significantly between the "best" and the "worst" knee. Bilateral simultaneous TKA can be performed without compromising the...

  10. Arthrography in sport injuries of the knee joint

    The arthrography is one of the most important diagnostic methods of sport injuries of the knee joint. The examination must give an exact information to the surgeon; a good technique and standard X-rays are an absolute postulate. The submitted examinations are based on 6687 arthrographies during a period of 5 years. The arthrography should not be carried out before the acute symptomatology has ceased, usually after an interval of 2-3 weeks. Most frequently are the meniscus injuries by rotary traumas of the knee-joint. Football as the most popular sport is responsible for more than 50% of the injuries, followed by skiing, handball and jogging. (orig.)

  11. Anterior approach for knee arthrography

    Objective. To develop a new method of magnetic resonance arthrography (MRA) of the knee using an anterior approach analogous to the portals used for knee arthroscopy.Design. An anterior approach to the knee joint was devised mimicking anterior portals used for knee arthroscopy. Seven patients scheduled for routine knee MRA were placed in a decubitus position and under fluoroscopic guidance a needle was advanced from a position adjacent to the patellar tendon into the knee joint. After confirmation of the needle tip location, a dilute gadolinium solution was injected.Results and conclusion. All the arthrograms were technically successful. The anterior approach to knee MRA has greater technical ease than the traditional approach with little patient discomfort. (orig.)

  12. Light scattering from dislocations in silicon

    Monier, Vanessa; Capello, Luciana; Kononchuk, Oleg; Pichaud, Bernard

    2010-11-01

    Nondecorated glide dislocations in Czochralski grown silicon have been studied by laser scattering tomography technique. Dependence of intensity of scattered light on polarization of the incident light has been measured for different orientations of the dislocation line and Burgers vector. Detailed theory of light scattering by dislocation in silicon crystals is presented. It is shown that by combination of polarization and tomography measurements it is possible to determine slip system of nondecorated mixed dislocation in Si.

  13. Intermittent dislocation flow in viscoplastic deformation

    Miguel, M. -Carmen; Vespignani, Alessandro; Zapperi, Stefano; Weiss, Jerome; Grasso, Jean-Robert

    2001-01-01

    The viscoplastic deformation (creep) of crystalline materials under constant stress involves the motion of a large number of interacting dislocations. Analytical methods and sophisticated `dislocation-dynamics' simulations have proved very effective in the study of dislocation patterning, and have led to macroscopic constitutive laws of plastic deformation. Yet, a statistical analysis of the dynamics of an assembly of interacting dislocations has not hitherto been performed. Here we report ac...

  14. Drift of dislocation tripoles under ultrasound influence.

    Murzaev, R T; Bachurin, D V; Nazarov, A A

    2016-01-01

    Numerical simulations of dynamics of different stable dislocation tripoles under influence of monochromatic standing sound wave were performed. The basic conditions necessary for the drift and mutual rearrangements between dislocation structures were investigated. The dependence of the drift velocity of the dislocation tripoles as a function of the frequency and amplitude of the external influence was obtained. The results of the work can be useful in analysis of motion and self-organization of dislocation structure under ultrasound influence. PMID:26278625

  15. Bilateral fracture dislocation of the shoulder (Presentation of a Case)

    Kuzgun, Unal; Baskir, Orhan; Temelli, Yener; Yazicioglu, Onder; Temocin, Bahattin O.; Kokino, Misel

    2004-01-01

    The largest portion of the dislocations encountered in the adults comprises shoulder dislocations and 2.16% of these dislocations constitute posterior dislocations. It is possible to detect that a dislocation develops secondary to convulsions due to immediate loss of consciousness in the history of most of the posterior dislocations of the shoulder. Approximately 20 cases have been so far reported in literature regurding bilateral dislocations of the shoulder. Bilateral dislocation associated...

  16. Knee Power Is an Important Parameter in Understanding Medial Knee Joint Load in Knee Osteoarthritis

    Calder, Kristina M; Acker, Stacey M; Arora, Neha; Beattie, Karen A.; Jack P. Callaghan; Jonathan D. Adachi; Maly, Monica R.

    2014-01-01

    Objective To determine the extent to which knee extensor strength and power explain variance in knee adduction moment (KAM) peak and impulse in clinical knee osteoarthritis (OA). Methods Fifty-three adults (mean ± SD age 61.6 ± 6.3 years, 11 men) with clinical knee OA participated. The KAM waveform was calculated from motion and force data and ensemble averaged from 5 walking trials. The KAM peak was normalized to body mass (Nm/kg). The mean KAM impulse reflected the mean total medial knee lo...

  17. Scattering of phonons by dislocations

    By 1950, an explicit effort had been launched to use lattice thermal conductivity measurements in the investigation of defect structures in solids. This technique has been highly successful, especially when combined with the measurements of other properties such as optical absorption. One exception has been the study of dislocations. Although dislocations have a profound effect on the phonon thermal conductivity, the mechanisms of the phonon-dislocation interaction are poorly understood. The most basic questions are still debated in the literature. It therefore is pointless to attempt a quantitative comparison between an extensive accumulation of experimental data on the one hand, and the numerous theoretical models on the other. Instead, this chapter will attempt to glean a few qualitative conclusions from the existing experimental data. These results will then be compared with two general models which incorporate, in a qualitative manner, most of the proposed theories of the phonon-dislocation interaction. Until very recently, measurement of thermal conductivity was the only means available to probe the interaction between phonons and defects at phonon frequencies above the standard ultrasonic range of approx. = 109 Hz. The introductory paragraphs provide a brief review of the thermal-conductivity technique and the problems which are encountered in practice. There is also a brief presentation of the theoretical models and the complications that may occur in more realistic situations

  18. Metal working and dislocation structures

    Hansen, Niels

    2007-01-01

    Microstructural observations are presented for different metals deformed from low to high strain by both traditional and new metal working processes. It is shown that deformation induced dislocation structures can be interpreted and analyzed within a common framework of grain subdivision on a finer...... metals with structures on the scale from about 10 nm to 1 mu m....

  19. Revision Knee Surgery

    Full Text Available ... and floating, which would probably not provide any benefit. Yeah, which is equally bad. Right. So what about you rehab process for this knee? Does it change in any manner to your primary setting? Not really. The pain management protocol that we have here is excellence. The ...

  20. Hypermobility and Knee Injuries.

    Steiner, Mark E.

    1987-01-01

    A review of research on the effect of hypermobility on knee injury indicates that greater than normal joint flexibility may be necessary for some athletic endeavors and that it may be possible to change one's underlying flexibility through training. However, for most athletes, inherited flexibility probably plays only a small role, if any, in…

  1. Knee Bracing: What Works?

    ... and flexibility are important for holding down knee pain and injuries. You should work out an exercise plan with your doctor to ... afp/20000115/411.html) Braces and Splints for Musculoskeletal Conditions by JR Gravlee, M.D., and DJ Van Durme, M.D. (American Family Physician February 01, 2007, ... Created: 09/00

  2. Atomistic simulations of dislocation processes in copper

    Vegge, T.; Jacobsen, K.W.

    2002-01-01

    We discuss atomistic simulations of dislocation processes in copper based on effective medium theory interatomic potentials. Results on screw dislocation structures and processes are reviewed with particular focus on point defect mobilities and processes involving cross slip. For example, the...... stability of screw dislocation dipoles is discussed. We show that the presence of jogs will strongly influence cross slip barriers and dipole stability. We furthermore present some new results on jogged edge dislocations and edge dislocation dipoles. The jogs are found to be extended, and simulations of...

  3. Slip systems, lattice rotations and dislocation boundaries

    Winther, Grethe

    of dislocation structure formed, in particular the crystallographic alignment of dislocation boundaries, and the slip pattern are demonstrated. These relations are applied to polycrystals deformed in tension and rolling, producing good agreement with experiment for rolling but less good agreement for......Plastic deformation by slip induces rotations of the crystallographic lattice and evolution of dislocation structures. Both lattice rotations and dislocation structures exhibit a dependence on the grain orientation, which reflects underlying relations to the slip pattern. Relations between the type...... these discrepancies is discussed. Finally, the implications of the relations between slip and dislocation structures for the modelling of mechanical properties are discussed....

  4. Kinetic Monte Carlo simulation of dislocation dynamics

    A kinetic Monte Carlo simulation of dislocation motion is introduced. The dislocations are assumed to be composed of pure edge and screw segments confined to a fixed lattice. The stress and temperature dependence of the dislocation velocity is studied, and finite-size effects are discussed. It is argued that surfaces and boundaries may play a significant role in the velocity of dislocations. The simulated dislocations are shown to display kinetic roughening according to the exponents predicted by the Kardar-Parisi-Zhang equation. copyright 1999 The American Physical Society

  5. Solute drag on perfect and extended dislocations

    Sills, R. B.; Cai, W.

    2016-04-01

    The drag force exerted on a moving dislocation by a field of mobile solutes is studied in the steady state. The drag force is numerically calculated as a function of the dislocation velocity for both perfect and extended dislocations. The sensitivity of the non-dimensionalized force-velocity curve to the various controlling parameters is assessed, and an approximate analytical force-velocity expression is given. A non-dimensional parameter S characterizing the strength of the solute-dislocation interaction, the background solute fraction ?, and the dislocation character angle ?, are found to have the strongest influence on the force-velocity curve. Within the model considered here, a perfect screw dislocation experiences no solute drag, but an extended screw dislocation experiences a non-zero drag force that is about 10 to 30% of the drag on an extended edge dislocation. The solutes can change the spacing between the Shockley partials in both stationary and moving extended dislocations, even when the stacking fault energy remains unaltered. Under certain conditions, the solutes destabilize an extended dislocation by either collapsing it into a perfect dislocation or causing the partials to separate unboundedly. It is proposed that the latter instability may lead to the formation of large faulted areas and deformation twins in low stacking fault energy materials containing solutes, consistent with experimental observations of copper and stainless steel containing hydrogen.

  6. Spontaneous Knee Ankylosis through Heterotopic Ossification after Total Knee Arthroplasty

    Samuel Boulezaz; Emmanuel Gibon; Philippe Loriaut; Laurent Casabianca; Romain Rousseau; Benjamin Dallaudiere; Hugues Pascal-Moussellard

    2016-01-01

    This paper reports on a case of total ankylosis of the knee after a cruciate-sacrificing cemented total knee arthroplasty (TKA). An 82-year-old female patient previously underwent primary TKA for osteoarthritis twenty years ago in our institution. She had recovered uneventfully and returned to her regular activities. There was no history of postsurgical trauma; however, she progressively lost knee range of motion. Radiographs revealed severe bridging heterotopic ossification.

  7. Spontaneous Knee Ankylosis through Heterotopic Ossification after Total Knee Arthroplasty

    Boulezaz, Samuel; Gibon, Emmanuel; Loriaut, Philippe; Casabianca, Laurent; Rousseau, Romain; Dallaudiere, Benjamin; Pascal-Moussellard, Hugues

    2016-01-01

    This paper reports on a case of total ankylosis of the knee after a cruciate-sacrificing cemented total knee arthroplasty (TKA). An 82-year-old female patient previously underwent primary TKA for osteoarthritis twenty years ago in our institution. She had recovered uneventfully and returned to her regular activities. There was no history of postsurgical trauma; however, she progressively lost knee range of motion. Radiographs revealed severe bridging heterotopic ossification. PMID:27119034

  8. Discrete dislocation dynamics simulations in a cylinder

    Li, Maosheng; Gao, Chan; Xu, Jianing

    2015-02-01

    Mechanical properties of material are closely related to the motion of dislocations, and predicting the interactions and resulting collective motion of dislocations is a major task in understanding and modelling plastically deforming materials. A discrete dislocation dynamics model is used to describe the orientation substructure within the microstructure. Discrete dislocation dynamics simulations in three dimensions have been used to examine the role of dislocation multiplication and mobility on the plasticity in small samples under uniaxial compression. In this paper we describe the application of the dislocation dynamics simulations in a cylindrical geometry. The boundary conditions for the simulation were estimated from the distribution of the geometrically necessary dislocation density which was obtained from the orientation map. Numerical studies benchmark could validate the accuracy of the algorithms and the importance of handling the singularity correctly. The results of the simulation explain the formation of the experimentally observed substructure.

  9. Dislocation motion in tungsten: Atomistic input to discrete dislocation simulations

    Srivastava, K.; Gröger, Roman; Weygand, D.; Gumbsch, P.

    2013-01-01

    Roč. 47, AUG (2013), s. 126-142. ISSN 0749-6419 R&D Projects: GA ČR GAP204/10/0255; GA MŠk(CZ) ED1.1.00/02.0068 Institutional support: RVO:68081723 Keywords : body-centered cubic * non-Schmid effects * anomalous slip * discrete dislocation dynamics Subject RIV: BM - Solid Matter Physics ; Magnetism; BM - Solid Matter Physics ; Magnetism (UFM-A) Impact factor: 5.971, year: 2013

  10. Evolution of geometrically necessary dislocation density from computational dislocation dynamics

    This paper presents a method for calculating GND densities in dislocation dynamics simulations. Evolution of suitably defined averages of GND density as well as maps showing the spatial nonuniform distribution of GNDs are analyzed under uniaxial loading. Focus is laid on the resolution dependence of the very notion of GND density, its dependence upon physical dimensions of plastically deformed specimens and its sensitivity to initial conditions. Acknowledgments Support from the National Science Foundation (CMMI-0748187) is gratefully acknowledged.

  11. Evolution of geometrically necessary dislocation density from computational dislocation dynamics

    Guruprasad, P J; Benzerga, A A, E-mail: pjguru@tamu.edu, E-mail: benzerga@aero.tamu.edu [Department of Aerospace Engineering, Texas A and M University, College Station, TX 77843-3141 (United States)

    2009-07-15

    This paper presents a method for calculating GND densities in dislocation dynamics simulations. Evolution of suitably defined averages of GND density as well as maps showing the spatial nonuniform distribution of GNDs are analyzed under uniaxial loading. Focus is laid on the resolution dependence of the very notion of GND density, its dependence upon physical dimensions of plastically deformed specimens and its sensitivity to initial conditions. Acknowledgments Support from the National Science Foundation (CMMI-0748187) is gratefully acknowledged.

  12. Synovial haemangioma of the knee joint: an unusual cause of knee pain in a 14-month old girl

    Wen, D.W.; Rasheed, S. [KK Women' s and Children' s Hospital, Department of Diagnostic and Interventional Imaging, Singapore (Singapore); Tan, T.J. [Changi General Hospital, Department of Radiology, Singapore (Singapore)

    2016-06-15

    We report a histologically proven case of synovial haemangioma of the knee in a 14-month old girl who presented to the emergency department with an acute 1-day history of refusing to weight-bear on the right leg and a preceding 3-week history of a right knee lump. Physical examination revealed a non-tender, soft lump over the lateral infrapatellar region. Radiographs revealed a poorly defined soft tissue density over the infrapatellar fat pad and a suprapatellar joint effusion. Ultrasound was used to confirm the presence of a vascular soft tissue mass compatible with a synovial haemangioma within the infrapatellar fat pad which showed both intra-articular and extra-articular extension. There was good correlation of the ultrasound findings with magnetic resonance imaging (MRI), highlighting the potential clinical utility of ultrasound as an alternative imaging modality in establishing the pre-operative diagnosis and extent of a synovial haemangioma about the knee joint. (orig.)

  13. Synovial haemangioma of the knee joint: an unusual cause of knee pain in a 14-month old girl.

    Wen, D W; Tan, T J; Rasheed, S

    2016-06-01

    We report a histologically proven case of synovial haemangioma of the knee in a 14-month old girl who presented to the emergency department with an acute 1-day history of refusing to weight-bear on the right leg and a preceding 3-week history of a right knee lump. Physical examination revealed a non-tender, soft lump over the lateral infrapatellar region. Radiographs revealed a poorly defined soft tissue density over the infrapatellar fat pad and a suprapatellar joint effusion. Ultrasound was used to confirm the presence of a vascular soft tissue mass compatible with a synovial haemangioma within the infrapatellar fat pad which showed both intra-articular and extra-articular extension. There was good correlation of the ultrasound findings with magnetic resonance imaging (MRI), highlighting the potential clinical utility of ultrasound as an alternative imaging modality in establishing the pre-operative diagnosis and extent of a synovial haemangioma about the knee joint. PMID:26960422

  14. Synovial haemangioma of the knee joint: an unusual cause of knee pain in a 14-month old girl

    We report a histologically proven case of synovial haemangioma of the knee in a 14-month old girl who presented to the emergency department with an acute 1-day history of refusing to weight-bear on the right leg and a preceding 3-week history of a right knee lump. Physical examination revealed a non-tender, soft lump over the lateral infrapatellar region. Radiographs revealed a poorly defined soft tissue density over the infrapatellar fat pad and a suprapatellar joint effusion. Ultrasound was used to confirm the presence of a vascular soft tissue mass compatible with a synovial haemangioma within the infrapatellar fat pad which showed both intra-articular and extra-articular extension. There was good correlation of the ultrasound findings with magnetic resonance imaging (MRI), highlighting the potential clinical utility of ultrasound as an alternative imaging modality in establishing the pre-operative diagnosis and extent of a synovial haemangioma about the knee joint. (orig.)

  15. Knee Pain and the Weekend Warriors

    Full Text Available ... knees to allow these knees to do their job. These knees carry sometimes ten times body weight, ... that block in, and he does a great job with these blocks, we work together, at least ...

  16. Arthritic Pain Relief through Partial Knee Replacement

    Full Text Available ... to a full knee replacement, what are the risks of stiffness with a partial knee replacement? Yeah, also known as arthrofibrosis for the doctors out there, knee surgery has a very - on average a pretty high ...

  17. Self-reported previous knee injury and low knee function increase knee injury risk in adolescent female football

    Clausen, M. B.; Tang, L.; Zebis, M. K.;

    2016-01-01

    Knee injuries are common in adolescent female football. Self-reported previous knee injury and low Knee injury and Osteoarthritis Outcome Score (KOOS) are proposed to predict future knee injuries, but evidence regarding this in adolescent female football is scarce. The aim of this study was to...... investigate self-reported previous knee injury and low KOOS subscale score as risk factors for future knee injuries in adolescent female football. A sample of 326 adolescent female football players, aged 15–18, without knee injury at baseline, were included. Data on self-reported previous knee injury and KOOS...... injury in adolescent female football....

  18. Manual khalifa therapy in patients with completely ruptured anterior cruciate ligament in the knee: First preliminary results from thermal imaging

    Gerhard Litscher

    2013-01-01

    Full Text Available Background: This preliminary publication describes acute temperature effects after manual Khalifa therapy. Aims : The goal of this study was to describe temperature distribution and the effects on surface temperature of the knees and feet in patients with completely ruptured anterior cruciate ligament before and immediately after the manual therapy. Materials and Methods: Ten male patients were investigated with thermal imaging. An infrared camera operating at a wavelength range of 7.5-13 μm was used. Temperature was analyzed at three locations on both knees and in addition on both feet. Results: The study revealed that baseline temperature of the injured knee differed from that of the untreated control knee. After the therapy on the injured knee, the surface temperature was significantly increased on both knees (injured and control. There were no significant changes in the temperature of the feet. Conclusions: Further studies using continuous thermal image recording may help to explain the details concerning the temperature distribution.

  19. Success outcome of reduction in anterior shoulder dislocation by FARES method

    Thirunarayanan Vasudevan

    2015-12-01

    Conclusion: Reduction of acute anterior shoulder dislocation by FARES method yields higher success rate in a quick time with less discomfort to the patients and without any complications. [Int J Res Med Sci 2015; 3(12.000: 3858-3862

  20. Simultaneous shoulder and elbow dislocation

    Çobanoğlu, Mutlu; Yumrukcal, Feridun; Karataş, Cengiz; Duygun, Fatih

    2014-01-01

    Ipsilateral shoulder and elbow dislocation is very rare and only six articles are present in the literature mentioning this kind of a complex injury. With this presentation we aim to emphasise the importance of assessing the adjacent joints in patients with trauma in order not to miss any accompanying pathologies. We report a case of a 43-year-old female patient with ipsilateral right shoulder and elbow dislocation treated conservatively. The patient reported elbow pain when first admitted to emergency service but she was diagnosed with simultaneous ipsilateral shoulder and elbow injury and treated conservatively. As a more painful pathology may mask the additional ones, one should hasten to help before performing a complete evaluation. Any harm caused to the patient due to this reason would not be a complication but a malpractice. PMID:24859563

  1. Lisfranc fracture dislocation. Clinical case

    Lora-Fernández Alberto Carlos; Cabarcas-Montes Gustavo

    2010-01-01

    The Lisfranc fracture dislocation is a serious lesion occur in tarsometatarsian joint and produce importants consequence, for anatomic complexiti of this foot area. The injury mechanisms ocasionality is asociated to automovilistic accidents. Our report of a clinical case into a patient endure fall since 8 meter altitud. Quirurgical manegement was make, open reduction and osteosíntesis with Kirschner nails. Favorable evolution and adecuate reponse to rehabilitation.RESUMENLa luxofractura de Li...

  2. Lattice dislocation in Si nanowires

    Omar, M.S., E-mail: dr_m_s_omar@yahoo.co [Department of Physics, College of Science, University of Salahaddin, Arbil, Iraqi Kurdistan (Iraq); Taha, H.T. [Department of Physics, College of Science, University of Salahaddin, Arbil, Iraqi Kurdistan (Iraq)

    2009-12-15

    Modified formulas were used to calculate lattice thermal expansion, specific heat and Bulk modulus for Si nanowires with diameters of 115, 56, 37 and 22 nm. From these values and Gruneisen parameter taken from reference, mean lattice volumes were found to be as 20.03 A{sup 3} for the bulk and 23.63, 29.91, 34.69 and 40.46 A{sup 3} for Si nanowire diameters mentioned above, respectively. Their mean bonding length was calculated to be as 0.235 nm for the bulk and 0.248, 0.269, 0.282 and 0.297 nm for the nanowires diameter mentioned above, respectively. By dividing the nanowires diameter on the mean bonding length, number of layers per each nanowire size was found to be as 230, 104, 65 and 37 for the diameters mentioned above, respectively. Lattice dislocations in 22 nm diameter wire were found to be from 0.00324 nm for the 1st central lattice to 0.2579 nm for the last surface lattice. Such dislocation was smaller for larger wire diameters. Dislocation concentration found to change in Si nanowires according to the proportionalities of surface thickness to nanowire radius ratios.

  3. Study of Imaging Pattern in Bone Marrow Oedema in MRI in Recent Knee Injuries and its Correlation with Type of Knee Injury

    Sahoo, Kulamani; Saha, Pramod; Dodia, Jainesh Valjibhai; Raj, Vinay Rajappa; Bhairagond, Shweta Jagadish

    2016-01-01

    Introduction The knee is a major weight bearing joint that provides mobility and stability during physical activity as well as balance while standing. If the knee is exposed to forces beyond its physiologic range, risk of injury to bone or soft tissue structures increases. A thorough understanding of knee injury patterns and their mechanisms may help in achieving more accurate assessment of injuries. Aim To identify imaging pattern in bone marrow oedema and to correlate the pattern of bone marrow oedema retrospectively with type of knee injury from clinical history. Materials and Methods A cross-sectional study was done on all patients referred to Krishna Hospital, Karad for MRI knee with history of recent (Dashboard injury in eight cases (5.8%), Hyperextension injury in four cases (2.9%), Lateral patellar dislocation in three cases (2.2%). In six cases (4.3%) no pattern of bone marrow contusion could be explained and was categorized as unclassified pattern. Conclusion Pivot shift pattern is most common contusion pattern and the most common type/mode of sports related injury. By analysing bone marrow contusion pattern, type/mode can be determined in most of the cases. By applying a biomechanical approach in MR interpretation, it is possible to detect lesions like ligament rupture and osseous contusion, to predict subtle but it might overlook important abnormalities. PMID:27190914

  4. Clinical consequences of bone bruise around the knee

    The aim of this study is to evaluate the relation between bone bruise and (peri-)articular derangement and to assess the impact of bone bruise on presentation and short term course of knee complaints. We recorded MR abnormalities in 664 consecutive patients with sub-acute knee complaints. Patients were divided in four groups: patients with and without intra-articular knee pathology, subdivided in patients with and without bone bruise. We assessed function and symptoms at the time of MR and 6 months thereafter. Bone bruises were diagnosed in 124 of 664 patients (18.7%). Patients with bone bruise had significantly more complete ACL, lateral meniscal, MCL and LCL tears. Both with and without intra-articular pathology patients with bone bruise had a significantly poorer function at the time of MR (Noyes score of, respectively, 313.21 versus 344.81 and 306.98 versus 341.19). Patients with bone bruise and intra-articular pathology showed significantly more decrease in activity (decrease of Tegner score from 6.28 to 2.12 versus 5.70-2.55). At 6 months there were no significant differences in clinical parameters between the four groups. We concluded that bone bruise in combination with MCL tear is an important cause of initial clinical impairment in patients with sub-acute knee complaints. Clinical improvement within 6 months is more pronounced than in patients without bone bruise. (orig.)

  5. Selectively Lockable Knee Brace

    Myers, W. Neill (Inventor); Shadoan, Michael D. (Inventor); Forbes, John C. (Inventor); Baker, Kevin J. (Inventor); Rice, Darron C. (Inventor)

    1996-01-01

    A knee brace for aiding in rehabilitation of damaged leg muscles includes upper and lower housings normally pivotable one relative to the other about the knee joint axis of a patient. The upper housing is attachable to the thigh of the patient above the knee joint while the lower housing is secured to a stirrup which extends downwardly along the patient's leg and is attached to the patient's shoe. An actuation rod is carried within the lower housing and is coupled to a cable. The upper and lower housings carry cooperative clutch/brake elements which normally are disengaged to permit relative movement between the upper and lower housings. When the cable is extended the clutch/brake elements engage and lock the housings together. A heel strike mechanism fastened to the stirrup and the heel of the shoe is connected to the cable to selectively extend the cable and lock the brace in substantially any position when the patient places weight on the heel.

  6. 3D Dislocation dynamics modelling of interactions between prismatic loops and mobile dislocations in pure iron

    Novokshanov, Roman [Department of Materials, University of Oxford, Oxford (United Kingdom)], E-mail: novoksha@maths.ox.ac.uk; Roberts, Steve [Department of Materials, University of Oxford, Oxford (United Kingdom)

    2009-04-30

    3D Dislocation dynamics simulations have been carried out to model the interaction between prismatic loops and dislocations in pure iron subject to uniaxial loading conditions. The primary goal was to understand the mechanism of interaction of an a/2 <1 1 1> interstitial loop and a mobile dislocation. The secondary goal was to investigate the dependence of the critical stress needed for dislocations to overcome the obstacles as a function of size of loops and their orientation with respect to the glide plane. The simulations have shown a complicated 3D interaction resulting in the mobile dislocation bowing around a loop, either reacting with the loop dislocation or leaving it behind unchanged.

  7. Visualization of dislocation dynamics in colloidal crystals.

    Schall, Peter; Cohen, Itai; Weitz, David A; Spaepen, Frans

    2004-09-24

    The dominant mechanism for creating large irreversible strain in atomic crystals is the motion of dislocations, a class of line defects in the crystalline lattice. Here we show that the motion of dislocations can also be observed in strained colloidal crystals, allowing detailed investigation of their topology and propagation. We describe a laser diffraction microscopy setup used to study the growth and structure of misfit dislocations in colloidal crystalline films. Complementary microscopic information at the single-particle level is obtained with a laser scanning confocal microscope. The combination of these two techniques enables us to study dislocations over a range of length scales, allowing us to determine important parameters of misfit dislocations such as critical film thickness, dislocation density, Burgers vector, and lattice resistance to dislocation motion. We identify the observed dislocations as Shockley partials that bound stacking faults of vanishing energy. Remarkably, we find that even on the scale of a few lattice vectors, the dislocation behavior is well described by the continuum approach commonly used to describe dislocations in atomic crystals. PMID:15448265

  8. Magnetic resonance imaging of bilateral lateral congenital dislocations of unossified patellae

    Calisir, Cuneyt; Yilmaz, Oguzhan [Osmangazi University, Medical Faculty, Department of Radiology, Eskisehir (Turkey); Inan, Ulukan [Osmangazi University, Medical Faculty, Department of Orthopaedic and Trauma Surgery, Eskisehir (Turkey)

    2006-06-15

    We describe our experience using magnetic resonance imaging (MRI) to evaluate the unossified dislocated cartilaginous patella in a 6-year-old male patient with restricted extension and flexion deformity of both knees. MRI is used widely in the visualization of cartilage since it can show cartilage directly. In addition, FS FLASH 3D sequence has recently been accepted as a suitable sequence in the evaluation of hyaline cartilage. MRI makes it possible to evaluate ligamentous, tendinous, muscular, and cartilaginous structures as well as the abnormalities related to them. We applied this technique in our case and found it very effective in locating the unossified dislocated cartilaginous patella. We also observed structural changes such as bilateral lateral displacement of short quadriceps tendon inserting into diminutive patella, insertion of bilateral patellar tendons into anterolateral tibia, and a stretching of the medial collateral ligament associated with valgus stress. (orig.)

  9. Diabetic Lisfranc fracture-dislocations and Charcot neuroarthropathy.

    Levitt, Bradley A; Stapleton, John J; Zgonis, Thomas

    2013-04-01

    The goal with Lisfranc fracture-dislocations is to regain joint congruity and reestablish midfoot stability to avoid debilitating posttraumatic arthrosis and chronic pain in the sensate patient. In the diabetic population, dense peripheral neuropathy and/or vascular disease are equally important and may alter the surgical approach to traumatic tarsometatarsal injuries. The initial diagnosis in the diabetic population may be delayed due to subtle radiographic findings and/or patient unawareness of trauma in the insensate foot. Failure to initiate treatment in the early stages of acute diabetic neuropathic Lisfranc injuries can predispose the patient to midfoot instability, potential ulceration, infection, and Charcot neuroarthropathy. PMID:23465814

  10. Magnetic resonance imaging evaluation of capsulolabral tears after traumatic primary anterior shoulder dislocation. A prospective comparison with arthroscopy of 25 cases

    Suder, P.A.; Frich, Lars Henrik; Hougaard, K.;

    1995-01-01

    The purpose of our study was to evaluate the use of static magnetic resonance imaging (MRI) as a preoperative diagnostic tool in young patients with a traumatic primary anterior shoulder dislocation. Twenty-five patients who had acute primary traumatic anterior shoulder dislocation were examined...... with MRI and arthroscopy. The patients (18 male and 7 female) were between 16 and 39 years old (mean age, 27 years). They had no previous shoulder dislocations. The dislocations were confirmed radiographically. Examination with MRI and arthroscopy was performed within 10 days after the trauma. The MRI...... joint side rotator cuff tear, 1 partial rupture of the biceps tendon, and 1 osseous Bankart lesion. Anterior capsulolabral tears and Hill-Sachs lesions appeared with a high incidence after acute anterior primary shoulder dislocation. Conventional MRI was only moderately reliable in the preoperative...

  11. Simultaneous MPFL and LPFL reconstruction for recurrent lateral patellar dislocation with medial patellofemoral instability

    Masashi Kusano

    2014-01-01

    Full Text Available We report an extremely rare case of both recurrent lateral patella dislocation and medial patellofemoral instability, following prior operations to correct patella maltracking. Manual translation of the patella revealed medial and lateral instability with a positive apprehension sign. 3-D computer modelling of kinematics based on MRI data demonstrated that the patella deviated laterally at full extension and translated medially with knee flexion. The medial and lateral patellofemoral ligaments were reconstructed simultaneously with hamstring tendons, alleviating peripatellar pain and patellar instability in both directions.

  12. Combination of medial patellofemoral ligament reconstruction with vastus medialis advancement for chronic patellar dislocation

    WANG Fei; KANG Hui-jun; CHEN Bai-cheng; CHEN Wei; SU Yan-ling; ZHANG Ying-ze

    2010-01-01

    Background The medial patellofemoral ligament (MPFL) reconstruction is popular in clinical practice for chronic patellar dislocation; however, the combination with vastus medialis advancement is rare. The aim of this study was to evaluate the clinical outcome of the combination of MPFL reconstruction with vastus medialis advancement.Methods We retrospectively analyzed 69 patients with chronic patellar dislocation between July 2004 and October 2008: twenty eight cases with isolated MPFL reconstruction (group Ⅰ), forty one cases with the combination of MPFL reconstruction with vastus medialis advancement (group C). All patients had CT scans available for review with knee flexion at 30 degree, on which the congruence angle, patellar tilt angle and patellar lateral shift were measured. Physical apprehension tests were examined and the redislocation was recorded. In addition, knee function was evaluated using the Kujala score and subjective questionnaires.Results Patients were followed up for a mean of 42 months (12-65 months) without a recurrent dislocation reported.Postoperatively, all indexes on CT scan were within the normal range without a statistical difference between the two groups. Results from the apprehension test showed eight patients in group Ⅰ and three in group Chad patellar lateral shift exceeding 1.5 cm with a hard end point (P <0.05). The Kujala score improved significantly from 51.3±4.5 to 79.9±6.2 in group Ⅰ and from 53.7±5.2 to 83.9±6.5 in group C (P >0.05). However, the subjective questionnaire revealed a significant difference (P <0.05), including 12 excellent, seven good and nine fair in group Ⅰ and 30 excellent, six good and five fair in group C.Conclusion The combination of MPFL reconstruction with vastus medialis advancement is better than isolated reconstruction to improve the subjective effects and decrease the patellar instability rate for chronic patellar dislocation.

  13. Treatment of neglected elbow dislocations with the help of hinged external fixator: Report of two cases

    Özgür Karakoyun

    2014-06-01

    Full Text Available Elbow dislocations are cases that have to be treated in emergency conditions. Neglected elbow dislocations are seen very rarely and the treatment of such cases are more complicated than acute cases. We present two cases of neglected elbow dislocations treated with open reduction and hinged external fixators. Case 1: 23 year old female patient had a neglected posterior dislocation of left elbow with ipsilateral humeral shaft fracture caused by car accident. The patient was treated after 3 months of initial trauma. We have performed open reduction for the joint. After that we fixed the joint whit a hinged external fixator. The humeral shaft fracture was also fixed with the components of the external fixator. Case 2: 33 year male patient had a large bone and soft tissue defect around the left elbow accompanying with neglected medial elbow dislocation. He presented to our clinic with a delay of 2 months. The patient was treated with open reduction and hinged external fixator after reconstruction of bone defect of distal humerus. Conclusion: The treatment of neglected cases is quite challenging. Open reduction and external fixation has satisfactory results in treatment of late cases of elbow dislocation with the possibility of early rehabilitation. This method can be considered as an option for such cases. J Clin Exp Invest 2014; 5 (2: 443-446

  14. Dislocation climb in GaAs

    The weak-beam technique of transmission-electron-microscopy is used to investigate dislocation climb in GaAs, a high supersaturation of point defects being introduced by electron irradiation in a high-voltage-electron-microscope. It is shown that, at room temperature, climb of dissociated a/2 dislocations proceeds by nucleation of both Frank and perfect interstitial loops on the individual partials. Irradiation carried out at higher temperature (4500C) showed evidence for the interaction of the new loops with the non-parent partial, leading to climb of the total dislocation. Dislocations of α and β-type, i.e. of opposite edge character, exhibit the same climb mechanism. In this paper, the microscopic mechanism of dislocation climb is analysed and the relevance of this study to the understanding of the degradation of GaAs devices by climbing dislocations is considered

  15. Mobility Laws in Dislocation Dynamics Simulations

    Cai, W; Bulatov, V V

    2003-10-21

    Prediction of the plastic deformation behavior of single crystals based on the collective dynamics of dislocations has been a challenge for computational materials science for a number of years. The difficulty lies in the inability of existing dislocation dynamics (DD) codes to handle a sufficiently large number of dislocation lines, to establish a statistically representative model of crystal plasticity. A new massively-parallel DD code is developed that is capable of modeling million-dislocation systems by employing thousands of processors. We discuss an important ingredient of this code--the mobility laws dictating the behavior of individual dislocations. They are materials input for DD simulations and are constructed based on the understanding of dislocation motion at the atomistic level.

  16. Mobility laws in dislocation dynamics simulations

    Cai, Wei; Bulatov, Vasily V

    2004-12-15

    Prediction of the plastic deformation behavior of single crystals based on the collective dynamics of dislocations has been a challenge for computational materials science for a number of years. The difficulty lies in the inability of existing dislocation dynamics (DD) codes to handle a sufficiently large number of dislocation lines, to establish a statistically representative model of crystal plasticity. A new massively parallel DD code is developed that is capable of modeling million-dislocation systems by employing thousands of processors. We discuss an important ingredient of this code - the mobility laws dictating the behavior of individual dislocations. They are materials input for DD simulations and are constructed based on the understanding of dislocation motion at the atomistic level.

  17. Magnification bone scan of knees for knee pain evaluation

    Knee pain is one of the common complaints of patients seen in our orthopedic clinic. Routine anterior and posterior views of whole body bone scan (WBBS) is often not sufficient in the evaluation of these patients. An ideal bone scan using pinhole collimator or single photon emission tomography (SPECT), however, is impractical and time consuming in busy nuclear medicine department with limited resources. Therefore, the aim of the study is to assess limited bone scan of knees with magnification (LNSKM) for knee pain evaluation. Technical aspect of LBSKM and diagnostic efficacy are discussed on this poster. Adult patients with knee pain were reffered for LBSKM from an orthopedic surgen specializing knees. Four hundred fifteen LBSKMs were performed since 1999. patients were given 740 MBq (20mCi) Tc-99m MDP intravenously and 3 hours later LBSKM was performed using a low energy high resolution parallel hole collimator and Siemens Orbitor camera. (Simens medical systems. Inc., Hoffman Estates, III., USA). Anterior view of the knees was taken for 5 min, without magnification and both lateral views of symptomatic knees were obtained with electronic magnification (1.25, upto 2.0) for 8 min each. Disease processes such as DJD, traumatic arthritis, P-F tendonitis, SONK, meniscus tear are detected and illustrated along with normal knee scan finding. We believe LBSKM may not be as good as SPECT or pinhole imaging of the knees in the evaluation of knee pain but superior to routine WBBS in the nuclear medicine department with limited resources of instrumentation and manpower

  18. On the measure of dislocation densities from diffraction line profiles: A comparison with discrete dislocation methods

    In this work the accuracy and range of applicability of peak broadening models, from which dislocation densities can be extracted, is studied. For that purpose dislocation microstructures are generated via a discrete dislocation dynamics method and the internal elastic strains within the simulated volume are calculated. Diffraction peaks are generated from the simulations and a whole pattern line profile analysis method based on the Wilkens model is used to quantify the dislocation densities associated with the simulated microstructures. The work is applied to the case of face-centered cubic crystals deforming in coplanar slip. The accuracy of the analytical models is quantified by considering realistic three-dimensional microstructures containing curved dislocations with a specified distribution. The dependence and sensitivity of the analytical models upon dislocation density and long-range order are investigated. It was found that, provided the distribution of dislocations is rather homogeneous, line profile analysis provides fairly accurate predictions of the dislocation density.

  19. Isolated Dislocation of Proximal Tibiofibular Joint

    Oktay, Alper; Baysal, Ozgur; Ecevız, Engin; Elmalı, Nurzat

    2014-01-01

    Objectives: Proximal tibiofibular joint luxation is very rare condition and usually missed in the ED. The aim of the study is if a patient is brought to ED with knee injury, we should keep in mind this pathology. Methods: A 23 year old man was admitted to emergency department with knee pain and restricted movement of the knee during the football match. Physical examination revealed mild swelling and limited ROM on his knee. We took AP and lateral X-rays immediately. We diagnosed the proximal ...

  20. FRONTAL PLANE KNEE MOMENTS IN GOLF: EFFECT OF TARGET SIDE FOOT POSITION AT ADDRESS

    Scott K. Lynn

    2010-06-01

    Full Text Available Golf has the potential to keep people active well into their later years. Injuries to the target side knee have been reported in golfers, yet no mechanisms for these injuries have been proposed. The loads on the knee during the golf swing may be insufficient to cause acute injury, yet they may be a factor in the progression of overuse/degenerative conditions; therefore, research developing swing modifications that may alter loading of the knee is warranted. It has been suggested that the proper golf set-up position has the target-side foot externally rotated but no reasoning for this modification has been provided. Frontal plane knee moments have been implicated in many knee pathologies. Therefore, this study used a 3-dimensional link segment model to quantify the frontal plane knee moments during the golf swing in a straight (STR and externally rotated (EXT target-side foot position. Subjects were 7 collegiate golfers and knee moments were compared between conditions using repeated measures T-tests. The golf swing knee moment magnitudes were also descriptively compared to those reported for two athletic maneuvers (drop jump landing, side-step cutting and activities of daily living (gait, stair ascent. The EXT condition decreased the peak knee adduction moment as compared to the STR condition; however, foot position had no effect on the peak knee abduction moment. Also, the magnitude of the knee adduction moments during the two activities of daily living were 9-33% smaller than those experienced during the two different golfing conditions. The drop jump landing and golf swing knee moments were of similar magnitude (STR= - 5%, EXT= + 8%; however, the moments associated with side- step cutting were 50-71% larger than those on the target side knee during the golf swing. The loading of the target side knee during the golf swing may be a factor in the development and progression of knee pathologies and further research should examine ways of

  1. A Numeric Study on Chaotic Dislocation Emission

    HonglaiTan; WeiYang

    1996-01-01

    Crack tip atom-string model is devised to study non-linear features of dislocation emission processes under mode II loads.Dynamic analysis shows that the atom motion at the crack tip changes from periodic to chaotic as the stress intensity factor increases.Study on the dislocation emission band reveals the phenomenon of cloud-like drifting of the dislocation core ahead of the crack tip.

  2. Rare Inferior Shoulder Dislocation (Luxatio Erecta)

    Hakan Cift; Salih Soylemez; Murat Demiroglu; Korhan Ozkan; Vahit Emre Ozden; Ozkut, Afsar T.

    2015-01-01

    Although shoulder dislocations have been seen very frequently, inferior dislocation of shoulder constitutes only 0.5% of all shoulder dislocations. We share our 4 patients with luxatio erecta and present their last clinical control. 2 male and 2 female Caucasian patients were diagnosed as luxatio erecta. Patients’ ages were 78, 62, 65, and 76. All patients’ reduction was done by traction-abduction and contour traction maneuver in the operating room. The patients had no symptoms and no limitat...

  3. Coupled dislocation and martensitic phase transformation dynamics

    Barros, Kipton; Acharya, Amit; Lookman, Turab

    2013-03-01

    We present a field theoretic model that couples dislocation dynamics and plasticity with martensitic phase transformation. Dislocations produce long-range stress via incompatibility of the elastic-distortion field. Phase transformations are modeled with a non-convex elastic potential that contains the crystal symmetries of austenite and martensite phases. We discuss the effects of dislocation dynamics on material microstructure produced under extreme conditions.

  4. Treating Osteoarthritis of the Knee

    ... with an artificial joint made from metals and plastic. All or part of the knee joint may be replaced in this procedure. Although recovery may take a long time depending on the extent of your surgery, the results of arthroplasty are often successful. Knee ...

  5. Minimally Invasive Total Knee Arthroplasty

    Full Text Available ... female. The knee is a little -- I would grade it a one plus lax knee but it’s ... I do not see problems with loss of blood supply in my patella and I don't ... I don't have problems with losing my blood supply of this patella. So this lady measured ...

  6. Exercise and the Knee Joint.

    Clarke, H. Harrison, Ed.

    1976-01-01

    This report by the President's Council on Physical Fitness and Sports examines the effects of various forms of physical exercise on the knee joint which, because of its vulnerability, is especially subject to injury. Discussion centers around the physical characteristics of the joint, commonly used measurements for determining knee stability,…

  7. Minimally Invasive Total Knee Arthroplasty

    Full Text Available ... up the midline to come down into the knee joint. The nice thing about that is when we ... whole lot of their own valgus into the knee. And I feel that those, if you set them in slightly less valgus, will tend to end up with a more parallel joint line with the floor and hopefully a longer- ...

  8. Cyclops lesion of the knee.

    Nikolic, O; Vanhoenacker, F. M.; Petrovic, K.; Vandenberk, P

    2012-01-01

    A 38-year-old patient had undergone Anterior Cruciate Ligament (ACL) reconstruction after severe ACL injury in the past. He presented with decreased range of motion, anterior knee pain and inability to fully extend the knee. Magnetic Resonance Imaging (MRI) was performed to assess the cause of extension loss.

  9. Total Knee Replacement for Women

    Full Text Available ... Ken, here’s another question. “Do you utilize highly cross linked polyethylene for all your total knees or just in younger patients? I use the highly cross linked polyethylene in all the knees. I think ...

  10. Minimally Invasive Total Knee Arthroplasty

    Full Text Available ... brought to you by Zimmer. During the program, it’s easy for you to learn more about the ... The knee is a little -- I would grade it a one plus lax knee but it’s basically ...

  11. Hybrid Dislocated Control and General Hybrid Projective Dislocated Synchronization for Memristor Chaotic Oscillator System

    Junwei Sun; Chun Huang; Guangzhao Cui

    2014-01-01

    Some important dynamical properties of the memristor chaotic oscillator system have been studied in the paper. A novel hybrid dislocated control method and a general hybrid projective dislocated synchronization scheme have been realized for memristor chaotic oscillator system. The paper firstly presents hybrid dislocated control method for stabilizing chaos to the unstable equilibrium point. Based on the Lyapunov stability theorem, general hybrid projective dislocated synchronization has been...

  12. Massively-Parallel Dislocation Dynamics Simulations

    Cai, W; Bulatov, V V; Pierce, T G; Hiratani, M; Rhee, M; Bartelt, M; Tang, M

    2003-06-18

    Prediction of the plastic strength of single crystals based on the collective dynamics of dislocations has been a challenge for computational materials science for a number of years. The difficulty lies in the inability of the existing dislocation dynamics (DD) codes to handle a sufficiently large number of dislocation lines, in order to be statistically representative and to reproduce experimentally observed microstructures. A new massively-parallel DD code is developed that is capable of modeling million-dislocation systems by employing thousands of processors. We discuss the general aspects of this code that make such large scale simulations possible, as well as a few initial simulation results.

  13. Anderson localization of light with topological dislocations

    Lobanov, Valery E; Vysloukh, Victor A; Torner, Lluis

    2013-01-01

    We predict Anderson localization of light with nested screw topological dislocations propagating in disordered two-dimensional arrays of hollow waveguides illuminated by vortex beams. The phenomenon manifests itself in the statistical presence of topological dislocations in ensemble-averaged output distributions accompanying standard disorder-induced localization of light spots. Remarkably, screw dislocations are captured by the light spots despite the fast and irregular transverse displacements and topological charge flipping undertaken by the dislocations due to the disorder. The statistical averaged modulus of the output local topological charge depends on the initial vorticity carried by the beam.

  14. Robust atomistic calculation of dislocation line tension

    Szajewski, B. A.; Pavia, F.; Curtin, W. A.

    2015-12-01

    The line tension Γ of a dislocation is an important and fundamental property ubiquitous to continuum scale models of metal plasticity. However, the precise value of Γ in a given material has proven difficult to assess, with literature values encompassing a wide range. Here results from a multiscale simulation and robust analysis of the dislocation line tension, for dislocation bow-out between pinning points, are presented for two widely-used interatomic potentials for Al. A central part of the analysis involves an effective Peierls stress applicable to curved dislocation structures that markedly differs from that of perfectly straight dislocations but is required to describe the bow-out both in loading and unloading. The line tensions for the two interatomic potentials are similar and provide robust numerical values for Al. Most importantly, the atomic results show notable differences with singular anisotropic elastic dislocation theory in that (i) the coefficient of the \\text{ln}(L) scaling with dislocation length L differs and (ii) the ratio of screw to edge line tension is smaller than predicted by anisotropic elasticity. These differences are attributed to local dislocation core interactions that remain beyond the scope of elasticity theory. The many differing literature values for Γ are attributed to various approximations and inaccuracies in previous approaches. The results here indicate that continuum line dislocation models, based on elasticity theory and various core-cut-off assumptions, may be fundamentally unable to reproduce full atomistic results, thus hampering the detailed predictive ability of such continuum models.

  15. Epidemiology of Isolated Acromioclavicular Joint Dislocation

    Claudio Chillemi

    2013-01-01

    Full Text Available Background. Acromioclavicular (AC joint dislocation is a common shoulder problem. However, information about the basic epidemiological features of this condition is scarce. The aim of this study is to analyze the epidemiology of isolated AC dislocation in an urban population. Materials and Methods. A retrospective database search was performed to identify all patients with an AC dislocation over a 5-year period. Gender, age, affected side and traumatic mechanism were taken into account. X-rays were reviewed by two of the authors and dislocations were classified according to the Rockwood’s criteria. Results. A total of 108 patients, with a mean age of 37.5 years were diagnosed with AC dislocation. 105 (97.2% had an isolated AC dislocation, and 3 (2.8% were associated with a clavicle fracture. The estimated incidence was 1.8 per 10000 inhabitants per year and the male-female ratio was 8.5 : 1. 50.5% of all dislocations occurred in individuals between the ages of 20 and 39 years. The most common traumatic mechanism was sport injury and the most common type of dislocation was Rockwood type III. Conclusions. Age between 20 and 39 years and male sex represent significant demographic risk factors for AC dislocation.

  16. Enabling Strain Hardening Simulations with Dislocation Dynamics

    Arsenlis, A; Cai, W

    2006-12-20

    Numerical algorithms for discrete dislocation dynamics simulations are investigated for the purpose of enabling strain hardening simulations of single crystals on massively parallel computers. The algorithms investigated include the /(N) calculation of forces, the equations of motion, time integration, adaptive mesh refinement, the treatment of dislocation core reactions, and the dynamic distribution of work on parallel computers. A simulation integrating all of these algorithmic elements using the Parallel Dislocation Simulator (ParaDiS) code is performed to understand their behavior in concert, and evaluate the overall numerical performance of dislocation dynamics simulations and their ability to accumulate percents of plastic strain.

  17. Dislocation-driven surface dynamics on solids.

    Kodambaka, S; Khare, S V; Swiech, W; Ohmori, K; Petrov, I; Greene, J E

    2004-05-01

    Dislocations are line defects that bound plastically deformed regions in crystalline solids. Dislocations terminating on the surface of materials can strongly influence nanostructural and interfacial stability, mechanical properties, chemical reactions, transport phenomena, and other surface processes. While most theoretical and experimental studies have focused on dislocation motion in bulk solids under applied stress and step formation due to dislocations at surfaces during crystal growth, very little is known about the effects of dislocations on surface dynamics and morphological evolution. Here we investigate the near-equilibrium dynamics of surface-terminated dislocations using low-energy electron microscopy. We observe, in real time, the thermally driven nucleation and shape-preserving growth of spiral steps rotating at constant temperature-dependent angular velocities around cores of dislocations terminating on the (111) surface of TiN in the absence of applied external stress or net mass change. We attribute this phenomenon to point-defect migration from the bulk to the surface along dislocation lines. Our results demonstrate that dislocation-mediated surface roughening can occur even in the absence of deposition or evaporation, and provide fundamental insights into mechanisms controlling nanostructural stability. PMID:15129275

  18. Interactions between dislocations and point defects

    Copper and copper-aluminum alloys were irradiated using a 3MV EM, and the interactions between straight dislocations and point defects were studied. Edge-dislocations climb up during irradiation and the interstitial-type loops are not formed around them. On the other hand, screw-dislocations turn into the helical ones by absorbing interstitials induced by irradiation. During irradiation, the number of helical turns do not change but the radius of helix increases. At the same time, the interstitial-type dislocation loops are formed close by the helical dislocations. The growth rate of these loops is the same as that of the radius of helical dislocations. From these facts, the sink efficiency of dislocations for point defects can be determined. Furthermore, when the fresh screw-dislocations are introduced by in-situ deformation during irradiation, the interstitial-type loops are preferentially formed on the active slip planes. The enhanced nucleation of the loops is closely related to the point defects formed by the motion of dislocation-jogs

  19. Moving dislocations studied by nuclear magnetic resonance

    Movements of dislocations in alkalihalogenides under strain conditions have been investigated by NMR techniques. From theory, it follows that electric quadrupole interactions contribute much more to dislocation motion than tripole interactions. Under the experimental conditions, the actual movement takes place in a time much shorter than 10-8 sec, and the period between successive jumps lasts much longer than 10-4 sec. The distance between the dislocations is found to vary from 5.10-4 cm to 5.10-5 in a deformation test. The mean distance covered by a moving dislocation agrees well with this distance

  20. Traumatic Dislodgement of Tibial Polyethylene Insert after a High-Flex Posterior-Stabilized Total Knee Replacement

    Juan Felix Astoul Bonorino

    2015-01-01

    Full Text Available Many pathologic entities can produce a painful total knee replacement (TKR that may lead to potential prosthetic failure. Polyethylene insert dissociation from the tibial baseplate has been described most frequently after mobile-bearing and cruciate-retaining TKRs. However, only 3 tibial insert dislocations in primary fixed-bearing High-Flex posterior-stabilized TKRs have been reported. We present a new case of tibial insert dislocation in a High-Flex model that shares similarities and differences with the cases reported, facilitating the analysis of the potential causes, which still remain undefined.

  1. PROSPECTIVE EPIDEMIOLOGICAL STUDY OF BASKETBALL INJURIES DURING ONE COMPETITIVE SEASON: ANKLE SPRAINS AND OVERUSE KNEE INJURIES

    Elke Cumps

    2007-06-01

    Full Text Available This prospective cohort study aims to assess the overall incidence of acute and overuse basketball injuries and identifies risk factors associated with ankle sprains and knee overuse injuries. In total, 164 senior players (23.7 years ± 7.0 of all levels of play, and including both men and women, participated voluntarily during one season. A total of 139 acute and 87 overuse injuries were reported, resulting in an overall injury incidence of 9.8 (8.5 to 11.1 per 1,000 hours. The incidence of acute injuries was 6.0/1,000 hours. Ankle sprains (n = 34 accounted for most acute injuries, and 52.9% of all players with ankle sprains reported a previous ankle sprain. Relative Risks (RR and Odds Ratio (OR with their 95% Confidence Intervals (CI were calculated to determine significant differences. Landing on an opponent's foot was the major inciting event, significantly more so than non contact mechanisms (RR=2.1 [95% CI: 1.0-4.2]. Acute knee injuries resulted in the highest playing absence (7 weeks 2 days ± 9 weeks 1 day. Overuse injury incidence was 3.8/1,000 hours. The knee (1.5/1,000 hours was the most common site. Forward players sustained less knee overuse injuries than players of all other playing positions, and significantly less than center players (OR=0.5 [95% CI: 0.2-0.9]. This study showed that ankle sprains and overuse knee injuries are the most common injuries in basketball, both accounting for 14.8%. Injury prevention programmes however should not concentrate on those injuries only, but might one to consider that acute knee injuries, in spite of the fact that they occur less frequently, also merit further research.

  2. MR findings in knee osteoarthritis

    Knee osteoarthritis (OA) is a leading cause of disability. Recent advances in drug discovery techniques and improvements in understanding the pathophysiology of osteoarthritic disorders have resulted in an unprecedented number of new therapeutic agents. Of all imaging modalities, radiography has been the most widely used for the diagnosis and management of the progression of knee OA. Magnetic resonance imaging is a relatively recent technique and its applications to osteoarthritis have been limited. Compared with conventional radiography, MR imaging offers unparalleled discrimination among articular soft tissues by directly visualizing all components of the knee joint simultaneously and therefore allowing the knee joint to be evaluated as a whole organ. In this article we present the MR findings in knee OA including cartilage abnormalities, osteophytes, bone edema, subarticular cysts, bone attrition, meniscal tears, ligament abnormalities, synovial thickening, joint effusion, intra-articular loose bodies, and periarticular cysts. (orig.)

  3. Total knee replacement for posttraumatic degenerative arthritis of the knee

    WU Li-dong; XIONG Yan; YAN Shi-gui; YANG Quan-sen

    2005-01-01

    Objective: To evaluate the results of total knee arthroplasty (TKA) in patients with posttraumatic degenerative arthritis due to a previous fracture around the knee. Methods: We analyzed the results of 15 TKAs, performed from 1997 to 2003, in 15 patients with post-traumatic degenerative arthritis due to a previous fracture around knee. There were 3 women and 12 men with an average age of 58 years (range, 31-76 years). The time from fracture to arthroplasty averaged 8.2 years (range, 2-27 years). Internal fixation had previously been performed in 8 patients resulting in retained hardware. At the time of arthroplasty a femoral fracture malunion was present in two knees. Lateral retinacular release (4 knees), extensor mechanism realignment (1 knee) or medial collateral ligament reconstruction (1 knee) were needed at the time of arthroplasty. Results: Follow-up averaged 35 months (range, 12-73 months). No patient was lost for follow-up. According to the Knee Society Score scale, the mean preoperative knee score was 37 (range, 10-70) and functional score was 41 (range, 0-60). They were improved significantly to a mean of 84 (range, 10-100) and 76 (range, 20-100) points, respectively at the latest follow-up. The mean knee arc of motion were improved from 84° preoperation to 94° at the latest follow-up. Postoperative manipulation under anesthesia for poor motion was carried out in 4 knees. No knee had aseptic loosening that required subsequent revision. Two knees developed superficial infection and were treated with debridement. It subsequently recovered with the retention of components. Conclusions: Significant improvement in function and relief of pain has been achieved in patients with previous fractures undergoing subsequent TKA. However, this procedure is technically demanding and patients are at increased risk for restricted motion and need more care following TKA. This study suggests that the outcome of TKA may be improved further by making special efforts to

  4. Arthroscopic findings after shoulder dislocation

    Medenica Ivica

    2009-01-01

    Full Text Available Background/Aim. Recurrent instability of the shoulder joint is frequently difficult to differentiate from diseased or injured rotator cuff or tendon of the forearm flexor (m. biceps brachii. Shoulder joint arthroscopy has been only recently introduced into instable shoulder joint lesion examination. The aim of this study was to present and analyze an arthroscopic finding on instable shoulder joint in order to determine causes and mechanisms of instability, as well as principles of surgical treatment. Methods. Arthroscopy of the shoulder joint was performed in 158 patients with at least one documented shoulder joint dislocation. These patients were divided into two groups. The group I included the patients with one to three dislocations, while the group II those with more than three dislocations. Preoperative diagnosis was based on anamnestic data and clinical examination using specific tests, and on the diagnosis of shoulder joint using radiography or computed tomography. Results. Out of the total number of the patients 138 (87.34% had injury of the anterior patellar brim, 119 (75.32% had failure of the anterior capsule, 126 (79.75% had compressive cartilage injury of the posterior part of the head of the upper arm bone (Hill-Sachs lesion, 102 (64.56% had insufficiency of glenohumeral tendon, 11 (6.96 had complete cut of the rotator cuff, 23 (14.56% had injury of the posterior patellar brim, 12 (7.59% had injury of the upper anterior-posterior patellar brim (SLAP. Conclusion. According to the obtained results it could be concluded that there is no a unique injury that leads to shoulder joint instability. It is necessary to point out to the significance of anamnesis and clinical examination in making diagnosis. Arthroscopic diagnostics is indicated in clinically unreliable findings as an additional method for determining operative treatment.

  5. Multiscale modeling of dislocation-precipitate interactions in Fe: From molecular dynamics to discrete dislocations

    Lehtinen, Arttu; Granberg, Fredric; Laurson, Lasse; Nordlund, Kai; Alava, Mikko J.

    2016-01-01

    The stress-driven motion of dislocations in crystalline solids, and thus the ensuing plastic deformation process, is greatly influenced by the presence or absence of various pointlike defects such as precipitates or solute atoms. These defects act as obstacles for dislocation motion and hence affect the mechanical properties of the material. Here we combine molecular dynamics studies with three-dimensional discrete dislocation dynamics simulations in order to model the interaction between different kinds of precipitates and a 1/2 {110 } edge dislocation in BCC iron. We have implemented immobile spherical precipitates into the ParaDis discrete dislocation dynamics code, with the dislocations interacting with the precipitates via a Gaussian potential, generating a normal force acting on the dislocation segments. The parameters used in the discrete dislocation dynamics simulations for the precipitate potential, the dislocation mobility, shear modulus, and dislocation core energy are obtained from molecular dynamics simulations. We compare the critical stresses needed to unpin the dislocation from the precipitate in molecular dynamics and discrete dislocation dynamics simulations in order to fit the two methods together and discuss the variety of the relevant pinning and depinning mechanisms.

  6. Self-reported previous knee injury and low knee function increase knee injury risk in adolescent female football.

    Clausen, M B; Tang, L; Zebis, M K; Krustrup, P; Hölmich, P; Wedderkopp, N; Andersen, L L; Christensen, K B; Møller, M; Thorborg, K

    2016-08-01

    Knee injuries are common in adolescent female football. Self-reported previous knee injury and low Knee injury and Osteoarthritis Outcome Score (KOOS) are proposed to predict future knee injuries, but evidence regarding this in adolescent female football is scarce. The aim of this study was to investigate self-reported previous knee injury and low KOOS subscale score as risk factors for future knee injuries in adolescent female football. A sample of 326 adolescent female football players, aged 15-18, without knee injury at baseline, were included. Data on self-reported previous knee injury and KOOS questionnaires were collected at baseline. Time-loss knee injuries and football exposures were reported weekly by answers to standardized text-message questions, followed by injury telephone interviews. A priori, self-reported previous knee injury and low KOOS subscale scores (female football. PMID:26179111

  7. Type IV acromioclavicular joint dislocation associated with a mid-shaft clavicle malunion.

    Mohammed, Khalid D; Stachiw, Danielle; Malone, Alex A

    2016-01-01

    This reports presents the case of a combined clavicle fracture malunion and chronic Type IV acromioclavicular (AC) joint dislocation. The patient was seen acutely in the emergency department following a mountain bike accident at which time the clavicle fracture was identified and managed conservatively however the AC dislocation was not diagnosed. The patient presented 25 months following the injury with persistent pain and disability and was treated with clavicle osteotomy and AC stabilization. We document the clinical details, surgical treatment and outcome. PMID:26980988

  8. Type IV acromioclavicular joint dislocation associated with a mid-shaft clavicle malunion

    Khalid D Mohammed

    2016-01-01

    Full Text Available This reports presents the case of a combined clavicle fracture malunion and chronic Type IV acromioclavicular (AC joint dislocation. The patient was seen acutely in the emergency department following a mountain bike accident at which time the clavicle fracture was identified and managed conservatively however the AC dislocation was not diagnosed. The patient presented 25 months following the injury with persistent pain and disability and was treated with clavicle osteotomy and AC stabilization. We document the clinical details, surgical treatment and outcome.

  9. Knees Lifted High

    2008-08-04

    The Eagle Books are a series of four books that are brought to life by wise animal characters - Mr. Eagle, Miss Rabbit, and Coyote - who engage Rain That Dances and his young friends in the joy of physical activity, eating healthy foods, and learning from their elders about health and diabetes prevention. Knees Lifted High gives children fun ideas for active outdoor play.  Created: 8/4/2008 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 8/5/2008.

  10. Use of computed tomography to determine the risk of patellar dislocation in 921 patients with patellar instability

    Schueda MA

    2015-03-01

    Full Text Available Marco Antonio Schueda,1 Diego Costa Astur,2 Rodrigo Schueda Bier,3 Debora Schueda Bier,4 Nelson Astur,5 Moisés Cohen2 1Serviço de Pós Graduação em Cirurgia do Joelho e Artroscopia do IOT e Traumasports de Joinville, Joinville, Santa Catarina, 2Departamento de Ortopedia e Traumatologia da Escola Paulista de Medicina, São Paulo, 3Serviço de Cirurgia do Joelho e Artroscopia do IOT e Traumasports de Joinville, Joinville, Santa Catarina, 4Pontifícea Universidade Católica, Curitiba, 5Faculdade de Ciencias Médicas da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil Abstract: The purpose of this research was to identify reliable tomographic measurements that can detect patellofemoral abnormality and allow quantification of the risk of patellar dislocation in patients with potential patellar instability. A cross-sectional study in 921 patients with anterior pain or knee instability of at least 6 months' duration was conducted from July 2001 to December 2009. All subjects were clinically evaluated and underwent radiography and computed tomography of their knees. According to their degree of dislocating patellar dysplasia, the subjects were classified into groups for statistical comparison. There was a statistically significant difference in all measurements when the groups were compared, except for external tibial torsion angle. The most sensitive and specific measurements for determining patellar instability were the trochlear groove angle, tibial tubercle-trochlear groove distance, average patellar tilt, and average patellar height. Patients with potential patellar instability, increased tibial tubercle-trochlear groove distance, and patellar height, tilt, and deviation measurements had a greater risk for patellar dislocation. The clinical relevance of this study is to determine measurements that are able to tell us about patellar dislocation risk. Keywords: patellofemoral instability, knee, patellofemoral syndrome

  11. Prospective epidemiological study of basketball injuries during one competitive season: ankle sprains and overuse knee injuries.

    Cumps, Elke; Verhagen, Evert; Meeusen, Romain

    2007-01-01

    This prospective cohort study aims to assess the overall incidence of acute and overuse basketball injuries and identifies risk factors associated with ankle sprains and knee overuse injuries. In total, 164 senior players (23.7 years ± 7.0) of all levels of play, and including both men and women, participated voluntarily during one season. A total of 139 acute and 87 overuse injuries were reported, resulting in an overall injury incidence of 9.8 (8.5 to 11.1) per 1,000 hours. The incidence of acute injuries was 6.0/1,000 hours. Ankle sprains (n = 34) accounted for most acute injuries, and 52.9% of all players with ankle sprains reported a previous ankle sprain. Relative Risks (RR) and Odds Ratio (OR) with their 95% Confidence Intervals (CI) were calculated to determine significant differences. Landing on an opponent's foot was the major inciting event, significantly more so than non contact mechanisms (RR=2.1 [95% CI: 1.0-4.2]). Acute knee injuries resulted in the highest playing absence (7 weeks 2 days ± 9 weeks 1 day). Overuse injury incidence was 3.8/1,000 hours. The knee (1.5/1,000 hours) was the most common site. Forward players sustained less knee overuse injuries than players of all other playing positions, and significantly less than center players (OR=0.5 [95% CI: 0.2-0.9]). This study showed that ankle sprains and overuse knee injuries are the most common injuries in basketball, both accounting for 14.8%. Injury prevention programmes however should not concentrate on those injuries only, but might one to consider that acute knee injuries, in spite of the fact that they occur less frequently, also merit further research. Key pointsAnkle sprains are the most common acute injuries in basketball with the inciting event being landing on an opponent's foot or changing direction.Anterior knee pain is the most common overuse injury. Etiologic factors are well described in literature, but prevention strategies are lacking.Acute knee injuries account for the

  12. Pulse lavage is inadequate at removal of biofilm from the surface of total knee arthroplasty materials.

    Urish, Kenneth L; DeMuth, Peter W; Craft, David W; Haider, Hani; Davis, Charles M

    2014-06-01

    In acute periprosthetic infection, irrigation and debridement with component retention has a high failure rate in some studies. We hypothesize that pulse lavage irrigation is ineffective at removing biofilm from total knee arthroplasty (TKA) components. Staphylococcus aureus biofilm mass and location was directly visualized on arthroplasty materials with a photon collection camera and laser scanning confocal microscopy. There was a substantial reduction in biofilm signal intensity, but the reduction was less than a ten-fold decrease. This suggests that irrigation needs to be further improved for the removal of biofilm mass below the necessary bioburden level to prevent recurrence of acute infection in total knee arthroplasty. PMID:24439797

  13. Atomistic simulation of hydrogen dynamics near dislocations in vanadium hydrides

    Ogawa, Hiroshi, E-mail: h.ogawa@aist.go.jp

    2015-10-05

    Highlights: • Hydrogen–dislocation interaction was simulated by molecular dynamics method. • Different distribution of H atoms were observed at edge and screw dislocation. • Planner distribution of hydrogen may be caused by partialized edge dislocation. • Hydrogen diffusivity was reduced in both edge and screw dislocation models. • Pipe diffusion was observed for edge dislocation but not for screw dislocation. - Abstract: Kinetics of interstitial hydrogen atoms near dislocation cores were analyzed by atomistic simulation. Classical molecular dynamics method was applied to model structures of edge and screw dislocations in α-phase vanadium hydride. Simulation showed that hydrogen atoms aggregate near dislocation cores. The spatial distribution of hydrogen has a planner shape at edge dislocation due to dislocation partialization, and a cylindrical shape at screw dislocation. Simulated self-diffusion coefficients of hydrogen atoms in dislocation models were a half- to one-order lower than that of dislocation-free model. Arrhenius plot of self-diffusivity showed slightly different activation energies for edge and screw dislocations. Directional dependency of hydrogen diffusion near dislocation showed high and low diffusivity along edge and screw dislocation lines, respectively, hence so called ‘pipe diffusion’ possibly occur at edge dislocation but does not at screw dislocation.

  14. Atomistic simulation of hydrogen dynamics near dislocations in vanadium hydrides

    Highlights: • Hydrogen–dislocation interaction was simulated by molecular dynamics method. • Different distribution of H atoms were observed at edge and screw dislocation. • Planner distribution of hydrogen may be caused by partialized edge dislocation. • Hydrogen diffusivity was reduced in both edge and screw dislocation models. • Pipe diffusion was observed for edge dislocation but not for screw dislocation. - Abstract: Kinetics of interstitial hydrogen atoms near dislocation cores were analyzed by atomistic simulation. Classical molecular dynamics method was applied to model structures of edge and screw dislocations in α-phase vanadium hydride. Simulation showed that hydrogen atoms aggregate near dislocation cores. The spatial distribution of hydrogen has a planner shape at edge dislocation due to dislocation partialization, and a cylindrical shape at screw dislocation. Simulated self-diffusion coefficients of hydrogen atoms in dislocation models were a half- to one-order lower than that of dislocation-free model. Arrhenius plot of self-diffusivity showed slightly different activation energies for edge and screw dislocations. Directional dependency of hydrogen diffusion near dislocation showed high and low diffusivity along edge and screw dislocation lines, respectively, hence so called ‘pipe diffusion’ possibly occur at edge dislocation but does not at screw dislocation

  15. "Dislocation"

    Li Wei

    2006-01-01

    @@ Over the past five years since September 11, the international community has been highly focused on the increasingly serious terrorist threat. In order to strike the international terrorist force, with al Qaeda as its core, the United Nations Security Council has established a special counter-terrorism committee, drawing up 12 related resolutions, agreements and conventions; multilateral and bilateral counter-terrorism cooperation has been expanding and deepening unceasingly. Many countries have brought counter-terrorism into their national security strategy, established or revised relevant laws, increased the input of manpower, material resources, and funds, actively researched and developed new technology and strengthened all kinds of counter-terrorist measures. Theoretically, international society has created an "inescapable net" for terrorism.

  16. Dislocated interests and climate change

    Davis, Steven J.; Diffenbaugh, Noah

    2016-06-01

    The predicted effects of climate change on surface temperatures are now emergent and quantifiable. The recent letter by Hansen and Sato (2016 Environ. Res. Lett. 11 034009) adds to a growing number of studies showing that warming over the past four decades has shifted the distribution of temperatures higher almost everywhere, with the largest relative effects on summer temperatures in developing regions such as Africa, South America, southeast Asia, and the Middle East (e.g., Diffenbaugh and Scherer 2011 Clim. Change 107 615–24 Anderson 2011 Clim. Change 108 581; Mahlstein et al 2012 Geophys. Res. Lett. 39 L21711). Hansen and Sato emphasize that although these regions are warming disproportionately, their role in causing climate change—measured by cumulative historical CO2 emissions produced—is small compared to the US and Europe, where the relative change in temperatures has been less. This spatial and temporal mismatch of climate change impacts and the burning of fossil fuels is a critical dislocation of interests that, as the authors note, has ‘substantial implications for global energy and climate policies.’ Here, we place Hansen and Sato’s ‘national responsibilities’ into a broader conceptual framework of problematically dislocated interests, and briefly discuss the related challenges for global climate mitigation efforts.

  17. Evaluation of mobile dislocation density based on distribution function of dislocation segments

    周志敏; 孙艳蕊; 周海涛

    2004-01-01

    A function is offered to represent the distribution of reduced length of dislocation segments. The segment distribution of materials, e. g. , MgO and Cu, can be well described by taking appropriate values of parametersm and n. Based on this function, a model for evaluating the mobile dislocation density is developed. Provided the total dislocation density and applied stress are known, the mobile dislocation density could be readily assessed by using this model. For pure copper the mobile dislocation density and strain rates at deferent strains are evaluated. The calculated results are consistent with the known experimental data.

  18. Dislocation-Free Czochralski Silicon Crystal Growth without the Dislocation-Elimination-Necking Process

    Hoshikawa, Keigo; Huang, Xinming; Taishi, Toshinori; Kajigaya, Tomio; Iino, Takayuki

    1999-12-01

    Dislocation-free silicon crystals have been grown successfully from heavily-boron-doped silicon melts by the Czochralski method without the dislocation-elimination-necking process (Dash neck). A dislocation-free silicon seed of orientation with a boron concentration of about 4×1019 atoms/cm3 was used to grow a silicon crystal with the same boron concentration. No dislocation was generated in the seed during the dipping process, and no misfit dislocation occurred in the grown crystal. These results show that shoulder and body growth can be started immediately after the seeding process.

  19. Hybrid dislocated control and general hybrid projective dislocated synchronization for the modified Lue chaotic system

    This paper introduces a modified Lue chaotic system, and some basic dynamical properties are studied. Based on these properties, we present hybrid dislocated control method for stabilizing chaos to unstable equilibrium and limit cycle. In addition, based on the Lyapunov stability theorem, general hybrid projective dislocated synchronization (GHPDS) is proposed, which includes complete dislocated synchronization, dislocated anti-synchronization and projective dislocated synchronization as its special item. The drive and response systems discussed in this paper can be strictly different dynamical systems (including different dimensional systems). As examples, the modified Lue chaotic system, Chen chaotic system and hyperchaotic Chen system are discussed. Numerical simulations are given to show the effectiveness of these methods.

  20. Osteonecrosis of the knee: review

    Karim, Ammar R.; Cherian, Jeffrey J.; Jauregui, Julio J.; Pierce, Todd

    2015-01-01

    Osteonecrosis is a devastating disease that can lead to end-stage arthritis of various joint including the knee. There are three categories of osteonecrosis that affect the knee: spontaneous osteonecrosis of the knee (SONK), secondary, and post-arthroscopic. Regardless of osteonecrosis categories, the treatment of this disease aims to halt further progression or delay the onset of end-stage arthritis of the knee. However, once substantial joint surface collapse has occurred or there are sign of degenerative arthritis, joint arthroplasty is the most appropriate treatment option. Currently, the non-operative treatment options consist of observation, non-steroidal anti-inflammatory drugs (NSAIDs), protected weight bearing, and analgesia as needed. Operative interventions include joint preserving surgery, unilateral knee arthroplasty (UKA), or total knee arthroplasty (TKA) depending on the extent and type of disease. Joint preserving procedures (i.e., arthroscopy, core decompression, osteochondral autograft, and bone grafting) are usually attempted in pre-collapse and some post-collapse lesions, when the articular cartilage is generally intact with only the underlying subchondral bone being affected. Conversely, after severe subchondral collapse has occurred, procedures that attempt to salvage the joint are rarely successful and joint arthroplasty are necessary to relieve pain. The purpose of this article is to highlight the recent evidence concerning the treatment options across the spectrum of management of osteonecrosis of the knee including lesion observation, medications, joint preserving techniques, and total joint arthroplasties. PMID:25705638

  1. Interactions between Dislocations and Grain Boundaries

    Soer, Wouter Anthon

    2006-01-01

    Dislocations (line defects) and grain boundaries (planar defects) are two types of lattice defects that are crucial to the deformation behavior of metals. Permanent deformation of a crystalline material is microscopically associated with the nucleation and propagation of dislocations, and extensive

  2. Developmental Dislocation (Dysplasia) of the Hip (DDH)

    .org Developmental Dislocation (Dysplasia) of the Hip (DDH) Page ( 1 ) The hip is a “ball-and-socket” joint. In a normal hip, the ball at the ... American Academy of Orthopaedic Surgeons. .org Developmental Dislocation (Dysplasia) of the Hip cont. • Family history of DDH (parents or siblings) • ...

  3. Dislocation networks in phosphorus-implanted silicon

    Observations, by transmission electron microscopy have been made on defects generated in 50 keV, high-dose (1 x 1015 to 3 x 1016 ions/cm2) phosphorus-implanted silicon (111) wafers followed by 11000C isothermal annealing in inert (dry N2) and oxidizing (wet O2) atmospheres. The formation of dislocation networks is closely associated with the generation of interstitial type dislocation loops which grow from point defects produced by ion implantation in silicon wafers. Also, dislocations grow more easily in wet O2 annealing than in dry N2. In wet O2 annealing, dislocation networks are formed by annealing within 1-2 min for samples implanted with doses above 3 x 1015 ions/cm2, and they move to deeper depths in the wafers during annealing. On the other hand, in dry N2 annealing, the critical ion dose for generation of dislocation networks is 1 x 1016 ions/cm2 and the location of dislocation networks in the wafers is usually unchanged during annealing. Such a difference in the generation and motion of dislocations between the two atmospheres can be explained in terms of the analysis of Sanders and Dobson (1969) for the vacancy flow between defect and surface. It is also shown that by implanting silicon into phosphorus-diffused layers, the generation of dislocation networks is strongly correlated with the formation of secondary defects caused by implantation and annealing. (author)

  4. A Bilateral Traumatic Hip Obturator Dislocation

    Karaarslan, Ahmet Adnan; Acar, Nihat; Karci, Tolga; Sesli, Erhan

    2016-01-01

    A case of a bilateral simultaneous traumatic obturator dislocation of both hip joints in an 18-year-old young man following a traffic accident is presented. We reduced the dislocated femoral heads immediately under general anesthesia followed by passive and active exercises and early full-weight bearing mobilization. After 5 years, the result was excellent. PMID:26977327

  5. Simulations of dislocation dynamics in aluminum interconnects

    Nicola, L; Van der Giessen, E; Needleman, A; Zavaliangos, A; Tikare,; Olevsky, EA

    2002-01-01

    A discrete dislocation simulation of plastic deformation in metallic interconnects caused by thermal stress is carried out. The calculations are carried out using a two dimensional plane strain formulation with only edge dislocations. A boundary value problem is formulated and solved for the evoluti

  6. A nonsingular solution of the edge dislocation in the gauge theory of dislocations

    A (linear) nonsingular solution for the edge dislocation in the translational gauge theory of defects is presented. The stress function method is used and a modified stress function is obtained. All field quantities are globally defined and the solution agrees with the classical solution for the edge dislocation in the far field. The components of the stress, strain, distortion and displacement fields are also defined in the dislocation core region and they have no singularity there. The dislocation density, moment and couple stress for an edge dislocation are calculated. The solutions for the stress and strain fields obtained here are in agreement with those obtained by Gutkin and Aifantis through an analysis of the edge dislocation in the strain gradient elasticity. Additionally, the relation between the gauge theory and Eringen's so-called nonlocal theory of dislocations is given

  7. Gait changes in patients with knee osteoarthritis are replicated by experimental knee pain

    Henriksen, Marius; Nielsen, Thomas Graven; Aaboe, Jens;

    2010-01-01

    Medial knee osteoarthritis (OA) is characterized by pain and associated with abnormal knee moments during walking. The relationship between knee OA pain and gait changes remains to be clarified, and a better understanding of this link could advance the treatment and prevention of disease...... progression. This study investigated changes in knee moments during walking following experimental knee pain in healthy volunteers, and whether these changes replicated the joint moments observed in medial knee OA patients....

  8. The MR diagnosis and clinical significance of bone contusion of knee

    Objective: To evaluate MRI in the diagnosis of the bone contusion of the knee .joint and its clinical significance. Methods: Using special coil for knee joint, coronal, sagittal, axial and oblique sagittal plane scanning with fast spin-echo sequence(T1WI, T2WI, PDWI + FS) was performed on knee joint in 205 patients in three days after injury. According the distributing bone marrow edema and injury mechanism, bone contusion were classified five types as pivot shift injury, clip injury, dashboard injury, hyperextension injury and lateral patellar dislocation. Results: One hundred and forty-five cases of the 205 patients were found bone marrow edema without fracture on X-ray films. Among them, pivot shift injury was found in 43 cases accompanied with anterior cruciate ligament rupture in 30 cases, tear of the posterior horn of the lateral or medial meniscus in 12 and tears of the medial collateral ligament in 8 cases; clip injury in 53 cases accompanied with anterior cruciate ligament rupture in 10 cases, tear of the posterior horn of the lateral or medial meniscus in 15 and tears of the medial collateral ligament in 38 cases; dashboard injury 40 cases accompanied with posterior cruciate ligament rupture in 16 cases, hyperextension injury. 9 cases accompanied with anterior cruciate ligament rupture in 2 cases, posterior cruciate ligament rupture in 3 cases. No lateral patellar dislocation was found. Forty-eight of 145 patients had undergone arthroscopy, 43 cases (89.6%) of them were in accordance with Mill diagnosis. Bone contusion were defined as geographic regions of abnormal signal intensity, that is, low signal intensity in T1-weighted images and high signal intensity in PD-weighted or T2-weigeted images with fat saturation. Conclusion: MRI can accurately display the location and area of bone contusion of the knee joint as well as its adjunctive structure injury and deduce their injury mechanism. MRI should be used routinely for knee trauma. (authors)

  9. Total knee arthroplasty for severe valgus knee deformity

    Zhou Xinhua; Wang Min; Liu Chao; Zhang Liang; Zhou Yixin

    2014-01-01

    Background Primary total knee arthroplasty (TKA) in severe valgus knees may prove challenging,and choice of implant depends on the severity of the valgus deformity and the extent of soft-tissue release.The purpose of this study was to review 8 to 11 years (mean,10 years) follow-up results of primary TKA for varient-Ⅲ valgus knee deformity with use of different type implants.Methods Between January 2002 and January 2005,20 women and 12 men,aged 47 to 63 (mean,57.19±6.08) years old,with varient-Ⅲ valgus knees underwent primary TKA.Of the 32 patients,37 knees had varient-Ⅲ deformities.Pie crusting was carefully performed with small,multiple inside-out incisions,bone resection balanced the knee in lieu of soft tissue releases that were not used in the series.Cruciate-retaining knees (Gemini MKⅡ,Link Company,Germany) were used in 13 knees,Genesis Ⅱ (Simth & Nephew Company,USA) in 14 knees,and hinged knee (Endo-Model Company,Germany) in 10 knees.In five patients with bilateral variant-Ⅲll TKAs,three patients underwent 1-stage bilateral procedures,and two underwent 2-stage procedures.All implants were cemented and the patella was not resurfaced.The Hospital for Special Surgery (HSS) knee score was assessed.Patients were followed up from 8 to 11 years.Results The mean HSS knee score were improved from 50.33±11.60 to 90.06±3.07 (P <0.001).The mean tibiofemoral alignment were improved from valgus 32.72°±9.68° pre-operation to 4.89°±0.90° post-operation (P <0.001).The mean range of motion were improved from 93.72°±23.69° pre-operation to 116.61±16.29° post-operation (P <0.001).No patients underwent revision.One patient underwent open reduction and internal fixation using femoral condylar plates for supracondylar femoral fractures secondary to a fall at three years.Three patients developed transient peroneal nerve palsies,which resolved within nine months.Two patients developed symptomatic deep vein thrombosis that was managed with rivaroxaban

  10. Chronic Lymphedema of the Lower Limb: A Rare Cause of Dislocation of Total Hip Arthroplasty.

    Vaishya, Raju; Agarwal, Amit Kumar; Gupta, Nishint; Vijay, Vipul

    2016-01-01

    Total hip arthroplasty (THA) in a patient with chronic lymphedema of both lower limbs is rarely reported in the literature. Chronic lymphedema is a challenging condition associated with various complications especially in a patient with THA. However, dislocation of the total hip prosthesis due to acute exacerbation of lower limb swelling in the postoperative period is an extremely rare complication. The cause that led to the dislocation of the prosthesis is intricate and difficult to assess, as this has not been discussed in the literature yet. We believe that the excessive weight of the limb due to chronic lymphedema had a deleterious effect on the biomechanics of total hip prosthesis, thereby increasing the tendency for dislocation. This case illustrates that chronic lymphedema of the lower limb should be dealt with aggressively using various modalities like intermittent pneumatic compression pumps and compression stockings after THA in such patients. PMID:27226940

  11. Knee Muscles Power Evolution in Patients with Total Knee Arthroplasty

    Ileana Monica BORDA; IRSAY Laszlo; Rodica UNGUR; Viorela CIORTEA; Ioan ONAC; Alina SUSMAN; Liviu POP

    2012-01-01

    Purpose: To measure changes in muscle power from before to 6 months after total knee arthroplasty and to compare outcomes with those from a control group of healthy adults. Material and Methods: 26 patients who underwent a total knee replacement were compared with 12 healthy age-matched adults in a prospective cohort study. Patients’ assessment was performed preoperatively, as well as at 1, 2 and 6 months postoperatively, by the isokinetic method. Healthy adults were assessed once by the same...

  12. Cosmetic effect of knee joint in a knee disarticulation prosthesis.

    de Laat, Fred A; van der Pluijm, Mark J; van Kuijk, Annette A; Geertzen, Jan H; Roorda, Leo D

    2014-01-01

    Despite numerous advantages, knee disarticulations (KDs) are rarely performed because of the anticipated KD prosthesis fitting problems that include the positioning of the knee joint distally from the KD socket. This results in lengthening of the thigh and subsequent shortening of the shank. The objective of this study was to assess the cosmetic effect of the knee joint in a KD prosthesis by determining the extent of the lengthening of the thigh and the shortening of the shank. This lengthening and shortening were measured through an experimental setup using laser techniques. These measurements were made of 18 knee joints used in KD prostheses. Lengthening of the thigh varied between 23 and 92 mm, and shortening of the shank varied between 3 and 50 mm. The polycentric knees Medi KH6 and Medi KHF1 showed the least lengthening of the thigh, and the polycentric knees Teh Lin Prosthetic & Orthotic Co. Ltd Graph-Lite and Medi KP5 showed the least shortening of the shank. PMID:25856500

  13. 肩锁关节脱位的诊断与治疗%Diagnosis and treatment of acromioclavicular dislocation

    黄高; 王金华; 孔建中

    2012-01-01

    The acromioclavicular dislocation is a type of common shoulder athletic injury in clinic , and its incidence accounted for 12% of the local sites injuries. At present,The acute dislocation of Rockwood type I , II was recommended to be managed non -operatively, while acute dislocation of type IV, V and VI operatively. But there still exist controversial in the treatment of acute dislocation of type III. In this peper, the authors have reviewed the current status of treatment of acromioclavicular dislocation .%肩锁关节脱位是临床常见的肩部运动损伤.目前,临床认为Rockwood Ⅰ、Ⅱ型急性脱位应行非手术治疗,Ⅳ、V及Ⅵ型急性脱位应行手术治疗,但对Ⅲ型急性脱位是采取非手术治疗还是手术治疗仍存在争议.本文对肩锁关节脱位的治疗现状进行综述.

  14. Diffusion along and around dislocations

    We have gathered together in this text some solutions for Fick's equations applicable to diffusion in dislocations. The problems is fairly similar to that of grain boundaries but in this case a further difficulty arises, purely mathematical in fact, due to the supposedly cylindrical shape of the perturbed region around a dislocation. It follows that Fick's equation is used in the form: ∂C/∂t=D[∂2C/∂r2+1/r∂C/∂ r + ∂2C/∂z2] in order to express simply the limiting conditions and so that the solution takes into account the symmetry of revolution of the system. This very much complicates the final form of the results. We give here as an illustration a solution obtained using the same hypotheses and making the same approximations as those employed by WHIPPLE for his grain boundary work. Unfortunately the final form is not suitable for a numerical calculation. By making grosser approximations, such a those used by FISHER, it is possible to determine the parameter D/(a2D'); the same result as for grain boundary is found i.e that the logarithm of the mean concentration varies linearly with penetration, the slope of this straight line is proportional to √(D/(a2D')) Finally we give the exact solution for a platelet of finite thickness assuming that the diffusion in the defect less crystal is negligible and that the surface diffusion is infinitely fast. This is the problem dealt with by HENDRIGKSON and MACHLIN. We arrive at conclusions different to those obtained by these two authors. (author)

  15. Minimally Invasive Total Knee Arthroplasty

    Full Text Available ... the midline to come down into the knee joint. The nice thing about that is when we ... prevent , you know, essentially bleeding out of the joint in the postoperative phase? We'd like to ...

  16. Total Knee Replacement for Women

    Full Text Available ... to Dr. Gustke, who is live with the patient right now. Ken. Hello. I’m Ken Gustke, ... You can see the X-rays of this patient. She has classic osteoarthritis of the knee. She ...

  17. Minimally Invasive Total Knee Arthroplasty

    Full Text Available ... the knees well balanced, which I think we should be doing anyhow for all of our cases. ... tibial component. Do you agree with that or should we- Well, certainly the -- let’s have a pin -- ...

  18. Total Knee Replacement for Women

    Full Text Available ... do most of my younger patients with computer navigation. I believe that that does help with the ... knee. And I think with use of computer navigation we can obtain that essentially a hundred percent ...

  19. Bowlegs and Knock-Knees

    ... Emotional Problems Eyes Fever From Insects or Animals Genitals and Urinary Tract Glands ... and Knock-Knees Page Content Article Body Toddlers’ legs often have a bowed appearance. In fact, many children have bowing of the ...

  20. Total Knee Replacement for Women

    Full Text Available ... do my tibial resection, so I put the large bent knee lateral to the posterior cruciate ligament, ... like I just did. Can I have a large tibial punch. And really you just need the ...

  1. Minimally Invasive Total Knee Arthroplasty

    Full Text Available ... that certainly is personal preference. And is that gender-specific or is that for all comers? No, ... of the other knee systems, indeed, there are gender-specific femoral components that can be used. With ...

  2. Minimally Invasive Total Knee Arthroplasty

    Full Text Available ... just elevating a flap subperiosteally from the medial aspect of this knee. I'll do some pretty ... fat pad, I can see the whole distal aspect of the femur and even the tibia there, ...

  3. Minimally Invasive Total Knee Arthroplasty

    Full Text Available ... get started. We've prepped our knee in standard fashion. We have actually already exsanguinated this leg. ... poorly, we still will end up with our standard instability and/or rapid aware problems. Heavy hookup, ...

  4. Minimally Invasive Total Knee Arthroplasty

    Full Text Available ... started. We've prepped our knee in standard fashion. We have actually already exsanguinated this leg. Load ... re going to come just in a peripatellar fashion but we're only going to come to ...

  5. Total Knee Replacement for Women

    Full Text Available ... notch anteriorly. If you can give me the male size two. You can see that there’s a difference in the gender knee between the males and the females. Females tend to have narrower ...

  6. Minimally Invasive Total Knee Arthroplasty

    Full Text Available ... because, once again, I don't want to leave any communicating passages up into that sub-q ... the knee into its native position. If we leave it subluxed here laterally, we tend to very ...

  7. Total Knee Replacement for Women

    Full Text Available ... that we feel because of their health and age has the potential for a total knee to ... I can evaluate? Is there any cut-off age that you would put in regular polyethylene or ...

  8. Unusual Cause of Knee Locking

    Gazi Huri

    2013-01-01

    Full Text Available We report a case of partial intrasubstance tear of popliteus tendon as an unusual cause of pseudolocking of the knee. A 13-year-old semiprofessional soccer player applied to our clinic with a locked right knee in spite of the therapy applied (cold pack, NSAID, and immobilization in another institution 20 days after the injury. Significant extension loss was observed in his right knee with 30∘–90∘ ROM. Magnetic resonance imaging (MRI and arthroscopy confirmed the intrasubstance tear of popliteus tendon and synovitis. The ruptured part of the tendon was debrided, and the inflammatory tissue around the tendon, which may lead to pseudolocking, was gently removed with a shaver in order to regain the normal ROM. The patient was discharged with full ROM and weight bearing first day after the surgery. To our knowledge, this is the first case demonstrating intrasubstance tear of popliteus tendon causing pseudolocking of the knee.

  9. Minimally Invasive Total Knee Arthroplasty

    Full Text Available ... and drill her. And how much are you rotating there? This rotates 3 degrees externally with respect ... femoral components that can be used. With the rotating knee system, a class III device at this ...

  10. Minimally Invasive Total Knee Arthroplasty

    Full Text Available ... there’s any change that makes us concentrate and focus on ligament balancing a little more than we ... be used. With the rotating knee system, a class III device at this point, with respect to ...

  11. Total Knee Replacement for Women

    Full Text Available ... it’s going to cause abnormal loading of the plastic posteriorly, which will wear it out and won’ ... a higher ramp anteriorly, which gives you stability against posterior subluxation throughout the entire knee range of ...

  12. Minimally Invasive Total Knee Arthroplasty

    Full Text Available ... that the knee has indeed improved in its design. The pivot point of the mobile bearing in ... reading about with some of the other mobile designs. So I've been so far very pleased ...

  13. Minimally Invasive Total Knee Arthroplasty

    Full Text Available ... things and then take advantage of these nice new mobile designs I think we find ourselves in ... we really can maximize the benefits of these new knees. But even if the designs are wonderful, ...

  14. Minimally Invasive Total Knee Arthroplasty

    Full Text Available ... Sekundiak. I'm an Assistant Professor at Creighton University Medical Center in Omaha, Nebraska. We're actually ... male knee. Dr. Mafoos I believe at the University of Missouri proved that point. And with some ...

  15. Total Knee Replacement for Women

    Full Text Available ... m removing some lateral osteophytes, which, again, will help me getting my patella subluxated laterally. Now I ... with computer navigation. I believe that that does help with the overall alignment of the knee. We’ ...

  16. Minimally Invasive Total Knee Arthroplasty

    Full Text Available ... contractures after I remove that. So it certainly aids in my being able to see. What I' ... you can see how just a little bit aids in Denton's ability to show me this knee. ...

  17. Total Knee Replacement for Women

    Full Text Available ... are you dialing up on that jig to account for cartilage loss and bony erosion? Right now ... younger patients I do cement less knees, which accounts for about 20 -- 25 percent of my practice, ...

  18. Knee Brace Would Lock And Unlock Automatically

    Myers, Neill; Forbes, John; Shadoan, Mike; Baker, Kevin

    1995-01-01

    Proposed knee brace designed to aid rehabilitation of person who suffered some muscle damage in leg. Not limited to locking in straight-leg position and, instead, locks at any bend angle. Does not prevent knee from bearing weight. Instead, knee brace allows knee to bear weight and locks only when foot and lower leg bear weight. Thus, brace prevents flexion that wearer desired to prevent but could not prevent because of weakened muscles. Knee bends freely to exercise knee-related muscles. Knee brace strapped at upper end to leg above knee, and anchored at lower end by stirrup under foot. Joint mechanism (identical mechanisms used in left and right assemblies) allows knee joint to flex freely except when weight applied to heel.

  19. Analysis of Joint Sounds in the Diagnosis of Knee Disorders

    2015-07-22

    Healthy Patients; No Knee Complaints; No Knee Injuries; No Knee Surgeries; No Neurological Problems; Patients Undergoing Knee Arthroscopy, Who Has a Pre-op MRI; Age Groups of 20,40 and 60 Years of Age.

  20. Evolution, Interaction, and Intrinsic Properties of Dislocations in Intermetallics: Anisotropic 3D Dislocation Dynamics Approach

    Qian Chen

    2008-08-18

    The generation, motion, and interaction of dislocations play key roles during the plastic deformation process of crystalline solids. 3D Dislocation Dynamics has been employed as a mesoscale simulation algorithm to investigate the collective and cooperative behavior of dislocations. Most current research on 3D Dislocation Dynamics is based on the solutions available in the framework of classical isotropic elasticity. However, due to some degree of elastic anisotropy in almost all crystalline solids, it is very necessary to extend 3D Dislocation Dynamics into anisotropic elasticity. In this study, first, the details of efficient and accurate incorporation of the fully anisotropic elasticity into 3D discrete Dislocation Dynamics by numerically evaluating the derivatives of Green's functions are described. Then the intrinsic properties of perfect dislocations, including their stability, their core properties and disassociation characteristics, in newly discovered rare earth-based intermetallics and in conventional intermetallics are investigated, within the framework of fully anisotropic elasticity supplemented with the atomistic information obtained from the ab initio calculations. Moreover, the evolution and interaction of dislocations in these intermetallics as well as the role of solute segregation are presented by utilizing fully anisotropic 3D dislocation dynamics. The results from this work clearly indicate the role and the importance of elastic anisotropy on the evolution of dislocation microstructures, the overall ductility and the hardening behavior in these systems.

  1. Dislocation dynamics based modelling of dislocation-precipitate interactions in bcc metals

    The influence of dislocation core on the interaction between an edge dislocation and a spherical precipitate was investigated using the combination of the parametric dislocation dynamics and the boundary element method with a dislocation core model. In the results of the simulations, the dislocation core of the edge dislocation behaves differently between inside and outside the precipitate. The calculated critical resolved shear stress is strongly affected by the dislocation core. Therefore, it could be found that the influence of dislocation core is a dominant factor in determining the strength of the interaction. Then, we derived an equation for evaluating the influence of dislocation core on the critical resolved shear stress. The derivation was done using the difference between the γ-surface energy in iron and that in copper, because there is a significant difference in-between. The equation can be solved without any simulation runs. The result of the equation was then compared to that of the simulations, which showed that the equation gives a good evaluation of the influence of dislocation core. Since the equation is derived without any limitation on the kind of materials, it can be applicable to the evaluation of the strength of the other alloys with precipitates.

  2. Continuum framework for dislocation structure, energy and dynamics of dislocation arrays and low angle grain boundaries

    Zhu, Xiaohong; Xiang, Yang

    2014-09-01

    We present a continuum framework for dislocation structure, energy and dynamics of dislocation arrays and low angle grain boundaries that are allowed to be nonplanar or nonequilibrium. In our continuum framework, we define a dislocation density potential function on the dislocation array surface or grain boundary to describe the orientation dependent continuous distribution of dislocations in a very simple and accurate way. The continuum formulations incorporate both the long-range dislocation interaction and the local dislocation line energy, and are derived from the discrete dislocation model. The continuum framework recovers the classical Read-Shockley energy formula when the long-range elastic fields of the low angle grain boundaries are canceled out. Applications of our continuum framework in this paper are focused on dislocation structures on static planar and nonplanar low angle grain boundaries and misfitting interfaces. We present two methods under our continuum framework for this purpose, including the method based on the Franks formula and the energy minimization method. We show that for any (planar or nonplanar) low angle grain boundary, the Franks formula holds if and only if the long-range stress field in the continuum model is canceled out, and it does not necessarily hold for a total energy minimum dislocation structure.

  3. Thompson's quadricepsplasty for stiff knee

    Kundu, ZS; Sangwan, SS; Guliani, G; Siwach, RC; Kamboj, P; Singh, Raj

    2007-01-01

    Background: Stiffness of the knee after trauma and/or surgery for femoral fractures is one of the most common complications and is difficult to treat. Stiffness in extension is more common and can be reduced by vigorous physiotherapy. If it does not improve then quadricepsplasty is indicated. The present study was undertaken to evaluate the results of Thompsons quadricepsplasty. Materials and Methods: Twenty-two male patients (age range 20-45 years) with posttraumatic knee stiffness following...

  4. Ultrasonic Study of Dislocation Dynamics in Lithium -

    Han, Myeong-Deok

    1987-09-01

    Experimental studies of dislocation dynamics in LiF single crystals, using ultrasonic techniques combined with dynamic loading, were performed to investigate the time evolution of the plastic deformation process under a short stress pulse at room temperature, and the temperature dependence of the dislocation damping mechanism in the temperature range 25 - 300(DEGREES)K. From the former, the time dependence of the ultrasonic attenuation was understood as resulting from dislocation multiplication followed by the evolution of mobile dislocations to immobile ones under large stress. From the latter, the temperature dependence of the ultrasonic attenuation was interpreted as due to the motion of the dislocation loops overcoming the periodic Peierls potential barrier in a manner analogous to the motion of a thermalized sine-Gordon chain under a small stress. The Peierls stress obtained from the experimental results by application of Seeger's relaxation model with exponential dislocation length distribution was 4.26MPa, which is consistent with the lowest stress for the linear relation between the dislocation velocity and stress observed by Flinn and Tinder.

  5. Epidemiology, Etiology, and Prevention of Late IOL-Capsular Bag Complex Dislocation: Review of the Literature

    Francisco J. Ascaso

    2015-01-01

    Full Text Available Posterior chamber intraocular lens (PC-IOL subluxation is uncommon but represents one of the most serious complications following phacoemulsification. Late spontaneous IOL-capsular bag complex dislocation is defined as occurring three months or later following cataract surgery. Unlike early IOL dislocation, late spontaneous IOL dislocation is due to a progressive zonular dehiscence and contraction of the capsular bag many years what seemed to be uneventful surgery. In recent years, late in-the-bag IOL subluxation or dislocation has been reported with increasing frequency, having a cumulative risk of IOL dislocation following cataract extraction of 0.1% after 10 years and 1.7% after 25 years. A predisposition to zonular insufficiency and capsular contraction is identified in 90% of reviewed cases. Multiple conditions likely play a role in contributing to this zonular weakness and capsular contraction. Pseudoexfoliation is the most common risk factor, accounting for more than 50% of cases. Other associated conditions predisposing to zonular dehiscence are aging, high myopia, uveitis, trauma, previous vitreoretinal surgery, retinitis pigmentosa, diabetes mellitus, atopic dermatitis, previous acute angle-closure glaucoma attack, and connective tissue disorders. The recognition of these predisposing factors suggests a modified approach in cases at risk. We review certain measures to prevent IOL-bag complex luxation that have been proposed.

  6. Epidemiology, Etiology, and Prevention of Late IOL-Capsular Bag Complex Dislocation: Review of the Literature.

    Ascaso, Francisco J; Huerva, Valentín; Grzybowski, Andrzej

    2015-01-01

    Posterior chamber intraocular lens (PC-IOL) subluxation is uncommon but represents one of the most serious complications following phacoemulsification. Late spontaneous IOL-capsular bag complex dislocation is defined as occurring three months or later following cataract surgery. Unlike early IOL dislocation, late spontaneous IOL dislocation is due to a progressive zonular dehiscence and contraction of the capsular bag many years what seemed to be uneventful surgery. In recent years, late in-the-bag IOL subluxation or dislocation has been reported with increasing frequency, having a cumulative risk of IOL dislocation following cataract extraction of 0.1% after 10 years and 1.7% after 25 years. A predisposition to zonular insufficiency and capsular contraction is identified in 90% of reviewed cases. Multiple conditions likely play a role in contributing to this zonular weakness and capsular contraction. Pseudoexfoliation is the most common risk factor, accounting for more than 50% of cases. Other associated conditions predisposing to zonular dehiscence are aging, high myopia, uveitis, trauma, previous vitreoretinal surgery, retinitis pigmentosa, diabetes mellitus, atopic dermatitis, previous acute angle-closure glaucoma attack, and connective tissue disorders. The recognition of these predisposing factors suggests a modified approach in cases at risk. We review certain measures to prevent IOL-bag complex luxation that have been proposed. PMID:26798506

  7. Galeazzi's modified technique for recurrent patella dislocation in skeletally immature patients

    A large number of surgical techniques have been proposed for the treatment of recurrent patellar dislocation in adolescents, one of the most famous being Galeazzi's semitendinosus tenodesis as modified by Baker. The aim of this study was to verify the mid-term results of this technique, the effectiveness of restoring the patellofemoral congruency, by both static and dynamic computed tomography (CT), and to determine whether the preoperative type of patellofemoral relationship affects the results. The study included 14 patients (16 knees), with a mean age of 11.6 years, Tanner stage ≤3, with at least two to three episodes of patellar dislocation. The patients underwent surgery using Baker's modification of Galeazzi's technique. All 14 patients were evaluated preoperatively and at least 4 years afterward by static and dynamic CT. Clinical evaluation at follow-up was performed using the criteria described by Crosby and Insall. Clinical results at follow-up were excellent in 62.5% and good in 37.5%. As preoperative evaluation showed a high patella in 7 out of 16 knees, two groups were considered: A, high patella; B, not high patella. The data obtained with static CT show that the patella reached a satisfactory congruence in all knees. The data obtained with dynamic CT showed different results between group A and B. A preoperative high patella remains high with quadriceps contraction and again shows the change of tilt and subluxation. In group B, the data obtained with dynamic CT are comparable with those obtained with static CT. This technique produces good mid-term clinical results. However, the dynamic CT showed that in those patients with high patellas, semitendinosus tenodesis alone is not enough to stabilize the patella. (author)

  8. Experimental radiation synovectomy in rabbit knee with holmium-166 ferric hydroxide macroaggregate

    Holmium-166 ferric hydroxide macroaggregate (Ho-166 FHMA) particles possess two important properties for radiosynovectomy; relatively short half-life of the radioisotope and appropriate carrier size. Both these minimize radioactive leakage from the treated joint. This study was conducted to assess the effects of Ho-166 FHMA on synovium and synovial fluid in rabbit knee joints. Whole-knee autoradiography was utilized to determine distribution of radioactivity after intra-articular Ho-166 FHMA injection. Intra-articular injection of Ho-166 FHMA resulted in focal acute radiation necrosis in synovial lining but no hyperplasia of synoviocytes. Later, subsynovial fibrosis became evident. White blood cell and total protein levels in the joint fluid were elevated because of intra-articular inflammation due to the acute effects of radiation. Whole knee autoradiograms showed uneven distribution of the radionuclide along the synovium and extraarticular leakage on the third day after treatment

  9. Treatment of cervical dislocation with locked facets

    YU Ze-sheng; James J.Yue; WEI Feng; LIU Zhong-jun; CHEN Zhong-qiang; DANG Geng-ting

    2007-01-01

    Background Lower cervical dislocation with locked facets is common in cervical injury. The locked facets include unilateral and bilateral types. Different successful closed reduction rates has been achieved between unilateral and bilateral types by using rapid skull traction, which was commonly used to reduce the cervical dislocation. It is important to investigate a suitable management specific to patients with different types of cervical locked facets.Methods A total of 38 patients with cervical dislocation with locked facet due to cervical injury treated by rapid skull traction and operation from 1988 to 2005 were reviewed. Rapid skull traction was used in all the patients. Successful closed reduction rate was 88.0% in patients with bilateral cervical locked facets and that was 15.4% in those with unilateral cervical locked facets. These data were then statistically compared by Chi-square test. Patients who were reduced successfully underwent anterior cervical discectomy and fusion at the injured level, and those who failed in closed reduction received posterior open reduction and fixation.Results In this series, there was statistically significant difference (P<0.05) in the rate of successful closed skull traction reduction between unilateral and bilateral locked facets dislocation. Unilateral cervical locked facets dislocation was not easily reduced by skull traction which was suitable for reduction of bilateral cervical locked facets dislocation. However,unilateral cervical locked facets dislocation can be reduced by posterior open reduction.Conclusions Unilateral cervical locked facets dislocation should be treated immediately with posterior open reduction and instrumentation. Bilateral cervical locked facets dislocation can be reduced by rapid skull traction firstly and anterior cervical discectomy and interbody fusion later.

  10. Operative treatment of acromioclavicular joint dislocation: a new technique with suture anchors

    Zhang Jingwei

    2014-07-01

    Full Text Available 【Abstract】Objective: To evaluate clinical outcome of suture anchors in strengthening both acromioclavicular and coracoclavicular ligaments in the surgical treatment of acromioclavicular joint dislocation. Methods: Twenty-eight patients with acute traumatic Rockwood III, IV and V dislocations of the acromioclavicular joint surgically treated at our institute between October 2010 and January 2012 were recruited. All patients underwent open reduction combined with suture anchors. Function was evaluated using the ConstantMurley shoulder score. Clinical and radiographic shoulder ratings were evaluated using Taft criteria at 3, 6 and 12 months. Results:Two cases with fixation loosening were not included in final statistical analysis. Other patients obtained full joint reposition on immediate postoperative radiographs. Follow-up was performed with an average of 15.6 months (range, 12-19. After early range of motion exercises, 96.2% of the patients (25/26 could abduct and elevate their shoulders more than 90 degrees within postoperative 3 months. There was no infection. Average Constant-Murley score was 96.3 points (range, 94-100 and mean Taft shoulder rating was 10.7 points (range, 8-12 at 12 months. Conclusion: The suture anchor is a relatively simple technique and can avoid screw removal which is helpful in reconstructing both acromioclavicular and coracoclavicular ligaments in acute traumatic acromioclavicular joint dislocation. Key words: Acromioclavicular joint; Dislocations; Surgery; Suture anchors

  11. Experimental knee pain reduces muscle strength

    Henriksen, Marius; Mortensen, Sara Rosager; Aaboe, Jens;

    2011-01-01

    experimental knee pain in healthy volunteers, and if these changes were associated with the pain intensities. In a crossover study, 18 healthy subjects were tested on 2 different days. Using an isokinetic dynamometer, maximal muscle strength in knee extension and flexion was measured at angular velocities 0....... Knee pain reduced the muscle strength by 5 to 15% compared to the control conditions (P <.001) in both knee extension and flexion at all angular velocities. The reduction in muscle strength was positively correlated to the pain intensity. Experimental knee pain significantly reduced knee extension and...

  12. Dislocations in SmS single crystals

    Single crystals of SmS with NaCl structure are grown by zone melting in a sealed molybdenum tube. Dislocations introduced during cleaving the crystal are investigated by transmission electron microscopy. The dislocations have Burgers vector of 1/2 and their glide plane is (11-bar0), i.e. the slip system is (11-bar0) as in alkali-halide NaCl-type crystals. The slip seems to be governed by the Peierls mechanism for the screw dislocation. (author)

  13. Preventing knee injuries in adolescent female football players – design of a cluster randomized controlled trial [NCT00894595

    Waldén Markus

    2009-06-01

    Full Text Available Abstract Background Knee injuries in football are common regardless of age, gender or playing level, but adolescent females seem to have the highest risk. The consequences after severe knee injury, for example anterior cruciate ligament (ACL injury, are well-known, but less is known about knee injury prevention. We have designed a cluster randomized controlled trial (RCT to evaluate the effect of a warm-up program aimed at preventing acute knee injury in adolescent female football. Methods In this cluster randomized trial 516 teams (309 clusters in eight regional football districts in Sweden with female players aged 13–17 years were randomized into an intervention group (260 teams or a control group (256 teams. The teams in the intervention group were instructed to do a structured warm-up program at two training sessions per week throughout the 2009 competitive season (April to October and those in the control group were informed to train and play as usual. Sixty-eight sports physical therapists are assigned to the clubs to assist both groups in data collection and to examine the players' acute knee injuries during the study period. Three different forms are used in the trial: (1 baseline player data form collected at the start of the trial, (2 computer-based registration form collected every month, on which one of the coaches/team leaders documents individual player exposure, and (3 injury report form on which the study therapists report acute knee injuries resulting in time loss from training or match play. The primary outcome is the incidence of ACL injury and the secondary outcomes are the incidence of any acute knee injury (except contusion and incidence of severe knee injury (defined as injury resulting in absence of more than 4 weeks. Outcome measures are assessed after the end of the 2009 season. Discussion Prevention of knee injury is beneficial for players, clubs, insurance companies, and society. If the warm-up program is proven to

  14. On dislocation-defect interactions and patterning: stochastic discrete dislocation dynamics (SDD)

    Hiratani, M.; Zbib, H.M. E-mail: zbib@wsu.edu

    2003-12-01

    The problem of dislocation patterning and interaction of threading dislocations with immobile dislocation loops and defects is investigated analytically and computationally based on a statistical analysis and a recently developed model of discrete stochastic dislocation dynamics (SDD), respectively. The statistical analysis is based on the Friedel-Kocks model and shows the validity of the Friedel relation for the critical resolved stress while a power law with different stress dependence is obtained for the average pinning distance on a stable dislocation array. The difference of the stress dependence is attributed to each model assumptions, such as stable dislocation configurations in athermal system or meta-stable configurations in thermally activated system. The SDD computational study includes thermal and strain fluctuation, predicting non-trivial fractal instability of the plastic strain. The height difference correlations of the plastic strain show that the external load causes a multifractality, and enhances the instability at higher order moments.

  15. Association between knee alignment and knee pain in patients surgically treated for medial knee osteoarthritis by high tibial osteotomy. A one year follow-up study.

    Roos Ewa M; Toksvig-Larsen Sören; W-Dahl Annette

    2009-01-01

    Abstract Background The association between knee alignment and knee pain in knee osteoarthritis (OA) is unclear. High tibial osteotomy, a treatment option in knee OA, alters load from the affected to the unaffected compartment of the knee by correcting malalignment. This surgical procedure thus offers the possibility to study the cross-sectional and longitudinal association of alignment to pain. The aims were to study 1) the preoperative association of knee alignment to preoperative knee pain...

  16. A nonsingular solution of the edge dislocation in the gauge theory of dislocations

    Lazar, Markus

    2002-01-01

    A (linear) nonsingular solution for the edge dislocation in the translational gauge theory of defects is presented. The stress function method is used and a modified stress function is obtained. All field quantities are globally defined and the solution agrees with the classical solution for the edge dislocation in the far field. The components of the stress, strain, distortion and displacement field are also defined in the dislocation core region and they have no singularity there. The dislo...

  17. Increasing preoperative dislocations and total time of dislocation affect surgical management of anterior shoulder instability

    Denard, Patrick J.; Xuesong Dai; Burkhart, Stephen S.

    2015-01-01

    Purpose: Our purpose was to determine the relationship between number of preoperative shoulder dislocations and total dislocation time and the need to perform bone deficiency procedures at the time of primary anterior instability surgery. Our hypothesis was that need for bone deficiency procedures would increase with the total number and hours of dislocation. Materials and Methods: A retrospective review was performed of primary instability surgeries performed by a single surgeon. Patient...

  18. Dislocation dynamics simulations with climb: kinetics of dislocation loop coarsening controlled by bulk diffusion

    Dislocation climb mobilities, assuming vacancy bulk diffusion, are derived and implemented in dislocation dynamics simulations to study the coarsening of vacancy prismatic loops in fcc metals. When loops cannot glide, comparison of the simulations with a coarsening model based on the line tension approximation shows good agreement. Dislocation dynamics simulations with both glide and climb are then performed. Allowing for glide of the loops along their prismatic cylinders leads to faster coarsening kinetics, as direct coalescence of the loops is now possible. (authors)

  19. Radiosynovectomy: Another Approach to Treat Inflamed Knee Joint

    Introduction: Radiosynovectomy (RSV) by intra-articular injection of Yettrium-90 (90Y) offers a local and minimally invasive therapy for treating chronic and recurrent inflamed synovium of the knee. 90Y causes necrosis of the villi in the synovium and subsequently decreasing fluid collection. In this study the effectiveness of RSV was assessed in patients with inflammatory knee joint conditions refractory to conventional treatment. Methods: Patients referred from different hospitals from May 2007 to Oct 2008. Twenty joints of 17 patients were injected, age 26 -59 years, 3 female, 14 male. All had chronic synovitis due to RA (2), psoriatic arthritis (2), villonodular synovitis (2), non-specific synovitis (4) and OA (10) and were refractory to conventional therapy (including intra-articular corticoids). X-ray, ultrasound (U/S) and 3-phase bone-scan (BS) are needed for preliminary assessment. Written consent is signed and total procedure along its complications explained to the patient by the doctor. Under aseptic conditions, the needle is inserted within the joint cavity under fluoroscopy guidance and 185 MBq of 90Y-colloid is injected followed by a steroid flush to reduce acute refractory synovitis. Follow-up with clinical parameters like pain, joint swelling and range of motion are assessed at 0, 1, 6 and 12 months post injection. 2 phase BS and U/S of the injected knee are repeated at 3 months to assess synovial response. Results: Out of 20 injected joints, 4 didn't complete follow up BS, the rest shows good clinical improvement. Baseline BS was compared to follow-up BS and showed mild, moderate, and marked improvement in blood pool images in 2, 7 and 6 knee joints respectively. One joint didn't show any response, a 2nd injection after 6 months was repeated with 90 marked improvement. Conclusions: RSV using 90Y is an effective alternative therapeutic approach in patients with chronic inflammatory knee joint conditions refractory to conventional treatment. (author)

  20. The in vivo assessment of tibial motion in the transverse plane in anterior cruciate ligament-reconstructed knees.

    Nordt, W E; Lotfi, P; Plotkin, E; Williamson, B

    1999-01-01

    Twenty-one knees with acutely injured anterior cruciate ligaments were reconstructed with patellar tendon autografts. Eight of the knees had concomitant medial ligament injuries that were not addressed surgically. Follow-up evaluation (average, 25 months) included computed tomography measurements to analyze transverse-plane laxity in both translation and rotation. These measurements were performed with the patient's leg in a load cell device that stabilizes the distal femur and applies known anterior translational force to the proximal tibia at approximately 20 degrees of flexion. A torque apparatus was used to apply internal and external rotational torque to the leg. Images of the tibial plateau in neutral, internal, and external rotation were performed, with and without an anterior translational force. Both knees of each patient were tested and categorized as group I (anterior cruciate ligament-reconstructed) or group II (uninjured). Translation as measured by computed tomography averaged 1 mm side-to-side difference. Internal rotation averaged 8.7 degrees in group I knees and 10.8 degrees in group II knees. External rotation averaged 9.1 degrees in group I knees and 7.4 degrees in group II knees. The eight knees with concomitant medial ligament injuries were analyzed separately; external rotation without anterior load in group I was 9.5 degrees, compared with 5 degrees in group II. This difference was significant (P < 0.01). PMID:10496578

  1. Dislocation dynamics simulations of interactions between gliding dislocations and radiation induced prismatic loops in zirconium

    The mechanical behavior of Pressurized Water Reactor fuel cladding tubes made of zirconium alloys is strongly affected by neutron irradiation due to the high density of radiation induced dislocation loops. In order to investigate the interaction mechanisms between gliding dislocations and loops in zirconium, a new nodal dislocation dynamics code, adapted to Hexagonal Close Packed metals, has been used. Various configurations have been systematically computed considering different glide planes, basal or prismatic, and different characters, edge or screw, for gliding dislocations with 〈a〉-type Burgers vectors. Simulations show various interaction mechanisms such as (i) absorption of a loop on an edge dislocation leading to the formation of a double super-jog, (ii) creation of a helical turn, on a screw dislocation, that acts as a strong pinning point or (iii) sweeping of a loop by a gliding dislocation. It is shown that the clearing of loops is more favorable when the dislocation glides in the basal plane than in the prismatic plane explaining the easy dislocation channeling in the basal plane observed after neutron irradiation by transmission electron microscopy

  2. Short-range dislocation interactions using molecular dynamics: Annihilation of screw dislocations

    We present results of a large-scale atomistic study of the annihilation of oppositely signed screw dislocations in an fcc metal using molecular dynamics (MD) and an Embedded-Atom-Method (EAM) potential for Cu. The mechanisms of the annihilation process are studied in detail. From the simulation results, we determined the interaction energy between the dislocations as a function of separation. These results are compared with predictions from linear elasticity to examine the onset of non-linear-elastic interactions. The applicability of heuristic models for annihilation of dislocations in large-scale dislocation dynamics simulations is discussed in the light of these results. copyright 1998 Materials Research Society

  3. Dislocation dynamics simulations of interactions between gliding dislocations and radiation induced prismatic loops in zirconium

    Drouet, Julie, E-mail: julie.drouet@cea.fr [Service de Recherches Métallurgiques Appliquées, CEA-Saclay, 91191 Gif-sur-Yvette (France); Dupuy, Laurent; Onimus, Fabien [Service de Recherches Métallurgiques Appliquées, CEA-Saclay, 91191 Gif-sur-Yvette (France); Mompiou, Frédéric [CEMES-CNRS and Université de Toulouse, 29 Rue Jeanne Marvig, 31055 Toulouse Cedex 4 (France); Perusin, Simon [AREVA NP SAS Fuel Business Unit 10, Rue Juliette Recamier, 69456 Lyon Cedex 06 (France); Ambard, Antoine [EDF/R and D Les Renardières, Ecuelles, 77818 Moret sur Loing Cedex (France)

    2014-06-01

    The mechanical behavior of Pressurized Water Reactor fuel cladding tubes made of zirconium alloys is strongly affected by neutron irradiation due to the high density of radiation induced dislocation loops. In order to investigate the interaction mechanisms between gliding dislocations and loops in zirconium, a new nodal dislocation dynamics code, adapted to Hexagonal Close Packed metals, has been used. Various configurations have been systematically computed considering different glide planes, basal or prismatic, and different characters, edge or screw, for gliding dislocations with 〈a〉-type Burgers vectors. Simulations show various interaction mechanisms such as (i) absorption of a loop on an edge dislocation leading to the formation of a double super-jog, (ii) creation of a helical turn, on a screw dislocation, that acts as a strong pinning point or (iii) sweeping of a loop by a gliding dislocation. It is shown that the clearing of loops is more favorable when the dislocation glides in the basal plane than in the prismatic plane explaining the easy dislocation channeling in the basal plane observed after neutron irradiation by transmission electron microscopy.

  4. Dislocation dynamics simulations of interactions between gliding dislocations and radiation induced prismatic loops in zirconium

    Drouet, Julie; Dupuy, Laurent; Onimus, Fabien; Mompiou, Frédéric; Perusin, Simon; Ambard, Antoine

    2014-06-01

    The mechanical behavior of Pressurized Water Reactor fuel cladding tubes made of zirconium alloys is strongly affected by neutron irradiation due to the high density of radiation induced dislocation loops. In order to investigate the interaction mechanisms between gliding dislocations and loops in zirconium, a new nodal dislocation dynamics code, adapted to Hexagonal Close Packed metals, has been used. Various configurations have been systematically computed considering different glide planes, basal or prismatic, and different characters, edge or screw, for gliding dislocations with -type Burgers vectors. Simulations show various interaction mechanisms such as (i) absorption of a loop on an edge dislocation leading to the formation of a double super-jog, (ii) creation of a helical turn, on a screw dislocation, that acts as a strong pinning point or (iii) sweeping of a loop by a gliding dislocation. It is shown that the clearing of loops is more favorable when the dislocation glides in the basal plane than in the prismatic plane explaining the easy dislocation channeling in the basal plane observed after neutron irradiation by transmission electron microscopy.

  5. Extracting dislocations and non-dislocation crystal defects from atomistic simulation data

    We describe a novel method for extracting dislocation lines from atomistic simulation data in a fully automated way. The dislocation extraction algorithm (DXA) generates a geometric description of dislocation lines contained in an arbitrary crystalline model structure. Burgers vectors are determined reliably, and the extracted dislocation network fulfills the Burgers vector conservation rule at each node. All remaining crystal defects (grain boundaries, surfaces, etc), which cannot be represented by one-dimensional dislocation lines, are output as triangulated surfaces. This geometric representation is ideal for visualization of complex defect structures, even if they are not related to dislocation activity. In contrast to the recently proposed on-the-fly dislocation detection algorithm (ODDA) Stukowski (2010 Modelling Simul. Mater. Sci. Eng. 18 015012) the new method is extremely robust. While the ODDA was designed for a computationally efficient on-the-fly analysis, the DXA method enables a detailed analysis of dislocation lines even in highly distorted crystal regions, as they occur, for instance, close to grain boundaries or in dense dislocation networks

  6. Dislocation engineered silicon light emitting devices

    The influence of boron-induced dislocation loops on the luminescence efficiency of silicon-based light-emitting diodes is investigated. Luminescence measurements and transmission-electron-microscopy images from devices fabricated by boron implantation into crystalline silicon, and subsequently processed under different conditions to form dislocation loops of different size and densities, were compared. Light emitting devices were also fabricated in an otherwise identical but a pre-amorphized substrate, to prevent boron-induced loop formation. The results demonstrate a strong correlation between the dislocation loop density and areal coverage, and the light emission efficiency. The devices produced in the pre-amorphized substrate, without dislocation loops, show strongly quenched light emission

  7. Dislocation equation from the lattice dynamics

    Wang Shaofeng [Institute for Structure and Function, Chongqing University, Chongqing 400044 (China)

    2008-01-11

    A dislocation equation satisfied by both horizontal displacement parallel to the glide plane and vertical displacement perpendicular to the glide plane has been derived generally from the lattice dynamics. In the slow-varying approximation that can be well applied to the dislocation, the equation has been changed into an integro-differential equation that possesses a universal form except the coefficients. If the higher-order derivatives of the displacement are canceled, the classic Peierls equation is recovered. The terms proportional to the higher-order derivatives represent the lattice effects that cannot be obtained in the continuum theory, and cannot be neglected in the core of the dislocation. The results are helpful to link the plasticity with the electronic structure of material because it is rigorously shown that the dislocation structure is mainly controlled by a few factors.

  8. Quenched pinning and collective dislocation dynamics.

    Ovaska, Markus; Laurson, Lasse; Alava, Mikko J

    2015-01-01

    Several experiments show that crystalline solids deform in a bursty and intermittent fashion. Power-law distributed strain bursts in compression experiments of micron-sized samples, and acoustic emission energies from larger-scale specimens, are the key signatures of the underlying critical-like collective dislocation dynamics - a phenomenon that has also been seen in discrete dislocation dynamics (DDD) simulations. Here we show, by performing large-scale two-dimensional DDD simulations, that the character of the dislocation avalanche dynamics changes upon addition of sufficiently strong randomly distributed quenched pinning centres, present e.g. in many alloys as immobile solute atoms. For intermediate pinning strength, our results adhere to the scaling picture of depinning transitions, in contrast to pure systems where dislocation jamming dominates the avalanche dynamics. Still stronger disorder quenches the critical behaviour entirely. PMID:26024505

  9. 21 CFR 888.3580 - Knee joint patellar (hemi-knee) metallic resurfacing uncemented prosthesis.

    2010-04-01

    ... resurfacing uncemented prosthesis. 888.3580 Section 888.3580 Food and Drugs FOOD AND DRUG ADMINISTRATION... § 888.3580 Knee joint patellar (hemi-knee) metallic resurfacing uncemented prosthesis. (a) Identification. A knee joint patellar (hemi-knee) metallic resurfacing uncemented prosthesis is a device made...

  10. 21 CFR 888.3590 - Knee joint tibial (hemi-knee) metallic resurfacing uncemented prosthesis.

    2010-04-01

    ... uncemented prosthesis. 888.3590 Section 888.3590 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Knee joint tibial (hemi-knee) metallic resurfacing uncemented prosthesis. (a) Identification. A knee joint tibial (hemi-knee) metallic resurfacing uncemented prosthesis is a device intended to be...

  11. Posterior sternoclavicular dislocation: an American football injury

    Marker, L B; Klareskov, B

    1996-01-01

    Posterior dislocation of the sternoclavicular joint is uncommon, accounting for less than 0.1% of all dislocations. Since 1824 a little more than 100 cases have been reported, and the majority in the past 20 years. A review of published reports suggests that this injury is seen particularly in...... connection with American football. A typical case is described. The importance of this injury is that there is often a delay in diagnosis with potentially serious complications....

  12. Hip dysplasia and congenital hip dislocation

    Lingg, G.; Nebel, G.; von Torklus, D.

    1981-11-01

    In human genetics and orthopedics quite different answers have been given to the question of hereditary transmission and frequency of hip dysplasia in families of children with congenital hip dislocation. We therefore have made roentgenometric measurements of 110 parents of children with congenital hip dislocation. In 25% we found abnormal flat acetabulae, whereas 12% had pathologic deep hips. This may propose a new concept of morphology of congenital hip dysplasia.

  13. Dislocation dynamics of web type silicon ribbon

    Dillon, O. W., Jr.; Tsai, C. T.; De Angelis, R. J.

    1987-01-01

    Silicon ribbon grown by the dendritic web process passes through a rapidly changing thermal profile in the growth direction. This rapidly changing profile induces stresses which produce changes in the dislocation density in the ribbon. A viscoplastic material response function (Haasen-Sumino model) is used herein to calculate the stresses and the dislocation density at each point in the silicon ribbon. The residual stresses are also calculated.

  14. Cerebral salt wasting syndrome following atlantoaxial fracture dislocation in Down syndrome

    Abdel-Latif, Mohamed El-Amin; Chan, Patrick W-K; Goh, Adrian Yu-Teik; Lum, Lucy Chai-See

    2009-01-01

    We describe cerebral salt wasting syndrome (CSWS) in a 5-year-old female child with Down syndrome who had acute myelopathy secondary to chronic atlantoaxial subluxation and fracture dislocation of the odontoid process. The patient developed hyponatraemia associated with excessive urine output and elevated urine sodium concentration following her injury. An administered volume-for-volume replacement of urine loss with 0.9% sodium chloride resulted in an excellent outcome. This patient illustra...

  15. Epidemiological survey of orthopedic joint dislocations based on nationwide insurance data in Taiwan, 2000-2005

    Yang Nan-Ping; Chen Hou-Chaung; Phan Dinh-Van; Yu I-Liang; Lee Yi-Hui; Chan Chien-Lung; Chou Pesus; Renn Jenn-Huei

    2011-01-01

    Abstract Background The epidemiology of acute orthopedic dislocations is poorly understood. A nationwide database provides a valuable resource for examining this issue in the Taiwanese population. Methods A 6-year retrospective cohort study of 1,000,000 randomly-sampled beneficiaries from the year 2005 was used as the original population. Based on the hospitalized and ambulatory data, the concomitant ICD9-CM diagnosis codes and treatment codes were evaluated and classified into 8 and 3 major ...

  16. Arthritic Pain Relief through Partial Knee Replacement

    Full Text Available ... Advil and anti-inflammatories, as well as some physical therapy. Continuing with other non-operative treatment modalities, she ... is the full knee replacement. Some of the benefits of a partial knee replacement include a less ...

  17. Knee Pain and the Weekend Warriors

    Full Text Available ... of that knee not being completely and totally flexible. But the knees bend right away. The next ... the past, but in other cases, they have led such active lives and they’re so full ...

  18. Arthritic Pain Relief through Partial Knee Replacement

    Full Text Available ... of articular cartilage lining the bone within the joint. That compares and contrasts to the arthritic knee ... swelling in and around her knee. The damaged joint was caused by bones grinding against each other, ...

  19. Knee Pain and the Weekend Warriors

    Full Text Available ... the knee. So welcome to you inside our patient’s knee. And this is a 26-year-old ... ask a quick question. You mentioned that the patient had been playing golf and sustained the injury. ...

  20. Knee Pain and the Weekend Warriors

    Full Text Available ... knee joint so that we get extra blood flow into the knee. I want a little clot ... a stroke some years ago, and suffers from high blood pressure. Is an individual in their early ...

  1. Arthritic Pain Relief through Partial Knee Replacement

    Full Text Available ... is the full knee replacement. Some of the benefits of a partial knee replacement include a less ... get a lot of information, both on the Internet, from other doctors, from friends, and I think ...

  2. Arthritic Pain Relief through Partial Knee Replacement

    Full Text Available ... doesn't have a lot of the mechanical sensations that a total knee replacement patient has, they ... a full knee replacement probably has a better sense of which one will be more helpful for ...

  3. Knee Pain and the Weekend Warriors

    Full Text Available ... lives in the back of the knee, and holds the bones together. The knee replacement design that ... there. It looks real nice. It’s going to hold up real nice. Probe please. I’m going ...

  4. Arthritic Pain Relief through Partial Knee Replacement

    Full Text Available ... is gone through the skin and we're working our way down to the knee joint capsule ... that medial partial knee replacements don't really work. So they come in with the idea that ...

  5. Arthritic Pain Relief through Partial Knee Replacement

    Full Text Available ... is what you see on the left, which has a good full healthy layer of articular cartilage ... bone showing that only part of the knee has been replaced, whereas the rest of the knee ...

  6. Arthritic Pain Relief through Partial Knee Replacement

    Full Text Available ... itself. And again, this is when only one part of the knee, what we call a compartment ... prosthesis secured to the bone showing that only part of the knee has been replaced, whereas the ...

  7. Knee Pain and the Weekend Warriors

    Full Text Available ... this have a small tear propagate into a large tear, and that kind of tear can really ... knee replacement. So we’re seeing a very large epidemic, if you would, of knee arthritis in ...

  8. Knee Pain and the Weekend Warriors

    Full Text Available ... of pivot injury to the knee. Is that something related to exercise, lack of exercise? Is there ... the knee. And luckily for him, this is something that can be repaired with a little insertion ...

  9. Knee Pain and the Weekend Warriors

    Full Text Available ... and takes care of the kinematic or the mechanics of the knee without the anterior cruciate ligament. ... the audience will be seeing some of the mechanics of the total knee replacement, and obviously some ...

  10. Knee Pain and the Weekend Warriors

    Full Text Available ... room you’re going to see the end-stage or what happens to the knees that end ... what you’re observing here is the last stage of preparation in the knee replacement in which ...

  11. Arthritic Pain Relief through Partial Knee Replacement

    Full Text Available ... aspect of the partial knee replacement at this stage is you'll see another cut in the ... all practice components. Now how important is this stage, Dr. McCauley, during the knee replacement? Well, it's ...

  12. Arthritic Pain Relief through Partial Knee Replacement

    Full Text Available ... in this outline here, where on the inner aspect of her knee, what we call the medial ... injection to try and re-lubricate the inner aspect of the knee. However, this failed to provide ...

  13. Knee Pain and the Weekend Warriors

    Full Text Available ... the rest of the knee. Let’s have the table up a little bit. Dr. Hommen, is that ... shame, because you play end up on the table next door getting a knee replacement in 25 ...

  14. Arthritic Pain Relief through Partial Knee Replacement

    Full Text Available ... to introduce our patient. We're going to go into the definition of arthritis. We're going ... a full knee replacement. We are going to go through a surgical video of a partial knee ...

  15. Arthritic Pain Relief through Partial Knee Replacement

    Full Text Available ... the arthritic knee that we see on the right where the cartilage is starting to break down ... different patient who underwent that procedure where the right opaque portion of the knee shows the partial ...

  16. Knee Pain and the Weekend Warriors

    Full Text Available ... of that knee not being completely and totally flexible. But the knees bend right away. The next ... is very dilated and the heart doesn’t work that well, I’m more afraid of that ...

  17. Knee Pain and the Weekend Warriors

    Full Text Available ... that. That’s normal structures in the knee. That helps bathe the knee in normal joint fluid. Okay. ... re saying is that the early intervention can help prevent further problems. Exactly. In certain cases, yes. ...

  18. Arthritic Pain Relief through Partial Knee Replacement

    Full Text Available ... bones grinding against each other, leading to pain, stiffness and inflammation. At times in younger patients this ... full knee replacement, what are the risks of stiffness with a partial knee replacement? Yeah, also known ...

  19. Knee Pain and the Weekend Warriors

    Full Text Available ... in order to fit this patient with an artificial knee. Dr. Lavernia, the moat common, I think, ... That’s not the case. When you have an artificial knee or hip in you, you have to ...

  20. Arthritic Pain Relief through Partial Knee Replacement

    Full Text Available ... glossy layer of cartilage that's intact without any evidence of arthritis in other aspects of the knee. ... have in their knee from rupturing this ligament, evidence has shown that most of these patients do ...

  1. Investigation of the Dynamics of a Screw Dislocation in Copper

    Kolupaeva, S. N.; Petelina, Yu. P.; Polosukhin, K. A.; Petelin, A. E.

    2015-08-01

    A modification of the mathematical model of forming the crystallographic shear band is proposed in which the strength of elastic interaction between all dislocations of the forming dislocation pileups is taken into account in addition to the Peach-Keller force; lattice, impurity, and dislocation friction; linear tension; viscous braking; and intensity of generation of point defects behind kinks. The model is used to investigate the influence of the dislocation density on the time characteristics of the formation of dislocation loops in copper.

  2. Slightly flexed knee position within a standard knee coil: MR delineation of the anterior cruciate ligament

    Niitsu, M.; Itai, Y. [Department of Radiology, Institute of Clinical Medicine, University of Tsukuba, Tennodai, Tsukuba, Ibaraki 305 (Japan); Ikeda, K. [Department of Orthopedic Surgery, Institute of Clinical Medicine, University of Tsukuba, Tennodai, Tsukuba, Ibaraki 305 (Japan)

    1998-02-01

    The purpose of this study was to assess the value of positioning the knee slightly flexed within a standard MR knee coil in delineation of the anterior cruciate ligament (ACL). Within the confined space of a commercially available knee coil, knee could bend as much as 30 , average 17 of flexion. Sets of oblique sagittal MR images were obtained at both fully extended and slightly flexed positions. Twenty-two normal knees and 18 knees with ACL tears were examined and paired MR images were evaluated by two observers. Compared with knee extension, the MR images for knee flexion provided better clarity in 57 % of reviews of full length of the ACL and 53 % of the femoral attachment. In the extended position the anterior margin of the ligament was obscured due to partial averaging with the intercondylar roof. We recommend examining the knee in an achievable flexed position within the standard knee coil. (orig.) With 3 figs., 1 tab., 6 refs.

  3. Slightly flexed knee position within a standard knee coil: MR delineation of the anterior cruciate ligament

    The purpose of this study was to assess the value of positioning the knee slightly flexed within a standard MR knee coil in delineation of the anterior cruciate ligament (ACL). Within the confined space of a commercially available knee coil, knee could bend as much as 30 , average 17 of flexion. Sets of oblique sagittal MR images were obtained at both fully extended and slightly flexed positions. Twenty-two normal knees and 18 knees with ACL tears were examined and paired MR images were evaluated by two observers. Compared with knee extension, the MR images for knee flexion provided better clarity in 57 % of reviews of full length of the ACL and 53 % of the femoral attachment. In the extended position the anterior margin of the ligament was obscured due to partial averaging with the intercondylar roof. We recommend examining the knee in an achievable flexed position within the standard knee coil. (orig.)

  4. Knee extensor muscle weakness is a risk factor for development of knee osteoarthritis

    Oiestad, B E; Juhl, C B; Eitzen, I;

    2015-01-01

    The objective of this study was to perform a systematic review and meta-analysis on the association between knee extensor muscle weakness and the risk of developing knee osteoarthritis. A systematic review and meta-analysis was conducted with literature searches in Medline, SPORTDiscus, EMBASE......, CINAHL, and AMED. Eligible studies had to include participants with no radiographic or symptomatic knee osteoarthritis at baseline; have a follow-up time of a minimum of 2 years, and include a measure of knee extensor muscle strength. Hierarchies for extracting data on knee osteoarthritis and knee...... extensor muscle strength were defined prior to data extraction. Meta-analysis was applied on the basis of the odds ratios (ORs) of developing symptomatic knee osteoarthritis or radiographic knee osteoarthritis in subjects with knee extensor muscle weakness. ORs for knee osteoarthritis and 95% confidence...

  5. Total hip arthroplasty in paralytic dislocation from poliomyelitis.

    Laguna, Rafael; Barrientos, Jesús

    2008-02-01

    This article presents a case of a patient with degenerative hip disease in paralytic dislocation by poliomyelitis. Poliomyelitis is an acute infection disease caused by a group of neurotrophic viruses, which has a special affinity by the anterior horns cells of the spinal cord and for certain motor nuclei of the brain stem. Paralysis is a flaccid type and characteristically paralysis is asymmetrical. It is said that the joints of the affected limb by poliomyelitis are protected from the development of osteoarthritis. Hip dislocation in poliomyelitis is an acquired deformity caused by flaccid paralysis and the resulting muscular imbalance. In young children, when the gluteus maximus and medius muscles are paralyzed and the hip flexors and adductors are of normal strength, eventual luxation of the hip is almost inevitable. Hip osteoarthritis in a limb with poliomyelitis is an unusual entity because these limbs do not support excessive loads. In patients who present with the residual effects of poliomyelitis including degenerative disease and hip dysplastic, surgery is one of the most difficult challenges faced by reconstructive surgeons. In such cases, surgeons should attempt to optimize the component position and choice, surgical approach, and soft tissue tensioning because stability of the prosthesis can be problematic. PMID:19292189

  6. Results of a Second-generation Constrained Condylar Prosthesis in Complex Primary and Revision Total Knee Arthroplasty: A Mean 5.5-Year Follow-up

    Ye, Chen-Yi; Xue, De-Ting; Jiang, Shuai; He, Rong-Xin

    2016-01-01

    Background: The application of second-generation constrained condylar knee (CCK) prostheses has not been widely studied. This retrospective study was carried out to evaluate the clinical and radiographic outcomes of a second-generation CCK prosthesis for complex primary or revision total knee arthroplasty (TKA). Methods: In total, 51 consecutive TKAs (47 patients) were performed between June 2003 and June 2013 using second-generation modular CCK prostheses. The follow-up was conducted at 3rd day, 1st, 6th, and 12th months postoperatively and later annually. Anteroposterior (AP), lateral, skyline, and long-standing AP radiographs of the affected knees were taken. The Hospital for Special Surgery (HSS) Knee Score, the Knee Society Knee Score (KSKS), the Knee Society Function Score (KSFS), and range of motion (ROM) were also recorded. Heteroscedastic two-tailed Student's t-tests were used to compare the HSS score and the Knee Society score between primary and revision TKAs. A value of P 0.05). Two complications were observed in the revision TKA group (one intraoperative distal femur fracture and one recurrence of infection) while one complication (infection) was observed in the primary TKA group. No prosthesis loosening, joint dislocation, patella problems, tibial fracture, or nerve injury were observed. Radiolucent lines were observed in 4% of the knees without progressive osteolysis. Conclusions: Second-generation modular CCK prostheses are a safe and practical treatment for both primary and revision knees that cannot be balanced. However, further studies focusing on different types of constrained prostheses are required to validate these results. PMID:27231172

  7. Normal Parameters Of Skeletally Immature Knees

    Bathen, Mary; Bastrom, Tracey P.; Edmonds, Eric W.

    2013-01-01

    Objectives: A child’s knee undergoes significant morphologic changes during development. Age-specific normal parameters have not been previously described. The purpose of this study was to delineate the changes that occur with growth utilizing magnetic resonance imaging (MRI). Methods: A retrospective review of a radiologic database of MRI knees, ages 4 to 18 years, was undertaken using “normal” diagnosis codes, including: knee pain, plicae, septic arthritis, jumper’s knee, growing pains, ben...

  8. Radiographic assessment of knee joint rotation.

    Straiton, J A; Todd, B; Venner, R M

    1987-01-01

    A radiographic technique for measuring conjunct rotation at the knee joint is described. Conjunct rotation was demonstrated to occur over a greater range of values of flexion than conventionally believed. Rotation increased progressively as the knee extended, and was not confined to the last phase of extension. Consideration of such rotatory movement is relevant to the design of knee arthroplasties and also to possible mechanisms of non-bony injury of the knee.

  9. Association between knee alignment and knee pain in patients surgically treated for medial knee osteoarthritis by high tibial osteotomy. A one year follow-up study

    W-Dahl, Annette; Toksvig-Larsen, Sören; Roos, Ewa

    2009-01-01

    radiographs including the hip and ankle joints. Knee pain was measured by the subscale pain (0 - 100, worst to best scale) of the Knee injury and Osteoarthritis Outcome Score (KOOS) preoperatively and at one year follow-up. To estimate the association between knee alignment and knee pain multivariate......BACKGROUND: The association between knee alignment and knee pain in knee osteoarthritis (OA) is unclear. High tibial osteotomy, a treatment option in knee OA, alters load from the affected to the unaffected compartment of the knee by correcting malalignment. This surgical procedure thus offers the...... possibility to study the cross-sectional and longitudinal association of alignment to pain. The aims were to study 1) the preoperative association of knee alignment to preoperative knee pain and 2) the association of change in knee alignment with surgery to change in knee pain over time in patients operated...

  10. The Knee: Theory and Experiment

    Yodh, Gaurang B.

    2006-10-01

    A review of current status of theoretical paradigm and results of direct and indirect experiments to study cosmic rays through the knee region are presented and discussed. There is general agreement that the knee is around a PeV and that it reflects a rigidity cutoff. The composition of cosmic rays in the knee region is mixed and changing with energy. The two direct experiments, JACEE and RUNJOB with measurements in the 100 TeV per particle to 1000 TeV per particle and with similar exposures do not agree. While JACEE indicates a increase in langlelnArangle from its low energy value of 1.5 to a value closer to 3 , the RUNJOB experiment sees no change in the composition albeit with large uncertainty. Of the indirect experiments, KASKADE, SPASEAMANDA, HEGRA-Airobic, CACTI, TUNKA and Tibet favor ''Heavy'' composition above the knee and beyond. The KASKADE energy range extends to 100 PeV where their analysis indicates iron dominance. KASKADE does not see a proton rigidity cutoff until about 3 PeV, while Tibet measures a steepening of the proton slope at a few hundred TeV. BLANCA and DICE favor little composition change or a change towards a proton dominated composition around 10 PeV. We need experiments with much better mass resolution in the energy range of the knee and a more quantitative understanding of the hadron production in the forward region at these energies to make definitive progress.

  11. Clinical Application of Total Knee Arthroplasty on Patients with Advanced Knee Osteoarthritis

    WU Zhi-sen; ZHENG Chen-xiao; Qi, Liang; CHANG Shang-yi

    2014-01-01

    Objective: To investigate the clinical value of total knee arthroplasty (TKA) on patients with advanced knee osteoarthritis. Methods: The clinical data and efficacy of 26 patients with advanced knee osteoarthritis (26 knees) who were given TKA in our department from June 2012 to May 2013 were retrospectively observed and analyzed. The knee function scores before operation and after follow up were evaluated according to American HSS scoring standard. Results: At the end of follow up, of...

  12. Computing of dislocation motion in a material: coupling of molecular dynamics and dislocation dynamics

    Recently, molecular dynamics (MD) computer simulation technique is becoming very promising approach to predict materials behavior such as dislocation motion owing to the development of reliable inter-atomic potentials and high-speed modern computers. The MD technique enables us to perform very realistic simulation of local interactions between a dislocation and an obstacle, for example, if we could handle more than 10 million atoms in a model crystal. However, even such a very large scale MD simulation is still insufficient to investigate real complex interactions that occur in real materials in terms of the length and time scales. On the other hand, a new computer simulation technique known as a dislocation dynamics (DD) has been studied in recent years. This method simulates dislocation behavior based on the elasticity theory of dislocation motion, and enables us to study the phenomena of the length scale up to tens of micro-meters which is a typical length scale for crystal grains. The method also predicts the stress-strain behavior of the model crystal. However, one disadvantage of DD is that the elasticity theory does not predict the behavior of dislocations when they meet obstacles. In this paper, we couple the MD and DD techniques to perform simulations of complex dislocation behavior in nickel-base super-alloy. Information on the local interactions between a dislocation and obstacles, such as γ' phase in the nickel-base super-alloy, are obtained from large-scale MD simulations. The results are modeled as local rules between a dislocation and obstacles, and the rule is used in the DD simulations to predict the dislocation behavior in a complex material. In the MD simulation of the interaction between a γ' particle with a diameter of about 8 nm and a straight edge dislocation, we can clearly observe that the motion of a straight dislocation, which extends to two partial dislocations, is delayed at he position where the leading partial dislocation meets the

  13. COMBINED TIBIAL AVULSION OF ANTERIOR AND POSTERIOR CRUCIATE LIGAMENT OF KNEE JOINT: A CASE REPORT

    Ajaybir

    2015-01-01

    Full Text Available Avulsion fractures of tibial intercondylar eminence is a rare injury mainly affecting the pediatric population between 8 to 14 and is even rarer in adults with very few cases reported in literature. It occurs with high energy trauma in adults and may be associated with knee dislocation and neurovascular injuries. A 30 yr old male presented with a painful swollen left knee , limite d knee motion , and difficulty with weight bearing after a history of fall from motorcycle. Imaging revealed Type 3 Meyers and McKeever tibial spine avulsion of both ACL and PCL. A two staged surgical procedure was performed : (a Arthroscopic reduction and fixation with headed cannulated sc r ew of ACL tibial fragment; (b ORIF with headed cannulated screw of PCL tibial fragment via posterior approach to knee. Good functional outcome and early mobilization was achieved. Diagnostic arthroscopic helps to evaluat e the condition of the cruciate ligaments as well as fracture bed. Simultaneously fixation of ACL fragment with cannulated screw can be done , which is a simpler procedure to suture fixation. ORIF of PCL fragment in a staged manner has helped to address the injury in a detailed manner achieving goal of anatomical reduction and early mobilization.

  14. Knee Pain and the Weekend Warriors

    Full Text Available ... is a camera-insertion-type procedure in the knee joint. Can everybody see the knee joint down here? So what I have outlined here ... And that’s a camera being put into the knee joint through a small skin incision just big enough ...

  15. Automatically Locking/Unlocking Orthotic Knee Joint

    Weddendorf, Bruce

    1994-01-01

    Proposed orthotic knee joint locks and unlocks automatically, at any position within range of bend angles, without manual intervention by wearer. Includes tang and clevis, locks whenever wearer transfers weight to knee and unlocks when weight removed. Locking occurs at any angle between 45 degrees knee bend and full extension.

  16. Knee Pain and the Weekend Warriors

    Full Text Available ... talking a little bit about the kind of knee injuries that weekend warriors tend to have, and the ... symptom for those having either knee arthritis or knee injuries is obviously pain, and that’s obviously what drives ...

  17. Knee Pain and the Weekend Warriors

    Full Text Available ... knee is. This is where the medial meniscus structures will be. This is where the lateral structures would be. This is the kneecap tendon right ... we’ll go back to that. That’s normal structures in the knee. That helps bathe the knee ...

  18. Crystal Dislocations with Different Orientations and Collisions

    Patrizi, Stefania; Valdinoci, Enrico

    2015-07-01

    We study a parabolic differential equation whose solution represents the atom dislocation in a crystal for a general type of Peierls-Nabarro model with possibly long range interactions and an external stress. Differently from the previous literature, we treat here the case in which such dislocation is not the superposition of transitions all occurring with the same orientations (i.e. opposite orientations are allowed as well). We show that, at a long time scale, and at a macroscopic space scale, the dislocations have the tendency to concentrate as pure jumps at points which evolve in time, driven by the external stress and by a singular potential. Due to differences in the dislocation orientations, these points may collide in finite time. More precisely, we consider the evolutionary equation where is the atom dislocation function at time t > 0 at the point is an integro-differential operator of order is a periodic potential, is an external stress and is a small parameter that takes into account the small periodicity scale of the crystal. We suppose that is the superposition of N- K transition layers in the positive direction and K in the negative one (with ); more precisely, we fix points and we take Here is either -1 or 1, depending on the orientation of the transition layer u, which in turn solves the stationary equation . We show that our problem possesses a unique solution and that, as , it approaches the sum of Heaviside functions H with different orientations centered at points x i ( t), namely The point x i evolves in time from , being subject to the external stress and a singular potential, which may be either attractive or repulsive, according to the different orientation of the transitions; more precisely, the speed is proportional to The evolution of such a dynamical system may lead to collisions in finite time. We give a detailed description of such collisions when N = 2, 3 and we show that the solution itself keeps track of such collisions; indeed, at

  19. [Imaging strategies for knee injuries].

    Hegenscheid, K; Puls, R; Rosenberg, C

    2012-11-01

    Injuries of the knees are common. The Ottawa knee rule provides decisional support to determine whether radiographs are indicated or not. With the use of ultrasound it is possible to detect defects of the extensor ligaments and the anterior cruciate ligament. Furthermore, it is possible to detect indirect signs of an intra-articular fracture, e.g. lipohemarthrosis. In complex fractures, e.g. tibial plateau fractures, further diagnostic procedures with multislice computed tomography (CT) are needed for accurate classification and preoperative planning. Multislice CT with CT angiography enables three-dimensional reconstruction of the knee and non-invasive vascular imaging for detection of vascular injury. Magnetic resonance imaging (MRI) is the gold standard for detection of occult fractures and injuries of the ligaments and menisci. Higher field strengths can be used to improve the diagnostics of cartilage lesions. Virtual MR arthrography is superior to conventional MRI for detection of cartilage lesions especially after meniscus surgery. PMID:23154845

  20. Arthroscopic surgery for degenerative knee

    Thorlund, J B; Juhl, C B; Roos, E M;

    2015-01-01

    OBJECTIVE: To determine benefits and harms of arthroscopic knee surgery involving partial meniscectomy, debridement, or both for middle aged or older patients with knee pain and degenerative knee disease. DESIGN: Systematic review and meta-analysis. MAIN OUTCOME MEASURES: Pain and physical function....... DATA SOURCES: Systematic searches for benefits and harms were carried out in Medline, Embase, CINAHL, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) up to August 2014. Only studies published in 2000 or later were included for harms. ELIGIBILITY CRITERIA FOR SELECTING...... STUDIES: Randomised controlled trials assessing benefit of arthroscopic surgery involving partial meniscectomy, debridement, or both for patients with or without radiographic signs of osteoarthritis were included. For harms, cohort studies, register based studies, and case series were also allowed...