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Sample records for acute knee dislocations

  1. Current concepts in acute knee dislocation: the missed diagnosis?

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    McKee, Lesley; Ibrahim, Mazin S; Lawrence, Trevor; Pengas, Ioannis P; Khan, Wasim S

    2014-01-01

    Traumatic knee dislocation is a serious and potentially limb threatening injury that can be easily missed if meticulous history and examination have not been employed. Neurovascular injuries are common in this condition, and due diligence should be given to their thorough evaluation at time of secondary survey so as to avoid complications such as ischaemia, compartment syndrome and eventual amputation. There is growing evidence in the literature that morbid obesity is associated with low energy knee dislocation, therefore this should be considered when assessing this cohort of patients presenting with an acute knee injury. Early operative intervention especially with multi ligaments involvement is the preferable strategy in the management of this acute injury. Controversy exists whether to reconstruct or repair damaged structures, and whether to adopt a one stage or two stage reconstruction of the cruciate ligaments. Early rehabilitation is important and essential to achieve satisfactory outcomes. This article is an evidence-based overview of this rare but devastating injury.

  2. Acute Thrombotic Occlusion of the Popliteal Artery following Knee Dislocation: A Case Report of Management, Local Unit Practice, and a Review of the Literature

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    Hindi, Fadi; Ettles, Callum; Pemberton, Mark

    2017-01-01

    Arterial complications following traumatic knee injury are relatively rare but mandate timely recognition and treatment to avoid significant comorbidity and medicolegal ramifications. In this report we describe a case of acute thrombotic occlusion of the popliteal artery occurring after knee dislocation, successfully repaired by intimal fixation and a limited venous patch reconstruction. We present a review of local practice in screening vascular injuries following knee dislocation, aligned with a review of the literature and considerations for practice. PMID:28246569

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

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    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.

  4. Traumatic bilateral knee dislocations, unilateral hip dislocation, and contralateral humeral amputation: a case report.

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    Voos, James E; Heyworth, Benton E; Piasecki, Dana P; Henn, R Frank; MacGillivray, John D

    2009-02-01

    Bilateral traumatic knee dislocations are a rarity. We report a case of bilateral traumatic knee dislocations with concomitant right hip dislocation and complete traumatic amputation of the left, nondominant upper extremity at the level of the proximal one-third of the humerus. Angiograms revealed no evidence of popliteal artery injury. Orthopedic treatment consisted of immediate reduction of the dislocations and urgent revision amputation of the upper extremity. Staged, bilateral knee ligamentous reconstructions were performed on hospital days 24 and 29, respectively. Despite this constellation of devastating injuries, the patient had a satisfactory outcome. In patients with high-energy hip or knee dislocations, the bilateral hips and knees should be carefully examined to check for associated fractures and/or dislocations.

  5. An Unexpected Complication of Hip Arthroplasty: Knee Dislocation

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    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.

  6. The MR dimple sign in irreducible posterolateral knee dislocations

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    Harb, Ali; Lincoln, Denis [Providence Hospital and Medical Center, Department of Radiology, Southfield, MI (United States); Michaelson, Jefferey [Providence Hospital and Medical Center, Department of Orthopedics, Southfield, MI (United States)

    2009-11-15

    While posterolateral knee dislocation is a rare entity, its identification has important implications. The invagination of skin seen in posterolateral knee dislocations is referred to as the ''dimple sign'' on physical exam. We report a case where the ''dimple sign'' was also demonstrated on magnetic resonance imaging. Failure to recognize this finding on imaging will render the knee irreducible, as a result of interposed tissues, until discovered by the orthopedic surgeon intraoperatively. The incarcerated medial capsule and medial collateral ligament could also be misinterpreted as torn meniscus, as occurred in our case. (orig.)

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

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    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.

  8. Knee Dislocation: A Case Report, Diagnostic Vascular Work-Up, and Literature Review

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    Burg, Michael D.; Dijkstra, Björn L.

    2017-01-01

    Knee dislocation is an uncommon, potentially limb-threatening, knee injury. Most often caused by high-velocity trauma, it can also result from low- or even ultra-low-velocity trauma. Rapid identification of the injury, reduction, and definitive management are necessary to minimize neurovascular damage. We present a case of rotatory anterolateral knee dislocation sustained during a twisting sports-related event. Special emphasis is placed on diagnosing vascular injuries associated with knee dislocations. PMID:28321343

  9. A RARE CASE OF IPSILATERAL HIP AND KNEE DISLOCATION

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    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.

  10. Abduction dislocation of the knee joint--a case study.

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    Wójcik, Krzysztof; Bielecki, Tomasz; Polak, Damian; Skowron, Lukasz

    2013-10-31

    The paper presents a case of untypical, not included in existing classifications, knee joint dislocation in a young man. An MRI scan confirmed a rupture of both cruciate ligaments and damage to the ligamento-capsular complex on the medial side of the knee joint. Two weeks after injury, an arthroscopy was performed with joint lavage followed by repair of the damaged ligamento-capsular complex. A very good functional result was obtained three years after the injury, in spite of the patient not having consented to an elective cruciate ligament reconstruction.

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

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    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.

  12. Non-reducible knee dislocation with interposition of the vastus medialis muscle

    OpenAIRE

    2011-01-01

    Irreducibility of the knee following complete dislocation is a rare event determined by the interposition of various capsulo-ligamentous structures in the joint space. Such cases often require urgent surgical treatment. We report the case of a healthy 70-year-old man with a sprain of the left knee that occurred after a sports trauma. The patient showed knee dislocation with multiple ligamentous injuries and articular block due to interposition of a portion of the vastus medialis muscle. After...

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

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    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.

  14. NEGLECTED POSTERIOR KNEE DISLOCATION TREATED WITH CLOSED MANIPULATION AND UNIPLANAR EXTERNAL FIXATOR : A CASE REPORT

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    Manikumar

    2015-06-01

    Full Text Available Neglected traumatic posterior knee dislocations were rare in orthopaedic literature more so after a surgical intervention . Majority of the injuries are associated with vascular trauma and distal or proximal fractures and complete disruption of anterior and posterior cruciate ligaments and nerve traction injuries. Traumatic knee dislocations are therefore treated as an orthopaedic emergency. There were no definitive guide lines to open reduction as well as conservative methods of treatment. The end results of functional recovery are still controversial with residual posterior subluxation. Here we present a case of neglected posterior knee dislocation treated with closed manipulation and uni planar external fixator

  15. Total knee arthroplasty in a pseudoachondroplastic dwarfism patient with bilateral patellar dislocation.

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    Oh, Kwang-Jun; Yoon, Jung-Ro; Yang, Jae-Hyuk

    2013-01-01

    Late presentation of congenital patellar dislocation with advanced osteoarthritis is rare. This article presents a case of a 59-year-old man with underlying pseudoachondroplastic dwarfism. Advanced osteoarthritis due to bilateral neglected congenital patellar dislocation was treated with total knee arthroplasty without patella relocation surgery. Two years later, the patient had an improvement in Knee Society scores, painless function, and stability. Copyright © 2012 Elsevier B.V. All rights reserved.

  16. A magnetic resonance imaging study of abnormalities of the patella and patellar tendon that predispose children to acute patellofemoral dislocation.

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    Yılmaz, Barış; Çiçek, Esin Derin; Şirin, Evrim; Özdemir, Güzelali; Karakuş, Özgün; Muratlı, Hasan Hilmi

    This study compared 20 children hospitalised with acute patellofemoral dislocation with an age-matched healthy control group with no history of knee problems or patellar dislocation. The following morphological parameters were significantly different between the groups: the mean patellar width and length, mean sulcus depth, mean patellar tendon width and total patellar volume. The magnetic resonance imaging findings of this study suggested that structurally smaller than normal patella and patellar tendon volumes are predisposing factors for acute patellofemoral dislocation. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Primary traumatic patellar dislocation

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    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.

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

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    Viswanath, Y K; Rogers, I M

    1999-09-01

    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 bypass graft. Similar injury in association with Aikido has not been described in the English literature previously. Various martial art injuries are briefly discussed and safety recommendations made.

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

    OpenAIRE

    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...

  20. Dislocation of a constrained total knee arthroplasty with patellar tendon rupture after trivial trauma

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    Raju Vaishya; Vipul Vijay; Abhishek Vaish

    2015-01-01

    Constrained total knee prostheses are used in knees with severe deformities and insufficiency of collaterals to provide stable and mobile knees.Dislocation after constrained knee prosthesis is an extremely rare and dreaded complication.When dislocation is associated with patellar tendon rupture,the management includes restoration of the extensor apparatus along with a stable knee.Repair of the patellar tendon is challenging due to poor soft tissue coverage in the area and a bulky repair can put tension on the wound closure.Ideal method of restoration of the extensor apparatus is a matter of debate.There are various modalities used ranging from primary end-to-end repair,augmentation by medial gastrocnemius flap,semitendinosus and synthetic implants and allograft tendoachilles.We report a rare case of a posterior dislocation of a constrained total knee arthroplasty in association with patellar tendon rupture due to a minor fall after a few weeks of surgery.The first episode was managed by reposition of the dislocation and V-Y plasty of the quadriceps and primary repair.The second episode of dislocation with re-rupture needed augmentation by semitendinosus along with the insertion of the thicker insert.The management of this complex problem along with the review of literature is discussed in this case report.

  1. Bilateral knee replacements for treatment of acute septic arthritis in both knees.

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    Ashraf, Muhammad Omer; Asumu, Theophilus

    2013-11-01

    A case report of bilateral acute septic arthritis of knees is presented, which was managed with staged total knee replacements for both knees. A literature review on septic arthritis treated with knee arthroplasty is also presented.

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

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    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 bypass graft. Similar injury in association with Aikido has not been described in the English literature previously. Various martial art injuries are briefly discussed and safety recommendations made.


Keywords: Aikido; knee dislocation; popliteal artery disruption; sports injury PMID:10616692

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

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    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.

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

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    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

  5. Neglected surgically intervened bilateral congenital dislocation of knee in an adolescent

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    Jaswant Kumar

    2014-01-01

    Full Text Available Neglected bilateral congenital dislocation of knee is unusual. A 12 year old boy presented with inability to walk due to buckling of the knee. The symptoms were present since the child learnt walking. He preferred not to walk. Bilateral supracondylar femoral osteotomy was done at the age of 6 years. Patient had a fixed flexion deformity of both knees, 30° in the right (range of flexion from 30° to 45° and 45° fixed flexion deformity in left knee respectively (range of flexion from 45° to 65° when presented to us. The radiological examination revealed bilateral congenital dislocation of knee (CDK. No syndromic association was observed. He was planned for staged treatment. In stage I, the knee joints were distracted by Ilizarov ring fixators and this was followed by open reduction of both the knee joints in stage II. A bilateral supracondylar extension osteotomy was done 18 months after the previous surgery (stage III. The final followup visit at 4 years the patient presented with range of motion 5-100° and 5-80° on the right and left knee respectively with good functional outcome. The case is reported in view of lack of treatment guidelines for long standing neglected CDK in an adolescent child.

  6. Total Knee Arthroplasty in a Patient with Neglected Congenital Patellar Dislocation

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    Emrah Kovalak

    2013-08-01

    Full Text Available Congenital patellar dislocation is a rare deformity and late presentation is usually with knee osteoarthritis. Total knee arthroplasty (TKA is also a treatment choice of this rare pathology. There are few cases reported gonarthrosis with congenital patellar dislocation treated with TKA. And there are some contradictions in the written literature. This article presents a case of a 55 years old woman who had left knee pain for 8 years that was worsened in last 2 years with gonarthrosis and congenital patellar dislocation treated by cruciate retaining TKA with proximal and distal patellar alignment without patellar resurfacing. At the final follow-up after 1 year ROM was 5°-100°. There was no patellar maltracking or instability. The Knee Society score and functional scores were 55 and 15 preoperatively, improved to 83 and 55 respectively at the postoperative period. Congenital patella dislocation with gonarthrosis is hard to manage by TKA, but it can be handled with a good pre-operative planning with meticulous attention.

  7. Total knee arthroplasty with subvastus approach in patient with chronic post-traumatic patellar dislocation.

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    Junqueira, Jader Joel Machado; Helito, Camilo Partezani; Bonadio, Marcelo Batista; Pécora, Jose Ricardo; Demange, Marco Kawamura

    2016-01-01

    Chronic lateral dislocation of the patella is a rare condition and acquired causes are usually secondary to knee trauma. The neglected chronic dislocation leads to progressive genu valgum and external tibial torsion deformities with subsequent gonarthrosis, which becomes painful and debilitating. There is no consensus regarding treatment of these patients, but total knee arthroplasty (TKA) is a useful therapy in cases of painful symptomatic gonarthrosis. Few reports have shown that subvastus approach and lateral release may be a valid option for TKA, since it allows the correction of valgus deformity and patellar tracking without interrupting vascular blood supply of patella. This article reports a case of TKA and extensor mechanism realignment without patellar resurfacing in a patient with genu valgum and chronic post-traumatic patellar dislocation with satisfactory results after two years of follow-up.

  8. Total knee arthroplasty with subvastus approach in patient with chronic post-traumatic patellar dislocation

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    Jader Joel Machado Junqueira

    Full Text Available ABSTRACT Chronic lateral dislocation of the patella is a rare condition and acquired causes are usually secondary to knee trauma. The neglected chronic dislocation leads to progressive genu valgum and external tibial torsion deformities with subsequent gonarthrosis, which becomes painful and debilitating. There is no consensus regarding treatment of these patients, but total knee arthroplasty (TKA is a useful therapy in cases of painful symptomatic gonarthrosis. Few reports have shown that subvastus approach and lateral release may be a valid option for TKA, since it allows the correction of valgus deformity and patellar tracking without interrupting vascular blood supply of patella. This article reports a case of TKA and extensor mechanism realignment without patellar resurfacing in a patient with genu valgum and chronic post-traumatic patellar dislocation with satisfactory results after two years of follow-up.

  9. Treatment of habitual dislocation of patella in an adult arthritic knee

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    Raghuveer K Reddy

    2013-01-01

    Full Text Available Habitual dislocation of the patella (HDP is a common presentation in pediatric age unlike adults. Many surgical procedures using proximal realignment and distal realignment have been reported to treat HDP in children with satisfactory results. However, late presentation of habitual patellar dislocation with osteoarthritis is rare and treatment plan has not yet been established. We present a case of neglected iatrogenic habitual patellar dislocation with osteoarthritis in a 50-year-old woman. Two-staged procedure was planned, first with patellar realignment and later with definitive total knee arthroplasty. Quadricepsplasty, medial patello-femoral ligament reconstruction, lateral release and tibial tuberosity transfer was done as primary procedure and total knee arthroplasty, which was planned as secondary procedure, was deferred as the patient improved functionally.

  10. [Knee dislocation: concurrent arthroscopic ACL and PCL reconstruction - operating technique].

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    Piontek, Tomasz; Ciemniewska-Gorzela, Kinga; Szulc, Andrzej

    2008-01-01

    Injuries involving knee luxation or subluxation generally result in damage to two or three out of the four major ligaments which stabilize this joint. Past treatment of this type of multiligament injuries, consisting in 6- to 12-week immobilization in a plaster cast, does not allow for restoration of the normal, anatomical course of these ligaments. A consequence of this type of healing, which involves the formation of random scars in place of ligaments, is mechanical and functional instability of the knee joint. The goal of this article is to present a classification of multiligament knee injuries and surgical treatment options. We also present our own technique of arthroscopic, concurrent reconstruction of knee joint ligaments. The study material consisted of 20 patients who underwent surgical treatment for multiligament knee injuries in the Department of Pediatric Orthopedics and Traumatology in Poznań. We performed concurrent arthroscopic reconstruction of ACL and PCL in all 20 patients. In addition, reconstruction of the medial complex was performed in 7 patients, and lateral complex was reconstructed in another 7 patients. In three cases we stitched the medial meniscus using a Smith & Nephew FasT-Fix system, and partial menisectomy was performed in 2 patients. The details of the proposed concurrent arthroscopic ACL and PCL reconstruction are extensively discussed. One of the advantages of this operating technique is the exclusive use of autogenous ST and GR tendon grafts for reconstruction of all damaged knee joint structures. The presented operating technique makes possible the reconstruction of all damaged knee joint ligaments in less than two hours, which in turn allows the surgery to be performed in an ischemic setting using an Esmarch band around the limb.

  11. Reconstruction of the medial patellofemoral ligament in cases of acute traumatic dislocation of the patella: current perspectives and trends in Brazil1,

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    Gustavo Gonçalves Arliani

    2014-10-01

    Full Text Available Objective:To evaluate the approaches and procedures used by knee surgeons in Brazil for treating medial patellofemoral lesions (MPFL of the knee in cases of acute traumatic dislocation of the patella.Materials and methods:A questionnaire comprising 15 closed questions on topics relating to treating MPFL of the knee following acute dislocation of the patella was used. It was applied to Brazilian knee surgeons during the three days of the 44th Brazilian Congress of Orthopedics and Traumatology, in 2012.Results:106 knee surgeons completely filled out the questionnaire and formed part of the sample analyzed. Most of them were from the southeastern region of Brazil. The majority (57% reported that they perform fewer than five MPFL reconstruction procedures per year. Indication of non-surgical treatment after a first episode of acute dislocation of the patella was preferred and done by 93.4% of the sample. Only 9.1% of the participants reported that they had never observed postoperative complications. Intraoperative radioscopy was used routinely by 48%. The professionals who did not use this tool to determine the point of ligament fixation in the femur did not have a statistically greater number of postoperative complications than those who used it (p > 0.05.Conclusions:There are clear evolutionary trends in treatments and rehabilitation for acute dislocation of the patella due to MPFL, in Brazil. However, further prospective controlled studies are needed in order to evaluate the clinical and scientific benefit of these trends.

  12. Long-Term Follow-Up of Nonoperatively and Operatively Treated Acute Primary Patellar Dislocation in Skeletally Immature Patients

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    Eva Bengtsson Moström

    2014-01-01

    Full Text Available Purpose. The present study reports a long-term follow-up of acute primary patellar dislocation in patients with open physes. The purpose of the study was to evaluate knee function and recurrence rates after surgical and nonsurgical treatment of patellar dislocation. Methods. A total of 51 patients, including 29 girls and 22 boys, who were 9–14 years of age at the time of injury, were retrospectively evaluated. The minimum follow-up time was 5 years. Thigh muscle torque, range of motion, the squat test, the knee injury and osteoarthritis outcome score (KOOS, the Kujala score, and the recurrence rate were registered. Radiological predisposing factors at the time of injury were determined. Results. Quality of life and sports/recreation were the most affected subscales, according to KOOS, and a reduced Kujala score was also observed in all treatment groups. The surgically treated patients had a significantly lower recurrence rate. Those patients also exhibited reduced muscle performance, with a hamstring to quadriceps ratio (H/Q of 1.03. The recurrence rate was not correlated with knee function. Conclusions. Patellar dislocation in children influences subjective knee function in the long term. Surgery appears to reduce the recurrence rate, but subjective knee function was not restored.

  13. Treatment of acute and subacute dorsal perilunate fracture dislocations

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    Levent Kucuk

    2014-04-01

    Outcomes: Results of the perilunate fracture dislocations treated in acute or subacute phase by open reduction and internal fixation via dorsal approach are satisfactory. There is a strong demand for prospective, randomized studies to compare the results of different treatment modalities. [Hand Microsurg 2014; 3(1.000: 1-7

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

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    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

  15. Acute Dislocation of the Metacarpal-Trapezoid Joint

    Science.gov (United States)

    Plata, Guillermo Varón; Casas, Jairo Antonio Camacho; Rodríguez, Natalia Sauza

    2016-01-01

    The trapezoid metacarpal dislocation is a rare event. In the literature, it is found in case reports. This injury is caused by direct or indirect high energy trauma. In most cases, the dislocation is dorsal and is difficult to reproduce because the joint is not very mobile. Given the low incidence and little evidence supported in the literature regarding the management, this injury can be treated by open or closed reduction; however, it has been published that most authors use Kirschner wire fixation with good results. Here we present our experience in the management of a male patient with acute trapezoid metacarpal dislocation handled with a splint with good functional results at 6 weeks. PMID:27247751

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

    Science.gov (United States)

    Marchie, Anthony; Kumar, Arun; Catre, Melanio

    2009-01-01

    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. PMID:20671868

  17. Bilateral sequential knee dislocation in a patient with connective tissue disorder: Report of an unusual case and lessons learnt.

    Science.gov (United States)

    Al-Azzani, Waheeb; Wronka, Konrad; Lewis, James; Ghandour, Adel; Robertson, Angus

    2016-01-01

    Tibiofemoral knee dislocation is a rare but serious limb-threatening injury. Without prompt recognition and management, amputation or long-term functional impairment may result. The authors present a case of bilateral sequential knee dislocation, secondary to low-energy trauma, in a patient with Systemic Lupus Erythematosus and antiphospholipid syndrome. Adequate stability was achieved on both occasions by reconstruction of the postero-lateral corner and MCL. During the first reconstruction, ipsi-lateral autograft, as well as hamstring tendons from the contra-lateral side, were used to strengthen the graft. For the second reconstruction, allografts were used. This case highlights that, a patient with soft-tissue disorder presenting with low-energy knee dislocation may be at risk of further dislocations. Treating surgeons should anticipate these issues and consider the role of allograft in ligamentous repair.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. Radiological assessment of irreducible posterolateral knee subluxation after dislocation due to interposition of the vastus medialis: a case report.

    Science.gov (United States)

    Paulin, Emilie; Boudabbous, Sana; Nicodème, Jean-Damien; Arditi, Daniel; Becker, Christoph

    2015-06-01

    Knee dislocation is a serious and relatively uncommon traumatism that every emergency room is supposed to diagnose and treat rapidly. Most of the time these dislocations reduce spontaneously or with closed reduction. If a subluxation persists, an incarceration of soft tissue in the joint must be suspected. Irreducible knee subluxations after dislocation are rare entities better described in the orthopaedic than in the radiological literature. However, the initial radiological assessment is an important tool to obtain the correct diagnosis, to detect neurovascular complications, and to plan the most suitable treatment. In cases of delayed diagnosis, the functional prognosis of the joint and even the limb may be seriously compromised primarily because of vascular lesions. Thereby, vascular imaging is essential in cases of dislocation of the knee, and we will discuss the role of angiography and the more recent use of computed tomography angiography or magnetic resonance angiography. Our patient presented with an irreducible knee subluxation due to interposition of the vastus medialis, and we will review the classical clinical presentation and 'do not miss' imaging findings on conventional radiography, computed tomography angiography, and magnetic resonance imaging. Finally, we will also report the classical imaging pathway indicated in knee dislocation, with a special emphasis on the irreducible form.

  20. PREFERED SURGICAL TECHNIQUE USED BY ORTHOPEDISTS IN ACUTE ACROMIOCLAVICULAR DISLOCATION

    Science.gov (United States)

    NISHIMI, ALEXANDRE YUKIO; ARBEX, DEMETRIO SIMÃO; MARTINS, DIOGO LUCAS CAMPOS; GUSMÃO, CARLOS VINICIUS BUARQUE DE; BONGIOVANNI, ROBERTO RANGEL; PASCARELLI, LUCIANO

    2016-01-01

    ABSTRACT Objective: To determine whether training on shoulder and elbow surgery influences the orthopedist surgeons' preferred technique to address acute acromioclavicular joint dislocation (ACD). Methods: A survey was conducted with shoulder and elbow specialists and general orthopedists on their preferred technique to address acute ACD. Results: Thirty specialists and forty-five general orthopedists joined the study. Most specialists preferred the endobutton technique, while most general orthopedists preferred the modified Phemister procedure for coracoclavicular ligament repair using anchors. We found no difference between specialists and general orthopedists in the number of tunnels used to repair the coracoclavicular ligament; preferred method for wire insertion through the clavicular tunnels; buried versus unburied Kirschner wire insertion for acromioclavicular temporary fixation; and time for its removal; and regarding the suture thread used for deltotrapezoidal fascia closure. Conclusion: Training on shoulder and elbow surgery influences the surgeons' preferred technique to address acute ACD. Level of Evidence V, Expert Opinion. PMID:28149190

  1. Combined common peroneal and tibial nerve injury after knee dislocation: one injury or two? An MRI-clinical correlation.

    Science.gov (United States)

    Reddy, Chandan G; Amrami, Kimberly K; Howe, Benjamin M; Spinner, Robert J

    2015-09-01

    OBJECT Knee dislocations are often accompanied by stretch injuries to the common peroneal nerve (CPN). A small subset of these injuries also affect the tibial nerve. The mechanism of this combined pattern could be a single longitudinal stretch injury of the CPN extending to the sciatic bifurcation (and tibial division) or separate injuries of both the CPN and tibial nerve, either at the level of the tibiofemoral joint or distally at the soleal sling and fibular neck. The authors reviewed cases involving patients with knee dislocations with CPN and tibial nerve injuries to determine the localization of the combined injury and correlation between degree of MRI appearance and clinical severity of nerve injury. METHODS Three groups of cases were reviewed. Group 1 consisted of knee dislocations with clinical evidence of nerve injury (n = 28, including 19 cases of complete CPN injury); Group 2 consisted of knee dislocations without clinical evidence of nerve injury (n = 19); and Group 3 consisted of cases of minor knee trauma but without knee dislocation (n = 14). All patients had an MRI study of the knee performed within 3 months of injury. MRI appearance of tibial and common peroneal nerve injury was scored by 2 independent radiologists in 3 zones (Zone I, sciatic bifurcation; Zone II, knee joint; and Zone III, soleal sling and fibular neck) on a severity scale of 1-4. Injury signal was scored as diffuse or focal for each nerve in each of the 3 zones. A clinical score was also calculated based on Medical Research Council scores for strength in the tibial and peroneal nerve distributions, combined with electrophysiological data, when available, and correlated with the MRI injury score. RESULTS Nearly all of the nerve segments visualized in Groups 1 and 2 demonstrated some degree of injury on MRI (95%), compared with 12% of nerve segments in Group 3. MRI nerve injury scores were significantly more severe in Group 1 relative to Group 2 (2.06 vs 1.24, p knee dislocations

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  3. Patellar Dislocations and Reduction Procedure.

    Science.gov (United States)

    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.

  4. Joystick reduction and percutaneous pinning for an acutely anteriorly dislocated coccyx: a case report.

    Science.gov (United States)

    Kim, Weon-Yoo; Han, Chang-Whan; Kim, Yong-Hwan

    2004-07-01

    A sacrococcygeal dislocation is a rare occurrence, and the treatment options vary. Initial treatment is nonoperative, consisting of a manual reduction with a gloved finger and local rest. Acute operative treatment of a failed closed reduction is unusual. We report a case of an acute irreducible anteriorly dislocated coccyx successfully treated with a minimally invasive technique: joystick reduction and Steinman pin fixation.

  5. Biceps tendinitis as a cause of acute painful knee after total knee arthroplasty.

    Science.gov (United States)

    Pandher, Dilbans Singh; Boparai, Randhir Singh; Kapila, Rajesh

    2009-12-01

    The case report highlights an unusual case of posterolateral knee pain after total knee arthroplasty. Tendinitis of the patellar tendon or pes anserinus is a common complication after total knee arthroplasty; however, there is no report in the literature regarding the biceps femoris tendinitis causing acute pain in the early postoperative period. In this case, the biceps tendinitis was diagnosed and treated by ultrasound-guided injection into the tendon sheath.

  6. Relationship between bony tunnel and knee function in patients after patellar dislocation triple surgeries—a CT-based study

    Science.gov (United States)

    Qin, Le; Li, Mei; Yao, Weiwu; Shen, Ji

    2017-01-01

    We aimed to assess the CT-based bony tunnel valuations and their correlation with knee function after patellar dislocation triple surgeries. A retrospective study was performed on 66 patients (70 knees) who underwent patellar dislocation triple surgeries. The surgery was MPFL reconstruction primarily, combined with lateral retinaculum release and tibial tubercle osteotomy. CT examinations were performed to determine the femoral tunnel position, along with the patellar and femoral tunnel width 3 days and more than 1 year after operation for follow-up. Functional evaluation based on Kujala and Lysholm scores was also implemented. We compared tunnel width of the first and last examinations and correlated femoral tunnel position of the last examination with knee function. At the last follow-up, femoral tunnel position in the anterior-posterior direction was moderately correlated with knee function. Femoral tunnel position in the proximal-distal direction was not associated with postoperative knee function. Patellar and femoral tunnel width increased significantly at the last follow-up. However, no significant functional difference was found between patients with and without femoral tunnel enlargement. Our results suggested that the tunnel malposition in anterior-posterior position based on CT was related to impaired knee function during the follow-ups.

  7. Haemodynamics in acute arthritis of the knee in puppies

    DEFF Research Database (Denmark)

    Bünger, C; Hjermind, J; Harving, S

    1984-01-01

    In order to study the haemodynamic changes of the juvenile knee in acute arthritis, an experimental model was developed in puppies by unilateral intra-articular injections of Carragheenin solution into the knee. Tissue blood flow was studied by the tracer microsphere technique in eight dogs...

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

    LENUS (Irish Health Repository)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  10. All arthroscopic stabilization of acute acromioclavicular joint dislocation with fiberwire and endobutton system

    Science.gov (United States)

    Spoliti, Marco; De Cupis, Mauro; Via, Alessio Giai; Oliva, Francesco

    2014-01-01

    Summary Introduction: acromioclavicular (AC) joint dislocation is common in athletes and in contact sports and about 9% of shoulder injuries involves this joint. The majority of these AC lesions can be successfully treated conservatively but high grade dislocation and some cases of type III dislocation need a surgical treatment. Many different operative techniques have been described over the years. The purpose of this study is to evaluate the results of arthroscopic stabilization of AC joint dislocation with TightRope® system. Materials and methods: nineteen patients with acute AC dislocation were treated by arthroscopic fixation with TightRope® system. Any associated lesions were repaired. All patients were assessed before surgery (T0), at 3 months (T1), at 6 months (T2) and at 1 year after the surgery (T3) using a visual analogic scale (VAS) and Constant-Murley Score (CMS). All patients were evaluated with X-ray. Results: six AC-joint dislocations involved the right shoulder and thirteen the left shoulder. Ten were type III dislocation, three were type IV and six were type V dislocation. We found a statistically significant reduction of pain (p< 0.01) at T1 compared to the pretreatment scores. The CMS measures showed an improvement between T1, T2 and T3, but the difference was statistically significant only between T1 and T3 (p= 0.017). The postoperative X-Ray of the shoulder showed a good reduction of the AC joint dislocation. We had 1 case of recurrence and 2 cases of loss of intraoperative reduction. Conclusion: arthroscopic technique for acute AC joint dislocations with the use of the TightRope® device is minimally invasive and it allows an anatomic restoration of the joint. It is a safe and effective procedure ensuring stable AC joint reconstruction and good cosmetic results. PMID:25767774

  11. A retrospective review over 1999 to 2007 of head, shoulder and knee soft tissue and fracture dislocation injuries and associated costs for rugby league in New Zealand.

    Science.gov (United States)

    King, D; Hume, P; Gianotti, S; Clark, T

    2011-04-01

    King et al. reported that of 5 941 moderate to serious claims resulting in medical treatment for rugby league injuries, the knee, shoulder, and head and neck body sites and soft tissue and fracture-dislocation injuries were most frequent and costly in the New Zealand national no-fault injury compensation corporation database during 1999 to 2007. However, additional analyses of knee, shoulder and head and neck body sites by soft tissue and fracture-dislocation injury types was required to enable a greater understanding of the nature of injuries most likely to be seen by sports medical personnel dealing with rugby league players. From 1999 to 2007 the injury claims and costs for head and neck soft tissue, fracture-dislocations, shoulders soft tissue significantly increased. Knee soft tissue injury claims and costs significantly decreased from 1999 to 2007. There was no significant difference in knee fracture-dislocation injury claims but there was a significant increase in knee fracture-dislocation injury costs from 1999 to 2007. Changes in the nature of injuries may be related to changes in defensive techniques employed in rugby league during this time. Sports medical personnel dealing with rugby league players should focus their injury prevention strategies on reducing musculoskeletal injuries to the head and shoulder. There should be a focus on increasing awareness of correct tackling technique, head injury awareness and management of suspected cervical spine injuries. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Acute finger injuries: part II. Fractures, dislocations, and thumb injuries.

    Science.gov (United States)

    Leggit, Jeffrey C; Meko, Christian J

    2006-03-01

    Family physicians can treat most finger fractures and dislocations, but when necessary, prompt referral to an orthopedic or hand surgeon is important to maximize future function. Examination includes radiography (oblique, anteroposterior, and true lateral views) and physical examination to detect fractures. Dislocation reduction is accomplished with careful traction. If successful, further treatment focuses on the concomitant soft tissue injury. Referral is needed for irreducible dislocations. Distal phalanx fractures are treated conservatively, and middle phalanx fractures can be treated if reduction is stable. Physicians usually can reduce metacarpal bone fractures, even if there is a large degree of angulation. An orthopedic or hand surgeon should treat finger injuries that are unstable or that have rotation. Collateral ligament injuries of the thumb should be examine with radiography before physical examination. Stable joint injuries can be treated with splinting or casting, although an orthopedic or hand surgeon should treat unstable joints.

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

    Directory of Open Access Journals (Sweden)

    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

  14. Arterial damages in acute elbow dislocations: which diagnostic tests are required?

    Science.gov (United States)

    Lutter, Christoph; Pfefferkorn, Ronny; Schoeffl, Volker

    2016-07-19

    Blunt vessel injuries of peripheral arteries caused by a direct trauma are rare. Studies have described the frequency of arterial ruptures following closed elbow dislocations in 0.3-1.7% of all cases. However, arterial damage does not always necessarily appear as a complete rupture of the vessel with a loss of peripheral circulation and ischaemic symptoms; a relatively strong periarticular system of collaterals can maintain circulation. Furthermore, the traumatic dislocation can also cause intimal tears, arterial dissections and aneurysms or thrombosis. In all cases of vessel injury, including total disruption, a peripheral pulse might still be palpable. 3 weeks after an acute elbow dislocation, we have diagnosed a patient with a long-segment stenosis of the brachial artery and a thrombosis of the radial artery. Therefore, the close anatomic proximity to the neurovascular structures should always be considered in cases of elbow dislocations, even if peripheral pulses are traceable.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Double-button Fixation System for Management of Acute Acromioclavicular Joint Dislocation

    Directory of Open Access Journals (Sweden)

    Ali Torkaman

    2016-01-01

    Full Text Available Background: Surgical treatments for acromioclavicular (AC joint dislocation present with some complications. The present study was designed to evaluate the double-button fixation system in the management of acute acromioclavicular joint dislocation. Methods: This cross sectional study, done between February 2011 to June 2014, consisted of 28 patients who underwent surgical management by the double-button fixation system for acute AC joint dislocation. Age, sex, injury mechanism, dominant hand, side with injury, length of follow up, time before surgery, shoulder and hand (DASH, constant and visual analogue scale (VAS scores, and all complications of the cases during the follow up were recorded. Results: The mean age of patients was 33.23±6.7 years. Twenty four patients (85.71% were male and four (14.28% were female. The significant differences were observed between pre-operation VAS, constant shoulder scores and post-operation measurements (P=0.001, P=0.0001, P=0.0001, respectively. There were not any significant differences between right and left coracoclavicular (P=0.238, but two cases of heterotrophic ossifications were recorded. The mean follow-up time was 16.17±4.38 months. Conclusion: According to the results, the double-button fixation system for management of acute acromioclavicular joint dislocation has suitable results and minimal damage to the soft tissues surrounding the coracoclavicular ligaments.

  18. Double-button Fixation System for Management of Acute Acromioclavicular Joint Dislocation.

    Science.gov (United States)

    Torkaman, Ali; Bagherifard, Abolfazl; Mokhatri, Tahmineh; Haghighi, Mohammad Hossein Shabanpour; Monshizadeh, Siamak; Taraz, Hamid; Hasanvand, Amin

    2016-01-01

    Surgical treatments for acromioclavicular (AC) joint dislocation present with some complications. The present study was designed to evaluate the double-button fixation system in the management of acute acromioclavicular joint dislocation. This cross sectional study, done between February 2011 to June 2014, consisted of 28 patients who underwent surgical management by the double-button fixation system for acute AC joint dislocation. Age, sex, injury mechanism, dominant hand, side with injury, length of follow up, time before surgery, shoulder and hand (DASH), constant and visual analogue scale (VAS) scores, and all complications of the cases during the follow up were recorded. The mean age of patients was 33.23±6.7 years. Twenty four patients (85.71%) were male and four (14.28%) were female. The significant differences were observed between pre-operation VAS, constant shoulder scores and post-operation measurements. There were not any significant differences between right and left coracoclavicular, but two cases of heterotrophic ossifications were recorded. The mean follow-up time was 16.17±4.38 months. According to the results, the double-button fixation system for management of acute acromioclavicular joint dislocation has suitable results and minimal damage to the soft tissues surrounding the coracoclavicular ligaments.

  19. [Acute rhabdomyolysis after spinal anesthesia for knee arthroscopy].

    Science.gov (United States)

    Bouché, P M; Chavagnac, B; Cognet, V; Banssillon, V

    2001-08-01

    We report an observation of acute rhabdomyolysis of gluteus maximum muscles occurring in a non-obese patient installed in supine position that underwent knee arthroscopy under spinal anaesthesia. The patient had insulin-dependent diabetes melitus with documented microangiopathy. The interest of this observation resides in the occurrence of the syndrome after a short period of time (one hour) of installation in the supine position in a patient that did not have any of the generally described risk factors of rhabdomyolysis.

  20. Fixation of an osteochondral fragment after acute patellar dislocation in an immature skeleton,

    Directory of Open Access Journals (Sweden)

    Rodrigo Pires e Albuquerque

    2014-04-01

    Full Text Available Fixation of an osteochondral fracture after acute patellar dislocation is an infrequent form of treatment. Likewise, the location of this fragment in the lateral region of the lateral femoral condyle, functioning as a free body, is uncommon. The aim of this study was to present a case of osteochondral fracture of the patella at an unusual site, along with the therapy used and the clinical follow-up.

  1. Acute pseudo-septic arthritis following viscosuplementation of the knee.

    Science.gov (United States)

    Idrissi, Zineb; Benbouazza, Karima; Fourtassi, Maryam; Raissouni, Hanae; El Aadmi, Meriem; Zanat, Fatima; Hajjaj-Hassouni, Najia

    2012-01-01

    A 70-year-old woman with a history of medial femoro-tibial compartment of knee osteoarthritis was admitted for acute arthritis six days after a second intra-articular injection of Hyaluronic acid. The joint fluid was inflammatory, with no crystals, and laboratory tests showed marked inflammation leading to antibiotic treatment for suspected septic arthritis. The persistent symptoms and negative results of joint fluid and blood cultures led to discontinuation of the antibiotic therapy after 10 days. Anti-inflammatory with rehabilitation therapy of the knee relieved the symptoms, and the patient was discharged home 3 weeks after her admission. Aseptic arthritis induced by repeated Hyaluronic acid injection is the most likely diagnosis. Physicians should be conscious of this extremely severe complication.

  2. Evaluation of arthroscopic stabilization of acute acromioclavicular joint dislocation using the TightRope system.

    Science.gov (United States)

    El Sallakh, Sameh A

    2012-01-16

    The purpose of this study was to evaluate the results of the arthroscopic treatment of acute acromioclavicular dislocation using the TightRope system (Arthrex, Naples, Florida). Between January 2006 and May 2007, ten shoulders in 10 patients with acute acromioclavicular joint dislocation (Rockwood types IV and V) underwent arthroscopic acromioclavicular joint stabilization using the TightRope. Average patient age was 30 years (range, 22-42 years), and mean follow-up was 24 months (range, 18-30 months). Follow-up occurred at 2 and 6 weeks, 3 months, and then every 6 months postoperatively. The shoulders were evaluated radiologically by comparing the acromioclavicular joint with the normal side and clinically by assessing the pain, function, and range of joint motion using the Constant score.Ten patients returned to work without pain 10 to 12 weeks postoperatively. Average Constant score was 96.3 (range, 94-99) at last follow-up. Because of technical error, 1 patient experienced TightRope fixation failure on the coracoid side, and the acromioclavicular joint was redislocated, which was treated by an open technique. The 10 patients were satisfied with their functional results and cosmetic appearance.The arthroscopic treatment of acute acromioclavicular dislocation using the TightRope is a minimally invasive surgical technique that has been proven effective for the treatment of these lesions. It is characterized by less morbidity, less hospitalization, excellent cosmoses, and early rehabilitation. Copyright 2012, SLACK Incorporated.

  3. Displacing lateral meniscus masquerading as patella dislocation.

    Science.gov (United States)

    Arendt, Elizabeth A; Fontboté, Cristián A; Rohr, Sara R

    2014-10-01

    To alert the treating clinician to an uncommon knee meniscal condition that often masquerades as a more common patella condition. Retrospective chart review of a series of cases was undertaken. A series of 12 knees in 11 patients were referred to an orthopaedic surgeon with a diagnosis of recurrent lateral patella dislocation. Three knees had undergone patella realignment surgery with continuance of symptoms. Eight patients had prior magnetic resonance images read as no meniscal pathology and no acute patella/patella retinacular injury. All patients presented for a consult with a similar history. Under anaesthesia, all knees had a stable patella as judged by physical examination. At the time of surgery, six patients had a frank tear in the lateral meniscus, all of which were readily displaceable. Six knees showed a displaceable lateral meniscus with attenuation but not a visible frank tear. Ten menisci were treated with repair, and two knees underwent partial lateral meniscectomies. Patient follow-up of minimally 18 months revealed no further episodes of "knee-cap dislocation" or symptoms of catching and locking. The clinician treating a patient with a history of a knee locking in flexion should have a high index of suspicion for a lateral meniscus tear or an unstable hypermobile lateral meniscus, despite patient report of perceived patella movement. History of symptoms occurring in knee flexion and attention to patella physical examination should be key factors in this diagnostic conundrum. Retrospective chart review, Level IV.

  4. Knee biomechanics during walking in recurrent lateral patellar dislocation are normalized by 1 year after medial patellofemoral ligament reconstruction.

    Science.gov (United States)

    Asaeda, Makoto; Deie, Masataka; Fujita, Naoto; Shimada, Noboru; Orita, Naoya; Iwaki, Daisuke; Kono, Yoshifumi; Terai, Chiaki; Ochi, Mitsuo

    2016-10-01

    Gait kinematics and kinetics of the knee before and after medial patellofemoral ligament (MPFL) reconstruction in patients with recurrent lateral patellar dislocation (RPD) are unknown. The purpose of this study was to measure knee kinematics and kinetics during gait before and 1 year after anatomical MPFL reconstruction in patients with RPD and compare the results to healthy individuals. Eleven RPD patients were treated using an anatomical MPFL reconstruction procedure. Gait analysis was conducted before and at 3, 6, and 12 months after surgery. For comparison, 15 healthy volunteers with no history of orthopaedic problems in their lower limbs were included as the control group. Knee kinematics and kinetics were analysed during gait. Before surgery, the internal knee extension moment in RPD patients was significantly lower than in controls (P = 0.025). At 3 months post-operatively, there was an additional decrease in knee extension moment compared to before surgery, and so it was still significantly lower than in the control group (P knee extension moment in the RPD group was significantly increased compared to 3 months post-operatively (P knee flexion angle in the early stance phase in the RPD group at 3 months post-operatively was significantly lower than that of controls (P Knee kinematics and kinetics were similar to that of controls 1 year after surgery. Initially, RPD patients had lower knee extension moments during gait compared with controls, but by 1 year after MPFL reconstruction, knee kinematics and kinetics of gait in the RPD patients had returned to normal. These observations indicate that MPFL reconstruction may help to delay prospective knee OA as long as possible by restoring the conformation of the patellofemoral joint and gait biomechanics by surgery.

  5. Reduction of acute anterior shoulder dislocations using the Milch technique: a study of ski injuries.

    Science.gov (United States)

    Russell, J A; Holmes, E M; Keller, D J; Vargas, J H

    1981-09-01

    During the 1977-78, 1978-79, and 1979-80 ski seasons, 76 acute anterior shoulder dislocations were treated by one of three Orthopedic Surgeons at the Rutland Vermont Hospital Emergency Room: 68 (89.4%) were reduced on first attempt using the Milch technique of abduction and external rotation. Four (5.2%) required general anesthesia and four were reduced using meperidine hydrochloride (Demerol, Winthrop) and diazepam (Valium, Roche) and a traction-countertraction technique. Of the 68 shoulders reduced with the Milch technique, 47 (69.1%) required no analgesics or muscle relaxants. There were no complications attributable to the technique itself. Males were injured more frequently than females in a 4.4:1 ratio. Left shoulder injuries were as common as right. Recurrent dislocations occurred more frequently in younger individuals. Fractures of the greater tuberosity were associated injuries in five (6.6%) of all dislocations. These all occurred in individuals older than age 39 years and were coincident with primary dislocations.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  7. Intraarticular lidocaine versus intravenous analgesic for reduction of acute anterior shoulder dislocations. A prospective randomized study.

    Science.gov (United States)

    Matthews, D E; Roberts, T

    1995-01-01

    We performed a prospective, randomized study to evaluate the use of injected lidocaine as an anesthetic for closed reduction of acute anterior shoulder dislocations. Thirty consecutive patients who presented at the emergency department with acute anterior shoulder dislocations were randomly placed in one of two groups. One group received an intraarticular injection of 20 ml of 1% lidocaine and the other group, intravenous injections of morphine sulfate and midazolam. The groups were compared regarding time of reduction maneuver, difficulty of reduction, subjective pain, complications, and total time spent in the emergency department. The lidocaine provided adequate anesthesia and secondary relief of muscle spasm in 15 of 15 (100%) patients. When compared with the intravenous sedation group, the lidocaine group showed no statistically significant difference in time for reduction maneuver, difficulty of reduction, or subjective pain. The lidocaine group had no complications and had a statistically significant shorter emergency department visit when compared with the intravenous sedation group (mean, 78 minutes versus 186 minutes; P = 0.004). Lidocaine provides excellent anesthesia for patients with uncomplicated anterior shoulder dislocations and can be very beneficial when sedation is contraindicated. Lidocaine injections also proved to be cost effective in our institution, reducing total costs by as much as 62%.

  8. Severe valgus deformity of the knee with permanent patellar dislocation associated with melorheostosis: a case report and review of the literature.

    Science.gov (United States)

    Kitta, Yuki; Niki, Yasuo; Udagawa, Kazuhiko; Enomoto, Hiroyuki; Toyama, Yoshiaki; Suda, Yasunori

    2014-03-01

    We present a case of an 8-year-old boy diagnosed with melorheostosis who was suffering from severe genu valgum, permanent dislocation of the patella, knee flexion contracture and leg length shortening. Soft tissue contracture of the limb and subsequent joint deformities were reported to represent clinical manifestations of pediatric melorheostosis. As the epiphyseal plate had not closed, patellar reduction was achieved by soft tissue surgical stabilization, including lateral retinacular release, medial retinaculum plication, and transfer of the lateral half of the patellar tendon. At 4 years postoperatively, as a result of improved limb alignment and knee flexion contracture, the leg length shortening has improved, and the patient does not limp and participates in sports activities. Surgical intervention should be performed as early as possible, because genu valgum and external rotation of the tibia may deteriorate with age, rendering the patellar dislocation irreversible in patients with melorheostosis before epiphyseal closure. Copyright © 2012 Elsevier B.V. All rights reserved.

  9. Endocannabinoids and acute pain after total knee arthroplasty.

    Science.gov (United States)

    Azim, Syed; Nicholson, James; Rebecchi, Mario J; Galbavy, William; Feng, Tian; Reinsel, Ruth; Volkow, Nora D; Benveniste, Helene; Kaczocha, Martin

    2015-02-01

    Osteoarthritis (OA) of the knee is a progressive disease that is associated with inflammation of the joints and lower extremity pain. Total knee arthroplasty (TKA) is a surgical procedure that aims to reduce pain and restore motor function in patients suffering from OA. The immediate postoperative period can be intensely painful leading to extended recovery times including persistent pain. The endocannabinoid system regulates nociception, and the activation of cannabinoid receptors produces antinociceptive effects in preclinical models of OA. To date, the influence of the endocannabinoid tone on pain and disability in OA patients and on acute postoperative pain in humans has not been explored. In this study, we provide the first comprehensive profile of endocannabinoids in serum, cerebrospinal fluid, and synovial fluid of patients with painful end-stage OA undergoing TKA and examine correlations between endocannabinoid levels, interleukin 6, functional disability, acute postoperative pain, and postoperative opioid use. Our results reveal that central (cerebrospinal fluid) and peripheral (synovial fluid) levels of the endocannabinoid 2-arachidonoyl glycerol were significantly elevated in patients who developed higher postoperative pain after TKA. In addition, synovial fluid 2-arachidonoyl glycerol levels were positively correlated with postoperative opioid use. Similarly, synovial fluid levels of the anti-inflammatory lipid palmitoylethanolamide correlated with functional disability in OA. Taken together, our results are the first to reveal associations between central and peripheral endocannabinoid levels and postoperative pain. This suggests that endocannabinoid metabolism may serve as a target for the development of novel analgesics both for systemic or local delivery into the joint.

  10. Acute acromioclavicular dislocation: a cheaper, easier and all-arthroscopic system. Is it effective in nowadays economical crisis?

    Science.gov (United States)

    Sastre, Sergi; Dada, Michelle; Santos, Simon; Lozano, Lluis; Alemany, Xavier; Peidro, Lluis

    2015-03-01

    The objective of this manuscript is to show an effective, easier and cheaper way to reduce acute acromioclavicular (AC) dislocation type III and V (Rockwood classification). Numerous procedures have been described for surgical management of acromioclavicular joint disruption. Newest devices involve an arthroscopic technique that allows nonrigid anatomic fixation of the acromioclavicular joint. Arthroscopically assisted treatment of acute AC joint dislocation is advantageous because it provides good clinical results and few complications. It also allows reviewing glenohumeral associated lesions. This surgical technique requires no specific implants to achieve a correct AC reduction. Actually, economical advantages are very important factors to decide the use of determinate surgical techniques.

  11. Demographic and Psychosocial Predictors of Acute Perioperative Pain for Total Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Maya L Roth

    2007-01-01

    Full Text Available BACKGROUND: As the North American population ages, the prevalence of knee osteoarthritis and the surgical interventions (ie, total knee arthroplasty [TKA] aimed at correcting pain and disability will also rise proportionally. Therefore, efforts to better understand the factors associated with surgical outcomes are warranted. To date, no studies have examined the impact of psychosocial factors on acute postoperative TKA pain.

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

    OpenAIRE

    Pimenta Eduardo; Anti Sônia M. A.

    2003-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  15. Comparison of results between hook plate fixation and ligament reconstruction for acute unstable acromioclavicular joint dislocation.

    Science.gov (United States)

    Yoon, Jong Pil; Lee, Byoung-Joo; Nam, Sang Jin; Chung, Seok Won; Jeong, Won-Ju; Min, Woo-Kie; Oh, Joo Han

    2015-03-01

    In the present study, we aimed to compare clinical and radiographic outcomes between hook plate fixation and coracoclavicular (CC) ligament reconstruction for the treatment of acute unstable acromioclavicular (AC) joint dislocation. Forty-two patients who underwent surgery for an unstable acute dislocation of the AC joint were included. We divided them into two groups according to the treatment modality: internal fixation with a hook plate (group I, 24 cases) or CC ligament reconstruction (group II, 18 cases). We evaluated the clinical outcomes using a visual analog scale (VAS) for pain and Constant-Murley score, and assessed the radiographic outcomes based on the reduction and loss of CC distance on preoperative, postoperative, and final follow-up plain radiographs. The mean VAS scores at the final follow-up were 1.6 ± 1.5 and 1.3 ± 1.3 in groups I and II, respectively, which were not significantly different. The mean Constant-Murley scores were 90.2 ± 9.9 and 89.2 ± 3.5 in groups I and II, respectively, which were also not significantly different. The AC joints were well reduced in both groups, whereas CC distance improved from a mean of 215.7% ± 50.9% preoperatively to 106.1% ± 10.2% at the final follow-up in group I, and from 239.9% ± 59.2% preoperatively to 133.6% ± 36.7% at the final follow-up in group II. The improvement in group I was significantly superior to that in group II (p < 0.001). Furthermore, subluxation was not observed in any case in group I, but was noted in six cases (33%) in group II. Erosions of the acromion undersurface were observed in 9 cases in group I. In cases of acute unstable AC joint dislocation, hook plate fixation and CC ligament reconstruction yield comparable satisfactory clinical outcomes. However, radiographic outcomes based on the maintenance of reduction indicate that hook plate fixation is a better treatment option.

  16. Acute Knee Pain in a Child Due to Pigmented Villonodular Synovitis.

    Science.gov (United States)

    Hong, Cheung Man; Hing, Lui Tun

    2015-01-01

    Pigmented villonodular synovitis (PVNS) is a proliferative condition of the synovium, which is composed of nodules and/or villi and has an abundant number of hemosiderin-laden macrophages. A 10-year-old boy presented with an acute irritable knee. Emergency arthroscopy showed a nodular PVNS in the intercondylar notch. The symptoms resolved after resection of the lesion. PVNS of the knee in children is a rare entity. It can be one of the causes of acute irritable knee. Complete resection of the nodular PVNS can cure the disease.

  17. Habitual dislocation of patella: A review

    Science.gov (United States)

    Batra, Sumit; Arora, Sumit

    2014-01-01

    Habitual dislocation of patella is a condition where the patella dislocates whenever the knee is flexed and spontaneously relocates with extension of the knee. It is also termed as obligatory dislocation as the patella dislocates completely with each flexion and extension cycle of the knee and the patient has no control over the patella dislocating as he or she moves the knee1. It usually presents after the child starts to walk, and is often well tolerated in children, if it is not painful. However it may present in childhood with dysfunction and instability. Very little literature is available on habitual dislocation of patella as most of the studies have combined cases of recurrent dislocation with habitual dislocation. Many different surgical techniques have been described in the literature for the treatment of habitual dislocation of patella. No single procedure is fully effective in the surgical treatment of habitual dislocation of patella and a combination of procedures is recommended. PMID:25983506

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

    Directory of Open Access Journals (Sweden)

    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

  19. Intra-articular lignocaine as a means of analgesia during manual reduction of acute anterior shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Manoj Kadel

    2016-11-01

    Full Text Available Background & Objectives: Acute anterior shoulder dislocation needs prompt reduction of the dislocation. The ideal reduction method should be simple, fast, effective and non- traumatic, with minimal pain, and should not cause further injury to the affected shoulder. Intra-articular local lignocaine injection is a means of achieving analgesia with less complication, and allowing prompt patient discharge of patient after reduction. The study was conducted with objective to evaluate the effectiveness of intra-articular lignocaine for reduction of acute anterior shoulder dislocation.Materials & Methods: Twenty- one cases of acute anterior shoulder dislocation were reduced using intra-articular local lignocaine injection as a method of analgesia by modified Hippocrates method.Results: The mean age was 44.71 years ± SD 20.14 while 11 cases were reduced with one to six hours of injury. Pain assessed through application of a visual analogue scale during the maneuver revealed scores ranging from two to eight with mean score of 4.29 ± SD 1.55.Conclusion: This method is not only safe and effective but also reduces hospital stay and has negligible adverse effects making it a popular choice for most orthopedists.

  20. Physical therapy in the acute period after total knee arthroplasty

    OpenAIRE

    2011-01-01

    The knee joint is subjected to great static and dynamic load. It is often subjected to traumatic injuries, which cause instability, and further dystrophic and degenerative changes in the joint. The aim of the research is to approbate new massage methods (as part of the physical therapy) for functional recovery of the knee joint and the lower extremity in gonarthrosis.

  1. Surgical treatment of acute acromioclavicular joint dislocations: hook plate versus minimally invasive reconstruction.

    Science.gov (United States)

    Metzlaff, S; Rosslenbroich, S; Forkel, P H; Schliemann, B; Arshad, H; Raschke, M; Petersen, W

    2016-06-01

    This study was performed to compare the clinical results of a minimally invasive technique for acute acromioclavicular (AC) joint dislocation repair with the traditional hook plate fixation. Forty-four patients with an acute (within 2 weeks after trauma) complete AC joint separation (35 male, nine female; median age 36.2 years, range 18-56) underwent surgical repair with either a minimally invasive AC joint repair or a conventional hook plate. Functional outcome was evaluated using the Constant-Murley Score (CMS), the TAFT score and the AC joint instability score (ACJI). Radiographic evaluation was performed with bilateral anterior-posterior (a.p.) stress and Alexander views. All patients were available after a median follow-up of 32 months (range 24-51). There were no significant differences in the mean CMS, Taft score and the ACJI between the two groups. The radiological assessment revealed no significant difference in the coracoclavicular distance. In both groups, a slight loss of reduction was observed. Periarticular ossification was seen in 11 patients of the minimally invasive AC joint repair and eight patients of the hook plate group but this did not affect the final outcome. Hook plates were removed after a median interval of 11.9 weeks (range 10-13). Good clinical results can be achieved with both minimally invasive AC joint repair and hook plate fixation. However, in the hook plate group a second operation is mandatory for plate removal. III.

  2. Complications after arthroscopic coracoclavicular reconstruction using a single adjustable-loop-length suspensory fixation device in acute acromioclavicular joint dislocation.

    Science.gov (United States)

    Shin, Sang-Jin; Kim, Nam-Ki

    2015-05-01

    The purpose of this study was to evaluate clinical and radiological outcomes after arthroscopically assisted coracoclavicular (CC) fixation using a single adjustable-loop-length suspensory fixation device for acute acromioclavicular dislocation and to report intraoperative and postoperative complications. Eighteen consecutive patients with acute acromioclavicular dislocation underwent arthroscopically assisted CC fixation using a single TightRope (Arthrex, Naples, FL). Using the Rockwood classification, 3 patients had grade III dislocations, one patient had a grade IV dislocation, and 14 patients had grade V dislocations. The preoperative CC distance of the injured shoulder was 16.1 ± 2.7 mm (range, 11.2 to 21.0 mm), and it increased by 99% ± 36% (range, 17% to 153%) on average compared with the contralateral shoulder. The average CC distance was 10.5 ± 2.5 mm (range, 7.7 to 15.5 mm), and it increased by 30% ± 30% (range, -9.4% to 90%) at the final follow-up. Compared with immediate postoperative radiographs, the CC distance was maintained in 12 patients, increased between 50% and 100% in 4 patients, and increased more than 100% in 2 patients at final follow-up. However, there was no statistical difference in Constant scores between 6 patients with reduction loss (95.6 ± 4.5) and 12 patients with reduction maintenance (98.4 ± 2.5; P = .17). Perioperative complications occurred in 8 patients, including one case of acromioclavicular arthritis, one case of delayed distal clavicular fracture at the clavicular hole of the device, 3 cases of clavicular or coracoid button failures, and 3 cases of clavicular bony erosion. Satisfactory clinical outcomes were obtained after CC fixation using the single adjustable-loop-length suspensory fixation device for acute acromioclavicular joint dislocation. However, CC fixation failure of greater than 50% of the unaffected side in radiological examinations occurred in 33% of the patients within 3 months after the operation

  3. MR imaging of osteonecrosis of the knee in children with acute lymphocytic leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Karimova, E.J. [St. Jude Children' s Research Hospital, Department of Radiological Sciences, Memphis, TN (United States); Kaste, Sue C. [St. Jude Children' s Research Hospital, Division of Diagnostic Imaging, Department of Radiological Sciences, Memphis, TN (United States)

    2007-11-15

    This essay illustrates various patterns of progression of osteonecrosis of the knee and the relationship between early MR imaging findings and radiologic outcome in children with acute lymphocytic leukemia. It also includes a review of nonosteonecrosis signal abnormalities, which are common in the knee region and are often transient. Such abnormalities must be distinguished from osteonecrosis, which can lead to joint collapse and predispose to secondary arthritis. (orig.)

  4. Total Knee Arthroplasty in Severe Unstable Knee: Case-Report and Literature Review

    Science.gov (United States)

    Tahmasebi, Mohammad Naghi; Amjad, Gholamreza Ghorbani; Kaseb, Mohammad Hassan; Bashti, Kaveh

    2017-01-01

    Multiplanar or global laxity in arthritic knee is rare, most of this patients have neuromuscular disorder (post poliomyelitis, spinal dystrophy) or history of knee trauma. Ligament insufficiency and severe bone loss is significant in this patient. The estimated prevalence for the concurrence of charcot marie-tooth (CMT) with myasthenia gravis (MG) suggests an extremely rare event. We have presented a 54-year-old female patient with CMT and MG complaining of progressive pain, swelling, and crepitation of the knee joints who had been undergone total knee arthroplasty (TKA) with rotating hinge prosthesis. She had an acute myasthenia crisis soon after operation with prolonged intubation and intensive care unit admission. Radiographies and physical examination revealed bilateral severe unstable arthritic knee joints and left knee posterior dislocation. Short-term postoperative follow-up revealed improved knee function and resolution of all symptoms in the operated side. PMID:28271089

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

    Energy Technology Data Exchange (ETDEWEB)

    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. The acutely ACL injured knee assessed by MRI

    DEFF Research Database (Denmark)

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

    2008-01-01

    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. Uni...

  7. Evaluation of a treatment algorithm for acute traumatic osseous Bankart lesions resulting from first time dislocation of the shoulder with a two year follow-up

    OpenAIRE

    Spiegl, Ulrich J A; Ryf, Christian; Hepp, Pierre; Rillmann, Paavo

    2013-01-01

    Background Studies dealing with acute osseous Bankart lesions and corresponding treatment strategies are rare. The purpose of this study is to analyze the results after applying our treatment algorithm for acute glenoid rim fractures caused by first time traumatic anterior shoulder dislocations. Methods 25 patients were included in this retrospective case series. All patients sustained a first time shoulder dislocation caused by ski or snowboard accidents. An osseous Bankart lesion was detect...

  8. Inter- and intraobserver reliability of the Rockwood classification in acute acromioclavicular joint dislocations.

    Science.gov (United States)

    Schneider, M M; Balke, M; Koenen, P; Fröhlich, M; Wafaisade, A; Bouillon, B; Banerjee, M

    2016-07-01

    The reliability of the Rockwood classification, the gold standard for acute acromioclavicular (AC) joint separations, has not yet been tested. The purpose of this study was to investigate the reliability of visual and measured AC joint lesion grades according to the Rockwood classification. Four investigators (two shoulder specialists and two second-year residents) examined radiographs (bilateral panoramic stress and axial views) in 58 patients and graded the injury according to the Rockwood classification using the following sequence: (1) visual classification of the AC joint lesion, (2) digital measurement of the coracoclavicular distance (CCD) and the horizontal dislocation (HD) with Osirix Dicom Viewer (Pixmeo, Switzerland), (3) classification of the AC joint lesion according to the measurements and (4) repetition of (1) and (2) after repeated anonymization by an independent physician. Visual and measured Rockwood grades as well as the CCD and HD of every patient were documented, and a CC index was calculated (CCD injured/CCD healthy). All records were then used to evaluate intra- and interobserver reliability. The disagreement between visual and measured diagnosis ranged from 6.9 to 27.6 %. Interobserver reliability for visual diagnosis was good (0.72-0.74) and excellent (0.85-0.93) for measured Rockwood grades. Intraobserver reliability was good to excellent (0.67-0.93) for visual diagnosis and excellent for measured diagnosis (0.90-0.97). The correlations between measurements of the axial view varied from 0.68 to 0.98 (good to excellent) for interobserver reliability and from 0.90 to 0.97 (excellent) for intraobserver reliability. Bilateral panoramic stress and axial radiographs are reliable examinations for grading AC joint injuries according to Rockwood's classification. Clinicians of all experience levels can precisely classify AC joint lesions according to the Rockwood classification. We recommend to grade acute ACG lesions by performing a digital

  9. Luxação aguda isolada da articulação tibiofibular proximal Acute isolated anterolateral dislocation of the proximal tibiofibular joint

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    Paulo Roberto de Almeida Silvares

    2010-01-01

    Full Text Available A luxação traumática isolada da articulação tibiofibular proximal é rara. Esta lesão pode não ser reconhecida ou diagnosticada no atendimento inicial. A ausência de suspeita clínica pode causar problemas para o diagnóstico. O diagnóstico necessita de história precisa do mecanismo e sintomas da lesão, avaliação clínica e radiográfica adequada de ambos joelhos. Casos não reconhecidos são fonte de alterações crônicas. O tratamento é feito por redução fechada e imobilização ou, em casos irredutíveis ou instáveis, redução aberta com fixação interna temporária. Um caso raro de luxação tibiofibular proximal isolada em um jogador de basquetebol é relatado para ilustrar essa lesão.The isolated traumatic dislocation of the proximal tibiofibular joint is rare. The injury could go unrecognized or be misdiagnosed at the initial presentation. Lack of clinical suspicion can cause diagnostic problems. The diagnosis requires accurate history of the mechanism and symptoms of the injury, and adequate clinical and radiographic evaluation of the both knees. Overlooked injuries are a source of potentially chronic changes. The treatment is closed reduction and immobilization or, in case of a failed or unstable reduction, open reduction with temporary internal fixation. A rare case of acute isolated anterolateral dislocation of the proximal tibiofibular joint in a basketball player was described to illustrate this injury.

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

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    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.

  11. Diagnostic imaging in a patient with an acute knee injury.

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    Sago, Carrie E; Labuda, Craig S

    2013-01-01

    The patient was a 23-year-old man, currently serving in a military airborne operations unit. During a jump training exercise, the patient's right lower extremity became entangled in his parachute equipment upon exiting the aircraft, which caused hyperextension and valgus forces upon his right knee. Due to concern for a fracture, the patient was transported to an emergency department, where conventional radiographs were completed and interpreted by a radiologist as negative for a fracture. Following further physical examination by a physical therapist, magnetic resonance imaging of the right knee was ordered, revealing ruptures of the anterior cruciate ligament and medial collateral ligament.

  12. Dor aguda no joelho do paciente idoso Acute knee pain in elderly patients

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    Gilberto Luís Camanho

    2008-09-01

    Full Text Available A dor aguda no joelho de pacientes idosos é freqüente, sendo caracterizada por seu aparecimento súbito, sem causa aparente, com exame radiográfico dentro dos padrões da normalidade, na maioria dos casos. A etiologia da dor aguda no joelho é decorrente de insuficiência das estruturas, e seu quadro clínico difere completamente daquele determinado pela osteoartrose, sendo sempre unilateral e ocorre na grande maioria em pacientes do sexo feminino, após a quinta década de vida, e na região medial do joelho (local de maior carga. Com o propósito de analisar as possíveis etiologias para a dor aguda do joelho de pacientes acima de 60 anos de idade, suas características e tratamento, os autores discutem as etiologias relacionadas à dor aguda: lesão meniscal, fratura por fadiga e osteonecrose idiopática.Acute knee pain in elderly patients is not uncommon, and is characterized by a sudden onset, no apparent cause, and by normal radiographic findings in most cases. The etiology of acute knee pain is the result of insufficient structures, and clinical symptoms are totally different from the symptoms seen in osteoarthrosis. This acute pain in the knee is always unilateral and in the medial region of the knee joint (site with the heaviest load, predominantly in females after the fifth decade of live. In order to consider the possible etiologies for acute knee joint pain in patients older than 60 years, its characteristics and treatment, the authors discuss etiologies related to acute pain: lesion of the meniscus, stress fracture, and idiopathic osteonecrosis.

  13. Loss of reduction and complications of coracoclavicular ligament reconstruction with autogenous tendon graft in acute acromioclavicular dislocations.

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    Choi, Nam Hong; Lim, Seok Min; Lee, Sang Young; Lim, Tae Kang

    2017-04-01

    This study was conducted to report loss of reduction and complications after single-tunnel coracoclavicular (CC) ligament reconstruction with autogenous semitendinosus tendon graft for acute acromioclavicular (AC) joint dislocations. This retrospective study included patients with acute, unstable AC dislocations (surgery within 6 weeks after trauma). We excluded patients with chronic injury and distal clavicle fractures with CC ligaments disruption. We measured the CC distance on anteroposterior radiographs of both clavicles, preoperatively, immediately postoperatively, and at the final follow-up visit. We evaluated clinical outcomes using the American Shoulder and Elbow Surgeons Shoulder Assessment and the University of California, Los Angeles Shoulder Rating Scale scores and perioperative complications. There were 30 patients (27 men and 3 women) with mean age of 41 years (range, 19-70 years). The mean follow-up period was 31 months (range, 12-186 months). Mean CC distance was 15.5 ± 3.7 mm (84% ± 14% of the contralateral shoulder) preoperatively, 8.9 ± 2.6 mm (9% ± 40%) immediately postoperatively (P 25% increase of CC distance) developed in 14 patients (47%), and complications occurred in 6 patients (20%), including 3 distal clavicle fractures through the tunnel. Final clinical scores were significantly lower in patients with complications (27 vs. 33 of the University of California, Los Angeles assessment [P < .001] and 81 vs. 95 of the American Shoulder and Elbow Surgeons Shoulder assessment [P < .001]). In acute AC joint dislocation, single-tunnel CC ligament reconstruction using autogenous tendon graft resulted in loss of reduction rate of 47% and a complication rate of 20%. The development of complications adversely affected clinical outcomes. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  14. Clinical effect of acute complete acromioclavicular joint dislocation treated with micro-movable and anatomical acromioclavicular plate.

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    Liu, Qingjun; Miao, Jianyun; Lin, Bin; Guo, Zhimin

    2012-01-01

    We evaluated the long-term clinical results of acute complete acromioclavicular dislocations treated with micro-movable and anatomical acromioclavicular plate. Open reduction and internal fixation was performed using the MAAP in 16 patients (10 males, 6 females; mean age 36 years; range 16 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). 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 1 patient (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. 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.

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

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    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. Arthroscopic treatment of acute acromioclavicular dislocations using a double button device: Clinical and MRI results.

    Science.gov (United States)

    Loriaut, P; Casabianca, L; Alkhaili, J; Dallaudière, B; Desportes, E; Rousseau, R; Massin, P; Boyer, P

    2015-12-01

    Arthroscopic treatment of acute grade 3 and 4 acromioclavicular dislocation is controversial, due to the risk of recurrence and of postoperative reduction defect. The purpose of the present study was to investigate whether the healing of the acromioclavicular (AC) and coracoclavicular (CC) ligaments and the accurate 3D positioning parameters of the AC joint using MRI were correlated with satisfactory functional outcome. Thirty-nine patients were enrolled from 2009 to 2011 and managed arthroscopically by CC lacing using a double-button device. Clinical assessment included the Shoulder and Hand (QuickDash) score, Constant-Murley score and visual analog scale (VAS) for residual pain. Time and rate to return to work and return to sport were assessed according to type of sport and work. Postoperative complications were recorded. Radiological examination consisted of anteroposterior clavicle and lateral axillary radiographs. AC ligament healing and 3D joint congruency were assessed on MRI and correlated to the clinical results. Mean patient age was 35.7 years (range, 20-55). Mean follow-up was 42.3±10.6 months (range, 24-60). At final follow-up, mean QuickDash score, Constant score and VAS were respectively 1.7±4 (range, 0-11), 94.7±7.3 (range, 82-100) and 0.5±1.4 (range, 0-2). Thirty-five (90%) patients were able to resume work, including heavy manual labor, and sport. Radiology found accurate 3D joint congruency in 34 patients (87%) and CC and AC ligament healing in 36 (93%). Complications included reduction loss at 6 weeks in 3 patients, requiring surgical stabilization. Satisfactory functional results were associated with accurate AC joint congruency in the coronal and axial planes (P<0.05) and good AC and CC ligament healing (P<0.04). An initial 25% reduction defect in the coronal plane was not associated with poor functional results (P=0.07). Arthroscopic treatment by CC lacing satisfactorily restored ligament and joint anatomy in the present series. These

  17. Arthroplasties of hips and knees ankylosis in an adolescent with acute lymphoblastic leukaemia.

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    Dipo Samuel OLABUMUYI

    2011-10-01

    Full Text Available Acute lymphoblastic leukaemia (ALL is the most common malignancy in children, representing one third of all paediatric malignancies. Patients are often at high risk for complications due aggressive chemotherapy regimes required for treatment. Musculoskeletal complications include septic arthritis, osteonecrosis, osteoporosis, avascular necrosis and bony ankylosis. We report the case of a 16-year-old boy with ALL who developed osteonecrosis of multiple bones on a background of septicaemia, resulting in bony ankylosis of both hips and knees. He was treated with bilateral conversion of ankylosed hips (one hip to total hip replacement, the second hip to Girdlestone arthroplasty and bilateral ankylosed knees to total knee replacements. He remained well in remission five years after the last surgery. Our case highlights he possible musculoskeletal complications of ALL. 

  18. Injury patterns of the acromioclavicular ligament complex in acute acromioclavicular joint dislocations: a cross-sectional, fundamental study.

    Science.gov (United States)

    Maier, Dirk; Jaeger, Martin; Reising, Kilian; Feucht, Matthias J; Südkamp, Norbert P; Izadpanah, Kaywan

    2016-09-06

    Horizontal instability impairs clinical outcome following acute acromioclavicular joint (ACJ) reconstruction and may be caused by insufficient healing of the superior acromioclavicular ligament complex (ACLC). However, characteristics of acute ACLC injuries are poorly understood so far. Purposes of this study were to identify different ACLC tear types, assess type-specific prevalence and determine influencing cofactors. This prospective, cross-sectional study comprised 65 patients with acute-traumatic Rockwood-5 (n = 57) and Rockwood-4 (n = 8) injuries treated operatively by means of mini-open ACJ reduction and hook plate stabilization. Mean age at surgery was 38.2 years (range, 19-57 years). Standardized pre- and intraoperative evaluation included assessment of ACLC tear patterns and cofactors related to the articular disc, the deltoid-trapezoidal (DT) fascia and bony ACJ morphology. Articular disc size was quantified as 0 = absent, 1 = remnant, 2 = meniscoid and 3 = complete. All patients showed complete ruptures of the superior ACLC, which could be assigned to four different tear patterns. Clavicular-sided (AC-1) tears were observed in 46/65 (70.8 %), oblique (AC-2) tears in 12/65 (18.5 %), midportion (AC-3) tears in 3/65 (4.6 %) and acromial-sided (AC-4) tears in 4/65 (6.1 %) of cases. Articular disc size manifestation was significantly (P < .001) more pronounced in patients with AC-1 tears (1.89 ± 0.57) compared to patients with AC-2 tears (0.67 ± 0.89). Other cofactors did not influence ACLC tear patterns. ACLC dislocation with incarceration caused mechanical impediment to anatomical ACJ reduction in 14/65 (21.5 %) of cases including all Rockwood-4 dislocations. Avulsion "in continuity" was a consistent mode of failure of the DT fascia. Type-specific operative strategies enabled anatomical ACLC repair of all observed tear types. Acute ACLC injuries follow distinct tear patterns. There exist clavicular-sided (AC-1

  19. Surgical treatment of acute and chronic anterior and posterior cruciate ligament and lateral side injuries of the knee.

    Science.gov (United States)

    Levy, Bruce A; Boyd, Joel L; Stuart, Michael J

    2011-06-01

    Combined anterior cruciate ligament, posterior cruciate ligament, and lateral-sided injuries of the knee most often occurs secondary to a forced varus moment or after knee dislocation. Management controversies include the optimal timing of surgery, operative techniques, and postoperative rehabilitation. Recent systematic literature reviews have demonstrated higher rates of failure with repair of the lateral and posterolateral corner structures, as opposed to reconstruction. However, the ideal ligament reconstruction techniques remain unclear. This chapter will review the combined anterior cruciate ligament/posterior cruciate ligament/lateral-sided injury pattern, including the physical examination findings, imaging, timing of surgery, graft selection, operative techniques, and postoperative rehabilitation protocols.

  20. Acute and old ruptures of the extensor apparatus of the knee in adults (excluding knee replacement).

    Science.gov (United States)

    Saragaglia, D; Pison, A; Rubens-Duval, B

    2013-02-01

    Rupture of the extensor apparatus of the knee in adults is infrequent and dominated by patellar fracture, which in our experience is six times as frequent as quadriceps or patellar tendon tear. Patellar fracture poses few diagnostic problems and treatment is now well codified. Tension-band osteosynthesis is generally used, involving two longitudinal K-wires and wire in a figure-of-eight pattern looped over the anterior patella; sometimes, for more complex fractures, cerclage wiring is added to the tension band. Non-union is rare and generally well tolerated. Quadriceps tendon tear mainly affects patients over 40 years of age, in a context of systemic disease. Diagnosis is easily suggested by inability to actively extend the knee, but is unfortunately still often overlooked in emergency. In most cases, early surgical management is needed to reinsert the tendon at the proximal pole of the patella by bone suture. For chronic lesions, it is often necessary to lengthen the quadriceps tendon by V-Y plasty or the Codivilla technique. Patellar tendon tear, on the other hand, typically occurs in patients under 40 years of age, often involved in sports. Diagnosis is again clinically straightforward, but again may be missed in emergency, especially in case of incomplete tear. Surgery is mandatory in all cases. The procedure depends on the type of lesion: either end-to-end suture or transosseous reinsertion. In most cases repair is protected by tendon augmentation. Old lesions often require tendon graft or a tendon-bone-tendon-bone graft taken from the opposite side.

  1. Evaluation of medial patellofemoral ligament tears after acute lateral patellar dislocation: comparison of high-frequency ultrasound and MR.

    Science.gov (United States)

    Zhang, Guang-Ying; Zheng, Lei; Ding, Hong-Yu; Li, En-Miao; Sun, Bai-Sheng; Shi, Hao

    2015-01-01

    The purpose of this study was to compare the diagnostic performance of high-frequency ultrasound with MR in the evaluation of medial patellofemoral ligament (MPFL) lesions after acute lateral patellar dislocation (LPD). High-frequency ultrasound and MR images were prospectively obtained in 97 consecutive patients with acute LPD. Images were acquired using standardised protocols and were independently evaluated by two radiologists. The MPFL was assessed at three sites (patellar insertion, femoral attachment, and mid-substance) for signs of injury. Of a total of 291 sites in 97 MPFLs, 127 showed proven MPFL tear at surgery, including 51 sites of complete tear and 76 sites of partial tear. In a site-based analysis, the sensitivity, specificity, and accuracy of high-frequency ultrasound was 90.8%, 96.3%, and 94.6%, respectively, for partial MPFL tear and 86.3%, 96.3%, and 94%, respectively, for complete tear. For MR, the sensitivity, specificity, and accuracy was 81.6%, 95.7%, and 91.3%, respectively, for partial MPFL tear and 80.4%, 95.7%, and 92.1%, respectively, for complete tear. There was no statistical difference between high-frequency ultrasound and MR in the assessment of partial (P = 0.1, 0.777, 0.155) or complete (P = 0.425, 0.777, 0.449) MPFL lesions. Interobserver agreement was very good for high-frequency ultrasound and good for MR. Data suggest that high-frequency ultrasound and MR have similar diagnostic performance in the evaluation of MPFL lesions after acute LPD. • High-frequency ultrasound and MR were able to detect MPFL lesions after acute lateral patellar dislocation. • High-frequency ultrasound and MR showed similarly high accuracy in diagnosing MPFL lesions. • Interobserver agreement was very good for high-frequency ultrasound and good for MR.

  2. Isolated osteochondral fracture of the patella without patellar dislocation.

    Science.gov (United States)

    Bhatt, Jay; Montalban, Antonio Santa Cruz; Wang, Kook Hyun; Lee, Hee Du; Nha, Kyung Wook

    2011-01-03

    Chondral fractures of the patella are associated with acute dislocation of the patella. Osteochondral fracture in patellar dislocation is located in the medial facet of the patella. This article presents a case of a 15-year-old female ballerina with isolated displaced osteochondral fracture of the patella without patellar dislocation. She had no history of trauma. A Merchant's view of both knees showed mild subluxation of the patella, a small fragment on the lateral aspect of the knee, and a small defect of the centromedial patella. Axial magnetic resonance imaging (MRI) revealed an osteochondral fragment measuring 13 mm medial to the patella. However, the medial patellofemoral ligament and medial retinaculum were intact. An effusion on the medial side of the patella consistent with hemarthrosis was observed. An absence of a contusion or bone bruise on the lateral femoral condyle was shown. The loose body was removed arthroscopically. Intraoperative findings included a 1.5×2 cm osteochondral fragment. It is unusual that the osteochondral patellar defect site in this patient was in the inferior and central areas of the patella. Patellar chondral fractures without dislocation or patella fracture are rare. Therefore, the possibility of a trivial trauma leading to an osteochondral fracture should be kept in mind in adolescent and young adults who present with knee pain and hemarthrosis. Copyright 2011, SLACK Incorporated.

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

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    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.

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

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    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.)

  5. A case of acute trans-scaphoid volar dislocation of the lunate into the distal forearm

    Institute of Scientific and Technical Information of China (English)

    Mohamed Al Khayarin; Mohamed Al Ateeq Al Dosari; Shibly Abdul Basith; Mohammed Waseemuddin

    2016-01-01

    Trans-scaphoid volar dislocation of the lunate with displacement into the distal forearm proximal to the radiocarpal joint is an extremely rare, high energy injury with extensive ligament disruption. They are unstable and require open reduction and internal fixation with repair of ligaments. They are associated with significant morbidity and loss of function. We report the case of a patient with this injury. Open reduction, internal fixation and ligament repair were done. The patient had a good functional outcome.

  6. Hook plate fixation for acute acromioclavicular dislocations without coracoclavicular ligament reconstruction: a functional outcome study in military personnel.

    Science.gov (United States)

    Kumar, Narinder; Sharma, Vyom

    2015-08-01

    The aim of our study was to evaluate the shoulder function after clavicular hook plate fixation of acute acromioclavicular dislocations (Rockwood type III) in a population group consisting exclusively of high-demand military personnel. This prospective study was carried out at a tertiary care military orthopaedic centre during 2012-2013 using clavicular hook plate for management of acromioclavicular injuries without coracoclavicular ligament reconstruction in 33 patients. All patients underwent routine implant removal after 16 weeks. The functional outcome was assessed at 3, 6 and 12 months after hook plate removal and 2 years from the initial surgery using the Constant Murley and UCLA Scores. All the patients were male serving soldiers and had sustained acromioclavicular joint dislocation (Rockwood type III). Mean age of the patient group was 34.24 years (21-55 years). The mean follow-up period in this study was 23.5 months (20-26 months) after hook plate fixation and an average of 19.9 months (17-22 months) after hook plate removal. The average Constant Score at 3 months after hook plate removal was 60.3 as compared to 83.7 and 90.3 at 6 months and 1 year, respectively, and an average of 91.8 at the last follow-up that was approximately 2 years after initial surgery which was statistically significant (p value acromioclavicular dislocations producing excellent medium-term functional results in high-demand soldiers.

  7. Nonoperative treatment of acute knee ligament injuries. A review with special reference to indications and methods.

    Science.gov (United States)

    Kannus, P; Järvinen, M

    1990-04-01

    Nonoperative treatment has received little attention in the numerous scientific reports on knee ligament injuries. Great controversy still exists concerning the proper treatment of a knee with a ruptured ligament, especially the anterior cruciate ligament. However, according to the studies of the authors and an extensive review of the literature the indications for conservative management can be established to be all grade I and II sprains (partial tears) of knee ligaments as well as an isolated grade III sprain (complete tear) of the posterior cruciate ligament. In addition, an isolated complete rupture of an anterior cruciate, or medial or lateral collateral ligament may be treated nonoperatively in an older sedentary person. Other injuries obviously call for an operative approach at the acute stage. Nonoperative therapy protocols must be based on the knowledge of the biological phenomenon occurring during connective tissue healing process. In the first phase of ligament healing the injured knee needs 2 to 3 weeks immobilisation for undisturbed fibroblast invasion and proliferation of collagen fibres. This is achieved by immobilising the knee in a rehabilitative knee brace locked in 40 to 45 degrees of flexion. Thereafter, a gradually increasing controlled mobilisation is allowed in the brace to avoid the deleterious effects of immobilisation to cartilage, bone, muscles, tendons and ligaments, and to enhance the orientation of collagen fibres to the stress lines of the healing ligament. After 4 to 8 weeks the goal for rehabilitation is rapid and full recovery to work and sports. A functional knee brace may be used at this phase to give extra protection before final strengthening of the injured ligament. During the mobilisation and muscle training of the therapy protocol various specific techniques can be used for strengthening of the hamstring and quadriceps muscles, including isometric, isotonic, isokinetic and eccentric exercises with or without resistive

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

    Energy Technology Data Exchange (ETDEWEB)

    Schueller-Weidekamm, C.; Schueller, G.; Uffmann, M.; Bader, T.R. [Medical University of Vienna, Department of Radiology, Vienna (Austria)

    2006-10-15

    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.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  10. Acute effects of anterior thigh foam rolling on hip angle, knee angle, and rectus femoris length in the modified Thomas test

    OpenAIRE

    Vigotsky, Andrew D.; Lehman, Gregory J; Contreras, Bret; Beardsley, Chris; Chung, Bryan; Feser, Erin H.

    2015-01-01

    Background. Foam rolling has been shown to acutely increase range of motion (ROM) during knee flexion and hip flexion with the experimenter applying an external force, yet no study to date has measured hip extensibility as a result of foam rolling with controlled knee flexion and hip extension moments. The purpose of this study was to investigate the acute effects of foam rolling on hip extension, knee flexion, and rectus femoris length during the modified Thomas test. Methods. Twenty-three h...

  11. Acute effects of anterior thigh foam rolling on hip angle, knee angle, and rectus femoris length in the modified Thomas test

    OpenAIRE

    Vigotsky, Andrew D.; Lehman, Gregory J; Bret Contreras; Chris Beardsley; Bryan Chung; Feser, Erin H.

    2015-01-01

    Background. Foam rolling has been shown to acutely increase range of motion (ROM) during knee flexion and hip flexion with the experimenter applying an external force, yet no study to date has measured hip extensibility as a result of foam rolling with controlled knee flexion and hip extension moments. The purpose of this study was to investigate the acute effects of foam rolling on hip extension, knee flexion, and rectus femoris length during the modified Thomas test.Methods. Twenty-three he...

  12. Acute injury affects lubricin expression in knee menisci: an immunohistochemical study.

    Science.gov (United States)

    Musumeci, Giuseppe; Loreto, Carla; Carnazza, Maria Luisa; Cardile, Venera; Leonardi, Rosalia

    2013-03-01

    The aim of this study was to investigate for the first time lubricin expression in intact menisci and in menisci from patients with recent knee joint injury using histology, immunohistochemistry, Western blotting and gene expression analysis, to provide insights into pathological processes affecting meniscal tissue. Lubricin expression was studied in vivo in 20 patients (14 males and 6 females) with recent joint injury subjected to arthroscopic partial meniscectomy and in vitro in fibroblast-like cells from meniscus tissue to establish whether it is down-regulated following acute traumatic knee injury. The control group consisted of cadaver donors with normal menisci. Histology demonstrated a normal tissue without structural changes in control samples and structural alterations and clefts in injured menisci. Very strong lubricin immunohistochemical staining was observed in intact menisci; in contrast weak staining was seen in injured menisci. Western blot and mRNA expression analysis also demonstrated strong lubricin expression in control cells and a negligible amount of lubricin in injured fibroblast-like cells. Our data provide information concerning the immediate in vivo response to injury of human knee menisci by documenting early changes in the boundary-lubricating ability of synovial fluid and articular cartilage integrity. These findings may provide the biological basis for developing novel medical therapies to be applied before surgical treatment to preserve tissue function and prevent cartilage damage.

  13. A comparison between two double-button endoscopically assisted surgical techniques for the treatment acute acromioclavicular dislocations.

    Science.gov (United States)

    Vulliet, P; Le Hanneur, M; Cladiere, V; Loriaut, P; Boyer, P

    2017-08-31

    To compare clinical and radiological outcomes between two endoscopically assisted double-button techniques in high-grade acute acromioclavicular separations. A retrospective single-center study was conducted in patients with acute acromioclavicular joint dislocation Rockwood types III and V, from 2009 to 2014. All were treated endoscopically, with a 1-year minimum follow-up. Two consecutive series were conducted; the first (TR group) received the TightRope(®) system, whereas last series (DB group) was treated with the Dog Bone(®) button technology (Arthrex, Naples, FL, USA). Primary endpoints were last follow-up values of Constant score (CS) and Quick-DASH (QD) score. Moreover, the posttraumatic displacement and its evolution were assessed on bilateral Zanca radiographs. A displacement of 5 mm or greater the day after surgery was considered as a lack of reduction; the same difference on last follow-up X-rays was considered as a loss of reduction. Forty patients were reviewed: 22 in the TR group and 18 in the DB group. After a mean follow-up of 27.7 ± 8.3 months, CS and QD averaged, respectively, 94.3 ± 4.4 and 2.0 ± 2.6 in the TR series, whereas they averaged, respectively, 95 ± 6.1 and 3.4 ± 3.3 in the DB series after a mean follow-up of 24.1 ± 5 months (PCS = 0.16, PQDS = 0.08). Lack of reduction and loss of reduction rates were significantly higher in the DB group, with P = 0.0005 and P < 0.0001, respectively. Both techniques provided good to excellent functional outcomes. However, considering inferior radiological results using the Dog Bone(®) device, we would prefer the TightRope(®) device in acute acromioclavicular dislocations. IV: Therapeutic study-cases series.

  14. Predicting acute recovery of physical function following total knee joint arthroplasty.

    Science.gov (United States)

    Robbins, Shawn M; Rastogi, Ravi; McLaughlin, Terry-Lyne

    2014-02-01

    The objective was to explore predictors of physical function during acute in-patient rehabilitation within a few days after TKA. Physical function status of participants (n = 72) three days after total knee arthroplasty (TKA) was measured using the Timed Up and Go Test (TUG) and the function subscale of the Western Ontario McMaster Universities Index of Osteoarthritis (WOMAC-function). Potential predictors of physical function were measured day one post-TKA. Their relationship with physical function was examined using backward elimination, multiple regression analyses. Older age and increased comorbidity were associated (R(2) = 0.20) with worse TUG times. Increased pain severity was associated (R(2) = 0.08) with worse WOMAC-function scores. Age, comorbidity, and pain severity should be considered when predicting which patients will struggle with acute recovery post-TKA.

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

    Energy Technology Data Exchange (ETDEWEB)

    Roemer, F.W.; Bohndorf, K. [Department of Radiology, Klinikum Augsburg, Stenglinstrasse 2, 86152 Augsburg (Germany)

    2002-11-01

    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 cm{sup 3} (range 0.25-175 cm{sup 3}). 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 cm{sup 3}, range 0.3-4.8 cm{sup 3}). 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

  16. Acute high-grade acromioclavicular dislocations treated with triple button device (MINAR): Preliminary results.

    Science.gov (United States)

    Cano-Martínez, José Antonio; Nicolás-Serrano, Gregorio; Bento-Gerard, Julio; Picazo-Marín, Francisco; Andrés-Grau, Josefina

    2016-11-01

    Describe the clinical and radiological results of triple button device in the treatment of high-grade AC dislocations (Rockwood, type V) and assess whether improves vertical and horizontal stability compared to the techniques previously described. This retrospective study included 39 patients with type V acromioclavicular dislocations treated with Twin Tail TightRope™ system (triple button device). Of the 39 patients, 33 (26 men and 7 women) were able to participate in clinical and radiographic follow up. At the time of surgery, the mean age was 25years±7(range, 17-49). All patients underwent bilateral-weighted Zanca (CC distance) and Alexander view (AC distance) as well as the Constant Score (CS) and Acromioclavicular Joint Instability Scoring System (ACJI). Radiological and clinical outcome was assessed during routine follow-up examinations preoperatively, postoperatively, 1, 3, 6 months and every year after the surgery. The presence of calcification, degenerative changes, mobilization of implants and bone resorption were also assessed. After a mean follow up of 25±4months (range 14-38), the results of the Constant (CS) were 94.1±5,5 (range 76-100) and test ACJI 87.3±9,8 (range 65-100), showing no significant differences with the uninjured shoulder (CS 95.8±2.5, range 83-100; ACJI 94.1±3.7, range 80-100). At final review, we observed that preoperative coracoclavicular distance (Zanca View) improved from 21,75±1.97mm to 8,73mm±0.75 and the acromioclavicular distance (Alexander View) from 12,65mm±1.99 to 0,35±0.3mm. Compared with healthy shoulder, these differences were not significant. There was no loss of reduction with this system in the vertical plane. 4 patients (12.12%) revealed signs of posterior instability with worse clinical test results. The presence of degenerative joint changes (6,06%), calcifications (27,2%) or mobilization of the implant (18,18%) was not associated with worse clinical outcomes. Twin Tail device using minimally invasive

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  18. Lower limb fractures associated with multiligament knee injury

    Science.gov (United States)

    Stagnaro, Joaquin; Yacuzzi, Carlos; Barla, Jorge; Zicaro, Juan Pablo; Costa-Paz, Matias

    2017-01-01

    Objectives: Knee ligament injuries related to lower limb fractures are common and frequently unnoticed. Management of acute polytrauma is usually focused in the bone lesion and a complete physical examination might be really difficult. The purpose of this study was to analyze a series of patients who suffered multiligament knee injuries associated to a lower limb fracture. Hypothesis: The use of magnetic resonance imaging (MRI) during the initial management can lead to an early diagnosis of ligament injuries. Methods: A retrospective search was conducted from our hospital´s electronic database. We evaluated the initial diagnosis and acute surgical treatment, and management and functional outcomes after the ligament lesion was diagnosed. Results: Seven patients who presented a knee multiligament injury associated with a lower limb fracture were evaluated. The average age was 29 years. Primary diagnoses were: four tibial plateau fractures; one open fracture-dislocation of the knee; one open leg fracture and ipsilateral hip dislocation; and one bifocal femur fracture. Only three patients had an MRI during the initial management of trauma. Six out of seven patients had to be operated on for the multiligament knee injury. The period between the resolution of the fracture and the ligamentous repair was from 3 to 24 months. Conclusion: Poor functional outcomes are reported in patients with multiligament knee injuries associated with high-energy lower limb fractures. We consider an MRI during the initial management can lead to better outcomes. A trauma surgeon working alongside an arthroscopic surgeon might optimize the results for these lesions.

  19. First-Time Patellofemoral Dislocation: Risk Factors for Recurrent Instability.

    Science.gov (United States)

    Lewallen, Laura; McIntosh, Amy; Dahm, Diane

    2015-08-01

    Patellofemoral instability is a complex problem, which can be difficult to manage. The purpose of this study was to describe the demographics of patients with a first-time patellofemoral dislocation, and identify risk factors for recurrent instability. This was a single institution, institutional review board-approved, retrospective review of >2,000 patients with a patellar dislocation between 1998 and 2010. Inclusion criteria are as follows: (1) no prior history of patellofemoral subluxation or dislocation of the affected knee; (2) X-rays within 4 weeks of the initial instability episode; and (3) a dislocated patella requiring reduction, or history/findings suggestive of acute patellar dislocation (effusion/hemarthrosis, tenderness along the medial parapatellar structures, and apprehension with lateral patellar translation). Clinical records and radiographs were reviewed. The Caton-Deschamps and Insall-Salvati indices were used to evaluate patella alta. Trochlear dysplasia was assessed using the Dejour classification system. Skeletal maturity was graded based on the distal femoral and proximal tibial physes, using one of the following categories: open, closing, or closed. Three hundred twenty-six knees (312 patients) met the aforementioned criteria. There were 145 females (46.5%) and 167 males (53.5%), with an average age of 19.6 years (range, 9-62 years). Thirty-five patients (10.7%) were treated with surgery after the initial dislocation. All others were initially managed nonoperatively. Of the 291 patients managed nonoperatively, 89 (30.6%) had recurrent instability, 44 (49.4%) of which eventually required surgery. Several risk factors for recurrent instability were identified, including younger age (p alta (p = 0.02), and trochlear dysplasia (p plan. The clinical tool shown in Fig. 4 may be especially useful.

  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

    Institute of Scientific and Technical Information of China (English)

    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. Acute traumatic posterior fracture dislocation of the elbow in pediatric patients: impact of surgery time and associated fractures on outcome.

    Science.gov (United States)

    Bilgili, Fuat; Dikmen, Goksel; Baş, Ali; Asma, Ali; Batibay, Sefa G; Şirikçi, Murat; Atalar, Ata Can

    2016-09-01

    This study assessed the effect of the time interval from initial injury to surgery and the presence of associated fracture on functional outcomes after acute posterior elbow fracture dislocation. Twenty-six pediatric patients were evaluated with respect to operation time point (within 24 h vs. later) and associated fracture retrospectively. The Mayo Elbow Performance Index (MEPI) score was used to assess functional results. The MEPI score was 91 (80-100) in patients with one associated fracture and 83 (75-95) (P=0.02) in patients with more than one associated fracture. The MEPI score in patients treated within 24 h was 90.3 (75-95) and in those treated later than 24 h, it was 88.6 (75-100) (P=0.6). Treatment time (within 24 h vs. later) does not affect outcomes, but increasing numbers of associated injuries affect outcomes negatively. Level of study: Level IV case series.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Role of magnetic resonance imaging in the clinical management of the acutely locked knee

    Energy Technology Data Exchange (ETDEWEB)

    McNally, Eugene G.; Nasser, Khalid N.; Dawson, Stewart; Goh, Leslie A. [Department of Musculoskeletal Radiology, Nuffield Orthopaedic Centre and Oxford Radcliffe Hospital, Oxford, OX3 7LD (United Kingdom)

    2002-10-01

    To explore prospectively the hypothesis that MRI of the acutely locked knee can alter surgical decision-making.Design and patients. The study group comprised patients with a clinical diagnosis of knee locking requiring arthroscopy. The decision to carry out arthroscopy was made by an experienced consultant orthopaedic surgeon specialising in trauma and recorded in the patient's notes prior to MRI. Preoperative MRI was carried out using a 1.5 T system. The management was altered from surgical to conservative treatment in 20 (48%) patients on the basis of the MR findings. Arthroscopy was limited to patients with an MR diagnosis of a mechanical block, usually a displaced meniscal tear or loose body. Both patient groups were followed clinically until symptoms resolved.Results. Forty-two patients were entered into the study. MRI identified a mechanical cause for locking in 22 patients (21 avulsion meniscal tears and 1 loose body). All were confirmed at arthroscopy. Twenty patients were changed from operative to non-operative treatment on the basis of the MRI findings. One patient in this group required a delayed arthroscopy for an impinging anterior cruciate ligament stump. The sensitivity/specificity/accuracy of MRI in identifying patients who require arthroscopy was therefore 96%/100%/98% respectively.Conclusion. MRI can successfully segregate patients with a clinical diagnosis of mechanical locking into those who have a true mechanical block and those who can be treated conservatively. MRI should precede arthroscopy in this clinical setting. (orig.)

  4. Clinical, nociceptive and psychological profiling to predict acute pain after total knee arthroplasty

    DEFF Research Database (Denmark)

    Luna, I E; Kehlet, H; Petersen, M A

    2017-01-01

    BACKGROUND: Pre-operative identification of high-pain responders for acute pain after total knee arthroplasty (TKA) could lead to targeted analgesic trials and individualized analgesic strategies to improve recovery and potentially reduce the risk of persistent post-surgical pain. The aim...... outcome. Predictive variables collected prior to surgery included demographics, nociceptive testing (pressure pain threshold (PPT), cold pressor tolerance, electrical pain threshold and tolerance) and psychological profile (pain catastrophizing scale (PCS) and hospital anxiety and depression scale...... catastrophizing are predictive of moderate severe post-TKA pain. If validated in a larger population, the clinically applicable tests should be considered in future interventions aiming to minimize post-operative pain in high-risk patients....

  5. Occult renal cell carcinoma with acrometastasis and ipsilateral juxta-articular knee lesions mimicking acute inflammation

    Directory of Open Access Journals (Sweden)

    Bhaskar Borgohain

    2012-01-01

    Full Text Available Generally, skeletal peripheral metastases below the elbow and the knee are rare. Skeletal metastases to the hand or foot are very rare; but when they do it may be a revealing clinical finding. Purely lytic lesions are commonly seen in metastases from lung, renal, and thyroid tumors, but they are also known to occur in primary myeloma, brown tumor and lymphomas. A 70-year-old man was brought to the emergency department with acute painful swelling involving his right hand and the right knee. Due to significant accompanying soft tissue swellings cellulitis, acute osteomyelitis and gouty arthropathy were included in the initial differential diagnosis. Radiographs showed pure lytic bony lesion with complete disappearance of lower two third of the second metacarpal, trapezium and trapezoid bones of the right hand along with a lytic subarticular lesion of medial condyle of ipsilateral femur. Chest X-ray (CXR was normal but sonography of the abdomen readily demonstrated a large renal mass, later confirmed at biopsy as renal cell carcinoma (RCC. Clinicians should be cognizant of the strong association between digital acrometastases and renal cell carcinoma in male patients with normal CXR findings. In suspected hand acrometastasis associated with a soft tissue component outside the contours of normal bone, screening the abdomen by sonography should be done prior to bone biopsy and before costly or time-consuming investigations are offered. Metastatic RCC should be included in the differential diagnosis of all unilateral expansile bony lesions of the digit. It is particularly important if such lesion/lesions are accompanied by local inflammation. Screening the abdomen by sonography may be of particular value in such elderly male patient when Chest X-ray shows no abnormality.

  6. Functional and radiological evaluation of acute acromioclavicular dislocation treated with anchors without eyelet: comparison with other techniques

    Directory of Open Access Journals (Sweden)

    Alexandre Tadeu do Nascimento

    Full Text Available ABSTRACT OBJECTIVE: To assess the repair results of acromioclavicular dislocations (ACJD grades III and V, with anchors without eyelet, when compared with other techniques, and to evaluate factors that can affect the final result. METHODS: A retrospective study of 36 patients with ACJD grades III and V in the Rockwood classification, 12 treated with anchors without eyelet, 11 with one tightrope, six with two tightropes, and six with subcoracoid cerclage, operated from September 2012 to February 2015. Patients were assessed radiographically and through DASH, UCLA, the visual analog scale of pain (VAS and the Short-Form 36 (SF-36. Surgical time and the possible influence of some factors in the outcome were also assessed. RESULTS: The mean DASH score was 6.7; UCLA, 32.9; VAS, 1.2; and SF-36, 79.47. Radiographically, the final mean measurement was 9.93 mm, with no statistical difference between the groups. The mean surgical time for Group I was 31 min; Group II, 19 min; Group III, 29 min; and Group IV, 59 min. There was a significant difference between Groups II and IV when compared with the study group. The initial and immediate post-operative ACJD measurements ACJD were correlated with the final measure. CONCLUSION: The repair of acute ACJD with anchors without eyelet is as effective as the other methods, with significantly shorter operative time when compared with the subcoracoid cerclage technique. The final radiological result is influenced by the coracoclavicular initial distance and the immediate postoperative measurement.

  7. Importance of additional temporary pin fixation combined coracoclavicular augmentation using a suture button device for acute acromioclavicular joint dislocation.

    Science.gov (United States)

    Cho, Chul-Hyun; Kim, Beom-Soo; Kwon, Doo-Hyun

    2016-06-01

    We evaluated the outcomes of coracoclavicular (CC) augmentation using a suture button device with additional temporary pin fixation for acute acromioclavicular (AC) joint dislocation. Thirty-six consecutive cases who underwent CC augmentation using TightRope™ (Arthrex, Naples, FL, USA) were included. We temporarily fixed trans-articular pins in the first 10 cases (TA group) and a trans-spine pin in the next 26 cases (TS group). The radiological and clinical outcomes were evaluated at minimum 2 years postoperatively. The mean follow-up period was 56.7 months (range, 24-84 months). At the final follow-up evaluation, reduction status showed anatomical reduction in 25 cases (69.4 %), slight loss of reduction in seven cases (19.4 %), partial loss of reduction in two cases (5.6 %), and total loss of reduction in two cases (5.6 %). The mean ASES score, UCLA score, and subjective shoulder value were 92.3, 32.9, and 91.6 %, respectively. There were no significant differences between the two groups with respect to the outcomes. Intraoperative complications occurred in three cases (8.3 %) including two cases of failed reduction and one case of technical failure of the implant. Postoperative complications occurred in three cases (8.3 %) including one case of pin tract infection and distal clavicle fracture at the clavicle-hole, one case of reduction loss by severe subsidence of the clavicular button, and one case of shoulder stiffness. CC augmentation using a suture button device with temporary pin fixation yielded satisfactory radiological and clinical outcomes. These results support that temporary pin fixation for the AC joint may help to protect the AC reduction in the early phase of healing and rigid scar formation when performing CC fixation using a suture button device. Level-IV, Retrospective Case Series, Treatment Study.

  8. Transarticular fixation by hook plate versus coracoclavicular stabilization by single multistrand titanium cable for acute Rockwood grade-V acromioclavicular joint dislocation: a case-control study.

    Science.gov (United States)

    Gao, You-Shui; Zhang, Yue-Lei; Ai, Zi-Sheng; Sun, Yu-Qiang; Zhang, Chang-Qing; Zhang, Wei

    2015-11-19

    Hook plate (HP) is popularly used for acute and severely displaced acromioclavicular (AC) dislocations. However, subacromial impingement and acromion osteolysis induced by transarticular fixation are notorious. The current case-control study was to compare transarticular fixation by HP to coracoclavicular (CC) stabilization by single multistrand titanium cable (MSTC). Between January 2006 and August 2009, 24 patients with acute AC dislocations were surgically treated by open reduction and transarticular fixation with HP. These patients were matched to a series of 24 patients, who were managed by CC stabilization with MSTC in the same period. All AC dislocations were graded as Rockwood type V. Implant was removed 8-12 months after the primary operation in all patients, and 12 months at least were needed to assess the maintenance of AC joint. Functional results were evaluated before implant removal as well as in the last follow-up based on Constant-Murley criteria. There were no differences of demographic data including age, dominant gender and side, injury-to-surgery interval, operation time and follow-up period. In terms of functionality, Constant score was 95.8 ± 4.1 in MSTC group, while 76.7 ± 8.0 in HP group before implant removal (P acromioclavicular joint presented in 16 patients (66.7%) in patients treated by HP, while it was found in only 3 patients (12.5%) treated by MSTC (P acromioclavicular dislocation both before and after removal of the implant. Hardware removal is of great benefits for functional improvement in patients treated by HP.

  9. Acute effects of blood flow restriction on muscle activity and endurance during fatiguing dynamic knee extensions at low load.

    Science.gov (United States)

    Wernbom, Mathias; Järrebring, Rickard; Andreasson, Mikael A; Augustsson, Jesper

    2009-11-01

    The purpose of this study was to investigate muscle activity and endurance during fatiguing low-intensity dynamic knee extension exercise with and without blood flow restriction. Eleven healthy subjects with strength training experience performed 3 sets of unilateral knee extensions with no relaxation between repetitions to concentric torque failure at 30% of the 1 repetition maximum. One leg was randomized to exercise with cuff occlusion and the other leg to exercise without occlusion. The muscle activity in the quadriceps was recorded with electromyography (EMG). Ratings of perceived exertion (RPE) and acute pain were collected immediately, and delayed onset muscle soreness (DOMS) was rated before and at 24, 48, and 72 hours after exercise. The results demonstrated high EMG levels in both experimental conditions, but there were no significant differences regarding maximal muscle activity, except for a higher EMG in the eccentric phase in set 3 for the nonoccluded condition (p = 0.005). Significantly more repetitions were performed with the nonoccluded leg in every set (p knee extension decreases the endurance but does not increase the maximum muscle activity compared with training without restriction when both regimes are performed to failure. The high levels of muscle activity suggest that performing low-load dynamic knee extensions in a no-relaxation manner may be a useful method in knee rehabilitation settings when large forces are contraindicated. However, similarly to fatiguing blood flow restricted exercise, this method is associated with ischemic muscle pain, and thus its applications may be limited to highly motivated individuals.

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

    OpenAIRE

    Emerito Carlos Rodriguez-Merchan

    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, napr...

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

    OpenAIRE

    Emerito Carlos Rodriguez-Merchan

    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, napr...

  12. 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

    Institute of Scientific and Technical Information of China (English)

    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

  13. Evaluation of a treatment algorithm for acute traumatic osseous Bankart lesions resulting from first time dislocation of the shoulder with a two year follow-up.

    Science.gov (United States)

    Spiegl, Ulrich J A; Ryf, Christian; Hepp, Pierre; Rillmann, Paavo

    2013-10-25

    Studies dealing with acute osseous Bankart lesions and corresponding treatment strategies are rare. The purpose of this study is to analyze the results after applying our treatment algorithm for acute glenoid rim fractures caused by first time traumatic anterior shoulder dislocations. 25 patients were included in this retrospective case series. All patients sustained a first time shoulder dislocation caused by ski or snowboard accidents. An osseous Bankart lesion was detected in all shoulders. Operative therapy was performed in patients with osseous defects of 5% or more, otherwise conservative therapy was initiated. Primary study outcome parameter was the Rowe score. Additionally, the outer rotation deficit and operative complications were analysed. 12 patients showed a defect size of less than 5% and were treated conservatively. The average lesion size was 2%. For these patients, the Rowe score was excellent in 58%, good in 25%, and moderate in 17% of patients. Three patients (25%) complained about a feeling of instability. 13 patients had a lesion size of more than 5%, average 15%, and were treated operatively. The Rowe score for this group was excellent in 54%, good in 31%, and moderate results in 15% of patients. One patient (8%) complained about a feeling of instability, without recurrent dislocations. There were no statistically significant differences between both study groups (ROWE score: p = 0.98). Applying our treatment algorithm for acute osseous Bankart lesions consisting of a conservative strategy for small defect sizes and a surgical approach for medium-sized and large defects leads to encouraging mid-term results and a low rate of recurrent instability in active patients.

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

    LENUS (Irish Health Repository)

    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

  15. Congenital dislocation of the patella - clinical case

    Directory of Open Access Journals (Sweden)

    Pedro Miguel Sá

    2016-02-01

    Full Text Available ABSTRACT 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.

  16. Acute phase response of selenium status and glutathione peroxidase activity in blood plasma before and after total knee arthroplasty surgery.

    Science.gov (United States)

    Defi, Irma Ruslina; Yamazaki, Chiho; Kameo, Satomi; Kobayashi, Kenji; Nakazawa, Minato; Shinya, Yanagisawa; Sato, Naoki; Wada, Naoki; Shirakura, Kenji; Koyama, Hiroshi

    2011-12-01

    Several studies show the consistent results of the decrease in plasma or serum selenium (Se) after surgery, and the change is suggested to be a negative acute phase response of Se to the surgical inflammation. Plasma glutathione peroxidase (GPx), which is included in the acute phase response proteins, is a selenoenzyme. However, previous studies failed to show any changes in GPx activity before and after surgery. In the present study, we investigated the Se- and selenoenzyme responses that accompany the acute inflammatory reactions during and following major surgery. Patients who underwent elective total knee arthroplasty surgery due to knee osteoarthritis at the Department of Orthopaedic Surgery at Gunma University Hospital in Japan were studied. The plasma Se concentration was determined, and the activity of plasma GPx was measured. C-reactive protein (CRP), albumin, blood urea nitrogen (BUN), and white blood cell (WBC) count were also analysed. Increases in the inflammatory biomarkers of CRP and WBC showed inflammatory reactions with the surgery. A significant increase in plasma GPx activity (p production of other series of acute phase proteins, the present results suggest that there is a redistribution of plasma Se to GPx that occurs as an acute phase response, and the source of Se for GPx could be, at least partly, from albumin.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  18. Estudo prospectivo e comparativo entre o tratamento conservador e o cirúrgico (reparo do ligamento femoropatelar medial nas luxações agudas de patela Prospective and comparative study between conservative and surgical treatment (medial petellofemoral ligament repair in patellar acute dislocations

    Directory of Open Access Journals (Sweden)

    Gilberto Luis Camanho

    2006-01-01

    with mean age of 26.8 years old, being eight females, were submitted to conservative treatment with 18.5 days of immobilization, in average. The mean follow-up time was 35.7 months and the least, 11 months. Eight knees presented recurrence of the dislocation, only two knees were regarded as stable. In this group, 14 patients had predisposing factors. We concluded that the surgical treatment of traumatic patellofemoral acute dislocations presents superior outcomes regarding recurrence when compared to the conservative approach within the period of study. The presence of predisposing factors in our patient series did not influence the recurrences of patellofemoral dislocations.

  19. Jaw Dislocation

    Science.gov (United States)

    ... This Article Medical Dictionary Also of Interest (Quiz) Biology of the Mouth (Video) Root Canal Additional Content Medical News Jaw Dislocation By David F. Murchison, DDS, MMS, Clinical Professor, Department of Biological Sciences;Clinical Professor, The University ...

  20. Dislocated Shoulder

    Science.gov (United States)

    ... bruising Intense pain Inability to move the joint Shoulder dislocation may also cause numbness, weakness or tingling near the injury, such as in your neck or down your arm. The muscles in your shoulder may spasm from the disruption, ...

  1. Atlantoaxial dislocation

    Directory of Open Access Journals (Sweden)

    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.

  2. Acute traumatic open posterolateral dislocation of the ankle without tearing of the tibiofibular syndesmosis ligaments: a case report.

    Science.gov (United States)

    Demiralp, Bahtiyar; Komurcu, Mahmut; Ozturk, Cagatay; Ozturan, Kutay; Tasatan, Ersin; Erler, Kaan

    2008-01-01

    Pure open dislocation of the ankle, or dislocation not accompanied by rupture of the tibiofibular syndesmosis ligaments or fractures of the malleoli or of the posterior border of the tibia, is an extremely rare injury. A 62-year-old man injured his right ankle in a motor vehicle accident. Besides posterolateral ankle dislocation, there was a 7-cm transverse skin cut on the medial malleolus, and the distal end of the tibia was exposed. After reduction, we made a 2- to 2.5-cm longitudinal incision on the lateral malleolus; the distal fibular fracture was exposed. Two Kirschner wires were placed intramedullary in a retrograde manner, and the fracture was stabilized. The deltoid ligament and the medial capsule were repaired. The tibiofibular syndesmosis ligaments were intact. At the end of postoperative year 1, right ankle joint range of motion had a limit of approximately 5 degrees in dorsiflexion, 10 degrees in plantarflexion, 5 degrees in inversion, and 0 degrees in eversion. The joint appeared normal on radiographs, with no signs of osteoarthritis or calcification. The best result can be obtained with early reduction, debridement, medial capsule and deltoid ligament restoration, and early rehabilitation. Clinical and radiographic features at long-term follow-up also confirm good mobility of the ankle without degenerative change or mechanical instability.

  3. The Impact of Demographic, Clinical, Symptom and Psychological Characteristics on the Trajectories of Acute Postoperative Pain After Total Knee Arthroplasty

    Science.gov (United States)

    Miaskowski, Christine; Rustøen, Tone; Rosseland, Leiv Arne; Paul, Steven M.; Cooper, Bruce A.; Lerdal, Anners

    2017-01-01

    Objective. Total knee arthroplasty is a painful procedure. No studies have evaluated modifiable predictors of acute postoperative pain trajectories during hospitalization. Methods. Consecutive patients (N = 188) were enrolled in a longitudinal cohort study and completed a demographic questionnaire, as well as the Brief Pain Inventory, Hospital Depression and Anxiety Scale, Lee Fatigue Scale, Fatigue Severity Scale, and Brief Illness Perception Questionnaire on the day before surgery. Clinical data were extracted from medical records. Setting and Patients. Each patient completed a pain diary that assessed pain at rest and with activity, and hours per day in pain every evening from day of surgery until postoperative day 3. Using hierarchical linear modeling, we investigated which demographic, clinical, symptom, and psychological characteristics predicted initial levels as well as the trajectories of acute pain at rest and with activity, and hours per day in pain. Results. Higher levels of all three acute pain characteristics on the day of surgery resulted in worse trajectories. Higher pain scores with rest and with activity on the day of surgery were associated with more days with femoral block, higher average dose of opioids, and higher emotional response to osteoarthritis. Higher number of comorbidities, higher average dose of opioids, and lower perceived control predicted more hours per day in pain on the day of surgery. Conclusions. This study identified several potentially modifiable predictors of worsening pain trajectories following total knee arthroplasty. Optimal pain management warrants identification of these high-risk patients and treatment of modifiable risk factors. PMID:27165969

  4. Isolated Proximal Tibiofibular Dislocation during Soccer

    Directory of Open Access Journals (Sweden)

    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.

  5. Crystal Dislocations

    Directory of Open Access Journals (Sweden)

    Ronald W. Armstrong

    2016-01-01

    Full Text Available Crystal dislocations were invisible until the mid-20th century although their presence had been inferred; the atomic and molecular scale dimensions had prevented earlier discovery. Now they are normally known to be just about everywhere, for example, in the softest molecularly-bonded crystals as well as within the hardest covalently-bonded diamonds. The advent of advanced techniques of atomic-scale probing has facilitated modern observations of dislocations in every crystal structure-type, particularly by X-ray diffraction topography and transmission electron microscopy. The present Special Issue provides a flavor of their ubiquitous presences, their characterizations and, especially, their influence on mechanical and electrical properties.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. 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

    Directory of Open Access Journals (Sweden)

    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.

  9. Association between traumatic bone marrow abnormalities of the knee, the trauma mechanism and associated soft-tissue knee injuries

    Energy Technology Data Exchange (ETDEWEB)

    Berger, Nicole [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); University of Zurich, Department of Forensic Medicine and Radiology, Institute of Forensic Medicine, Zurich (Switzerland); Andreisek, Gustav; Karer, Anissja T.; Manoliu, Andrei; Ulbrich, Erika J. [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Bouaicha, Samy [University Hospital Zurich, Department of Trauma Surgery, Zurich (Switzerland); Naraghi, Ali [University of Toronto, Department of Medical Imaging, Mount Sinai Hospital and the University Health Network, Toronto, ON (Canada); Seifert, Burkhardt [University of Zurich, Epidemiology, Biostatistics and Prevention Institute, Department of Biostatistics, Zurich (Switzerland)

    2017-01-15

    To determine the association between traumatic bone marrow abnormalities, the knee injury mechanism, and associated soft tissue injuries in a larger cohort than those in the published literature. Retrospective study including 220 patients with traumatic knee injuries. Knee MRIs were evaluated for trauma mechanism, soft tissue injury, and the location of bone marrow abnormalities. The locations of the abnormalities were correlated with trauma mechanisms and soft tissue injuries using the chi-square test with Bonferroni correction. One hundred and forty-four valgus injuries, 39 pivot shift injuries, 25 lateral patellar dislocations, 8 hyperextensions, and 4 dashboard injuries were included. Valgus and pivot shift injuries showed traumatic bone marrow abnormalities in the posterolateral regions of the tibia. Abnormalities after patellar dislocation were found in the anterolateral and centrolateral femur and patella. Hyperextension injuries were associated with abnormalities in almost all regions, and dashboard injuries were associated with changes in the anterior regions of the tibia and femur. Our study provides evidence of associations between traumatic bone marrow abnormality patterns and different trauma mechanisms in acute knee injury, and reveals some overlap, especially of the two most common trauma mechanisms (valgus and pivot shift), in a large patient cohort. (orig.)

  10. 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.

    Science.gov (United States)

    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 (Pexercises demonstrated greater changes in knee ROM, quadriceps strength, and knee pain than those performing I-EXE in addition to regular ambulation and activities-of-daily-living exercises. The nonrandomized, asynchronous design decreases certainty of these findings. Level of Evidence Therapy, level 2b. J Orthop Sports Phys Ther 2016;46(9):742-748. Epub 5 Aug 2016. doi:10.2519/jospt.2016.6409.

  11. Effectiveness of acute in-hospital physiotherapy with knee-extension strength training in reducing strength deficits in patients with a hip fracture

    DEFF Research Database (Denmark)

    Kronborg, Lise; Bandholm, Thomas; Palm, Henrik

    2017-01-01

    QUESTION: Is acute in-hospital physiotherapy with additional progressive knee-extension strength training (ST) of the fractured limb more effective in reducing knee-extension strength deficit at follow-up compared to physiotherapy without strength training in patients with a hip fracture? DESIGN......: Assessor blinded, randomised controlled trial with intention-to-treat analysis. PARTICIPANTS: 90 patients with a hip fracture admitted to an acute orthopaedic Hip Fracture Unit at a university hospital between October 2013 and May 2015. INTERVENTION: Daily physiotherapy with or without progressive knee...... strength training from baseline to follow-up. In the per-protocol analysis of non-missing data, significant between-group improvements by 10.5% (95% CI 0.3; 20.7) were found in favour of additional ST. No significant between-group differences were found in any secondary outcome. CONCLUSION: Physiotherapy...

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  13. Injury patterns of medial patellofemoral ligament after acute lateral patellar dislocation in children: Correlation analysis with anatomical variants and articular cartilage lesion of the patella

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Guang-ying; Ding, Hong-yu [Shandong Provincial Qianfoshan Hospital of Shandong University, Department of Ultrasonography, Jinan (China); Zheng, Lei; Ji, Bing-jun [Shandong Provincial Corps Hospital of Chinese People' s Armed Police Force, Department of Radiology, Jinan (China); Shi, Hao [Shandong Provincial Qianfoshan Hospital of Shandong University, Department of Radiology, Jinan (China); Feng, Yan [Affiliated Hospital of Binzhou Medical College, Department of Radiology, Binzhou (China)

    2017-03-15

    To assess the relationship between injury patterns of medial patellofemoral ligament (MPFL) and anatomical variants and patellar cartilage lesions after acute lateral patellar dislocation (LPD) in children. MR images were obtained in 140 children with acute LPD. Images were acquired and evaluated using standardised protocols. Fifty-eight cases of partial MPFL tear and 75 cases of complete MPFL tear were identified. Injuries occurred at an isolated patellar insertion (PAT) in 52 cases, an isolated femoral attachment (FEM) in 42 cases and an isolated mid-substance (MID) in five cases. More than one site of injury was identified in 34 cases. Compared with Wiberg patellar type C, Wiberg patellar type B predisposed to complete MPFL tear (P = 0.042). No correlations were identified between injury patterns of MPFL and trochlear dysplasia, patellar height and tibial tuberosity-trochlear groove distance (P > 0.05). Compared with partial MPFL tear, complete MPFL tear predisposed to Grade-IV and Grade-V patellar chondral lesion (P = 0.02). There were no correlations between incidence of patellar cartilage lesion and injury locational-subgroups of MPFL (P = 0.543). MPFL is most easily injured at the PAT in children. Wiberg patellar type B predisposes to complete MPFL tear. Complete MPFL tear predisposes to a higher grade of patellar chondral lesion. (orig.)

  14. Chronic pre-operative opioid use and acute pain after fast-track total knee arthroplasty

    DEFF Research Database (Denmark)

    Aasvang, E K; Lunn, T H; Hansen, T B;

    2016-01-01

    BACKGROUND: Pre-operative opioid use has been suggested to increase post-operative pain and opioid consumption after total knee arthroplasty (TKA), but previous studies are either retrospective or inhomogeneous with regard to surgical procedures or control of analgesic regimes, or with few opioid...

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

    DEFF Research Database (Denmark)

    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...

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

    Science.gov (United States)

    Yeung, Simon S.; Yeung, Ella W.

    2016-01-01

    Abstract 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 < 0.01). Post hoc analysis revealed that facilitative KT treatment resulted in higher knee extensor peak torque performance than inhibitory KT treatment (P = 0.036, effect size 0.26). There were, however, no significant differences in the reflex latency (F(2,54) = 2.84, P = 0.067) nor in the EMG values (F(2,54) = 0.18, P = 0.837) in the patellar reflex between the 3 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

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

    Institute of Scientific and Technical Information of China (English)

    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

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

    Science.gov (United States)

    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 < 0.01). Post hoc analysis revealed that facilitative KT treatment resulted in higher knee extensor peak torque performance than inhibitory KT treatment (P = 0.036, effect size 0.26). There were, however, no significant differences in the reflex latency (F(2,54) = 2.84, P = 0.067) nor in the EMG values (F(2,54) = 0.18, P = 0.837) in the patellar reflex between the 3 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.

  19. Acute Effects of Contract-Relax Stretching vs. TENS in Young Subjects With Anterior Knee Pain: A Randomized Controlled Trial.

    Science.gov (United States)

    Valenza, Marie C; Torres-Sánchez, Irene; Cabrera-Martos, Irene; Valenza-Demet, Gerald; Cano-Cappellacci, Marcelo

    2016-08-01

    Valenza, MC, Torres-Sánchez, I, Cabrera-Martos, I, Valenza-Demet, G, and Cano-Cappellacci, M. Acute effects of contract-relax stretching vs. TENS in young subjects with anterior knee pain: A randomized controlled trial. J Strength Cond Res 30(8): 2271-2278, 2016-The aim of this study was to examine the immediate effects on pressure point tenderness, range of motion (ROM), and vertical jump (VJ) of contract-relax stretching vs. transcutaneous electrical nerve stimulation (TENS) therapy in individuals with anterior knee pain (AKP). Eighty-four subjects with AKP were randomly assigned to 1 of 3 different intervention groups: a contract-relax stretching group (n = 28), a TENS intervention group (n = 28), and a control group (n = 28). The participants included in the sample were both sex (37.5% men vs. 62.5% women) at a mean age of 21 years, with mean values of height and weight of 169 cm and 64 kg, respectively. The main outcome measures were knee ROM, pressure pain threshold (PPT), and VJ. The participants were assessed at baseline and immediately after treatment. In the case of VJ, at baseline, immediately after the intervention, at 3 and at 6 minutes posttreatment. The data analysis showed that PPT scores of participants in the stretching and TENS group significantly increased from pretest to posttest (p ≤ 0.05). A significant increase pre- to posttreatment in ROM (p stretching groups showed significant differences between preintervention and all postintervention values (p ≤ 0.05), whereas no significant differences were found in the control group. In conclusion, the results show significant pre-to-post-treatment effects in PPT, ROM, and VJ from both contract-relax stretching and TENS in young subjects with AKP.

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

    Science.gov (United States)

    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 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 power in healthy men and women.

  1. stabilisation of posterior sternoclavicular joint dislocation using ...

    African Journals Online (AJOL)

    Posterior sternoclavicular joint dislocation is a rare injury. It is usually sustained acutely in ... structure for preventing both anterior and posterior translation of the .... healed well and she was commenced on physiotherapy with good functional ...

  2. Acute effects of anterior thigh foam rolling on hip angle, knee angle, and rectus femoris length in the modified Thomas test.

    Science.gov (United States)

    Vigotsky, Andrew D; Lehman, Gregory J; Contreras, Bret; Beardsley, Chris; Chung, Bryan; Feser, Erin H

    2015-01-01

    Background. Foam rolling has been shown to acutely increase range of motion (ROM) during knee flexion and hip flexion with the experimenter applying an external force, yet no study to date has measured hip extensibility as a result of foam rolling with controlled knee flexion and hip extension moments. The purpose of this study was to investigate the acute effects of foam rolling on hip extension, knee flexion, and rectus femoris length during the modified Thomas test. Methods. Twenty-three healthy participants (male = 7; female = 16; age = 22 ± 3.3 years; height = 170 ± 9.18 cm; mass = 67.7 ± 14.9 kg) performed two, one-minute bouts of foam rolling applied to the anterior thigh. Hip extension and knee flexion were measured via motion capture before and after the foam rolling intervention, from which rectus femoris length was calculated. Results. Although the increase in hip extension (change = +1.86° (+0.11, +3.61); z(22) = 2.08; p = 0.0372; Pearson's r = 0.43 (0.02, 0.72)) was not due to chance alone, it cannot be said that the observed changes in knee flexion (change = -1.39° (-5.53, +2.75); t(22) = -0.70; p = 0.4933; Cohen's d = - 0.15 (-0.58, 0.29)) or rectus femoris length (change = -0.005 (-0.013, +0.003); t(22) = -1.30; p = 0.2070; Cohen's d = - 0.27 (-0.70, 0.16)) were not due to chance alone. Conclusions. Although a small change in hip extension was observed, no changes in knee flexion or rectus femoris length were observed. From these data, it appears unlikely that foam rolling applied to the anterior thigh will improve passive hip extension and knee flexion ROM, especially if performed in combination with a dynamic stretching protocol.

  3. Sonography on injury of the medial patellofemoral ligament after acute traumatic lateral patellar dislocation: Injury patterns and correlation analysis with injury of articular cartilage of the inferomedial patella.

    Science.gov (United States)

    Zhang, Guang-Ying; Zheng, Lei; Shi, Hao; Qu, Su-Hui; Ding, Hong-Yu

    2013-12-01

    The purpose of this study was to investigate the accuracy of high-frequency ultrasonography in the diagnosis of injuries of medial patellofemoral ligaments (MPFLs), analyse the characteristics of MPFL injury and correlations between injury of the MPFL and articular cartilage of the inferomedial patella in patients with acute traumatic lateral patellar dislocation. High-frequency sonographic images of 49 patients with acute traumatic lateral patellar dislocations treated surgically were reviewed. The χ(2) tests were performed for statistical analysis. Twenty-eight cases of complete MPFL tear and 21 cases of partial MPFL tear were identified in operation, with 27 cases of MPFL tear located at their femoral attachment, 21 cases of tear at the patellar attachment and one case of midsubstance tear. The diagnostic accuracy of sonography regarding partial MPFL tear and complete MPFL tear was 89.8% and 89.8%. Among the patients with MPFL tear at the patellar attachment, eight and six cases were concomitant with chondral and osteochondral lesions in the inferomedial patella, respectively, in contrast to nine and six cases in patients with MPFL tear at the femoral attachment, respectively. There was no significant difference between the two locations described above regarding the prevalence rates of chondral or osteochondral lesions of the inferomedial patella (P=0.732, P=0.614). Among the patients with complete MPFL tear, 12 and 10 cases were concomitant with chondral and osteochondral lesions in the inferomedial patella, respectively, while six and two cases were concomitant with partial MPFL tear. There was no significant difference between the two types of injuries discussed above on the prevalence rates of chondral lesions of the inferomedial patella (P=0.305), but the prevalence rate of osteochondral lesions between the two types of injuries discussed above was statistically different (P=0.035). The MPFL is most easily injured at the femoral attachment, secondly at

  4. Traumatic knee extension deficit (the locked knee)

    DEFF Research Database (Denmark)

    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 consisted...... of 50 patients who had an acute, traumatic extension deficit of the knee. All patients were submitted to MRI prior to arthroscopy. Following MRI and surgery, standardized forms were filled out, attempting to objectify the findings. The orthopaedic surgeon was not aware of the MRI result prior to surgery......, the following results were calculated for the overall appearance of a lesion able to cause locking: Positive predictive value = 0.85, negative predictive value = 0.77, sensitivity = 0.95, specificity = 0.53. Two knees were erroneously evaluated with no mechanical locking at MRI (one bucket-handle lesion and one...

  5. Arthroscopic stabilisation of an acute acromioclavicular dislocation grade III in a patient with ectopic insertion of the pectoralis minor: technical considerations.

    Science.gov (United States)

    Minuesa-Asensio, Alvaro; Barrio-Asensio, Carmen; González-Gómez, Ignacio; Murillo-González, Jorge

    2016-07-01

    The different approaches used in arthroscopic stabilisation of the acromioclavicular joint are well known. However, and despite a great incidence of ectopic pectoralis minor insertion, an alternative choice for the use of arthroscopic portal has not being sufficiently described. Here, we describe a case of acute acromioclavicular dislocation grade III. The arthroscopic stabilisation was achieved using the TightRope (Arthrex, Naples, USA) implant. Through this technique, the approach to the articular portion of the coracoid process can be made intra-articularly or from the subacromial space. We accessed intra-articularly, by opening the rotator interval to reach the coracoid process from the joint cavity. After opening the rotator interval, an ectopic insertion of the pectoralis minor was observed. The choice of approach of the coracoid process from the subacromial space would have complicated the intervention, making it necessary to sever the ectopic tendon to complete the technique, lengthening the surgical time and increasing the chance of complications. For this reason, the use of a standard posterior portal providing intra-articular arthroscopic access through the rotator interval is recommended since the aforementioned anatomical variation is not infrequent. Level of evidence Therapeutic studies-investigating the results of treatment, Level V.

  6. Arthroscopically Assisted Reconstruction of Acute Acromioclavicular Joint Dislocations: Anatomic AC Ligament Reconstruction With Protective Internal Bracing—The “AC-RecoBridge” Technique

    Science.gov (United States)

    Izadpanah, Kaywan; Jaeger, Martin; Ogon, Peter; Südkamp, Norbert P.; Maier, Dirk

    2015-01-01

    An arthroscopically assisted technique for the treatment of acute acromioclavicular joint dislocations is presented. This pathology-based procedure aims to achieve anatomic healing of both the acromioclavicular ligament complex (ACLC) and the coracoclavicular ligaments. First, the acromioclavicular joint is reduced anatomically under macroscopic and radiologic control and temporarily transfixed with a K-wire. A single-channel technique using 2 suture tapes provides secure coracoclavicular stabilization. The key step of the procedure consists of the anatomic repair of the ACLC (“AC-Reco”). Basically, we have observed 4 patterns of injury: clavicular-sided, acromial-sided, oblique, and midportion tears. Direct and/or transosseous ACLC repair is performed accordingly. Then, an X-configured acromioclavicular suture tape cerclage (“AC-Bridge”) is applied under arthroscopic assistance to limit horizontal clavicular translation to a physiological extent. The AC-Bridge follows the principle of internal bracing and protects healing of the ACLC repair. The AC-Bridge is tightened on top of the repair, creating an additional suture-bridge effect and promoting anatomic ACLC healing. We refer to this combined technique of anatomic ACLC repair and protective internal bracing as the “AC-RecoBridge.” A detailed stepwise description of the surgical technique, including indications, technical pearls and pitfalls, and potential complications, is given. PMID:26052493

  7. 肿瘤型旋转铰链式人工膝关节置换术后脱位的原因分析与治疗%Cause analysis and treatment for dislocation after tumor type rotating hinge knee replacement surgery

    Institute of Scientific and Technical Information of China (English)

    王毅飞; 郭卫; 姬涛; 王师尧

    2012-01-01

    Objective To explore the reasons and therapeutic strategies of postoperative dislocation through analyzing the cases of postoperative dislocation after tumor type rotating hinge knee replacement surgery retrospectively. Methods The clinical data of 8 cases who underwent postoperative dislocation after tumor type rotating hinge knee replacement surgery from November 2004 to November 2009 were retrospectively analyzed. There were 4 males and 4 females with an average age of 23.8 years old (range; 16-41 years). All were diagnosed as primary osteosarcoma, among which 6 cases were of osteosarcoma, 1 case of malignant fibrous histiocytoma and 1 case of fibrosarcoma. In 6 out of 8 cases, the tumors were located in distal femur while that of the other 2 were in proximal tibia. The average length of the resected bones was 14.6 cm. We applied medial approach of the knee. As for all the patients of proximal tibia tumor, we dissociated medial head of gastrocnemius muscle flap, made it cover the front side of prothesis and sutured it with musculoaponeurotic layer around for fixation to improve the local soft tissue covering. The length of the rotational sleeve of the selected rotating hinge knee joint prosthesis were 22.5 mm (5 cases) and 37 mm (3 cases). Results The average postoperative dislocation time was 9.3 months (range; 10 days-2 years). 5 out of 8 cases underwent dislocation once while the other 3 twice. 1 out of 8 cases was manually reduced successfully under anesthesia. The other 7 cases all underwent open reduction and (or) prosthesis revision surgery, after which their knee joints all regained stability. Function assessment: the function of knee was evaluated according to Musculoskeletal Tumor Society (MSTS) 93 Score. The functional score of knee before dislocation was 64.5±15.2% and 67.2±15.9%after reduction surgery. The differences of the function before dislocation and after revision surgery were not statistically significant (P>0.05). Conclusions There are 3

  8. Knee Injuries in Downhill Skiers

    OpenAIRE

    Shea, Kevin G.; Archibald-Seiffer, Noah; Murdock, Elizabeth; Grimm, Nathan L.; Jacobs, John C.; Willick, Stuart; Van Houten, Heather

    2014-01-01

    Background: Knee injuries account for approximately one third of injuries in skiers. Researchers have proposed several mechanisms of knee injury in skiers. However, the frequencies of these mechanisms have varied in different studies. Purpose: To identify the most common knee injury mechanisms in recreational downhill skiers and to assess injury frequencies across several demographics. Study Design: Descriptive epidemiology study. Methods: Over 6 ski seasons, 541 patients with acute knee inju...

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

    DEFF Research Database (Denmark)

    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...

  10. Knee Bursitis

    Science.gov (United States)

    Knee bursitis Overview By Mayo Clinic Staff Knee bursitis is inflammation of a small fluid-filled sac (bursa) situated ... in your knee can become inflamed, but knee bursitis most commonly occurs over the kneecap or on ...

  11. Knee Replacement

    Science.gov (United States)

    Knee replacement is surgery for people with severe knee damage. Knee replacement can relieve pain and allow you to ... Your doctor may recommend it if you have knee pain and medicine and other treatments are not ...

  12. Acute effects of lateral shoe wedges on joint biomechanics of patients with medial compartment knee osteoarthritis during stationary cycling.

    Science.gov (United States)

    Gardner, Jacob K; Klipple, Gary; Stewart, Candice; Asif, Irfan; Zhang, Songning

    2016-09-06

    Cycling is commonly prescribed for individuals with knee osteoarthritis (OA) but very little biomechanical research exists on the topic. Individuals with OA may be at greater risk of OA progression or other knee injuries because of their altered knee kinematics. This study investigated the effects of lateral wedges on knee joint biomechanics and pain in patients with medial compartment knee OA during stationary cycling. Thirteen participants with OA and 11 paired healthy participants volunteered for this study. A motion analysis system and a customized instrumented pedal were used to collect 5 pedal cycles of kinematics and kinetics, respectively, during 2 minutes of cycling in 1 neutral and 2 lateral wedge (5° and 10°) conditions. Participants pedaled at 60 RPM and an 80W workrate and rated their knee pain on a visual analog scale during each minute of each condition. There was a 22% decrease in the internal knee abduction moment with the 10° wedge. However, this finding was not accompanied by a decrease in knee adduction angle or subjective pain. Additionally, there was an increase in vertical and horizontal pedal reaction force which may negate the advantages of the decreased internal knee abduction moment. For people with medial knee OA, cycling with 10° lateral wedges may not be sufficient to slow the progression of OA beyond the neutral riding condition. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. 21 CFR 888.3480 - Knee joint femorotibial metallic constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint femorotibial metallic constrained... Knee joint femorotibial metallic constrained cemented prosthesis. (a) Identification. A knee joint... knee joint. The device prevents dislocation in more than one anatomic plane and has components that...

  14. Chronic bilateral dislocation of temporomandibular joint.

    Science.gov (United States)

    Shakya, S; Ongole, R; Sumanth, K N; Denny, C E

    2010-01-01

    Dislocation of the condyle of the mandible is a common condition that may occur in an acute or chronic form. It is characterised by inability to close the mouth with or without pain. Dislocation has to be differentiated from subluxation which is a self reducible condition. Dislocation can occur in any direction with anterior dislocation being the commonest one. Various predisposing factors have been associated with dislocation like muscle fatigue and spasm, the defect in the bony surface like shallow articular eminence, and laxity of the capsular ligament. People with defect in collagen synthesis like Ehler Danlos syndrome, Marfan syndrome are said to be genetically predisposed to this condition. Various treatment modalities have been used ranging from conservative techniques to surgical methods. Acute dislocations can be reduced manually or with conservative approach and recurrent and chronic cases can be reduced by surgical intervention. Though the dislocation in our case was 4 months a simple manual reduction proved to be successful. We believe that manual reduction can be attempted as first line of treatment prior to surgical intervention.

  15. Acute effects of anterior thigh foam rolling on hip angle, knee angle, and rectus femoris length in the modified Thomas test

    Directory of Open Access Journals (Sweden)

    Andrew D. Vigotsky

    2015-09-01

    Full Text Available Background. Foam rolling has been shown to acutely increase range of motion (ROM during knee flexion and hip flexion with the experimenter applying an external force, yet no study to date has measured hip extensibility as a result of foam rolling with controlled knee flexion and hip extension moments. The purpose of this study was to investigate the acute effects of foam rolling on hip extension, knee flexion, and rectus femoris length during the modified Thomas test.Methods. Twenty-three healthy participants (male = 7; female = 16; age = 22 ± 3.3 years; height = 170 ± 9.18 cm; mass = 67.7 ± 14.9 kg performed two, one-minute bouts of foam rolling applied to the anterior thigh. Hip extension and knee flexion were measured via motion capture before and after the foam rolling intervention, from which rectus femoris length was calculated.Results. Although the increase in hip extension (change = +1.86° (+0.11, +3.61; z(22 = 2.08; p = 0.0372; Pearson’s r = 0.43 (0.02, 0.72 was not due to chance alone, it cannot be said that the observed changes in knee flexion (change = −1.39° (−5.53, +2.75; t(22 = −0.70; p = 0.4933; Cohen’s d = − 0.15 (−0.58, 0.29 or rectus femoris length (change = −0.005 (−0.013, +0.003; t(22 = −1.30; p = 0.2070; Cohen’s d = − 0.27 (−0.70, 0.16 were not due to chance alone.Conclusions. Although a small change in hip extension was observed, no changes in knee flexion or rectus femoris length were observed. From these data, it appears unlikely that foam rolling applied to the anterior thigh will improve passive hip extension and knee flexion ROM, especially if performed in combination with a dynamic stretching protocol.

  16. The results of adductor magnus tenodesis in adolescents with recurrent patellar dislocation.

    Science.gov (United States)

    Malecki, Krzysztof; Fabis, Jaroslaw; Flont, Pawel; Niedzielski, Kryspin Ryszard

    2015-01-01

    Recurrent dislocation of the patella is a common orthopaedic problem which occurs in about 44% of cases after first-time dislocation. In most cases of first-time patellar dislocation, the medial patellofemoral ligament (MPFL) becomes damaged. Between 2010 and 2012, 33 children and adolescents (39 knees) with recurrent patellar dislocation were treated with MPFL reconstruction using the adductor magnus tendon. The aim of our study is to assess the effectiveness of this surgical procedure. The outcomes were evaluated functionally (Lysholm knee scale, the Kujala Anterior Knee Pain Scale, and isokinetic examination) and radiographically (Caton index, sulcus angle, congruence angle, and patellofemoral angle). Four patients demonstrated redislocation with MPFL graft failure, despite the fact that patellar tracking was found to be normal before the injury, and the patients had not reported any symptoms. Statistically significant improvements in Lysholm and Kujala scales, in patellofemoral and congruence angle, were seen (P magnus tendon in children and adolescents with recurrent patellar dislocation.

  17. Patellar dislocation with genu valgum treated by DFO.

    Science.gov (United States)

    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. Copyright 2013, SLACK Incorporated.

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  19. Superior dislocation of the patella: a case report

    Directory of Open Access Journals (Sweden)

    Garcia-Balletbo Montserrat

    2009-07-01

    Full Text Available Abstract Background Superior dislocation of the patella is an uncommon condition that mainly occurs in knees with a high patella and medial femorotibial degenerative arthritis. There are no previous reports of this condition occurring in association with tibial valgus osteotomy. Case report: We report the case of a patient in whom vertical dislocation recurred twice at 4 months after tibial valgus osteotomy. To avert additional recurrence or new dislocations, the patient was treated surgically to remove the existing osteophytes. Conclusions: An arthroscopic approach was decided because of the lower associated morbidity and good results with this technique compared to open surgery.

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

    Directory of Open Access Journals (Sweden)

    Rafael Salomon Silva Faria

    2015-04-01

    Full Text Available 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%.

  1. 'Inverse' temporomandibular joint dislocation.

    Science.gov (United States)

    Alemán Navas, R M; Martínez Mendoza, M G

    2011-08-01

    Temporomandibular joint (TMJ) dislocation can be classified into four groups (anterior, posterior, lateral, and superior) depending on the direction of displacement and the location of the condylar head. All the groups are rare except for anterior dislocation. 'Inverse' TMJ dislocation is a bilateral anterior and superior dislocation with impaction of the mandible over the maxilla; to the authors' knowledge only two cases have previously been reported in the literature. Inverse TMJ dislocation has unique clinical and radiographic findings, which are described for this case. Copyright © 2011 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  2. Acute effects of instrument assisted soft tissue mobilization vs. foam rolling on knee and hip range of motion in soccer players.

    Science.gov (United States)

    Markovic, Goran

    2015-10-01

    The aim of the present investigation was to evaluate the acute effects of foam rolling (FR) and a new form of instrument-assisted soft tissue mobilization (IASTM), Fascial Abrasion Technique ™ (FAT) on hip and knee range of motion in soccer players. Twenty male soccer players randomly allocated into FR and FAT group (n = 10 each). Passive knee flexion and straight leg raise tests were measured before, immediately after and 24 h after intervention (FR or FAT). The FR group applied a 2-min quadriceps and hamstrings rolling, while FAT group received a 2-min application of FAT to the quadriceps and hamstrings muscles. Both groups significantly improved knee and hip ROM (p < 0.05), with higher gains observed in FAT group (10-19% vs. 5-9%). At 24 h post-treatment, only FAT group preserved most of the gains in ROM (7-13%; p < 0.05). These results support the use of the newly developed IASMT, Fascial Abrasion Technique ™ and FR for increasing lower extremity ROM of athletes.

  3. Knee Problems

    Science.gov (United States)

    ... BMI Calculator myhealthfinder Immunization Schedules Nutrient Shortfall Questionnaire Knee ProblemsPain, swelling, stiffness and "water" on the knee are common symptoms. Follow this chart for more ...

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

    Directory of Open Access Journals (Sweden)

    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

  5. Femur chondrosarcoma misdiagnosed as acute knee arthritis and osteomyelitis--further developing a hitherto unreported complication of tumor embolic ischemic ileal perforation after arthroscopic lavage.

    Science.gov (United States)

    Chow, Louis Tsun Cheung

    2014-12-01

    The differentiation between osteomyelitis and bone tumor may be difficult due to their overlapping clinical and radiological features. A 25-year-old lady presented with left knee pain and joint effusion associated with redness and hotness. A sub-optimally taken plain radiograph showed mixed osteolytic and osteoblastic lesion in the left lower femur with surrounding soft tissue swelling. Since the clinical diagnosis was acute osteomyelitis and arthritis, arthroscopic lavage was performed as a diagnostic and therapeutic procedure. The removed loose bodies and fibrinous tissue showed pathological features suspicious of chondrosarcoma. Subsequent MRI revealed an infiltrative tumor eroding through the cortex and joint cartilage. En bloc excision of the left lower femur, upper tibia including the knee joint and patella was performed, and the final diagnosis was grade 2 chondrosarcoma. The patient developed bilateral pulmonary metastasis 33 months after operation. Five months later, she suffered from a hitherto undescribed complication of ischemic perforation of the terminal ileum secondary to tumor embolic arterial obstruction with no macroscopic intestinal or peritoneal tumor deposit. The patient developed multiple brain metastases and died 43 months after initial presentation. Our case illustrates that malignant bone tumor as a differential diagnosis of acute osteomyelitis and arthritis merits recognition and exclusion before arthroscopic lavage, which may enhance tumor dissemination and in our patient results in embolic ischemic ileal perforation.

  6. Knee Bursitis

    Science.gov (United States)

    ... make a diagnosis of knee bursitis during a physical exam. Your doctor will inspect your knee by: Comparing the condition of both knees, particularly if only one is painful Gently pressing on different areas of your knee to detect warmth, swelling and the source of pain Carefully moving ...

  7. MRI Manifestations of Iliotibial Band and Its Attachment to Knee Joint in Acute Injuries%髂胫束及其膝关节附着处急性损伤的MRI表现

    Institute of Scientific and Technical Information of China (English)

    丁爱兰; 丁长青; 王文生; 孙迎迎; 罗慧; 代兰兰; 张玉娜

    2015-01-01

    Objective To study the MRI manifestations of Iliotibial band(ITB) and its attachment to knee joint in acute injuries.Methods A retrospective analysis of MRI data of 15 persons with the acute injuries of ITB and its attachment to knee joint.Results ITB rupture in 8 cases, the attachment to knee joint of the ITB rupture in 2 cases, the rupture involved the ITB strap and its attachment to knee joint in 5 cases.Conclusions MRI can accurately evaluate the acute injuries of the ITB and its attachment to knee.%目的:探讨髂胫束(Iliotibial Band,ITB)及其膝关节附着处急性损伤的MRI诊断价值。方法回顾性分析15例临床随访证实的髂胫束及其膝关节附着处急性损伤的MRI资料。结果 ITB撕裂8例, ITB关节囊附着处纤维束撕裂2例,同时累及ITB束带及关节囊附着处纤维束撕裂5例。结论 MRI易于较为准确评价髂胫束及其膝关节附着处急性损伤。

  8. Tratamento da luxação femoro-patelar aguda pelo reparo do ligamento femoro-patelar medial Treatment of acute patellofemoral dislocation through medial patellofomoral ligament repair

    Directory of Open Access Journals (Sweden)

    Gilberto Luis Camanho

    2005-01-01

    Full Text Available Os autores avaliaram a evolução de 17 pacientes que tiveram luxação femoropatelar aguda e foram tratados pela sutura do ligamento femoropatelar medial. A sutura do ligamento foi feita por via artroscópica em 9 pacientes que apresentaram a lesão do ligamento próxima à patela. Nos oito pacientes restantes a lesão do ligamento femoropatelar ocorreu próxima ao epicôndilo femoral e foi tratada pela reinserção no epicôndilo femoral com âncoras. Os pacientes foram acompanhados por um tempo médio de 40 meses e não houve nenhuma recidiva da luxação femoropatelar durante este período.The authors evaluated the evolution of seventeen patients with acute patellofemoral dislocation. Patients were treated through medial patellar ligament suture. The suture of the ligament was performed by arthroscopy in nine patients with ligament lesion near to the patella. The other eight patients, with patellofemoral ligament lesion occurring near to the femoral epicondyle, were treated by reinsertion at the femoral epicondyle with anchors. The patients had a mean follow-up period of forty months and there was no femoropatellar dislocation recurrence.

  9. Surgical treatment of acute and chronic anterior and posterior cruciate ligament and medial-side injuries of the knee.

    Science.gov (United States)

    Hubert, Mark G; Stannard, James P

    2011-06-01

    KD-IIIM knee injuries are challenging injuries that can do well when anatomic reconstruction techniques are used. This article describes the authors preferred reconstructions, timing of surgery, and rehabilitation techniques. The reconstructions are generally initiated 3 or 4 weeks after the injury when the local soft tissue injury allows and associated fractures have already been stabilized. The posterior cruciate ligament, posteromedial corner, and meniscus injuries are addressed in the initial operation. The corresponding author prefers to come back 6 weeks later and reconstruct the anterior cruciate ligament and assure that acceptable progress has been made regarding knee motion.

  10. Operative treatment of acute acromioclavicular dislocations Rockwood III and V-Comparative study between K-wires combined with FiberTape(®) vs. TightRope System(®).

    Science.gov (United States)

    Vrgoč, G; Japjec, M; Jurina, P; Gulan, G; Janković, S; Šebečić, B; Starešinić, M

    2015-11-01

    Acromioclavicular (AC) joint dislocations usually occur in a young active population as a result of a fall on the shoulder. Rockwood divided these dislocations into six types. Optimal treatment is still a matter of discussion. Many operative techniques have been developed, but the main choice is between open and minimally-invasive arthroscopic procedures. The aim of this study was to compare two different surgical methods on two groups of patients to find out which method is superior in terms of benefit to the patient. The methods were evaluated through objective and subjective scores, with a focus on complications and material costs. A retrospective two-centre study was conducted in patients with acute AC joint dislocation Rockwood types III and V. The two methods conducted were an open procedure using K-wires combined with FiberTape(®) (Arthrex, Naples, USA) (Group 1) and an arthroscopic procedure using the TightRope System(®) (Arthrex, Naples, USA) (Group 2). Groups underwent procedures during a two-year period. Diagnosis was based on the clinical and radiographic examination of both AC joints. Surgical treatment and rehabilitation were performed. Sixteen patients were included in this study: Group 1 comprised 10 patients, all male, average age 41.6 years (range 17-64 years), Rockwood type III (eight patients) and Rockwood type V (two patients); Group 2 had six patients, one female and five male, average age 37.8 years (range 18-58 years), Rockwood type III (two patients) and Rockwood type V (four patients). Time from injury to surgery was shorter and patients needed less time to return to daily activities in Group 1. Duration of the surgical procedure was shorter in Group 2 compared with Group 1. Complications of each method were noted. According to the measured scores and operative outcome between dislocation Rockwood type III and V, no significant difference was found. Implant material used in Group 2 was 4.7 times more expensive than that used in Group 1

  11. Traumatic vertical atlantoaxial dislocation.

    Science.gov (United States)

    Payer, M; Wetzel, S; Kelekis, A; Jenny, B

    2005-08-01

    We present a case of traumatic vertical atlantoaxial dislocation of 16 millimetres with a fatal outcome. We hypothesize that this extremely rare traumatic vertical atlantoaxial dislocation results from insufficiency of the C1/C2 facet capsules after rupture of the tectorial membrane and the alar ligaments.

  12. 关节镜结合微创切口治疗膝关节脱位合并多韧带损伤31例临床分析%Arthroscopy combined with limited incision in the treatment of dislocated knee joint with multiple ligament injuries

    Institute of Scientific and Technical Information of China (English)

    罗福昌; 邱华文; 王一民; 黄醒中

    2015-01-01

    Objective To analyze the effect of operation for dislocation of knee joint combined with ligament injury. Methods From 2009 September to 2013 August, 31 patients with multiple ligament injury of knee dislocation were enrolled, they received the reconstruction of anterior and posterior cruciate ligament were achieved under arthroscopy, and at the same time by minimally invasive to repair collateral ligament, lateral collateral ligament, lateral complex injury.Reconstruction ma-terial was selected wiht autologous or allogeneic tendon, rehabilitation training was performed after operation.Results All the patients were followed up for 6-24 months.After 6 months of follow-up, the Lysholm knee score was (85.0 ±1.2) points, at final follow-up, the average socre was (92.0 ±1.8) points, and has a statistical significance difference from the preopera-tive (5.0 ±2.1) phase ( t =5.036, P <0.01);up to 6 months, activity of knee joint after operation was (121.0 ±1.6) °. Conclusion Arthroscopic reconstruction of anterior cruciate ligament and combined with minimally invasive incision repair of ligament injury can significantly improve the function of knee joint with good clinical curative effect.%目的:分析膝关节脱位合并多韧带损伤的手术治疗效果。方法2009年9月—2013年8月收治膝关节脱位合并多韧带损伤患者31例,应用关节镜技术重建前后交叉韧带,并同时通过微创切口修补内侧副韧带、外侧副韧带及内、外侧复合体损伤。重建材料选择自体或异体肌腱,术后进行康复训练。结果所有患者均获得随访,时间6~24个月。术后6个月随访膝关节Lysholm评分平均(85.0±1.2)分,终末随访时平均(92.0±1.8)分,与术前(5.0±2.1)分相比差异具有统计学意义( t =5.036, P <0.01);膝关节活动度术后6个月达(121.0±1.6)°。结论关节镜下重建前后交叉韧带结合微创切口修复多韧带损

  13. Irreducible, incarcerated vertical dislocation of patella into a Hoffa fracture

    Directory of Open Access Journals (Sweden)

    Prasad C Soraganvi

    2014-01-01

    Full Text Available Rotational dislocations of patella, which involve rotation of the patella around a horizontal or vertical axis are rare. These rotational dislocations of patella are difficult to reduce by close methods. These dislocations can have associated osteochondral and retinacular injury. We report a case of a 20-year-old male who presented with swelling and pain in the right knee following a motor cycle accident. Radiological evaluation using the computed tomography revealed a patellar dislocation with a concomitant Hoffa fracture. Patella was rotated around the vertical axis and was incarcerated into the Hoffa fracture. This is a very rare injury and first of its kind to be reported. The difficulties in diagnosis, mechanism of injury and management have been discussed. We feel closed reduction of such an injury is likely to fail and open reduction is recommended.

  14. Traumatic Posterior Dislocation of Hip in Child: A Case Report

    Directory of Open Access Journals (Sweden)

    Dinesh Dhar

    2017-07-01

    Full Text Available Traumatic hip dislocation in children is uncommon, but like in adults, it is an orthopedic emergency. We report a rare case of traumatic posterior dislocation left hip in a 9 year old boy following a motor vehicle accident. The dislocation was promptly reduced by closed manipulation in Accident and Emergency Department with the application of above knee skin traction which was maintained for 3 weeks  followed by non-weight bearing crutch walking for another 6 weeks. On follow up, the patient had a good outcome without any evidence of avascular necrosis (AVN. In this rare case report a literature review of pediatric hip dislocation with treatment recommendations have been highlighted.

  15. Possible effects of mobilisation on acute post-operative pain and nociceptive function after total knee arthroplasty

    DEFF Research Database (Denmark)

    Lunn, T H; Kristensen, B B; Gaarn-Larsen, L

    2012-01-01

    anaesthesia and analgesia underwent an exercise (mobilisation) strategy on the first post-operative morning consisting of 25-m walking twice, with a 20-min interval. Pain was assessed at rest and during passive hip and knee flexion before, and 5 and 20 min after walk, as well as during walk. Nociceptive...

  16. Unexpected wear of an unicompartimental knee arthroplasty in oxidized zirconium.

    Science.gov (United States)

    Luyet, Anais; Fischer, Jean-François; Jolles, Brigitte M; Lunebourg, Alexandre

    2015-12-01

    Unicompartimental knee arthroplasty is a successful procedure for the treatment of localized osteoarthritis to one compartment of the knee with good long-term results. However, several modes of failure of unicompartimental knee arthroplasty have been described, namely aseptic or septic loosening, progression of disease, wear, and instability. Metallosis after unicompartimental knee arthroplasty is rarely reported and is most often related with polyethylene wear or break. We report on a case of rapid failure of unicompartimental knee arthroplasty in oxidized zirconium associated with metallosis secondary to the dislocation of the polyethylene.

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

    Science.gov (United States)

    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

  18. Knee Injuries and Disability Among Enlisted Males in the U.S. Navy.

    Science.gov (United States)

    1985-05-01

    Loose body in knee 1 0.5 6 729.6 Chondromalacia 96 49.5 1 729.7 Other knee diseases 28 14.4 3 729.9 Fractured patella 5 2.6 5 822.0. 822.1 Dislocated...derangements (30.8%), and Chondromalacia (19.9%) were the most common knee diagnoses among the 1974 cohort. Estimated annual age- (length-of-service- and pay...ICDA-8 Code Description 724.5 Other knee derangement 729.6 Loose body in knee 729.7 Chondromalacia of knee 729.9 other diseases of knee 822.0, 822.1

  19. Outcome analysis of conservative treatment for acute Rockwood grade Ⅰ and grade Ⅱ acromioclavicular dislocation%急性Rockwood Ⅰ、Ⅱ型肩锁关节脱位非手术治疗疗效分析

    Institute of Scientific and Technical Information of China (English)

    刘燕洁; 何鸿陶; 陈云丰; 王磊; 魏海峰

    2012-01-01

    目的 评估急性Rockwood Ⅰ、Ⅱ型肩锁关节脱位非手术治疗的疗效.方法 对自2009年1月~2010年10月收治的急性Rockwood Ⅰ、Ⅱ型肩锁关节脱位38例采用非手术治疗.结果 30例平均随访19个月(8~28个月).最后一次随访平均VAS由(4.4±1.5)分降低到(0.8±0.1)分,Constant评分由(64.9±27.9)分上升到(91.6±14.8)分,按Constant评分优良率为89%.最后随访时9例(30%)有肩锁关节疼痛,3例(10%)有活动受限;影像学上8例(27%)显示肩锁关节半脱位;10例(33%)有肩锁关节退化性改变.结论 Ⅰ、Ⅱ型肩锁关节不完全脱位采用非手术治疗可获得满意的临床结果.但同时也有较高的并发症发生率,有必要对影响治疗效果的相关因素进行探索,以取得更好的临床疗效.%Objective To analyze the outcome of non -operation treatment for acute Rockwood grade I and grade U acromioclavicular dislocation. Methods Between Jan. 2009 and Oct. 2010, 38 patients with acute Rockwood grade I and grade II acromioclavicular dislocation were treated with non -operation methods. Results Thirty patients were averagely followed up for 19 months (range 8 to 28 months). The mean VAS score was decreased from (4.4±1.5) to (0.8±0.1) (P <0.05) at final follow-up, and the mean Constant score was increased from (64.9±27.9) to (91.6±14.8) (P <0.05), respectively. The good and excellent rate was 89% according to Constant score. At final follow -up, 9 (30% ) patients had pain at acromioclavicular joint,3(10%) had restriction of shoulder motion, 8(27%) showed partial dislocation in radiography,and 10 (33%) showed degenerative change. Conclusion The non-operation treatment for acute Rockwood grade I and grade II acromioclavicular dislocation can always have a good outcome, however, it has a relatively high complications rate. It is necessary to study the factors which affect the outcome of conservative treatment, so as to acquire more appropriate outcome.

  20. Dislocation climb in two-dimensional discrete dislocation dynamics

    NARCIS (Netherlands)

    Davoudi, K.M.; Nicola, L.; Vlassak, J.J.

    2012-01-01

    In this paper, dislocation climb is incorporated in a two-dimensional discrete dislocation dynamics model. Calculations are carried out for polycrystalline thin films, passivated on one or both surfaces. Climb allows dislocations to escape from dislocation pile-ups and reduces the strain-hardening r

  1. Effectiveness of balance exercises in the acute post-operative phase following total hip and knee arthroplasty: A randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Pankaj Jogi

    2015-02-01

    Full Text Available Objectives: To determine the effectiveness of balance exercises in the acute post-operative phase following total hip arthroplasty or total knee arthroplasty. Methods: Patients who had total hip arthroplasty (n = 30 or total knee arthroplasty (n = 33 were seen in their residence 1–2 times per week for 5 weeks. At the first post-operative home visit, patients were randomly assigned to either typical (TE, n = 33 or typical plus balance (TE + B, n = 30 exercise groups. The TE group completed seven typical surgery-specific joint range-of-motion and muscle strengthening exercises, while the TE + B group completed the typical exercises plus three balance exercises. Patients were assessed before and 5 weeks after administering the rehabilitation program using four outcome measures: (1 the Berg Balance Scale, (2 the Timed Up and Go test, (3 the Western Ontario McMaster Universities Osteoarthritis Index, and (4 the Activities-specific Balance Confidence Scale. Results: Post-intervention scores for all four outcome measures were significantly improved (p < 0.01 over baseline scores. Patients who participated in the TE + B group demonstrated significantly greater improvement on the Berg Balance Scale and the Timed Up and Go tests (p < 0.01. Conclusion: Balance exercises added to a typical rehabilitation program resulted in significantly greater improvements in balance and functional mobility compared to typical exercises alone.

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

    Directory of Open Access Journals (Sweden)

    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. Role of magnetic resonance imaging in the evaluation of articular cartilage in painful knee joint

    Directory of Open Access Journals (Sweden)

    Digish Shah

    2014-01-01

    Full Text Available Aim: The aim of this study was to determine the role of the magnetic resonance imaging (MRI in patients with atraumatic knee pain. Background and Objectives: Knee pain is one of the most common problems faced by people from time immemorial. There is a wide range of disease ranging from traumatic to degenerative causing knee pain in which articular cartilage is involved. Over the past 15 years, MRI has become the premier, first-line imaging study that should be performed in the evaluation of the painful knee in particular in tears of menisci, cruciate and collateral ligaments, osteochondral abnormalities (chondromalacia, osteoarthritis and osteochondral defects, synovial cysts and bone bruises. MRI, by virtue of its superior soft-tissue contrast, lack of ionizing radiation and multiplanar capabilities, is superior to more conventional techniques for the evaluation of articular cartilage. Materials and Methods: A prospective study was carried out on 150 patients in the Department of Radio-diagnosis, Padmashree Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune over a period of 2 years from June 2011 to May 2013. Patients having fracture or dislocations of the knee joint were also excluded from the study. Detailed clinical history, physical and systemic examination findings of all patients were noted in addition to the laboratory investigations. All patients were subjected to radiograph of knee anterior-posterior and lateral view. MRI was performed with Siemens 1.5 Tesla MAGNETOM Avanto machine. Results: In our study of 150 patients with knee pain, articular cartilage defect was found in 90 patients (60%. Out of 90 patients with articular cartilage defect, 30 patients (20% had full thickness cartilage defects. Subchondral marrow edema was seen beneath 30 patients (20% with articular cartilage defects. 32 patients (21.1% had a complex or macerated meniscal tear. Complete anterior cruciate ligament tear was found in seven

  4. Knee Injuries

    Science.gov (United States)

    ... bursitis . Symptoms of bursitis in the knee include warmth, tenderness, swelling, and pain on the front of ... injury without the aid of a television screen. Physical Therapy Depending on the type of knee injury ...

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

    Directory of Open Access Journals (Sweden)

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

    2016-03-01

    Full Text Available 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Galeazzi fracture-dislocations.

    Science.gov (United States)

    Mikić, Z D

    1975-12-01

    Among 125 patients with the Galeazzi-type fracture-dislocation of the forearm, there were fourteen children and eighty-six adults with the classic Galeazzi lesion, and twenty-five patients with a special type -- fracture of both bones and dislocation of the distal radio-ulnar joint. Conservative management was successful only in children. In adults this method resulted in failure in 80 per cent of cases. The results of operative treatment were much better. The fracture fragments of the radius and the dislocation of the radio-ulnar joint in this complex injury are very unstable, especially in the lesion with fractures of the radius and ulna, and it appears that rigid internal fixation is necessary for the dislocation as well as the fracture. With combined fixation over half of the results were excellent.

  8. Kneecap dislocation - aftercare

    Science.gov (United States)

    ... Armstrong B. Rehabilitation of the knee following sports injury. Clin Sports Med . 2010;29:81-106. PMID: 19945588 www. ... gov/pubmed/22071844 . Miller RH, Azar FM. Knee injuries. In: Canale ... Medicine. 4th ed. Philadelphia, PA: Elsevier Saunders; 2015: ...

  9. 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

    Directory of Open Access Journals (Sweden)

    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.

  10. Anterior knee pain

    Energy Technology Data Exchange (ETDEWEB)

    LLopis, Eva [Hospital de la Ribera, Alzira, Valencia (Spain) and Carretera de Corbera km 1, 46600 Alzira Valencia (Spain)]. E-mail: ellopis@hospital-ribera.com; Padron, Mario [Clinica Cemtro, Ventisquero de la Condesa no. 42, 28035 Madrid (Spain)]. E-mail: mario.padron@clinicacemtro.com

    2007-04-15

    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.

  11. 整脊治疗膝关节骨性关节炎急性期的疗效观察%Efficacy Observation on Acute Stage of Knee Osteoarthritis with Chiropractic Therapy

    Institute of Scientific and Technical Information of China (English)

    陈小砖; 陈淑惠

    2013-01-01

    Objective:To investigate the effects of chiropractic therapy on acute stage of knee osteoarthritis. Methods:60 cases of knee osteoarthritis in acute stage were randomly divided into treatment group and control group with each of 30 cases, treatment group received chiropractic and local conventional treatment on knee joint, control group with conventional manipulation treatment on knee joint, to evaluate the knee joint function, pain degree and curative effects of two groups after 3 months. Results:The total effective rate of treatment group was 90%, significantly higher than that of control group by 73.3%(P<0.05);improvements of pain degree and knee joint function in treatment group were better than those in control group (P<0.05). Conclusion:Chiropractic therapy significantly reduces the pain of osteoarthritis knee in acute stage, and improves the overall function of knee joint.%目的:探讨整脊疗法对膝关节骨性关节炎急性期的作用。方法:60例膝关节骨性关节炎急性期患者随机分为治疗组和对照组各30例,治疗组予整脊及膝关节局部常规手法治疗,对照组采用膝关节局部常规手法治疗,3个月后评价两组膝关节功能、疼痛度及疗效。结果:治疗组总有效率90.0%,明显高于对照组的73.3%(P<0.05);治疗组疼痛度及膝关节功能改善情况均优于对照组(P<0.05)。结论:整脊疗法明显减轻膝关节骨性关节炎急性期关节疼痛,改善膝关节整体功能。

  12. Statistical characterization of dislocation ensembles

    Energy Technology Data Exchange (ETDEWEB)

    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.

  13. Congenital subtalar dislocation--a case report.

    Science.gov (United States)

    Saini, Raghav; Dhillon, M S; Gill, S S

    2009-09-01

    Congenital dislocation of the subtalar joint is one of the rarest forms of presentation of a calcaneo-valgus foot. We report the second case of this type published; an 18-month female child aged was seen with calcaneo-valgus deformity of left foot since birth. She was walking over the medial malleolus and medial border of foot. Radiographs and 3D CT scan of the left foot confirmed the diagnosis of a congenital subtalar dislocation. Surgical correction was achieved through a posterolateral incision, and the reduced joint was fixed with a k-wires for 6 weeks; the foot was immobilized in below knee cast for another 6 weeks, and an ankle foot orthosis was used for another 3 years. At 3 years post-surgical follow up, the child has a plantigrade foot with no functional impairment. Follow up radiographs and 3D CT scan confirmed the maintenance of well aligned talo-calcaneal joint. This type of dislocation should be considered in the differential diagnosis of calcaneo-valgus foot; a clear understanding of the pathology, a precise operative reduction, and long-term use of orthosis results in a favourable outcome.

  14. Viscosupplementation of the knee: Three cases of acute Pseudoseptic Arthritis with painful and irritating complications and a literature review

    Science.gov (United States)

    Aydın, Murat; Arıkan, Murat; Toğral, Güray; Varış, Onur; Aydın, Güle

    2017-01-01

    Acute pseudoseptic arthritis is a very rare complication that is associated with intra-articular hyaluronic acid injections, which normally involve minimal risk. The most common adverse events that are caused by hyaluronic acid injections are inflammatory reactions or flares at the injection site. In this study, we described three cases of acute pseudoseptic arthritis that was caused by hyaluronic acid; the symptoms in these cases were reminiscent of acute septic arthritis. Moreover, we performed a literature review on pseudoseptic arthritis following hyaluronic acid injections to determine the manner in which this condition can be described, diagnosed, and treated. PMID:28293455

  15. Overuse Knee Injuries in Athletes

    Directory of Open Access Journals (Sweden)

    Miroslav Kezunović

    2013-03-01

    Full Text Available 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 certain sport activities. Generally speaking, these syndromes occur due to poor orientation of the knee extensor mechanism, i.e. friction of iliotibial band and patellofemoral chondromalacia. It is believed that about 45% of all overuse syndromes in the knee area occur as a result of running.

  16. Acquired permanent dislocation of the patella in a patient with rheumatoid genu valgum.

    Science.gov (United States)

    Nishikawa, Masataka; Owaki, Hajime; Kaneshiro, Shoichi; Fuji, Takeshi; Shi, Kenrin

    2015-06-01

    A case of acquired permanent dislocation of the patella associated with severe genu valgum in a patient with rheumatoid arthritis (RA) is herein reported. The pain and genu valgum progressed because of poor RA control. The patient had no history of major trauma of the knee before or after the onset of RA. The most reasonable hypothesis to explain this patient's pathology is that occult patellar dislocation developed after a minor trauma and progressed to permanent dislocation; poor RA control then worsened both the patellar dislocation and genu valgum. Total knee arthroplasty (TKA) with patella reduction was successfully performed with release of the lateral retinaculum and extension of the extensor mechanism by partial snipping of the rectus femoris tendon. Two years after the operation, the patient exhibited improvement in her Knee Society Knee and Function Scores from preoperative scores of 18 and 20 to postoperative scores of 94 and 80, respectively. Acquired permanent dislocation of the patella associated with severe genu valgum in patients with RA is rare. Excellent results were obtained with TKA, and the proximal realignment method was a useful procedure for patella reduction.

  17. Dislocation climb models from atomistic scheme to dislocation dynamics

    Science.gov (United States)

    Niu, Xiaohua; Luo, Tao; Lu, Jianfeng; Xiang, Yang

    2017-02-01

    We develop a mesoscopic dislocation dynamics model for vacancy-assisted dislocation climb by upscalings from a stochastic model on the atomistic scale. Our models incorporate microscopic mechanisms of (i) bulk diffusion of vacancies, (ii) vacancy exchange dynamics between bulk and dislocation core, (iii) vacancy pipe diffusion along the dislocation core, and (iv) vacancy attachment-detachment kinetics at jogs leading to the motion of jogs. Our mesoscopic model consists of the vacancy bulk diffusion equation and a dislocation climb velocity formula. The effects of these microscopic mechanisms are incorporated by a Robin boundary condition near the dislocations for the bulk diffusion equation and a new contribution in the dislocation climb velocity due to vacancy pipe diffusion driven by the stress variation along the dislocation. Our climb formulation is able to quantitatively describe the translation of prismatic loops at low temperatures when the bulk diffusion is negligible. Using this new formulation, we derive analytical formulas for the climb velocity of a straight edge dislocation and a prismatic circular loop. Our dislocation climb formulation can be implemented in dislocation dynamics simulations to incorporate all the above four microscopic mechanisms of dislocation climb.

  18. Supersonic Dislocation Bursts in Silicon

    Science.gov (United States)

    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.

  19. Atlantoaxial rotatory dislocation. A case report.

    Science.gov (United States)

    Niibayashi, H

    1998-07-01

    Report of a child who sustained an acute atlantoaxial rotatory dislocation, associated with fractures of the clavicle and the temporal bone, and rupture of the alar ligament demonstrated by magnetic resonance imaging. To describe the radiographic and pathoanatomic characteristics of the injury process. Only five cases of traumatic atlantoaxial rotatory dislocation associated with fracture of the clavicle have been reported previously. This is the first report of a ruptured alar ligament demonstrated on magnetic resonance imaging in a patient with atlantoaxial rotatory dislocation associated with fractures of the clavicle and the temporal bone. Computed tomography revealed the Type 1 rotatory dislocation described by Fielding and Hawkins, and magnetic resonance imaging delineated the ruptured alar ligament. Traction in a halter, followed by 6 weeks of immobilization with a cervical collar, was successful in the management of the injury. Concomitant fractures of the right temporal bone and the right clavicle may yield excessive left rotation of the atlas on the axis, resulting in the rupture of the right alar ligament. Awareness of this condition allows early diagnosis and effective conservative treatment.

  20. Behavior of dislocations in silicon

    Energy Technology Data Exchange (ETDEWEB)

    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.

  1. Effective dislocation lines in continuously dislocated crystals. III. Kinematics

    CERN Document Server

    Trzesowski, Andrzej

    2007-01-01

    A class of congruences of principal Volterra-type effective dislocation lines associated with a dislocation density tensor is distinguished in order to investigate the kinematics of continuized defective crystals in terms of their dislocation densities (tensorial as well as scalar). Moreover, it shown, basing oneself on a formula defining the mean curvature of glide surfaces for principal edge effective dislocation lines, that the considered kinematics of continuized defective crystals is consistent with some relations appearing in the physical theory of plasticity (e.g. with the Orowan-type kinematic relations and with the treatment of shear stresses as driving stresses of moving dislocations).

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    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 bruise....

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

    DEFF Research Database (Denmark)

    Eckstein, F; Wirth, W; Lohmander, Stefan

    2015-01-01

    Objective: Anterior cruciate ligament (ACL) rupture involves increased risk of osteoarthritis. We explored cartilage thickness changes over five years after ACL rupture. Methods: 121 young active adults (26% women, age 18-35 years) with acute traumatic ACL rupture were studied (the KANON...

  4. [Does intravenous gadolinium-DTPA administration have advantages in magnetic resonance imaging of acute injuries or chronic damage to the knee joint?].

    Science.gov (United States)

    Jerosch, J; Castro, W H; Müller, U; Assheuer, J

    1994-12-01

    79 patients with acute or chronic lesions of the knee were evaluated by MRI prior to and after application of Gd-DTPA. The MRI examination was performed by a 1.0 tesla imager with SE as well as FEDIF sequences. These MR studies were compared prior to and after intravenous Gd-DTPA application, focusing on the visibility and the definition of a possible lesion, and scored with a 3-point score. Statistic analysis and case analysis revealed that in patients with meniscus degeneration without a tear, Gd application yields no additional diagnostic information. However, in patients with meniscus tears Gd-DTPA significantly facilitates the definition of the lesion. Furthermore, Gd-DTPA makes differentiation possible between the synovial fluid and the synovial membrane. Whereas in cases with capsule or collateral ligament tears Gd-DTPA facilitates the documentation of the lesion, we found no advantage in using Gd-DPTA in patients with ACL tears. In patients with chondropathia patellae Gd-DTPA application supports the visualization of the secondary synovial reaction.

  5. Comparative study on the treatment of Rockwood type III acute acromioclavicular dislocation: Clinical results from the TightRope(®) technique vs. K-wire fixation.

    Science.gov (United States)

    Horst, K; Garving, C; Thometzki, T; Lichte, P; Knobe, M; Dienstknecht, T; Hofman, M; Pape, H-C

    2017-04-01

    The aim of this study was to address the inconsistency regarding the operative treatment of Rockwood type III acromioclavicular joint separation. We compared results after single- and double TightRope(®) reduction with results after acromioclavicular transfixation via K-wires only and additional ligament augmentation in acute acromioclavicular (AC) joint separations graded Rockwood type III, and hypothesized that the TightRope(®) technique leads to better clinical and radiological results. We conducted a retrospective clinical cohort study and included 42 consecutive patients (mean age 43 years [24-66]) diagnosed and operatively treated between 2004 and 2012 (mean follow-up was 54.6 months [15-118]). Specific shoulder scores as well as scores reflecting the patients' overall mental and physical health status were used. Radiological evaluation was also performed. The SF12 test revealed comparability between all subgroups. Specific shoulder tests and a visual analogue scale demonstrated comparable results. Radiographic measurements showed a significant reduction in the AC distance and CC distance after surgery in all subgroups. The early complication rate was 9.5% for all patients, while late complications occurred in 14.3% of all cases. Compared to the established methods, the operative TightRope(®) procedures represent a safe alternative in Rockwood III injuries. All investigated techniques predominantly led to good and excellent clinical results in acute Rockwood type III AC joint instabilities. Avoidance of material removal and shorter hospital stays appear to speak in favour for the TightRope(®) technique. IV. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  6. Imaging patellar complications after knee arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    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.

  7. Spontaneous osteonecrosis of the knee

    Energy Technology Data Exchange (ETDEWEB)

    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'.

  8. [Bilateral chronic dislocation of the temporomandibular joints and Meige syndrome].

    Science.gov (United States)

    Arzul, L; Henoux, M; Marion, F; Corre, P

    2015-04-01

    Chronic dislocation of the temporo-mandibular joint (TMJ) is rare. It occurs when an acute dislocation is left untreated, in certain situations, including severe illness, neurologic or psychiatric diseases or prolonged oral intubation. A 79 years old woman, with Meige syndrome, suffered from bilateral dislocation of the TMJ for over 1 year. Surgical repositioning of the mandibular condyles and temporal bone eminectomy were performed. At the 18 postoperative months control, no recurrence has been noted. Treatment of chronic TMJ dislocations often requires a surgical procedure. Manual reduction, even under general anaesthesia, often fails because of severe muscular spasm and periarticular fibrotic changes. The management of this disorder is still controversial. We review available surgical procedures. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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.

  10. Manual treatment of dislocation of temporomandibular joint%颞下颌关节脱位的手法治疗

    Institute of Scientific and Technical Information of China (English)

    雷绍音; 陈永全

    2002-01-01

    Background: That the condylar process slides out of articular fossa and exceeds normal limit of articular motion and can not reduce automatically is called dislocation of temporomandibular joint. It is divided into unilateral and bilateral dislocation according to the part of dislocation. Or it is divided into acute, recurrent, and old dislocations according to the time of dislocation or into anterior, posterior, superior and lateral dislocations according the direction of dislocation of the condylar process. Manifestations of dislocation of temporomandibular joint include mandibular abnormal motion, opening of the mouth that can' t close with outflowing of the saliva, he mandible protrudes anteriorly, the cheeks become smooth, a pit can be palpated anterior to the antilobium.

  11. Knee Replacement

    Science.gov (United States)

    ... need knee replacement surgery usually have problems walking, climbing stairs, and getting in and out of chairs. Some ... a total living space on one floor since climbing stairs can be difficult. Install safety bars or a ...

  12. Knee Arthroscopy

    Science.gov (United States)

    ... experience any of the following: • Fever • Chills • Persistent warmth or redness around the knee • Persistent or increased ... you should be able to return to most physical activities a er 6 to 8 weeks, or ...

  13. Runner's Knee

    Science.gov (United States)

    ... Over the summer he bought a pair of running shoes and took up jogging. He started with ... bending the knee — when walking, kneeling, squatting, or running, for example. Walking or running downhill or even ...

  14. The Results of Adductor Magnus Tenodesis in Adolescents with Recurrent Patellar Dislocation

    Directory of Open Access Journals (Sweden)

    Krzysztof Malecki

    2015-01-01

    Full Text Available Recurrent dislocation of the patella is a common orthopaedic problem which occurs in about 44% of cases after first-time dislocation. In most cases of first-time patellar dislocation, the medial patellofemoral ligament (MPFL becomes damaged. Between 2010 and 2012, 33 children and adolescents (39 knees with recurrent patellar dislocation were treated with MPFL reconstruction using the adductor magnus tendon. The aim of our study is to assess the effectiveness of this surgical procedure. The outcomes were evaluated functionally (Lysholm knee scale, the Kujala Anterior Knee Pain Scale, and isokinetic examination and radiographically (Caton index, sulcus angle, congruence angle, and patellofemoral angle. Four patients demonstrated redislocation with MPFL graft failure, despite the fact that patellar tracking was found to be normal before the injury, and the patients had not reported any symptoms. Statistically significant improvements in Lysholm and Kujala scales, in patellofemoral and congruence angle, were seen (P<0.001. A statistically significant improvement in the peak torque of the quadriceps muscle and flexor was observed for 60°/sec and 180°/sec angular velocities (P=0.01. Our results confirm the efficacy of MPFL reconstruction using the adductor magnus tendon in children and adolescents with recurrent patellar dislocation.

  15. Knee-Extension Training with a Single-Joint Hybrid Assistive Limb during the Early Postoperative Period after Total Knee Arthroplasty in a Patient with Osteoarthritis

    Science.gov (United States)

    Sugaya, Hisashi; Kubota, Shigeki; Onishi, Mio; Kanamori, Akihiro; Sankai, Yoshiyuki; Yamazaki, Masashi

    2016-01-01

    The knee range of motion is an important outcome of total knee arthroplasty (TKA). According to previous studies, the knee range of motion temporarily decreases for approximately 1 month after TKA due to postoperative pain and quadriceps dysfunction following surgical invasion into the knee extensor mechanism. We describe our experience with a knee-extension training program based on a single-joint hybrid assistive limb (HAL-SJ, Cyberdyne Inc., Tsukuba, Japan) during the acute recovery phase after TKA. HAL-SJ is a wearable robot suit that facilitates the voluntary control of knee joint motion. A 76-year-old man underwent HAL-SJ-based knee-extension training, which enabled him to perform knee function training during the acute phase after TKA without causing increased pain. Thus, he regained the ability to fully extend his knee postoperatively. HAL-SJ-based knee-extension training can be used as a novel post-TKA rehabilitation modality.

  16. Surgical treatment of acromioclavicular dislocation using the endobutton.

    Science.gov (United States)

    Teodoro, Renato Loureiro; Nishimi, Alexandre Yukio; Pascarelli, Luciano; Bongiovanni, Roberto Rangel; Velasco, Marcelo Andreotti Perez; Dobashi, Eiffel Tsuyoshi

    2017-01-01

    To evaluate the clinical and radiographic results of 23 patients diagnosed with acute type III acromioclavicular dislocation treated with the Endobutton. Twenty-three patients with a diagnosis of type III acromioclavicular dislocation were treated surgically. Twenty-one patients were male (91.3%) and 2 (8.7%) were female. The dominant side was affected in 15 patients (65.21%) and the non-dominant side in 8 patients (34.79%). All patients were operated on by the same surgical team within 4 weeks of the trauma. According to the UCLA score, 14 patients (60.86%) presented excellent results, 7 patients (30.43%) had good results and 2 patients (8.69%) had regular results. The technique was effective in treating acute type III dislocations with a high degree of patient satisfaction. Level of Evidence IV, Case Series.

  17. Knee Injuries and Disorders

    Science.gov (United States)

    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 ...

  18. Dislocation Dynamics in Nanocrystalline Nickel

    OpenAIRE

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

    2007-01-01

    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...

  19. Use of radiographic projections of knee

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. 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

    Institute of Scientific and Technical Information of China (English)

    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

  2. Temporomandibular chronic dislocation: The long-standing condition

    Science.gov (United States)

    Puche-Torres, Miguel; Iglesias-Gimilio, Maria-Eugenia

    2016-01-01

    Background The temporomandibular joint (TMJ) dislocation can be categorised into three groups: acute, habitual or recurrent and long-standing. The long-standing or protracted lower jaw dislocation refers to a condition that persists for more than one month without reduction. There are a great variety of methods for its treatment, from the manual or non-surgical, to surgical ones like the indirect approach (conservative surgical approach) and direct approach (open joint). Additional procedures in unsuccessful cases may include extra-articular orthognathic techniques to correct a malocclusion until joint replacement. Material and Methods We report four new cases with a minimum of 6 weeks dislocation who were seen since 1995 to 2015 in the Maxillofacial Department of the Clínico Hospital (Valencia, Spain), in which the mean age was 57.5 years. Most of them were bilateral and the gender was predominantly female. Additionally, we have reviewed the related literature. Results All of the cases were successfully treated and half of them required open surgery. Conclusions The report confirms the difficulty of the treatment and reaffirms the necessity to bear in mind the wide variety of methods available for the treatment of this pathology. We stress the difficulties associated with managing the treatment and of suggesting new guidelines. The best option still remains not to delay the diagnostic and to select the appropriate initial treatment. Key words:Temporomandibular luxation, TMJ dislocation, protracted dislocation, long-standing dislocation. PMID:27694782

  3. Chronic Irreducible Anterior Dislocation of the Shoulder without Significant Functional Deficit.

    Science.gov (United States)

    Chung, Hoejeong; Yoon, Yeo-Seung; Shin, Ji-Soo; Shin, John Junghun; Kim, Doosup

    2016-09-01

    Shoulder dislocation is frequently encountered by orthopedists, and closed manipulation is often sufficient to treat the injury in an acute setting. Although most dislocations are diagnosed and managed promptly, there are rare cases that are missed or neglected, leading to a chronically dislocated state of the joint. They are usually irreducible and cause considerable pain and functional disability in most affected patients, prompting the need to find a surgical method to reverse the worsening conditions caused by the dislocated joint. However, there are cases of even greater rarity in which chronic shoulder dislocations are asymptomatic with minimal functional or structural degeneration in the joint. These patients are usually left untreated, and most show good tolerance to their condition without developing disabling symptoms or significant functional loss over time. We report on one such patient who had a chronic shoulder dislocation for more than 2 years without receiving treatment.

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

    Institute of Scientific and Technical Information of China (English)

    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

    优,1例良。患者均对治疗效果满意。结论采用关节镜下四骨道四袢双束固定方法修复急性肩锁关节 Rockwood-Ⅴ型脱位,生物固定牢固,手术创伤小,并且避免了双袢单骨道应力过于集中、拉力线单薄等缺点,是治疗急性肩锁关节 Rockwood Ⅴ型损伤较好的方法。%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

  5. Pathologic conditions of the ligaments and tendons of the knee.

    Science.gov (United States)

    El-Dieb, Adam; Yu, Joseph S; Huang, Guo-Shu; Farooki, Shella

    2002-09-01

    Excellent spatial resolution and unparalleled contrast resolution have allowed MRI to emerge as the dominant imaging modality for diagnosis of ligament and tendon pathology of the knee joint This article presents several important mechanisms of injury associated with tendon and ligament disruptions. When present, the pattern of bone contusions may reveal the vector of force. When one is aware of the mechanism of injury, it is possible to analyze systematically the structures of the knee and maximize the detection of pathology. Recognition of a knee dislocation pattern is important because the diagnosis may be unsuspected, and the clinician may have to be alerted to the possibility of vascular and neural injury.

  6. Knee Pain and Patellofemoral Symptoms in Patients With Cerebral Palsy.

    Science.gov (United States)

    Rethlefsen, Susan A; Nguyen, Danny T; Wren, Tishya A L; Milewski, Matthew D; Kay, Robert M

    2015-01-01

    Knee pain in cerebral palsy (CP) is associated with increased patellofemoral forces present when walking with flexed knees. In typically developing children, knee pain and patellofemoral dysfunction are associated with obesity, genu valgum, femoral anteversion, and external tibial torsion. These problems are also common in CP, and may contribute to knee problems in this population. The purposes of this study were to define the prevalence of knee pain and patellofemoral dysfunction in children with CP, and to identify physical and gait characteristics (using 3-dimensional gait analysis data) that predispose them to such problems. Retrospective review of 121 children with CP, Gross Motor Function Classification System level I to IV, who underwent computerized gait analysis testing. Demographics, range of motion, body mass index and hip, knee, and ankle kinematics were compared between subjects with and without knee pain. Twenty-five of 121 subjects (21%) reported knee pain at the time of testing. Three of 121 subjects (2%) had a history of patellar subluxation/dislocation. Age and sex were significantly related to presence of knee pain. The likelihood of knee pain was almost 5 times higher in females (odds ratio=4.9, [95% confidence interval, 1.8-13.3], P=0.002), with a prevalence of 40% (17/42) in females versus 10% (8/79) in males. The likelihood of knee pain increased with age by approximately 13% per year (odds ratio=1.13, [95% confidence interval, 1.00-1.28], P=0.058). Malignant malalignment syndrome showed a potential relationship to more severe knee pain (P=0.05), which warrants further investigation. Body mass index, pes valgus, and degree of stance knee flexion showed no statistically significant relationships to knee pain (P>0.16). The prevalence of knee pain in ambulatory patients with CP is approximately 21%. Patellar subluxation (2%) and dislocation are rare in these patients. Knee pain is not always related to crouch, femoral anteversion, external

  7. Horizontal intra-articular patellar dislocation resulting in quadriceps avulsion and medial patellofemoral ligament tear: a case report.

    Science.gov (United States)

    Kramer, Dennis E; Simoni, Michael K

    2013-07-01

    Intra-articular patellar dislocations are rare. We present a 13-year-old boy who sustained a complete horizontal intra-articular patellar dislocation following blunt trauma to the flexed knee. Closed reduction was unsuccessful and open reduction indicated a repairable quadriceps avulsion and medial patellofemoral ligament tear. He is the youngest patient to sustain a quadriceps rupture and the only patient to sustain a medial patellofemoral ligament tear to date. His flexed knee and the horizontally positioned patella (seen on lateral radiograph) were indicative of a complete rotational injury with extensor mechanism involvement. Open reduction allowed for the repair of both injuries and a favorable outcome.

  8. Nature of Dislocations in Silicon

    DEFF Research Database (Denmark)

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

    1995-01-01

    -binding Hamiltonian that scales linearly with the number of atoms. The partial edge dislocation is found to be very accurately described by the Peierls-Nabarro dislocation model, with generalized stacking-fault restoring forces, as reflected both in the interaction energy and in the displacement field. An asymmetric...... core reconstruction provides fourfold coordination, making Si behave elastically down to atomic distances....

  9. Galeazzi fractures and dislocations.

    Science.gov (United States)

    Giannoulis, Filippos S; Sotereanos, Dean G

    2007-05-01

    In 1934, fractures of the middle and distal third of the radius associated with instability of the distal radial ulnar joint (DRUJ) were described by Galeazzi. This type of lesion is characterized by its unstable nature and the need for open reduction and internal fixation to achieve a satisfactory functional outcome. A high index of suspicion should be maintained by the surgeon, and a thorough examination for instability of the DRUJ must be conducted. The marked instability of this fracture-dislocation complex is further enhanced by the disruption of the triangular fibrocartilage complex, either with or without ulna styloid fracture. Treatment in adults is surgical, and both bone and soft tissue injuries should be addressed.

  10. Buckling of dislocation in graphene

    Science.gov (United States)

    Yao, Yin; Wang, Shaofeng; Bai, Jianhui; Wang, Rui

    2016-10-01

    The buckling of dislocation in graphene is discussed through the lattice theory of dislocation and elastic theory. The approximate solution of the buckling is obtained based on the inner stress distribution caused by different structure of dislocations and is proved to be suitable by the simulation. The position of the highest buckling is predicted to be at the vertex of the pentagon far away from the heptagon. The buckling is strongly influenced by the internal stress and the distance between the extrusive area and stretching area, as well as the critical stress σc. The SW defect is proved to be unbuckled due to its strong interaction between extrusion and stretching.

  11. [Traumatic elbow dislocations in bouldering].

    Science.gov (United States)

    Sandmann, G H; Siebenlist, S; Lenich, A; Neumaier, M; Ahrens, P; Kirchhoff, C; Braun, K F; Lucke, M; Biberthaler, P

    2014-03-01

    Bouldering is a new trend sport which has become popular in recent years. From April 2011 to June 2012 a total of 5 patients with elbow dislocations from bouldering were admitted to our level 1 trauma center. The injuries varied from simple elbow dislocations to complex fracture dislocations. Elbow dislocations occurred during falling backwards when patients tried to protect themselves by retroversion of both arms. In all cases the falling height was less than 4 meters. The bouldering injury pattern, the diagnostic and therapeutic management as well as the rehabilitation program are described in detail in this article. To the best of our knowledge this is the first report on the special danger of bouldering for complex elbow injuries.

  12. Water on the Knee

    Science.gov (United States)

    ... your knee joint. Some people call this condition "water on the knee." A swollen knee may be ... Choose low-impact exercise. Certain activities, such as water aerobics and swimming, don't place continuous weight- ...

  13. Knee pain (image)

    Science.gov (United States)

    ... 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 ...

  14. Knee microfracture surgery

    Science.gov (United States)

    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 ...

  15. Preventing Knee Injuries

    Science.gov (United States)

    ... Our Newsletter Donate Blog Skip breadcrumb navigation Preventing Knee Injuries Knee injuries in children and adolescent athletes ... this PDF Share this page: WHAT ARE COMMON KNEE INJURIES? Pain Syndromes One of the most common ...

  16. Multiple-ligament injured knee

    Institute of Scientific and Technical Information of China (English)

    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

  17. MRI versus radiography of acromioclavicular joint dislocation.

    Science.gov (United States)

    Nemec, Ursula; Oberleitner, Gerhard; Nemec, Stefan F; Gruber, Michael; Weber, Michael; Czerny, Christian; Krestan, Christian R

    2011-10-01

    Acromioclavicular joint injuries are usually diagnosed by clinical and radiographic assessment with the Rockwood classification, which is crucial for treatment planning. In view of the implementation of MRI for visualization of the acromioclavicular joint, the purpose of this study was to describe the MRI findings of acromioclavicular joint dislocation in comparison with the radiographic findings. Forty-four patients with suspected unilateral acromioclavicular joint dislocation after acute trauma were enrolled in this prospective study. All patients underwent digital radiography and 1-T MRI with a surface phased-array coil. MRI included coronal proton density-weighted turbo spin-echo and coronal 3D T1-weighted fast field-echo water-selective sequences. The Rockwood classification was used to assess acromioclavicular joint injuries at radiography and MRI. An adapted Rockwood classification was used for MRI evaluation of the acromioclavicular joint ligaments. The classifications of acromioclavicular joint dislocations diagnosed with radiography and MRI were compared. Among 44 patients with Rockwood type I-IV injuries on radiographs, classification on radiographs and MR images was concordant in 23 (52.2%) patients. At MRI, the injury was reclassified to a less severe type in 16 (36.4%) patients and to a more severe type in five (11.4%) patients. Compared with the findings according to the original Rockwood system, with the adapted system that included MRI findings, additional ligamentous lesions were found in 11 (25%) patients. In a considerable number of patients, the MRI findings change the Rockwood type determined with radiography. In addition to clinical assessment and radiography, MRI may yield important findings on ligaments that may influence management.

  18. Dislocation Multi-junctions and Strain Hardening

    Energy Technology Data Exchange (ETDEWEB)

    Bulatov, V; Hsiung, L; Tang, M; Arsenlis, A; Bartelt, M; Cai, W; Florando, J; Hiratani, M; Rhee, M; Hommes, G; Pierce, T; Diaz de la Rubia, T

    2006-06-20

    At the microscopic scale, the strength of a crystal derives from the motion, multiplication and interaction of distinctive line defects--dislocations. First theorized in 1934 to explain low magnitudes of crystal strength observed experimentally, the existence of dislocations was confirmed only two decades later. Much of the research in dislocation physics has since focused on dislocation interactions and their role in strain hardening: a common phenomenon in which continued deformation increases a crystal's strength. The existing theory relates strain hardening to pair-wise dislocation reactions in which two intersecting dislocations form junctions tying dislocations together. Here we report that interactions among three dislocations result in the formation of unusual elements of dislocation network topology, termed hereafter multi-junctions. The existence of multi-junctions is first predicted by Dislocation Dynamics (DD) and atomistic simulations and then confirmed by the transmission electron microscopy (TEM) experiments in single crystal molybdenum. In large-scale Dislocation Dynamics simulations, multi-junctions present very strong, nearly indestructible, obstacles to dislocation motion and furnish new sources for dislocation multiplication thereby playing an essential role in the evolution of dislocation microstructure and strength of deforming crystals. Simulation analyses conclude that multi-junctions are responsible for the strong orientation dependence of strain hardening in BCC crystals.

  19. Data Collection and Analysis Using Wearable Sensors for Monitoring Knee Range of Motion after Total Knee Arthroplasty

    Science.gov (United States)

    Chiang, Chih-Yen; Chen, Kun-Hui; Liu, Kai-Chun; Hsu, Steen Jun-Ping; Chan, Chia-Tai

    2017-01-01

    Total knee arthroplasty (TKA) is the most common treatment for degenerative osteoarthritis of that articulation. However, either in rehabilitation clinics or in hospital wards, the knee range of motion (ROM) can currently only be assessed using a goniometer. In order to provide continuous and objective measurements of knee ROM, we propose the use of wearable inertial sensors to record the knee ROM during the recovery progress. Digitalized and objective data can assist the surgeons to control the recovery status and flexibly adjust rehabilitation programs during the early acute inpatient stage. The more knee flexion ROM regained during the early inpatient period, the better the long-term knee recovery will be and the sooner early discharge can be achieved. The results of this work show that the proposed wearable sensor approach can provide an alternative for continuous monitoring and objective assessment of knee ROM recovery progress for TKA patients compared to the traditional goniometer measurements. PMID:28241434

  20. Comparison of the outcome of early and delayed surgical treatment of complete acromioclavicular joint dislocation.

    Science.gov (United States)

    Song, Tengfei; Yan, Xu; Ye, Tianwen

    2016-06-01

    The aim of this study is to compare the clinical and radiographic results and the complication rate between early and delayed surgical treatment of acromioclavicular joint (ACJ) dislocation. Publications in the management of ACJ dislocation are identified from the PubMed database between January 1993 and December 2013 using "acromioclavicular joint" and "dislocation" as keywords. The eligibility criteria included are as follows: (1) ACJ dislocation; (2) intervention, early compared with delayed surgical treatment or the surgical treatment for acute compared with chronic ACJ dislocation; (3) human; and (4) English articles. Exclusion criteria consist of the following: (1) type I and type II ACJ dislocation, (2) no definition of the time of early and delayed surgery in studies, (3) no comparison between the clinical result of early and delayed surgery in studies, (4) laboratory studies, radiographic studies, biomechanical studies, (5) the cases including fractures or revisions in studies, and (6) systematic analyses. Eight studies comparing early and delayed surgical treatment of ACJ dislocation are included in this systematic review. According to Constant scores and shoulder subjective value, early surgery has better functional outcomes than delayed surgery in the treatment of ACJ dislocation (P < 0.05). Partial-dislocation/re-dislocation is found at 26.0 % in early and 38.1 % in delayed surgical treatment (P < 0.05). The rate of CC ossification in early surgical treatment is found as the same as the delayed. The complication rates are found at 12.5 % in early surgical treatment and 17.7 % in the delayed, which is not significantly different. Early surgical treatment may have superiority to the delayed procedure in the management of ACJ dislocation with better functional outcomes and more satisfied reduction. However, high-quality evidence studies are required to provide stronger support for this opinion in the future. IV.

  1. Non-singular dislocation fields

    Energy Technology Data Exchange (ETDEWEB)

    Aifantis, Elias C, E-mail: mom@mom.gen.auth.gr [Laboratory of Mechanics and Materials, Faculty of Engineering, Aristotle University of Thessaloniki, GR-54124, Thessaloniki (Greece); Center for Mechanics of Materials, Michigan Technological University, Houghton MI 49931 (United States)

    2009-07-15

    Non-singular solutions for dislocation and disclination fields have recently been obtained by the author and his co-workers by using a robust model of gradient elasticity theory. These solutions, whose form is simple and easy to implement, are obtained by reducing the gradient elasticity problem to a corresponding linear elasticity boundary value problem through the solutions of an inhomogeneous Helmholtz equation where the source term is the classical singular solution. The Laplacian in the Helmholtz equation, involving the extra gradient coefficient, produces a new term in the gradient solution which asymptotically approaches the negative of the classical elasticity solution on the dislocation line. Thus, the singularity is eliminated and an arbitrary estimate of the dislocation core size introduced in classical theory, is not required. These predictions are tested against atomistic calculations and their implications to various dislocation related configurations are discussed. Due to the simple and elegant form of these solutions, it is hoped that they will be useful in discrete dislocation dynamics simulations.

  2. Dislocations and other topological oddities

    Science.gov (United States)

    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.

  3. CHRONIC TRAUMATIC DISLOCATION OF II-V METACARPAL BONES: CASE REPORT

    Directory of Open Access Journals (Sweden)

    Владимир Иванович Заварухин

    2014-12-01

    Full Text Available Dislocations in the carpometacarpal joints of three-phalanx fingers are rare form of injury. Their clinical manifestations are often veiled by swelling, and radiographs in standard views provide little information, which leads to difficulty in diagnosis and a high incidence of unidentified dislocations in the primary treatment. The article describes the basic provisions of the diagnosis and treatment of this type of injury, a clinical case of surgical treatment of undiagnosed dislocations of II-V metacarpal bones in the acute period, and long-term results of treatment.

  4. The difficult primary total knee arthroplasty: a review.

    Science.gov (United States)

    Baldini, A; Castellani, L; Traverso, F; Balatri, A; Balato, G; Franceschini, V

    2015-10-01

    Primary total knee arthroplasty (TKA) is a reliable procedure with reproducible long-term results. Nevertheless, there are conditions related to the type of patient or local conditions of the knee that can make it a difficult procedure. The most common scenarios that make it difficult are discussed in this review. These include patients with many previous operations and incisions, and those with severe coronal deformities, genu recurvatum, a stiff knee, extra-articular deformities and those who have previously undergone osteotomy around the knee and those with chronic dislocation of the patella. Each condition is analysed according to the characteristics of the patient, the pre-operative planning and the reported outcomes. When approaching the difficult primary TKA surgeons should use a systematic approach, which begins with the review of the existing literature for each specific clinical situation.

  5. A continuum theory of edge dislocations

    Science.gov (United States)

    Berdichevsky, V. L.

    2017-09-01

    Continuum theory of dislocation aims to describe the behavior of large ensembles of dislocations. This task is far from completion, and, most likely, does not have a ;universal solution;, which is applicable to any dislocation ensemble. In this regards it is important to have guiding lines set by benchmark cases, where the transition from a discrete set of dislocations to a continuum description is made rigorously. Two such cases have been considered recently: equilibrium of dislocation walls and screw dislocations in beams. In this paper one more case is studied, equilibrium of a large set of 2D edge dislocations placed randomly in a 2D bounded region. The major characteristic of interest is energy of dislocation ensemble, because it determines the structure of continuum equations. The homogenized energy functional is obtained for the periodic dislocation ensembles with a random contents of the periodic cell. Parameters of the periodic structure can change slowly on distances of order of the size of periodic cells. The energy functional is obtained by the variational-asymptotic method. Equilibrium positions are local minima of energy. It is confirmed the earlier assertion that energy density of the system is the sum of elastic energy of averaged elastic strains and microstructure energy, which is elastic energy of the neutralized dislocation system, i.e. the dislocation system placed in a constant dislocation density field making the averaged dislocation density zero. The computation of energy is reduced to solution of a variational cell problem. This problem is solved analytically. The solution is used to investigate stability of simple dislocation arrays, i.e. arrays with one dislocation in the periodic cell. The relations obtained yield two outcomes: First, there is a state parameter of the system, dislocation polarization; averaged stresses affect only dislocation polarization and cannot change other characteristics of the system. Second, the structure of

  6. Dislocation following revision total hip arthroplasty.

    Science.gov (United States)

    Gioe, Terence J

    2002-04-01

    Dislocation is a relatively common complication following revision total hip arthroplasty. Risk factors include surgical approach, gender, underlying diagnosis, comorbidities, surgical experience, and previous surgery; for later dislocations, risk factors include wear/deformation of polyethylene, trauma, and decreased muscle strength. Prevention and precaution are the watchwords for dislocations following revision total hip arthroplasty. For dislocations that do occur, treatment rests first on identifying the source of instability. Most dislocations can be managed by closed reduction. Constrained components may increase success rates, but only for appropriate indications. Prevention and treatment of dislocations following revision total hip arthroplasty are discussed in this article.

  7. Neglected anterior dislocation of shoulder with large Hillsach's lesion & deficient glenoid: Treated by autogenous bone graft & modified Latarjet procedure☆

    Science.gov (United States)

    Peshin, Chetan; Jangira, Vivek; Gupta, Ravi Kumar; Jindal, Rohit

    2015-01-01

    Neglected anterior dislocation of shoulder is rare in spite of the fact that the anterior dislocation of the shoulder is seen in around 90% of the acute cases. Most of the series of neglected dislocation describe posterior dislocation to be far more common.1,2 We hereby report a case of the neglected anterior shoulder dislocation in a 15 year old boy who had a history of epilepsy. There was a large Hill Sachs lesion in humeral head which was impacted in glenoid inferiorly and glenoid was eburnated at that margin. The humeral head was reconstructed with a tricortical iliac graft. Glenoid was reconstructed by transfer of coracoids process of scapula to antero-inferior glenoid (modified Latarjet procedure). This case is unique because management of humeral head defect with bone graft is not mentioned in anterior dislocation. PMID:26566343

  8. Neglected anterior dislocation of shoulder with large Hillsach's lesion & deficient glenoid: Treated by autogenous bone graft & modified Latarjet procedure.

    Science.gov (United States)

    Peshin, Chetan; Jangira, Vivek; Gupta, Ravi Kumar; Jindal, Rohit

    2015-12-01

    Neglected anterior dislocation of shoulder is rare in spite of the fact that the anterior dislocation of the shoulder is seen in around 90% of the acute cases. Most of the series of neglected dislocation describe posterior dislocation to be far more common.(1) (,2) We hereby report a case of the neglected anterior shoulder dislocation in a 15 year old boy who had a history of epilepsy. There was a large Hill Sachs lesion in humeral head which was impacted in glenoid inferiorly and glenoid was eburnated at that margin. The humeral head was reconstructed with a tricortical iliac graft. Glenoid was reconstructed by transfer of coracoids process of scapula to antero-inferior glenoid (modified Latarjet procedure). This case is unique because management of humeral head defect with bone graft is not mentioned in anterior dislocation.

  9. Surgical treatment of recurrent patellar dislocation in children associated with patello-femoral dysplasia

    OpenAIRE

    vergara- amador, Enrique; Universidad nacional de colombia; castro, Ricardo; Universidad nacional de colombia

    2014-01-01

    The aim of this paper is to show the results in a small series of patients withpatellofemoral instability or recurrent patellar dislocation in children operated with theproximal realignment technique. Materials and methods: It is a series of 10 knees in7 children, with proximal patela realignment patela using the Insall technique. The mostimportant role of the patela is to increase the quadriceps efficiency. The patelo -femoralinstability is defined as a condition in which there is insufficie...

  10. Multiscale Theory of Dislocation Climb.

    Science.gov (United States)

    Geslin, Pierre-Antoine; Appolaire, Benoît; Finel, Alphonse

    2015-12-31

    Dislocation climb is a ubiquitous mechanism playing a major role in the plastic deformation of crystals at high temperature. We propose a multiscale approach to model quantitatively this mechanism at mesoscopic length and time scales. First, we analyze climb at a nanoscopic scale and derive an analytical expression of the climb rate of a jogged dislocation. Next, we deduce from this expression the activation energy of the process, bringing valuable insights to experimental studies. Finally, we show how to rigorously upscale the climb rate to a mesoscopic phase-field model of dislocation climb. This upscaling procedure opens the way to large scale simulations where climb processes are quantitatively reproduced even though the mesoscopic length scale of the simulation is orders of magnitude larger than the atomic one.

  11. Effects of function improvement in acute knee- joint ligament injury between knee orthosis and dynamic action plaster immobilization%膝关节韧带损伤早期应用膝矫形器与动态石膏固定对膝关节功能恢复的影响

    Institute of Scientific and Technical Information of China (English)

    张毅; 黄东锋; 毛玉容; 伍丹

    2001-01-01

    Objective: To explore the different effect to function improvement of acute knee- joint ligament injure after rehabilitation therapy with hinge-locked knee orthosis or dynamic action plaster immobilization. Method: Orthosis or dynamic action plaster immobilization were used 4 weeks after acute injure in two groups. Rehabilitation therapy were arranged during immobilization and free periods, Function assessment comparison were conducted 3 months later. Result:ROM active and ROM passive were significantly different between the two groups (P<0.001, P<0.01 ). The Lysholmp scorings of the two groups were also significantly different (P<0.01). Couclusion: Dynamic action plaster immobilization could gently prevent contraction, but could not obviously improve muscle weakness and instability of the joint. Hinge-locked keen orthosis provided not only safe training within protective ROM. Stable immobilization could obviously improve ROM and function of the knee-joint.%目的:探讨膝韧带损伤急性期康复治疗中配置加锁膝关节绞链矫形器与动态石膏固定对膝关节功能恢复的不同影响。方法:两组伤后即分别配置矫形器与动态石膏固定4周,固定期间及拆除固定后进行康复治疗,3月后进行功能评估比较疗效。结果:矫形器组与动态石膏组膝关节主动ROM与被动ROM差异在统计学上有显著性(t值分别为4.59及3.23,P分别<0.001及<0.01),膝关节功能Lyshdmp评分差异在统计学上亦有显著性(t值为2.93,P<0.01)。结论:动态石膏固定在一定程度上可预防关节挛缩,但肌无力及关节不稳不能解除。加锁膝关节绞链矫形器配置有利于膝关节在保护范围内进行功能训练,有效地解决了制动与功能训练之间的矛盾,可显著改善膝关节ROM与综合功能。

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Bipolar dislocation of the clavicle

    Directory of Open Access Journals (Sweden)

    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.

  14. Closed medial total subtalar joint dislocation without ankle fracture: a case report

    Science.gov (United States)

    2014-01-01

    Introduction Total subtalar dislocation without fracture of the ankle is a rare clinical entity; it is usually due to a traumatic high-energy mechanism. Standard treatment is successful closed reduction under general anesthesia followed by non-weight bearing and ankle immobilization with a below-knee cast for 6 weeks. Case presentation We present the case of a 30-year-old Moroccan woman who was involved in a road traffic accident. She subsequently received a radiological assessment that objectified a total subtalar dislocation without fracture of her ankle. She was immediately admitted to the operating theater where an immediate reduction was performed under sedation, and immobilization in a plaster boot was adopted for 8 weeks. The management of this traumatic lesion is discussed in the light of the literature. Conclusions Medial subtalar dislocation is a rare dislocation and is not commonly seen as a sports injury because it requires transfer of a large amount of kinetic energy. The weaker talocalcaneal and talonavicular ligaments often bear the brunt of the energy and are more commonly disrupted, compared to the relatively stronger calcaneonavicular ligament. Urgent reduction is important, and closed reduction under general anesthesia is usually successful, often facilitated by keeping the knee in flexion to relax the gastrocnemius muscle. Long-term sequelae include talar avascular necrosis and osteochondral fracture, as well as chronic instability and pain. PMID:25240955

  15. Bilateral Shoulder Dislocations Following a Motocross Accident

    National Research Council Canada - National Science Library

    H J Schroepfer; B M Martin; P J Millett

    2017-01-01

    .... A professional motocross racer experienced a high speed traumatic accident which resulted in bilateral shoulder dislocations with a rare associated complete anterosuperior RC tear due to a posterior dislocation...

  16. Evaluation of the mechanism and principles of management of temporomandibular joint dislocation. Systematic review of literature and a proposed new classification of temporomandibular joint dislocation

    Science.gov (United States)

    2011-01-01

    Background Virtually all the articles in literature addressed only a specific type of dislocation. The aim of this review was to project a comprehensive understanding of the pathologic processes and management of all types of dislodgement of the head of the mandibular condyle from its normal position in the glenoid fossa. In addition, a new classification of temporomandibular joint dislocation was also proposed. Method and materials A thorough computer literature search was done using the Medline, Cochrane library and Embase database. Key words like temporo-mandibular joint dislocation were used for the search. Additional manual search was done by going through published home-based and foreign articles. Case reports/series, and original articles that documented the type of dislocation, number of cases treated in the series and original articles. Treatment done and outcome of treatment were included in the study. Result A total of 128 articles were reviewed out which 79 were found relevant. Of these, 26 were case reports, 17 were case series and 36 were original articles. 79 cases were acute dislocations, 35 cases were chronic protracted TMJ dislocations and 311 cases were chronic recurrent TMJ dislocations. Etiology was predominantly trauma in 60% of cases and other causes contributed about 40%. Of all the cases reviewed, only 4 were unilateral dislocation. Various treatment modalities are outlined in this report as indicated for each type of dislocation. Conclusion The more complex and invasive method of treatment may not necessarily offer the best option and outcome of treatment, therefore conservative approaches should be exhausted and utilized appropriately before adopting the more invasive surgical techniques. PMID:21676208

  17. Evaluation of the mechanism and principles of management of temporomandibular joint dislocation. Systematic review of literature and a proposed new classification of temporomandibular joint dislocation

    Directory of Open Access Journals (Sweden)

    Akinbami Babatunde O

    2011-06-01

    Full Text Available Abstract Background Virtually all the articles in literature addressed only a specific type of dislocation. The aim of this review was to project a comprehensive understanding of the pathologic processes and management of all types of dislodgement of the head of the mandibular condyle from its normal position in the glenoid fossa. In addition, a new classification of temporomandibular joint dislocation was also proposed. Method and materials A thorough computer literature search was done using the Medline, Cochrane library and Embase database. Key words like temporo-mandibular joint dislocation were used for the search. Additional manual search was done by going through published home-based and foreign articles. Case reports/series, and original articles that documented the type of dislocation, number of cases treated in the series and original articles. Treatment done and outcome of treatment were included in the study. Result A total of 128 articles were reviewed out which 79 were found relevant. Of these, 26 were case reports, 17 were case series and 36 were original articles. 79 cases were acute dislocations, 35 cases were chronic protracted TMJ dislocations and 311 cases were chronic recurrent TMJ dislocations. Etiology was predominantly trauma in 60% of cases and other causes contributed about 40%. Of all the cases reviewed, only 4 were unilateral dislocation. Various treatment modalities are outlined in this report as indicated for each type of dislocation. Conclusion The more complex and invasive method of treatment may not necessarily offer the best option and outcome of treatment, therefore conservative approaches should be exhausted and utilized appropriately before adopting the more invasive surgical techniques.

  18. Atomistic simulations of dislocation processes in copper

    DEFF Research Database (Denmark)

    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 sta......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...

  19. Financial Dislocations among Divorcing Families.

    Science.gov (United States)

    Little, Marilyn J.

    Extensive economic changes may be brought about by divorce. In an attempt to demonstrate that the degree of financial dislocation following divorce depends on three factors--custody arrangements, wife's employment, and social class--data on men's and women's employment, income, and support payments were gathered for 222 divorcing families. Total…

  20. Scattering of phonons by dislocations

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, A. C.

    1979-01-01

    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. = 10/sup 9/ 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.

  1. ARTHROSCOPIC TREATMENT OF ACROMIOCLAVICULAR JOINT DISLOCATION BY TIGHT ROPE TECHNIQUE (ARTHREX®)

    Science.gov (United States)

    GÓmez Vieira, Luis Alfredo; Visco, Adalberto; Daneu Fernandes, Luis Filipe; GÓmez Cordero, Nicolas Gerardo

    2015-01-01

    Presenting the arthroscopic treatment by Tight Rope - Arthrex® system for acute acromioclavicular dislocation and to evaluate results obtained with this procedure. Methods: Between August 2006 and May 2007, 10 shoulders of 10 patients with acute acromioclavicular dislocation were submitted to arthroscopic repair using the Tight Rope - Arthrex® system. Minimum follow-up was 12 months, with a mean of 15 months. Age ranged from 26 to 42, mean 34 years. All patients were male. Radiology evaluation was made by trauma series x-ray. The patients were assisted in the first month weekly and after three months after the procedure. Clinical evaluation was based on the University of California at Los Angeles (UCLA) criteria. Results: All patients were satisfied after the arthroscopic procedure and the mean UCLA score was 32,5. Conclusion: The arthroscopic treatment by Tight Rope – Arthrex® system for acute acromioclavicular dislocation showed to be an efficient technique. PMID:26998453

  2. Readmissions after fast-track hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Husted, Henrik; Otte, Niels Kristian Stahl; Kristensen, Billy B

    2010-01-01

    With the implementation of fast-track surgery with optimization of both logistical and clinical features, the postoperative convalescence has been reduced as functional milestones have been achieved earlier and consequently length of stay (LOS) in hospital has been reduced. However, it has been s...... speculated that a decrease in LOS may be associated with an increase in readmissions in general, including risk of dislocation after total hip arthroplasty (THA) or manipulation after total knee arthroplasty (TKA)....

  3. Surgical reduction in a delayed case of traumatic testicular dislocation.

    Science.gov (United States)

    Phuwapraisirisan, Samart; Lim, Meechai; Suwanthanma, Weerapat

    2010-11-01

    A 27-year-old Thai male was admitted with left groin pain and he felt that he lost his left testis three weeks after his motorcycle accident-car collision. He had not been diagnosed after four days of admission at the previous hospital. Surgical reduction was performed without acute and delayed complications after three months of follow-up. Traumatic testicular dislocation is an uncommon sequel of trauma usually related to straddle injury from motorcycle accidents. Diagnosis depends on the awareness of the physician of its possibility of occurrence. Physical examination is the most helpful in diagnosis. CT scan or Doppler ultrasound, if available, may be helpful in diagnosis, particularly locating the extrascrotal testicle and detecting testicular viability. Manual reduction is the treatment of choice for acute traumatic dislocation of testis. Open reduction is indicated for the delayed case, or if there are (1) difficulty in determining the integrity of dislocated testis, (2) possibility of torsion, (3) failure of close reduction, or (4) the minimal morbidity of an inguinal exploration.

  4. Solute drag on perfect and extended dislocations

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    Guruprasad, P. J.; Benzerga, A. A.

    2009-07-01

    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.

  6. Theory of interacting dislocations on cylinders.

    Science.gov (United States)

    Amir, Ariel; Paulose, Jayson; Nelson, David R

    2013-04-01

    We study the mechanics and statistical physics of dislocations interacting on cylinders, motivated by the elongation of rod-shaped bacterial cell walls and cylindrical assemblies of colloidal particles subject to external stresses. The interaction energy and forces between dislocations are solved analytically, and analyzed asymptotically. The results of continuum elastic theory agree well with numerical simulations on finite lattices even for relatively small systems. Isolated dislocations on a cylinder act like grain boundaries. With colloidal crystals in mind, we show that saddle points are created by a Peach-Koehler force on the dislocations in the circumferential direction, causing dislocation pairs to unbind. The thermal nucleation rate of dislocation unbinding is calculated, for an arbitrary mobility tensor and external stress, including the case of a twist-induced Peach-Koehler force along the cylinder axis. Surprisingly rich phenomena arise for dislocations on cylinders, despite their vanishing Gaussian curvature.

  7. Dislocation of the penis: a rare complication after traumatic pelvic injury.

    Science.gov (United States)

    Lim, Mei Chin; Srinivasan, Sivasubramanian; Teh, Hui Seong; Teh, Chang Peng Colin

    2015-01-01

    Traumatic injury to the male external genitalia is frequently encountered, but acute traumatic dislocation of the penile structure is extremely rare, with only a few reports found in the literature. We herein report the case of a 21-year-old man who sustained blunt trauma to the pelvis following a motor vehicle accident, and had features suspicious of penile dislocation. With the use of computed tomography and bedside ultrasonography, a diagnosis of penile dislocation was made, which was subsequently confirmed intraoperatively. Immediate surgical intervention via gentle manipulation of the penile tissue back to its native position was performed in order to restore normal anatomy. The exact mechanism of penile dislocation is not known. However, circumferential laceration around the foreskin causing degloving injury of the penis is suggested in our patient.

  8. Microprocessor prosthetic knees.

    Science.gov (United States)

    Berry, Dale

    2006-02-01

    This article traces the development of microprocessor prosthetic knees from early research in the 1970s to the present. Read about how microprocessor knees work, functional options, patient selection, and the future of this prosthetic.

  9. Prosthetic Knee Systems

    Science.gov (United States)

    ... Facebook Google Bookmarks Technorati Yahoo MyWeb Prosthetic Knee Systems Translated into plain language by Helen Osborne of ... Consulting Original article by Bill Dupes Prosthetic knee systems are among the most complex of all components. ...

  10. Partial knee replacement - slideshow

    Science.gov (United States)

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

  11. Knee braces - unloading

    Science.gov (United States)

    ... 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 ...

  12. Knee arthroscopy - slideshow

    Science.gov (United States)

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

  13. Knee joint replacement - slideshow

    Science.gov (United States)

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

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

    DEFF Research Database (Denmark)

    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)....

  15. Lattice dislocation in Si nanowires

    Energy Technology Data Exchange (ETDEWEB)

    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.

  16. Total knee arthroplasty

    DEFF Research Database (Denmark)

    Schrøder, Henrik M.; Petersen, Michael M.

    2016-01-01

    Total knee arthroplasty (TKA) is a successful treatment of the osteoarthritic knee, which has increased dramatically over the last 30 years. The indication is a painful osteoarthritic knee with relevant radiographic findings and failure of conservative measures like painkillers and exercise. Trea...

  17. Decreased Knee Joint Loading Associated With Early Knee Osteoarthritis After Anterior Cruciate Ligament Injury.

    Science.gov (United States)

    Wellsandt, Elizabeth; Gardinier, Emily S; Manal, Kurt; Axe, Michael J; Buchanan, Thomas S; Snyder-Mackler, Lynn

    2016-01-01

    Anterior cruciate ligament (ACL) injury predisposes individuals to early-onset knee joint osteoarthritis (OA). Abnormal joint loading is apparent after ACL injury and reconstruction. The relationship between altered joint biomechanics and the development of knee OA is unknown. Altered knee joint kinetics and medial compartment contact forces initially after injury and reconstruction are associated with radiographic knee OA 5 years after reconstruction. Case-control study; Level of evidence, 3. Individuals with acute, unilateral ACL injury completed gait analysis before (baseline) and after (posttraining) preoperative rehabilitation and at 6 months, 1 year, and 2 years after reconstruction. Surface electromyographic and knee biomechanical data served as inputs to an electromyographically driven musculoskeletal model to estimate knee joint contact forces. Patients completed radiographic testing 5 years after reconstruction. Differences in knee joint kinetics and contact forces were compared between patients with and those without radiographic knee OA. Patients with OA walked with greater frontal plane interlimb differences than those without OA (nonOA) at baseline (peak knee adduction moment difference: 0.00 ± 0.08 N·m/kg·m [nonOA] vs -0.15 ± 0.09 N·m/kg·m [OA], P = .014; peak knee adduction moment impulse difference: -0.001 ± 0.032 N·m·s/kg·m [nonOA] vs -0.048 ± 0.031 N·m·s/kg·m [OA], P = .042). The involved limb knee adduction moment impulse of the group with osteoarthritis was also lower than that of the group without osteoarthritis at baseline (0.087 ± 0.023 N·m·s/kg·m [nonOA] vs 0.049 ± 0.018 N·m·s/kg·m [OA], P = .023). Significant group differences were absent at posttraining but reemerged 6 months after reconstruction (peak knee adduction moment difference: 0.02 ± 0.04 N·m/kg·m [nonOA] vs -0.06 ± 0.11 N·m/kg·m [OA], P = .043). In addition, the OA group walked with lower peak medial compartment contact forces of the involved limb

  18. Knee Arthrodesis after failure of Knee Arthroplasty

    DEFF Research Database (Denmark)

    Gottfriedsen, Tinne B; Morville Schrøder, Henrik; Odgaard, Anders

    2016-01-01

    BACKGROUND: Arthrodesis is considered a salvage procedure after failure of a knee arthroplasty. Data on the use of this procedure are limited. The purpose of this study was to identify the incidence, causes, surgical techniques, and outcomes of arthrodesis after failed knee arthroplasty...... in a nationwide population. METHODS: Data were extracted from the Danish Civil Registration System, the Danish National Patient Register, and the Danish Knee Arthroplasty Register. A total of 92,785 primary knee arthroplasties performed in Denmark from 1997 to 2013 were identified by linking the data using....... Differences in cumulative incidence were compared with the Gray test. RESULTS: A total of 164 of the 165 arthrodeses were performed for causes related to failed knee arthroplasty. The 15-year cumulative incidence of arthrodesis was 0.26% (95% confidence interval, 0.21% to 0.31%). The 5-year cumulative...

  19. A survey of temporomandibular joint dislocation: aetiology, demographics, risk factors and management in 96 Nigerian cases.

    Science.gov (United States)

    Ugboko, V I; Oginni, F O; Ajike, S O; Olasoji, H O; Adebayo, E T

    2005-07-01

    A retrospective study of 96 cases of temporomandibular joint dislocation was undertaken. Patients' ages ranged from 9 to 85 years (mean+/-SD, 35.3+/-17.4 years) and peak incidence was at 20-29 years. Mean duration was 7.9 weeks (range, 1h to 3 years). Acute, chronic and recurrent dislocations were seen in 46 (47.9%), 29 (30.2%) and 21 (21.9%) patients, respectively. Males dominated in all three categories but this was not statistically significant (P = 0.8). Excessive mouth opening while yawning (44 cases) was the commonest cause of dislocation, followed by road traffic accidents (13 cases). Ten patients (10.4%) had an underlying systemic disease, the commonest being epilepsy (four cases); those with acute dislocation recorded the highest incidence of underlying illness. Bilateral anterior (86 cases) dislocations were the most frequent. Of the 96 patients, 89 (92.7%) were available for treatment. Manual reduction with or without anaesthesia proved effective for 38/45 acute, 5/24 chronic and 14/20 recurrent cases. Chronic dislocations were treated mainly by surgical osteotomy (13/24). Vertical subsigmoid and oblique ramus osteotomies were the commonest surgical techniques recorded. Treatment was satisfactory for all patients surgically handled except for one case of anterior open bite postoperatively. This study has shown that excessive mouth opening while yawning is the commonest cause of temporomandibular joint dislocation in Nigerians, and conservative approaches to management remain quite effective irrespective of the duration and clinical subtype. The best choice of surgical technique should be determined by proper clinical evaluation and the need to avoid or minimize postoperative morbidity.

  20. Surgical treatment for acute posterolateral structures injuries of the knee joint in 12 patients%12例急性膝关节后外侧结构损伤的手术治疗

    Institute of Scientific and Technical Information of China (English)

    王绍宏

    2012-01-01

    Objective ;To investigate the clinical results of surgical treatment for acute posterolaleral structures (PLS) injuries of knee joint. Methods:Twelve patients (12 knees) with acute PLS injuries were treated from May 2006 to October 2008,including 9 males and 3 females,ranging in age from 23 to 47 years,with an average of 31 years. Nine patients had posterior cruciate ligament (PCL) injuries,3 patients had both anterior cruciate ligament (ACL) and PCL injuries, and 7 patients had articular capsule injuries. The knee joint was explored under arthroscope and the meniscuses were repaired firstly, then the ACL was rebuilt,as well as the PCL and PLS at the same time. The popliteus muscle tendon unit( PMTU) and the lateral collateral ligament (LCL) were anatomy reconstructed using variant tendon according to the degree of injury. The cruciate ligament reconstructed and fixed after the PLS reconstruction. The capsule tears were treated by reinforced suture techniques in the end. IKDC and Lysholm score were used to evaluate the postoperative knee joint function. Results; All the patients were followed up,and the duration ranged from 12 to 24 months,with an average of (16.5±3.2) months. According to IKDC standard,8 cases restored to normal(grade A),3 caseB near to normal(grade B) and 1 poor(grade C). The preoperative Lysholm joint function score was (39.6±3.1) and improved to (85.1 ±2.2) after surgery. All the patients were satisfied with their operation because of no-swelling and no-pain of the knee joint. Conclusion:The acute PLS injuries should be repaired with anatomy reconstruction of the PMTU and LCL which were the most important structure of the PLS. The operative procedure required accurate establishment of the bone tunnel,protectionof fibular nerve,and avoiding the incision of the variant tendon,thus can make the PLS more stable after the reconstruction.%目的:探讨急性膝关节后外侧结构(posterolateral structures,PLS)损伤

  1. Dislocation nucleation in heteroepitaxial semiconducting films

    Energy Technology Data Exchange (ETDEWEB)

    Pichaud, B.; Burle, N.; Texier, M.; Alfonso, C.; Gailhanou, M.; Thibault-Penisson, J. [IM2NP UMR6242 CNRS, Aix-Marseille University, Marseille (France); Fontaine, C. [LAAS CNRS, Toulouse (France); Vdovin, V.I. [Institute for Chemical Problems of Microelectronics, Moscow (Russian Federation)

    2009-08-15

    The nucleation of dislocation in semiconductors is still a matter of debate and especially in heteroepitaxial films. To understand this nucleation process the classical models of dislocation nucleation are presented and criticized. Two main points are then developed: emission of dislocations from surface steps and the role of point defects agglomeration on dislocation nucleation. Recent atomic simulation of half loops emission from surface steps and experimental evidences of anisotropic relaxation of GaInAs films deposited on vicinal (111)GaAs substrates strongly support surface steps as preferential sites for nucleation. In low temperature buffer layer structures (SiGe/Si) an original dislocation structure is observed which corresponds to the dislocation emission in different glide systems by a unique nucleation centre. (copyright 2009 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim) (orig.)

  2. MOVING SCREW DISLOCATION IN CUBIC QUASICRYSTAL

    Institute of Scientific and Technical Information of China (English)

    ZHOU Wang-min; SONG Yu-hai

    2005-01-01

    The elasticity theory of the dislocation of cubic quasicrystals is developed.The governing equations of anti-plane elasticity dynamics problem of the quasicrystals were reduced to a solution of wave equations by introducing displacement functions,and the analytical expressions of displacements, stresses and energies induced by a moving screw dislocation in the cubic quasicrystalline and the velocity limit of the dislocation were obtained. These provide important information for studying the plastic deformation of the new solid material.

  3. Imaging findings of anterior hip dislocations

    Energy Technology Data Exchange (ETDEWEB)

    Pfeifer, Kyle [Mallinckrodt Institute of Radiology, Department of Radiology, St. Louis, MO (United States); Leslie, Michael [Yale School of Medicine, Department of Orthopedics and Rehabilitation, New Haven, CT (United States); Menn, Kirsten; Haims, Andrew [Yale University School of Medicine, Department of Radiology and Biomedical Imaging, New Haven, CT (United States)

    2017-06-15

    Anterior hip dislocations are rare orthopedic emergencies resulting from high-energy trauma and have unique imaging characteristics on radiography, computed tomography (CT), and magnetic resonance imaging (MRI). Imaging findings on CT and MRI allow for the prompt recognition and classification of anterior hip dislocations, which guides patient management and reduces complications. The purpose of this article is to review imaging findings of anterior hip dislocations, specifically focusing on CT and MRI. (orig.)

  4. Analogy betwen dislocation creep and relativistic cosmology

    OpenAIRE

    J.A. Montemayor-Aldrete; J.D. Muñoz-Andrade; Mendoza-Allende, A.; Montemayor-Varela, A.

    2005-01-01

    A formal, physical analogy between plastic deformation, mainly dislocation creep, and Relativistic Cosmology is presented. The physical analogy between eight expressions for dislocation creep and Relativistic Cosmology have been obtained. By comparing the mathematical expressions and by using a physical analysis, two new equations have been obtained for dislocation creep. Also, four new expressions have been obtained for Relativistic Cosmology. From these four new equations, one may determine...

  5. A Numeric Study on Chaotic Dislocation Emission

    Institute of Scientific and Technical Information of China (English)

    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.

  6. Epidemiology of Isolated Acromioclavicular Joint Dislocation

    Directory of Open Access Journals (Sweden)

    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.

  7. Structure of the Dislocation in Sapphire

    DEFF Research Database (Denmark)

    Bilde-Sørensen, Jørgen; Thölen, A. R.; Gooch, D. J.;

    1976-01-01

    of ⅓ 01 0 and are separated by two identical faults. The distance between two partials is in the range 75-135 Å, corresponding to a fault energy of 320±60 mJ/m2. Perfect 01 0 dislocations have also been observed. These dislocations exhibited either one or two peaks when imaged in the (03 0) reflection......Experimental evidence of the existence of 01 0 dislocations in the {2 0} prism planes in sapphire has been obtained by transmission electron microscopy. By the weak-beam technique it has been shown that the 01 0 dislocations may dissociate into three partials. The partials all have a Burgers vector...

  8. The Unique Macroscopic Appearance of Gouty Arthritis of the Knee.

    Science.gov (United States)

    Mittl, Gregory S; Zuckerman, Joseph D

    2015-07-01

    Patients with significant gouty arthritis can develop disabling joint pain secondary to monosodium urate (MSU) articular deposition. We report a case of white, chalky MSU crystal deposition covering the articular surfaces of the knee as discovered by total knee arthroplasty. A 65-year-old male with a history of gout presented with bilateral knee pain. His radiographic imaging was negative for gouty tophi, and he elected to undergo left total knee arthroplasty. Intraoperatively a distinct chalky, white paste consistent with MSU deposition was observed covering the articular surfaces of the knee consistent with the diagnosis of gouty arthritis. Gout is the most common inflammatory arthritis affecting more than 3 million people in the USA. The inflammation results from the phagocytosis of monosodium urate crystals (MSU) and the release of inflammatory cytokines within the joint. Gout progresses from acute to chronic over many years and frequently causes chronic arthropathy. When significant knee pain and disability is associated with gouty arthropathy, total knee arthroplasty is certainly an option. The pathological appearance of gouty joints is characteristic. Macroscopic examination of joints affected by gout reveals a nodular, white, chalky appearance. Polarized microscopy of gout demonstrates negative birefringent needle-shaped MSU crystals. In this case report, we describe the characteristic chalky, white MSU deposit that covers the articular surfaces of a knee joint in a patient with a history of gout undergoing total knee arthroplasty. The investigators have obtained the patient's informed written consent for print and electronic publication of the case report.

  9. Arthroscopic findings after shoulder dislocation

    Directory of Open Access Journals (Sweden)

    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.

  10. Rotational dislocation of the thoracolumbar spine. Case report and review of the literature.

    Science.gov (United States)

    Debnath, Ujjwal K; Maripuri, Subramanyam Naidu; Mobini, Bahram; Etemadifar, Mohamed R; Mehdian, Syed M Hossein

    2007-02-01

    The authors report a rare case of rotational dislocation of the thoracolumbar spine in a 12-year-old girl with neurofibromatosis Type 1. The patient had progressive spinal kyphoscoliosis with acute-onset paraplegia. She was treated with corrective traction preoperatively, followed by spinal decompression and circumferential spinal fusion without instrumentation. She had complete neurological recovery after a solid fusion of her spine.

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

    Science.gov (United States)

    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〈111〉{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.

  12. Dynamic control of knee axial deformities

    Directory of Open Access Journals (Sweden)

    E. E. Malyshev

    2013-01-01

    Full Text Available The authors have evaluated the clinical examination of the patients with axial malalignments in the knee by the original method and device which was named varovalgometer. The measurements were conducted by tension of the cord through the spina iliaca anterior superior and the middle of the lower pole of patella. The deviation of the center of the ankle estimated by metal ruler which was positioned perpendicular to the lower leg axis on the level of the ankle joint line. The results of comparison of our method and computer navigation in 53 patients during the TKA show no statistically significant varieties but they differ by average 5° of valgus in clinical examination in comparison with mechanical axis which was identified by computer navigation. The dynamic control of axial malalignment can be used in clinical practice for estimation of the results of treatment of pathology with axial deformities in the knee; for the control of reduction and secondary displacement of the fractures around the knee; for assessment of instability; in planning of correctional osteotomies and intraoperative control of deformity correction; for estimation of Q angle in subluxation and recurrent dislocation of patella; in planning of TKA; during the growth of child it allows to assess the progression of deformity.

  13. Dislocation

    Science.gov (United States)

    To help prevent injuries in children: Create a safe environment around your home. Help prevent falls by placing ... no substitute for close supervision, no matter how safe the environment or situation appears to be. Teach children how ...

  14. "Dislocation"

    Institute of Scientific and Technical Information of China (English)

    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.

  15. Dislocations

    Science.gov (United States)

    ... sure kids wear the appropriate safety gear during sports activities. Supervise children when they're playing — a hard fall can happen anywhere, anytime. Avoid tugging hard on a young child's arm or shoulder, which can cause injury or ...

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

    Directory of Open Access Journals (Sweden)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  18. Arthrofibrosis of the knee following ligament surgery.

    Science.gov (United States)

    DeHaven, Kenneth E; Cosgarea, Andrew J; Sebastianelli, Wayne J

    2003-01-01

    Arthrofibrosis of the knee is one of the most serious complications that can result from ligament surgery. Reported incidence of arthrofibrosis following anterior cruciate ligament reconstruction ranges from 4% to 35%. The loss of motion caused by arthrofibrosis can be even more disabling than the instability for which the reconstruction was performed, often requiring extensive physical therapy and/or surgical lysis of adhesions. With aggressive rehabilitation and modifications in the bracing of knees undergoing ligament reconstruction, the incidence of this complication has decreased significantly. Additionally, delaying anterior cruciate ligament reconstruction until the acute inflammatory period has resolved has also been shown to be a significant factor in the reduction of postoperative knee stiffness.

  19. Dislocated interests and climate change

    Science.gov (United States)

    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.

  20. Formation of disorientations in dislocation structures during plastic deformation

    DEFF Research Database (Denmark)

    Pantleon, W.

    2002-01-01

    Disorientations developing during plastic deformation in dislocation structures are investigated. Based on expected mechanisms for the formation of different types of dislocation boundaries (statistical trapping of dislocations or differently activated slip systems) the formation of the disorient...

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

    Institute of Scientific and Technical Information of China (English)

    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.

  2. Dislocation pinning effects on fracture behavior: Atomistic and dislocation dynamics simulations

    Science.gov (United States)

    Noronha, S. J.; Farkas, D.

    2002-10-01

    We introduce an approach in which results from atomistic simulations are combined with discrete dislocation dynamics simulations of crack-tip plasticity. The method is used to study the effects of dislocation pinning due to grain boundaries or secondary particles on the fracture behavior of aluminum. We find that the fracture resistance is reduced with decreasing pinning distance. The results show that the pinning of the dislocations causes a net decrease in the shear stress projected on the slip plane, preventing further dislocation emission. Semibrittle cleavage occurs after a certain number of dislocations is emitted.

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

    Energy Technology Data Exchange (ETDEWEB)

    Xu Yuhua [College of Information Science and Technology, Donghua University, Shanghai 201620 (China) and Department of Maths, Yunyang Teacher' s College, Hubei 442000 (China)], E-mail: yuhuaxu2004@163.com; Zhou Wuneng [College of Information Science and Technology, Donghua University, Shanghai 201620 (China)], E-mail: wnzhou@163.com; Fang Jianan [College of Information Science and Technology, Donghua University, Shanghai 201620 (China)

    2009-11-15

    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.

  4. Interactions between Dislocations and Grain Boundaries

    NARCIS (Netherlands)

    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

  5. Statistics of dislocation pinning at localized obstacles

    Energy Technology Data Exchange (ETDEWEB)

    Dutta, A. [S. N. Bose National Centre for Basic Sciences, Salt Lake, Kolkata 700098 (India); Bhattacharya, M., E-mail: mishreyee@vecc.gov.in; Barat, P. [Variable Energy Cyclotron Centre, 1/AF Bidhannagar, Kolkata 700064 (India)

    2014-10-14

    Pinning of dislocations at nanosized obstacles like precipitates, voids, and bubbles is a crucial mechanism in the context of phenomena like hardening and creep. The interaction between such an obstacle and a dislocation is often studied at fundamental level by means of analytical tools, atomistic simulations, and finite element methods. Nevertheless, the information extracted from such studies cannot be utilized to its maximum extent on account of insufficient information about the underlying statistics of this process comprising a large number of dislocations and obstacles in a system. Here, we propose a new statistical approach, where the statistics of pinning of dislocations by idealized spherical obstacles is explored by taking into account the generalized size-distribution of the obstacles along with the dislocation density within a three-dimensional framework. Starting with a minimal set of material parameters, the framework employs the method of geometrical statistics with a few simple assumptions compatible with the real physical scenario. The application of this approach, in combination with the knowledge of fundamental dislocation-obstacle interactions, has successfully been demonstrated for dislocation pinning at nanovoids in neutron irradiated type 316-stainless steel in regard to the non-conservative motion of dislocations. An interesting phenomenon of transition from rare pinning to multiple pinning regimes with increasing irradiation temperature is revealed.

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

    Science.gov (United States)

    .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) • ...

  7. Dislocation generation during early stage sintering.

    Science.gov (United States)

    Sheehan, J. E.; Lenel, F. V.; Ansell, G. S.

    1973-01-01

    Discussion of the effects of capillarity-induced stresses on dislocations during early stage sintering. A special version of Hirth's (1963) theoretical calculation procedures modified to describe dislocation nucleation on planes meeting the sintering body's neck surface obliquely is shown to predict plastic flow at stress levels know to exist between micron size metal particles in the early stages of sintering.

  8. Imaging of knee arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Theodore T. [Department of Radiology, North Shore University Hospital, 825 Northern Blvd., Great Neck, NY 11021 (United States)]. E-mail: TMiller@NSHS.edu

    2005-05-01

    Knee replacement surgery, either with unicompartmental or total systems, is common. The purpose of this manuscript is to review the appearance of normal knee arthroplasty and the appearances of complications such as infection, polyethylene wear, aseptic loosening and particle-induced osteolysis, patellofemoral abnormalities, axial instability, and periprosthetic and component fracture. Knowledge of the potential complications and their imaging appearances will help the radiologist in the diagnostic evaluation of the patient with a painful knee arthroplasty.

  9. Dislocation patterning in a two-dimensional continuum theory of dislocations

    Science.gov (United States)

    Groma, István; Zaiser, Michael; Ispánovity, Péter Dusán

    2016-06-01

    Understanding the spontaneous emergence of dislocation patterns during plastic deformation is a long standing challenge in dislocation theory. During the past decades several phenomenological continuum models of dislocation patterning were proposed, but few of them (if any) are derived from microscopic considerations through systematic and controlled averaging procedures. In this paper we present a two-dimensional continuum theory that is obtained by systematic averaging of the equations of motion of discrete dislocations. It is shown that in the evolution equations of the dislocation densities diffusionlike terms neglected in earlier considerations play a crucial role in the length scale selection of the dislocation density fluctuations. It is also shown that the formulated continuum theory can be derived from an averaged energy functional using the framework of phase field theories. However, in order to account for the flow stress one has in that case to introduce a nontrivial dislocation mobility function, which proves to be crucial for the instability leading to patterning.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  11. THERMODYNAMIC VARIATIONAL APPROACH FOR CLIMB OF AN EDGE DISLOCATION

    Institute of Scientific and Technical Information of China (English)

    Yunxin Gao; A.C.F. Cocks

    2009-01-01

    A general thermodynamic variational approach is applied to study the force on an edge dislocation, which drives the dislocation to climb. Our attention is focused on the physical mechanism responsible for dislocation climb. A dislocation in a material element climbs as a result of vacancies diffusing into or out from the dislocation core, with the dislocation acting as a source or a sink for vacancy diffusion in the material element. The basic governing equations for dislocation climb and the climb forces on the dislocation are obtained naturally as a result of the present thermodynamic variational approach.

  12. Clinical and radiographic predictors of acute compartment syndrome in the treatment of tibial plateau fractures: a retrospective cohort study.

    Science.gov (United States)

    Gamulin, Axel; Lübbeke, Anne; Belinga, Patrick; Hoffmeyer, Pierre; Perneger, Thomas V; Zingg, Matthieu; Cunningham, Gregory

    2017-07-18

    The aim of the study was to evaluate the relation between demographic, injury-related, clinical and radiological factors of patients with tibial plateau fractures and the development of acute compartment syndrome. All consecutive adult patients with intra-articular tibial plateau fractures admitted in our urban academic medical centre between January 2005 and December 2009 were included in this retrospective cohort study. The main outcome measurement was the development of acute compartment syndrome. The charts of 265 patients (mean age 48.6 years) sustaining 269 intra-articular tibial plateau fractures were retrospectively reviewed. Acute compartment syndrome occurred in 28 fractures (10.4%). Four patients presented bilateral tibial plateau fractures; of them, 2 had unilateral, but none had bilateral acute compartment syndrome. Non-contiguous tibia fracture or knee dislocation and higher AO/OTA classification (type 41-C) were statistically significantly associated with the development of acute compartment syndrome in multivariable regression analysis, while younger age (compartment syndrome seemed unlikely during initial assessment. However, larger studies are mandatory to confirm and refine both factors in predicting the occurrence of acute compartment syndrome.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. The functional results of treatment of perilunate dislocations with volar approach and K-wires fixation

    Directory of Open Access Journals (Sweden)

    Hakan Basar

    2012-04-01

    Conclusion: Perilunate dislocations are rare and severe wrist injuries. Acute perilunate dislocations are usually relatively easy to reduce however carpal collaps and post-travmatic arthritis are seen usually during late period.Because of this open reduction and internal fixation technique is used to prevent carpal collaps and post-travmatic arthritis and to facilitate anatomic reduction.Our results show that open reduction and internal fixation with K-wire can restore affectively normal carpal relationship, providing acceptable grip strength and functional motion,also carpal collaps and post-travmatic arthritis were prevented. [Hand Microsurg 2012; 1(1.000: 17-21

  15. PHYSICAL THERAPY INTERVENTION FOR MEDIAL PATELLOFEMORAL LIGAMENT RECONSTRUCTION AFTER REPEATED LATERAL PATELLAR SUBLUXATION/DISLOCATION

    Science.gov (United States)

    Mooney, Brianne; Vitale, Ashley; Apergis, Demitra; Wirth, Stephen; Grossman, Mark G.

    2016-01-01

    ABSTRACT Background The incidence of patellar subluxation or dislocation has been documented up to 43/100,000 with females more prevalent then males. There are many contributing factors involving the hip, knee, and ankle that lead to patellar subluxation. A patellar position of lateral tilt with lateral glide may indicate weakness of the vastus medialis oblique (VMO) and adductors, increased tightness in the iliotibial band, and overpowering of the vastus lateralis. Patella alta can predispose an individual to lateral dislocation due to the patella placement outside of the femoral trochlear groove with a disadvantage of boney stability. Other factors that may cause the patella to laterally sublux or dislocate during a functional activity or sporting activity include a position of femoral external rotation, tibial internal rotation, and excessive contraction of the vastus lateralis. The medial patellofemoral ligament (MPFL) aids in the prevention of a lateral patellar subluxation or dislocation. In cases where there is recurrent subluxation/dislocation and Magnetic Resonance Imaging confirms a MPFL tear, a reconstruction may be the treatment of choice. Purpose The purpose of this case series is to describe the post-surgical physical therapy management of MPFL reconstructions, outcomes using the Modified Cincinnati Knee Outcome Measure (MCKOM) and to propose staged physical therapy interventions for this pathology in the form of a treatment progression. Methods Post-operative management data and outcomes were retrospectively collected using a detailed chart review methodology from seven subjects who underwent MPFL reconstruction. Findings The Modified Cincinnati Knee Outcome Measure (MCKOM) was analyzed for each participant in four sections that were most important to the return and maintenance of participation in sport. At follow-up the mean scores for the seven subjects in Section 3 (instability) was 19.3/20, Section 4 (overall activity level) was 17.3/20, Section

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

    Directory of Open Access Journals (Sweden)

    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.

  17. 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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Qian [Iowa State Univ., Ames, IA (United States)

    2008-01-01

    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.

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

    Science.gov (United States)

    Denard, Patrick J.; Dai, Xuesong; 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. Patients with 25% glenoid bone loss were treated with Latarjet reconstruction. Number of dislocations and total dislocation time were examined for their relationship with the treatment method. Results: Ten arthroscopic Bankart repairs, 13 arthroscopic Bankart plus remplissage procedures, and 9 Latarjet reconstructions were available for review. Total dislocations (P = 0.012) and total hours of dislocation (P = 0.019) increased from the Bankart, to the remplissage, to the Latarjet groups. Patients with a total dislocation time of 5 h or more were more likely to require a Latarjet reconstruction (P = 0.039). Patients with only 1 preoperative dislocation were treated with an isolated Bankart repair in 64% (7 of 11) of cases, whereas those with 2 or more dislocations required a bone loss procedure in 86% (18 of 21) of cases (P = 0.013). Conclusion: Increasing number of dislocations and total dislocation time are associated with the development of glenoid and humeral head bony lesions that alter surgical management of anterior shoulder instability. The necessity for the addition of a remplissage to an arthroscopic Bankart repair or the use of a Latarjet reconstruction increases with only 1 recurrent dislocation. Level of evidence: Level III, retrospective comparative study. PMID:25709237

  20. 磁共振成像对膝关节急性软骨损伤的研究%The study of magnetic resonance imaging in acute cartilage injury of knee joint

    Institute of Scientific and Technical Information of China (English)

    王宗博; 牛广明; 于静红; 吴琼

    2016-01-01

    Objective To study optimized sequence in acute cartilage injury of knee joint used fiber 1.5 T magnetic resonance imaging, and its diagnostic value in different levels of damage.Methods We colleted 40 patients of acute knee trauma, conduc-ted conventional scanning and sequence of FS-3D-SPRG (fast), MERGE, Fiesta-c.These patients underwent arthroscopic or sur-gery treatment after two weeks.The clinical and arthroscopic results were used as gold standard, in evaluation of accuracy, sensi-tivity, specificity and Kappa value of the above sequence in different levels of cartilage damage.Results The sensitivity of FS-3D-SPRG (fast) sequence was 94.29%, specificity was 95.29%, Kappa value was 0.793, sensitivity was 92.21%, specificity was 98.16%, Kappa value was 0.896, sensitivity was 90.54%, specificity was 95.18%, Kappa value was 0.558.Conclusion 1) Fiesta-c has better cartilage /joint fluid, cartilage/bone contrast, the degree of conformity of clinical surgery is very high, es-pecially, the display of the cartilage calcification is the most clear;2) As 3D-FS-SPRG( fast) parameter changes, the scan time was significantly shorter ( only 11 minutes and 3 seconds) , and good results were also obtained in this experiment.For acute inju-ry of knee joint, used the chonges in 3D-FS-SPGR (fast) sequence parameters, scanning time was significantly shortened (only 11 points 2 seconds) , this experiment has also been a good effect, which can be used as the optimized sequence of cartilage inju-ry, but have false negative in low level of cartilage damage;3) 3D-FS-SPGR sequence can be used as a reference value for the di-agnosis of MIP, which can get visual cartilage image;4) MERGE sequence in this study, whether from cartilage, or with the clin-ical results of the control, less than PDWI, Fiesta-c, 3D-FS-SPGR sequence.%目的:探讨光纤1.5T磁共振在膝关节急性软骨损伤时的序列优化,及其在不同级别损伤中的诊断价值。方法收集40例急性膝关

  1. Ultrasonic Study of Dislocation Dynamics in Lithium -

    Science.gov (United States)

    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.

  2. Total knee arthroplasty treatment of rheumatoid arthritis with severe versus moderate flexion contracture.

    Science.gov (United States)

    Yan, Denglu; Yang, Jing; Pei, Fuxing

    2013-11-15

    This study aims to explore the technique of soft tissue balance and joint tension maintenance in total knee arthroplasty (TKA) for the rheumatoid arthritis (RA) patients with flexion contracture of the knee. This retrospective study reviewed flexion contracture deformity of RA patients who underwent primary TKA and ligament and soft tissue balancing. Based on the flexion contracture deformity, the remaining 76 patients available for analysis were divided into two groups, i.e., severe flexion group (SF) and moderate flexion group (MF). There were no intraoperative complications in this study. All patients had improved Knee Society Rating System scores and range of motion. The flexion contracture was completely corrected in MF and SF patients. There were no cases of patellar dislocation, but three cases had mild mediolateral instability in severe flexion group. Four knees (two knees in SF versus two knees in MF) had transient peroneal nerve palsy but recovered after conservative therapy. TKA can be performed successfully in the RA knees with severe flexion contracture. It is very important in TKA to maintain the joint stability in the condition of severe flexion contracture deformity of the RA knee.

  3. Treatment of cervical dislocation with locked facets

    Institute of Scientific and Technical Information of China (English)

    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.

  4. Distribution of distances between dislocations in different types of dislocation substructures in deformed Cu-Al alloys

    Energy Technology Data Exchange (ETDEWEB)

    Trishkina, L., E-mail: trishkina.53@mail.ru; Zboykova, N.; Koneva, N., E-mail: koneva@tsuab.ru; Kozlov, E. [Tomsk State University of Architecture and Building, 2 Solyanaya St., Tomsk, 634003 (Russian Federation); Cherkasova, T. [Tomsk State University of Architecture and Building, 2 Solyanaya St., Tomsk, 634003 (Russian Federation); National Research Tomsk Polytechnic University, 50 Lenin Ave., Tomsk, 634050 (Russian Federation)

    2016-01-15

    The aim of the investigation was the determination of the statistic description of dislocation distribution in each dislocation substructures component forming after different deformation degrees in the Cu-Al alloys. The dislocation structures were investigated by the transmission diffraction electron microscopy method. In the work the statistic description of distance distribution between the dislocations, dislocation barriers and dislocation tangles in the deformed Cu-Al alloys with different concentration of Al and test temperature at the grain size of 100 µm was carried out. It was established that the above parameters influence the dislocation distribution in different types of the dislocation substructures (DSS): dislocation chaos, dislocation networks without disorientation, nondisoriented and disoriented cells, in the walls and inside the cells. The distributions of the distances between dislocations in the investigated alloys for each DSS type formed at certain deformation degrees and various test temperatures were plotted.

  5. Pneumatic osteoarthritis knee brace.

    Science.gov (United States)

    Stamenović, Dimitrije; Kojić, Milos; Stojanović, Boban; Hunter, David

    2009-04-01

    Knee osteoarthritis is a chronic disease that necessitates long term therapeutic intervention. Biomechanical studies have demonstrated an improvement in the external adduction moment with application of a valgus knee brace. Despite being both efficacious and safe, due to their rigid frame and bulkiness, current designs of knee braces create discomfort and difficulties to patients during prolonged periods of application. Here we propose a novel design of a light osteoarthritis knee brace, which is made of soft conforming materials. Our design relies on a pneumatic leverage system, which, when pressurized, reduces the excessive loads predominantly affecting the medial compartment of the knee and eventually reverses the malalignment. Using a finite-element analysis, we show that with a moderate level of applied pressure, this pneumatic brace can, in theory, counterbalance a greater fraction of external adduction moment than the currently existing braces.

  6. Musculoskeletal MR: knee

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  7. Transient medial patellar dislocation: injury patterns at US and MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Le Corroller, Thomas; Champsaur, Pierre [Hopital Sainte-Marguerite, Radiology Department, Marseille (France); Faculte de Medecine de Marseille, Anatomy Department, Marseille (France); Dediu, Melania [Hopital Sainte-Marguerite, Radiology Department, Marseille (France)

    2009-05-15

    Medial dislocation of the patella is an unusual entity. It is usually an iatrogenic complication of surgical lateral retinacular release. We describe the clinical, ultrasound (US), and magnetic resonance (MR) imaging features of a transient medial patellar dislocation in a 19-year-old patient with trochlear groove dysplasia presenting no surgical history. US showed acute injury to the lateral patellar retinaculum with complete avulsion at its patellar insertion. MR imaging confirmed the complete tear of the lateral patellar retinaculum and disclosed contusion of the anteromedial portion of the medial femoral condyle and lateral patella. This case is noteworthy because the injury patterns of patellar soft tissue restraints differ markedly from the classical features of lateral patellar dislocation. (orig.)

  8. Shape memory alloy smart knee spacer to enhance knee functionality: model design and finite element analysis.

    Science.gov (United States)

    Gautam, Arvind; Rani, A Bhargavi; Callejas, Miguel A; Acharyya, Swati Ghosh; Acharyya, Amit; Biswas, Dwaipayan; Bhandari, Vasundhra; Sharma, Paresh; Naik, Ganesh R; Gautam, Arvind; Rani, A Bhargavi; Callejas, Miguel A; Acharyya, Swati Ghosh; Acharyya, Amit; Biswas, Dwaipayan; Bhandari, Vasundhra; Sharma, Paresh; Naik, Ganesh R; Acharyya, Swati Ghosh; Sharma, Paresh; Bhandari, Vasundhra; Rani, A Bhargavi; Gautam, Arvind; Biswas, Dwaipayan; Callejas, Miguel A; Acharyya, Amit

    2016-08-01

    In this paper we introduce Shape Memory Alloy (SMA) for designing the tibial part of Total Knee Arthroplasty (TKA) by exploiting the shape-memory and pseudo-elasticity property of the SMA (e.g. NiTi). This would eliminate the drawbacks of the state-of-the art PMMA based knee-spacer including fracture, sustainability, dislocation, tilting, translation and subluxation for tackling the Osteoarthritis especially for the aged people of 45-plus or the athletes. In this paper a Computer Aided Design (CAD) model using SolidWorks for the knee-spacer is presented based on the proposed SMA adopting the state-of-the art industry-standard geometry that is used in the PMMA based spacer design. Subsequently Ansys based Finite Element Analysis is carried out to measure and compare the performance between the proposed SMA based model with the state-of-the art PMMA ones. 81% more bending is noticed in the PMMA based spacer compared to the proposed SMA that would eventually cause fracture and tilting or translation of spacer. Permanent shape deformation of approximately 58.75% in PMMA based spacer is observed compared to recoverable 11% deformation in SMA when same load is applied on both separately.

  9. Surgical versus non-surgical management for primary patellar dislocations: an up-to-date meta-analysis.

    Science.gov (United States)

    Zheng, Xiaozuo; Kang, Kai; Li, Tong; Lu, Bo; Dong, Jiangtao; Gao, Shijun

    2014-12-01

    The aim of this up-to-date meta-analysis was to compare the effects of surgical versus non-surgical treatment of patients following primary patellar dislocation and to provide the best evidence currently available. A comprehensive literature search was conducted using multiple databases, including Medline, Embase, and Cochrane Registry of Clinical Trials. All databases were searched from the earliest records to May 2013. Eligible studies were selected, and data were extracted by two independent investigators. The primary outcome variable was the frequency of recurrent patellar dislocation. The other outcomes included knee function scores, patient-rated outcomes, and radiographic examination. If appropriate, meta-analysis of these variables was performed. Nine independent trials were found to match the inclusion criteria. The pooled results demonstrated that the incidence of recurrent patellar dislocation and Hughston visual analog scale was significantly lower in the surgical treatment group than that in the non-surgical treatment group (P 0.05). This up-to-date meta-analysis indicates that surgical treatment was associated with a lower risk of recurrent patellar dislocation, but a lower Hughston VAS than non-surgical treatment for primary patellar dislocation. More large high-quality trials and further studies are needed to overcome the limitations of small sample sizes, and varieties of different surgical procedures or non-surgical management strategies adopted in the included trials.

  10. Radiologic findings in cases involving complications arising from total knee arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Deok Ho; Ryu, Kyung Nam; Bae, Dae Kyung [Kyunghee Univ. Hospital, Seoul (Korea, Republic of)

    1999-09-01

    Total knee arthroplasty(TKA) has been used for the treatment of knee joint pain, deformity, and instability caused by osteoarthritis, rheumatoid arthritis, or tuberculous arthritis, and by virtue of good results and rapid development, the procedure has been increasingly employed. With the development of total knee prosthesis, complications have also increased, however, and due to complications occurring up to six years after surgery, fusion occurs in about 2% of all replaced knees. The most common complication of TKA is loosening, followed by infection. Others are thrombosis, subluxation, dislocation and fracture, and complications may be divided into four groups: biologic, technical, specific to type of components, and associated with certain diagnosis. Where these complications occur, a patient must undergo a second procedure, but the success rate is lower than for the initial procedure. Exact etiological evaluation important clinically and radiologically. We illustrate the etiologies and radiologic characteristics of TKA complications according to classification.

  11. Mechanisms for decoration of dislocations by small dislocation loops under cascade damage conditions

    DEFF Research Database (Denmark)

    Trinkaus, H.; Singh, B.N.; Foreman, A.J.E.

    1997-01-01

    In metals under cascade damage conditions, dislocations are frequently found to be decorated with a high density of small clusters of self-interstitial atoms (SIAs) in the form of dislocation loops, particularly during the early stages of the microstructural evolution in well annealed pure metals....... This effect may arise as a result of either (a) migration and enhanced agglomeration of single SIAs in the form of loops in the strain field of the dislocation or (b) glide and trapping of SIA loops (produced directly in the cascades) in the strain field of the dislocation, In the present paper, both...... of these possibilities are examined. It is shown that the strain field of the dislocation causes a SIA depletion in the compressive as well as in the dilatational region resulting in a reduced rather than enhanced agglomeration of SIAs. (SIA depletion may, however, induce enhanced vacancy agglomeration near dislocations...

  12. Diagnostic Value of High Frequency Ultrasound in Acute and Chronic Injury of Tendon and Medial Collateral Ligament of Knee Joint%高频超声对膝关节肌腱及内侧副韧带急慢性损伤的诊断价值

    Institute of Scientific and Technical Information of China (English)

    赖荣仙

    2016-01-01

    Objective To explore the highfrequency ultrasound for knee tendon and the diagnostic value of the medial vice toughening of acute or chronic injury.Methods Our hospital 96 knee tendon or medial vice toughening of acute or chronic injury patients using high frequency ultrasound examination,the record of high frequency ultrasound image analysis.Results All 96 patients was diagnosed,including 44 patients with injury of medial collateral ligament,accounting for 45.8%of the total number of patients.Patellar tendon,tendon disease 31,accounting for 32.3%of the total.15 patients with injury of meniscus,accounting for 15.6%of the total.Damage to the iliotibial band six,accounting for 6.25%of the total patients.Conclusion High frequency ultrasound on knee tendon and medial collateral ligament acute or chronic damage diagnosis accuracy is higher,it can be used as knee tendon and medial collateral ligament best methods for the diagnosis of acute or chronic damage image.%目的探究高频超声波对膝关节肌腱及内侧副韧急慢性损伤的诊断价值.方法对本院的96例膝关节肌腱或内侧副韧急慢性损伤的患者利用高频超声进行检查,对记录的高频超声图像进行分析研究.结果96例患者的病情全部确诊,其中内侧副韧带损伤患者44例,占患者总人数中的45.8%.髌腱肌腱病31例,占总人数的32.3%.半月板损伤患者15例,占总人数的15.6%.髂胫束损伤6例,占总患者的6.25%.结论高频超声对膝关节肌腱及内侧副韧带急慢性损伤的诊断准确率较高,其可作为膝关节肌腱及内侧副韧带急慢性损伤影像诊断的最佳方法.

  13. Spontaneous Hemarthrosis of the Knee - Late Complication of Flexible Femur Nailing: A Case Report

    Directory of Open Access Journals (Sweden)

    Kushare

    2016-03-01

    Full Text Available We present a case report of acute spontaneous knee hemarthosis due to erosion of the nail through the knee joint capsule in a boy, seven months following retrograde flexible nailing for fractured femur. Careful positioning of the location of the insertion site of flexible nails and proper nail tip management are important to avoid this rare late complication.

  14. Spontaneous Hemarthrosis of the Knee - Late Complication of Flexible Femur Nailing: A Case Report

    Science.gov (United States)

    Kushare, Indranil V; Oetgen, Matthew E; Walters, Suzanne J

    2016-01-01

    We present a case report of acute spontaneous knee hemarthosis due to erosion of the nail through the knee joint capsule in a boy, seven months following retrograde flexible nailing for fractured femur. Careful positioning of the location of the insertion site of flexible nails and proper nail tip management are important to avoid this rare late complication. PMID:28180118

  15. Spontaneous Hemarthrosis of the Knee - Late Complication of Flexible Femur Nailing: A Case Report

    OpenAIRE

    Kushare; Oetgen; Walters

    2016-01-01

    We present a case report of acute spontaneous knee hemarthosis due to erosion of the nail through the knee joint capsule in a boy, seven months following retrograde flexible nailing for fractured femur. Careful positioning of the location of the insertion site of flexible nails and proper nail tip management are important to avoid this rare late complication.

  16. Spontaneous Hemarthrosis of the Knee - Late Complication of Flexible Femur Nailing: A Case Report.

    Science.gov (United States)

    Kushare, Indranil V; Oetgen, Matthew E; Walters, Suzanne J

    2016-09-01

    We present a case report of acute spontaneous knee hemarthosis due to erosion of the nail through the knee joint capsule in a boy, seven months following retrograde flexible nailing for fractured femur. Careful positioning of the location of the insertion site of flexible nails and proper nail tip management are important to avoid this rare late complication.

  17. Stress Field of Straight Edge Dislocation in Magnetic Field

    Institute of Scientific and Technical Information of China (English)

    LIU Zhao-long; HU Hai-yun; FAN Tian-you

    2007-01-01

    To study the changes in mechanical properties of materials within magnetic fields and the motion of dislocations,stress fields of dislocation in magnetic field need to be calculated.The straight edge dislocation is of basic importance in various defects.The stress field of straight edge dislocation in an external static magnetic field is determined by the theory of elasticity and electrodynamics according to the Volterra dislocation model for continuous media.This reduces to the known stress field when the magnet field is zero.The results can be used for further study on the strain energy of dislocations and the interactions between dislocations in magnetic fields.

  18. Dislocation dynamics simulations of interactions between gliding dislocations and radiation induced prismatic loops in zirconium

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  20. Surgical versus nonsurgical treatment in first traumatic anterior dislocation of the shoulder in athletes

    Directory of Open Access Journals (Sweden)

    Gustavo Gonçalves Arliani

    2011-03-01

    Full Text Available Gustavo Gonçalves Arliani, Diego da Costa Astur, Carina Cohen, Benno Ejnisman, Carlos Vicente Andreoli, Alberto Castro Pochini, Moises CohenCentro de Traumatologia do Esporte (CETE, Departamento de Ortopedia e Traumatologia da Universidade Federal de São Paulo, São Paulo, BrazilAbstract: Anterior traumatic dislocation is a common problem faced by orthopedic surgeons. After the first episode of shoulder dislocation, a combination of lesions can lead to chronic instability. The management in treatment of young athletes after the first acute anterior shoulder dislocation is controversial. The available literature supports early surgical treatment for young male athletes engaged in highly demanding physical activities after the first episode of traumatic dislocation of the shoulder. This is because of the best functional results and lower recurrence rates obtained with this treatment in this population. However, further clinical trials of good quality comparing surgical versus nonsurgical treatment for well-defined lesions are needed, especially for categories of patients who have a lower risk of recurrence.Keywords: athlete, conservative treatment, surgical treatment, immobilization, stabilization, primary treatment, shoulder dislocation

  1. Acromioclavicular dislocation: treatment and rehabilitation. Current perspectives and trends among Brazilian orthopedists.

    Science.gov (United States)

    Arliani, Gustavo Gonçalves; Utino, Artur Yudi; Nishimura, Eduardo Misao; Terra, Bernardo Barcellos; Belangero, Paulo Santoro; Astur, Diego Costa

    2015-01-01

    To evaluate the approaches and procedures used by Brazilian orthopedic surgeons in treatment and rehabilitation of acromioclavicular dislocation of the shoulder. A questionnaire comprising eight closed questions that addressed topics relating to treatment and rehabilitation of acromioclavicular dislocation was applied to Brazilian orthopedic surgeons over the three days of the 45th Brazilian Congress of Orthopedics and Traumatology, in 2013. A total of 122 surgeons completely filled out the questionnaire and formed part of the sample analyzed. Most of them came from the southeastern region of the country. In this sample, 67% of the participants would choose surgical treatment for patients with grade 3 acromioclavicular dislocation. Regarding the preferred technique for surgical treatment of acute acromioclavicular dislocation, a majority of the surgeons used subcoracoid ligature with acromioclavicular fixation and transfer of the coracoacromial ligament (25.4%). Regarding complications found after surgery had been performed, 43.4% and 32.8% of the participants, respectively, stated that residual deformity of the operated joint and pain were the complications most seen during the postoperative period. Although there was no consensus regarding the treatment and rehabilitation of acromioclavicular dislocation, evolution had occurred in some of the topics analyzed in this questionnaire applied to Brazilian orthopedists. However, further controlled prospective studies are needed in order to evaluate the clinical and scientific benefit of these trends.

  2. Acromioclavicular dislocation: treatment and rehabilitation. Current perspectives and trends among Brazilian orthopedists☆

    Science.gov (United States)

    Arliani, Gustavo Gonçalves; Utino, Artur Yudi; Nishimura, Eduardo Misao; Terra, Bernardo Barcellos; Belangero, Paulo Santoro; Astur, Diego Costa

    2015-01-01

    Objective To evaluate the approaches and procedures used by Brazilian orthopedic surgeons in treatment and rehabilitation of acromioclavicular dislocation of the shoulder. Methods A questionnaire comprising eight closed questions that addressed topics relating to treatment and rehabilitation of acromioclavicular dislocation was applied to Brazilian orthopedic surgeons over the three days of the 45th Brazilian Congress of Orthopedics and Traumatology, in 2013. Results A total of 122 surgeons completely filled out the questionnaire and formed part of the sample analyzed. Most of them came from the southeastern region of the country. In this sample, 67% of the participants would choose surgical treatment for patients with grade 3 acromioclavicular dislocation. Regarding the preferred technique for surgical treatment of acute acromioclavicular dislocation, a majority of the surgeons used subcoracoid ligature with acromioclavicular fixation and transfer of the coracoacromial ligament (25.4%). Regarding complications found after surgery had been performed, 43.4% and 32.8% of the participants, respectively, stated that residual deformity of the operated joint and pain were the complications most seen during the postoperative period. Conclusions Although there was no consensus regarding the treatment and rehabilitation of acromioclavicular dislocation, evolution had occurred in some of the topics analyzed in this questionnaire applied to Brazilian orthopedists. However, further controlled prospective studies are needed in order to evaluate the clinical and scientific benefit of these trends. PMID:26535196

  3. Atomistic modeling of dislocation-interface interactions

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Jian [Los Alamos National Laboratory; Valone, Steven M [Los Alamos National Laboratory; Beyerlein, Irene J [Los Alamos National Laboratory; Misra, Amit [Los Alamos National Laboratory; Germann, T. C. [Los Alamos National Laboratory

    2011-01-31

    Using atomic scale models and interface defect theory, we first classify interface structures into a few types with respect to geometrical factors, then study the interfacial shear response and further simulate the dislocation-interface interactions using molecular dynamics. The results show that the atomic scale structural characteristics of both heterophases and homophases interfaces play a crucial role in (i) their mechanical responses and (ii) the ability of incoming lattice dislocations to transmit across them.

  4. Posterior sternoclavicular dislocation: an American football injury

    DEFF Research Database (Denmark)

    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 co...... 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....

  5. Extended Dislocations in Plastically Deformed Metallic Nanoparticles

    Directory of Open Access Journals (Sweden)

    Bin Zheng

    2016-05-01

    Full Text Available In the present study, the sawtooth nature of compressive loading of metallic nanoparticles is observed using a molecular dynamics simulation. The atomic structure evolution confirmed that extended dislocations are the main defects split into two asynchronous partial disloca‐ tions, along with stored and released fault energy. This is considered the essence of sawtooth loading. The size of the nanoparticles relative to the equilibrium width of the extended dislocation is discussed to explain the simulation results.

  6. Traumatic Dislocation of the Elbow Joint

    OpenAIRE

    de Haan, Jeroen

    2011-01-01

    textabstractThis thesis addresses the major issues encountered in the diagnosis and treatment of adult elbow dislocation. Firstly, a literary review (Chapters Five and Eight) makes it clear that there is much uncertainty regarding trauma mechanism, biomechanics, and even anatomy (Chapter Two). Furthermore, an overview of the treatment options indicates that there is no uniformity in the treatment modalities applicable to elbow dislocation (Chapter Six). And last but not least, there is no Dut...

  7. On quantum corrections to dislocations mass

    CERN Document Server

    Kwiatkowski, Grzegorz

    2011-01-01

    Quasi-classical quantization of crystal dislocations field is considered in terms of functional integral. The generalized zeta-function is used to evaluate the functional integral and quantum corrections to mass in quasi-classical approximation. The quantum corrections to few classical solutions of one-dimensional Sin-Gordon model are evaluated with account of rest $n-1$ dimensions. The results are applied to appropriate crystal dislocation models.

  8. Locked Superior Dislocation of the Acromioclavicular Joint

    Directory of Open Access Journals (Sweden)

    Salma Eltoum Elamin

    2013-01-01

    Full Text Available Acromioclavicular (AC joint injuries account for approximately 3–5% of shoulder girdle injuries (Rockwood et al., 1998. Depending on severity of injury and direction of displacement these are classified using Rockwood classification system for AC joint dislocation. We present an unusual case presenting with locked superior dislocation of the AC joint highlighting the presentation and subsequent successful surgical management of such case. To our knowledge this has not been reported previously in literature.

  9. Chemical theory of dislocation mobility

    Energy Technology Data Exchange (ETDEWEB)

    Gilman, J.J. [Materials Science and Engineering, University of California at Los Angeles, Los Angeles, CA 90095 (United States)]. E-mail: gilman@seas.ucla.edu

    2005-11-15

    Crystal dislocations were invented (circa. 1930) to explain why pure metal crystals are soft compared with homogeneous shear strengths calculated from atomic theory. They do this very well. However, later (circa. 1945) it was found that pure semiconductor crystals (e.g., Ge and Si) have hardnesses at room temperature comparable with calculated homogeneous shear strengths. Furthermore, it was known that pure metal-metalloid crystals (e.g., TiC and WC) are very hard, although they conduct electricity like metals. How can these differences be explained? The differences just outlined cannot be explained by means of a classical mechanical model. However, they can be explained by considering the chemical bonding in differing solid crystals. In particular, hardness depends on the degree of localization of the valence (bonding) electrons. Qualitatively, this is a very old idea. What is new is that it is possible to provide quantitative theories by using the results of quantum chemistry, and relatively simple analysis. Selected sets of crystal types must be treated, of course, just as selected sets of molecules are treated in theoretical chemistry. Otherwise the rationalization becomes unmanageable.

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

    OpenAIRE

    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...

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

    Institute of Scientific and Technical Information of China (English)

    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.

  12. Predicting dislocation climb: Classical modeling versus atomistic simulations

    OpenAIRE

    Clouet, Emmanuel

    2011-01-01

    International audience; The classical modeling of dislocation climb based on a continuous description of vacancy diffusion is compared to recent atomistic simulations of dislocation climb in body-centered cubic iron under vacancy supersaturation [Phys. Rev. Lett. 105 095501 (2010)]. A quantitative agreement is obtained, showing the ability of the classical approach to describe dislocation climb. The analytical model is then used to extrapolate dislocation climb velocities to lower dislocation...

  13. Empirical potential simulations of interstitial dislocation loops in uranium dioxide

    Science.gov (United States)

    Le Prioux, Arno; Fossati, Paul; Maillard, Serge; Jourdan, Thomas; Maugis, Philippe

    2016-10-01

    Stoichiometric circular shaped interstitial dislocation loop energies are calculated in stoichiometric UO2 by empirical potential simulation. The Burgers vector directions studied are and . The main structural properties of each type of interstitial dislocation loop are determined, including stacking fault energy. Defect energies are compared and a maximum size for stable dislocation loops before transition to dislocation loops is given. A model of dislocation loop energy based on elasticity theory is then fitted on the basis of these simulation results.

  14. Creep Deformation by Dislocation Movement in Waspaloy

    Directory of Open Access Journals (Sweden)

    Mark Whittaker

    2017-01-01

    Full Text Available Creep tests of the polycrystalline nickel alloy Waspaloy have been conducted at Swansea University, for varying stress conditions at 700 °C. Investigation through use of Transmission Electron Microscopy at Cambridge University has examined the dislocation networks formed under these conditions, with particular attention paid to comparing tests performed above and below the yield stress. This paper highlights how the dislocation structures vary throughout creep and proposes a dislocation mechanism theory for creep in Waspaloy. Activation energies are calculated through approaches developed in the use of the recently formulated Wilshire Equations, and are found to differ above and below the yield stress. Low activation energies are found to be related to dislocation interaction with γ′ precipitates below the yield stress. However, significantly increased dislocation densities at stresses above yield cause an increase in the activation energy values as forest hardening becomes the primary mechanism controlling dislocation movement. It is proposed that the activation energy change is related to the stress increment provided by work hardening, as can be observed from Ti, Ni and steel results.

  15. Computed tomography of the patellofemoral alignment after arthroscopic reconstruction following patella dislocation; Postoperative Bestimmung des patellofemoralen Alignements nach Patellaluxation - eine computertomographische Analyse

    Energy Technology Data Exchange (ETDEWEB)

    Schroeder, R.J.; Hidajat, N.; Maeurer, J.; Felix, R. [Klinik fuer Strahlenheilkunde, Charite, Campus Virchow-Klinikum, Humboldt-Univ. Berlin (Germany); Weiler, A.; Hoeher, J. [Sektion Sporttraumatologie und Arthroskopie, Klinik fuer Unfall- und Wiederherstellungschirurgie, Charite, Campus Virchow-Klinikum, Humboldt-Univ. Berlin (Germany)

    2003-04-01

    Purpose: To evaluate the diagnostic impact of different CT-based measurements to analyze the patellofemoral alignment after arthroscopic reconstruction in patients with patella dislocation. Materials and Methods: In 18 patients with dislocation of the patella, CT of the patellofemoral joint was performed after arthroscopic reconstruction. Various methods recommended in the literature were used to analyze the structure and the alignment of the patellofemoral joint with a relaxed quadriceps muscle. Axial CT scans were taken in four different knee flexion angles (15 , 30 , 45 , 60 ). Results: After arthroscopic stabilization in patients with patella dislocation, only the lateral patellofemoral angle (15 and 30 knee flexion) and the congruence angle (15 knee flexion) showed significant differences between the CT-measurements in the normal and the operated group. The differences of the remaining mean values were not significant due to a high standard deviation. With increasing flexion of the knee, the differences between the normal and the dislocation group almost disappeared. Only the lateral patellofemoral angle, the patella tilt and the lateral patella shift revealed differences between the normal and the group with recurrent dislocation in every degree of knee flexion. With increasing knee flexion above 30 and especially at 60 , the majority of the measured values returned to the normal range. Conclusions: For CT-measurements of the patellofemoral joint after arthroscopic stabilization, the patellofemoral angle and the congruence angle seemed to be most useful. The measurements of the patellofemoral joint should be taken in various degrees of knee flexion. (orig.) [German] Ziel: Evaluation der Aussagekraft verschiedener CT-Vermessungsmethoden des Patellofemoralgelenkes nach arthroskopischer Stabilisierung bei Patellaluxation. Material und Methode: Axiale CT-Vermessung des Patellofemoralgelenkes bei 18 Patienten nach arthroskopischer medialer patellofemoraler Naht

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

    Directory of Open Access Journals (Sweden)

    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

  17. POSTEROSUPERIOR SURGICAL ACCESS ROUTE FOR TREATMENT OF ACROMIOCLAVICULAR DISLOCATIONS: RESULTS FROM 84 SURGICAL CASES.

    Science.gov (United States)

    Dal Molin, Danilo Canesin; Ribeiro, Fabiano Rebouças; Filho, Rômulo Brasil; Filardi, Cantídio Salvador; Tenor, Antonio Carlos; Stipp, Willian Nandi; Petros, Rodrigo Souto Borges

    2012-01-01

    To evaluate the results from surgical treatment of 84 cases of acute acromioclavicular dislocation, using a posterosuperior access route. Eighty-four cases of acute acromioclavicular dislocation (grade III in the Allman-Tossy classification) operated between November 2002 and May 2010 were evaluated. The patients' mean age was 34 years. The diagnoses were made using clinical and radiographic evaluations. The patients were operated by the same surgical team, within three weeks of the date of the trauma, using a posterosuperior approach to the shoulder to access the top of the base of the coracoid process for placement of two anchors, which were used in reducing the dislocation. The minimum follow-up was 12 months. The postoperative clinical-radiographic evaluation was done using the modified Karlsson criteria and the University of California at Los Angeles (UCLA) score. 92.8% of the 84 patients treated presented good or excellent results, and 7.2% presented fair or poor results, using the UCLA assessment score. According to the modified Karlsson criteria, 76.2% were assessed as grade A, 17.9% as grade B and 5.9% as grade C. The posterosuperior access route to the shoulder is a new option for accessing the coracoid process and treating acromioclavicular dislocation, with clinical and radiographic results equivalent to those in the literature.

  18. [The lateral splitting of the knee joint capsule for treatment of chondropathia patellae (author's transl)].

    Science.gov (United States)

    Dobler, R

    1977-06-26

    This is a report on the results of the lateral splitting of the knee-joint capsule for treatment of chondropathia patellae. The operative procedure is described. Pains relative to the patella syndrome, chondropathia patellae, forms of dysplasia of the patella and lateral dislocation of the patella are regarded as indications. 50 knee-joints were post-examined. 26% were without complaints, 54% showed improvement, 10% no change, 10% deteriorated. These results are comparable to those of other, more intensive surgery. Representing a comparatively minor operation, the lateral splitting of the capsule is therefore particularly recommended for young patients.

  19. 急性前交叉韧带损伤合并内侧副韧带损伤的治疗选择%Treatment of acute anterior cruciate and medial collateral ligament injuries of knee

    Institute of Scientific and Technical Information of China (English)

    姚建华; 李海鹏; 黄炎; 薛元锁

    2011-01-01

    目的 探讨急性前交叉韧带(ACL)损伤合并内侧副韧带(MCL)损伤的治疗时机及方法.方法 2002年12月-2008年10月,治疗急性ACL损伤合并MCL损伤58例.MCL损伤Ⅰ度7例,Ⅱ度25例,Ⅲ度26例.MCL Ⅰ、Ⅱ度损伤共32例经3-4周制动,待关节活动功能恢复后行ACL重建;Ⅲ度损伤7例经制动6周,伤后9-10周行ACL重建.19例伤后两周内行ACL重建,术后在伸直位和屈膝30°位用支具制动6-8周,11例阴性,8例阳性,6例有后内侧关节囊撕裂,于损伤部位小切口用缝合铆钉原位修复后内侧结构,术后用支具制动6-8周.结果 平均随访15月(6-34月),Ⅰ-Ⅱ度损伤32例外翻应力试验阴性,前抽屉试验(+)2例,术后Lysholm评分91.2.18例MCL Ⅲ度损伤保守治疗,外翻应力试验Ⅰ度3例、Ⅱ度1例,前抽屉试验(+)2例、(++)1例,术后Lysholm评分86.5.MCLⅢ度损伤8例经手术修复治疗,外翻应力试验Ⅰ度2例,前抽屉试验(+)1例,术后Lysholm评分89.3.结论 急性ACL损伤合并Ⅲ度MCL损伤应早期手术,ACL重建后外翻应力试验不稳者需早期手术修复MCL.%Objective To study the treatment modalities for acute anterior cruciate ligament (ACL) and medial collateral ligament (MCL) injuries. Methods Fifty-eight patients with acute ACL and MCL injuries (including grade I in 7, grade II in 25 and grade III in 26 cases) were treated in our department from December 2002 to October 2008. ACL was reconstructed when the knee function was recovered in 32 patients with grade I and grade II MCL injury after they were immobilized for 3-4 weeks, in 7 patients with grade M MCL injury after they were immobilized for 6 weeks, in 19 patients with grade 1H MCL injury after they were immobilized for 2 weeks. Valgus stress testing for full extension and 300 of flexion was negative in 11 patients and positive in 8 patients after they were immobilized for 6-8 weeks. Posterior knee capsule tear in 6 patients was repaired with its posteromedial structure

  20. Mechanical and physiological factors in knee joint contact mechanics

    DEFF Research Database (Denmark)

    Mølgaard, Carsten

    Numerous biomechanical studies have provided evidence that laterally wedged insoles reduce the knee adduction moment during walking in healthy controls as well as patients with knee osteoarthritis potentially reducing the contact stress of medial tibial and femoral condyles. The knee adduction...... conservative treatment modalities also increases. The aim of this thesis was to 1) identify relationships between footwear and laterally wedged insoles in a healthy group, 2) to evaluate the mechanical and physiological factors of experimental pain when introducing a laterally wedged insoles to otherwise...... healthy subjects, and 3) to identify the acute effect of laterally wedged insoles on biomechanical markers in patients after an medial arthroscopic partial meniscectomy. The results showed that shoe design and lateral wedges are equally important factors for changing the knee adduction moment...

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

    Directory of Open Access Journals (Sweden)

    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

  2. Knee MRI scan

    Science.gov (United States)

    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. Runners knee (image)

    Science.gov (United States)

    ... forces on the knee, such as a misaligned patella. Chondromalacia is treated with rest or immobilization and nonsteroidal anti-inflammatory drugs for pain. Physical therapy, especially ... alignment of the patella that cannot be corrected with therapy.

  4. Osteotomy of the knee

    Science.gov (United States)

    Proximal tibial osteotomy; Lateral closing wedge osteotomy; High tibial osteotomy; Distal femoral osteotomy ... There are two types of surgery: Tibial osteotomy is surgery done on ... osteotomy is surgery done on the thigh bone above the knee ...

  5. Dashboard (in the) knee

    National Research Council Canada - National Science Library

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

    2015-01-01

    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...

  6. Total Knee Replacement

    Science.gov (United States)

    ... walking, swimming, golf, driving, light hiking, biking, ballroom dancing, and other low-impact sports. With appropriate activity ... help prevent leg swelling and blood clots. Physical Therapy Most patients begin exercising their knee the day ...

  7. Partial knee replacement

    Science.gov (United States)

    ... al. American Academy of Orthopaedic Surgeons. Treatment of osteoarthritis of the knee (nonarthroplasty). J Am Acad ... Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  8. Dislocation Dynamics in Al-Li Alloys. Mean Jump Distance and Activation Length of Moving Dislocations

    NARCIS (Netherlands)

    Hosson, J.Th.M. De; Huis in 't Veld, A.; Tamler, H.; Kanert, O.

    1984-01-01

    Pulsed nuclear magnetic resonance proved to be a complementary new technique for the study of moving dislocations in Al-Li alloys. The NMR technique, in combination with transmission electron microscopy and strain-rate change experiments have been applied to study dislocation motion in Al-2.2 wt% Li

  9. Prevalent knee pain and sport

    DEFF Research Database (Denmark)

    Hahn, Thomas; Foldspang, Anders

    1998-01-01

    STUDY OBJECTIVE: To estimate the prevalence of knee pain in active athletes and to investigate potential associations to type, amount and duration of sports participation. MEASUREMENTS: 339 athletes gave information about occupation, sports activity and different features of knee pain, based...... on a self-filled questionnaire. MAIN RESULTS: The prevalence of knee pain within the preceding 12 months, constant or recurrent knee pain, absence from sport and absence from work due to knee pain, was 54%, 34%, 19% and 4%, respectively. Knee pain was positively associated with years of jogging...... and with 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...

  10. Quantum dynamics of a single dislocation

    Science.gov (United States)

    de Gennes, Pierre-Gilles

    We discuss the zero temperature motions of an edge dislocation in a quantum solid (e.g., He4). If the dislocation has one kink (equal in length to its Burgers vector b) the kink has a creation energy U and can move along the line with a certain transfer integral t. When t and U are of comparable magnitude, two opposite kinks can form an extended bound state, with a size l. The overall shape of the dislocation in the ground state is then associated with a random walk of persistence length l (along the line) and hop sizes b. We also discuss the motions of kinks under an applied shear stress σ: the glide velocity is proportional to exp(-σ*/σ), where σ* is a characteristic stress, controlled by tunneling processes. Mouvements quantiques d'une dislocation. On analyse le mouvement à température nulle d'une dislocation coin dans un solide quantique (He4). La dislocation peut avoir un cran (d'énergie U) dans son plan de glissement. Le cran peut avancer ou reculer le long de la dislocation par effet tunnel, avec une certaine intégrale de transfert t. Deux crans de signe opposé peuvent former un état lié. En présence d'une contrainte extérieure σ, la ligne doit avancer avec une vitesse ~exp(-σ*/σ) où σ* est une contrainte seuil, contrôlée par l'effet tunnel.

  11. Total hip arthroplasty in paralytic dislocation from poliomyelitis.

    Science.gov (United States)

    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.

  12. Taking care of your new knee joint

    Science.gov (United States)

    Knee arthroplasty - precautions; Knee replacement - precautions ... After you have knee replacement surgery , you will need to be careful about how you move your knee, especially for the first few ...

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

    Directory of Open Access Journals (Sweden)

    Junwei Sun

    2014-01-01

    Full Text Available 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 studied for the drive memristor chaotic oscillator system and the same response memristor chaotic oscillator system. For the different dimensions, the memristor chaotic oscillator system and the other chaotic system have realized general hybrid projective dislocated synchronization. Numerical simulations are given to show the effectiveness of these methods.

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

    Science.gov (United States)

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

    2016-07-29

    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. 2016 BMJ Publishing Group Ltd.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    PURPOSE: To evaluate the difference in post-operative knee awareness between knees in patients undergoing bilateral simultaneous total knee arthroplasty (TKA) and to assess factors predicting high or low knee awareness. METHODS: This study was conducted on 99 bilateral simultaneous TKAs performed...... at our institution from 2008 to 2012. All patients received one set of questionnaires [Forgotten Joint Score (FJS) and Oxford Knee Score (OKS)] for each knee. Based on the FJS, the patients' knees were divided into two groups: "best" and "worst" knees. The median of the absolute difference in FJS and OKS...... within each patient was calculated. Multivariate linear regression was performed to identify factors affecting FJS. RESULTS: The difference between knees was 1 point (CI 0-5) for the FJS and 1 point (CI 0-2) for the OKS. The FJS for females increased (decreasing awareness) with increasing age. Males had...

  16. Isolated dorsal dislocation of the tarsal naviculum

    Directory of Open Access Journals (Sweden)

    Kaziz Hamdi

    2015-01-01

    Full Text Available Isolated dislocation of the tarsal naviculum is an unusual injury, scarcely reported in the literature. The naviculum is surrounded by the rigid bony and ligamentous support hence fracture dislocation is more common than isolated dislocation. The mechanism and treatment options remain unclear. In this case report, we describe a 31 year old man who sustained an isolated dorsal dislocation of the left tarsal naviculum, without fracture, when he was involved in a motor vehicle collision. The reported mechanism of the dislocation is a hyper plantar flexion force applied to the midfoot, resulting in a transient disruption of the ligamentous support of the naviculum bone, with dorsal displacement of the bone. The patient was treated with open reduction and Krischner-wire fixation of the navicular after the failure of closed reduction. The wires were removed after 6 weeks postoperatively. Physiotherapy for stiffness and midfoot pain was recommended for 2 months. At 6 months postoperatively, limping, midfoot pain and weakness were reported, no X-ray abnormalities were found. The patient returned to his obvious activities with a normal range of motion.

  17. Salam: Of Dislocation, Marginality and Flexibility

    Directory of Open Access Journals (Sweden)

    Efenita M. Taqueban

    2012-12-01

    Full Text Available This paper reconstructs the life stories of residents of SalamCompound. The compound serves as entry point for many Muslim migrants who leave the southern Philippines. Salam is both a refuge and a halfway point. A sense of dislocation permeates the stories. Dislocation begins with the movement away from a homeland that is familiar and defining of identity. The dislocation is, in a sense, an escape, a desperate project to avoid armed conflict in the southern Philippines or a desperate enterprise in search of work.Salam is a halfway point for transients prospecting for overseas work, the staging area for a global labor exodus. The sense of dislocation is not unlike locating oneself in the margins, portrayed in the residents’ negotiated identitiesand spaces, constantly challenged, implicitly regulated. Dislocation is also depicted as flexibility, portrayed by the residents making do and their everyday creative resistance and struggle in new locations in the city. Gathered throughethnographic method, the stories offer a glimpse into the lives of the residents of the compound, how they negotiate around social constructions of identities — resisting and accommodating internal and external forces that impinge ontheir lives, revealing a rich and poignant tapestry of family relations, community ironies and an ever-impinging world beyond its walls.

  18. Use of cervical collar in temporomandibular dislocation.

    Science.gov (United States)

    Jaisani, Mehul R; Pradhan, Leeza; Sagtani, Alok

    2015-06-01

    Dislocation of the temporomandibular joint represents 3 % of all reported dislocated joints. In the last 3 decades many cases of TMJ dislocation have been reported with a wide variety of treatment options ranging from non-surgical conservative approaches to open joint procedures. The question remains whether one method is superior to the others. Conservative treatments are still the option in this part of the continent due to financial constraints and as well as due to availability of skilled manpower. A variety of conservative techniques have been described for reducing dislocations, all of which require 10-14 days of immobilization of the jaw post reduction so as to prevent further episodes of dislocation. Immobilization of the jaw can be done in the form of barrel bandage, barton bandage, head chin cap or maxillomandibular fixation using arch bars. We suggest the use of a cervical collar as a form of post reduction immobilization technique to overcome the inherent disadvantages of conventional forms of immobilization techniques.

  19. High dislocation density of tin induced by electric current

    Energy Technology Data Exchange (ETDEWEB)

    Liao, Yi-Han; Liang, Chien-Lung; Lin, Kwang-Lung, E-mail: matkllin@mail.ncku.edu.tw [Department of Material Science and Engineering, National Cheng Kung University, Tainan 70101, Taiwan, R. O. C (China); Wu, Albert T. [Department of Chemical and Material Engineering, National Central University, Jhongli 32001, Taiwan, R. O. C (China)

    2015-12-15

    A dislocation density of as high as 10{sup 17} /m{sup 2} in a tin strip, as revealed by high resolution transmission electron microscope, was induced by current stressing at 6.5 x 10{sup 3} A/ cm{sup 2}. The dislocations exist in terms of dislocation line, dislocation loop, and dislocation aggregates. Electron Backscattered Diffraction images reflect that the high dislocation density induced the formation of low deflection angle subgrains, high deflection angle Widmanstätten grains, and recrystallization. The recrystallization gave rise to grain refining.

  20. Successful Conservative Management of a Dislocated IUD.

    Science.gov (United States)

    Inal, Hasan Ali; Ozturk Inal, Zeynep; Alkan, Ender

    2015-01-01

    Background. Intrauterine contraceptive devices (IUDs) are widely utilized all over the world owing to their low cost and high efficacy. Uterine perforation is a rare complication that may occur at IUD insertion resulting in extrauterine location of the IUD. Traditionally, surgical removal of dislocated IUDs has been recommended. Case. A 68-year-old patient who had an IUD (Lippes loop) inserted 32 years ago and whose routine examination incidentally revealed a dislocated IUD in the abdominal cavity. The patient remained asymptomatic during three years of follow-up and the IUD was left in place. Conclusion. Asymptomatic patients, whose vaginal examinations and ultrasonography or X-ray results reveal a dislocated IUD, may benefit from conservative management.

  1. Micromechanics and dislocation theory in anisotropic elasticity

    CERN Document Server

    Lazar, Markus

    2016-01-01

    In this work, dislocation master-equations valid for anisotropic materials are derived in terms of kernel functions using the framework of micromechanics. The second derivative of the anisotropic Green tensor is calculated in the sense of generalized functions and decomposed into a sum of a $1/R^3$-term plus a Dirac $\\delta$-term. The first term is the so-called "Barnett-term" and the latter is important for the definition of the Green tensor as fundamental solution of the Navier equation. In addition, all dislocation master-equations are specified for Somigliana dislocations with application to 3D crack modeling. Also the interior Eshelby tensor for a spherical inclusion in an anisotropic material is derived as line integral over the unit circle.

  2. How to quantify knee function after total knee arthroplasty?

    NARCIS (Netherlands)

    Boonstra, M.C.; Waal Malefijt, M.C. de; Verdonschot, N.J.J.

    2008-01-01

    Total knee arthroplasty (TKA) is being undertaken in a younger population than before and as a result the functional demands on the knee are likely to be increasing. As a consequence, it is important to define quantitative functional knee tests that can monitor any increase. A valuable functional

  3. Dislocation evolution with rheological forming of metal

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    It is known that some internal defects exist in metal materials. Preliminary attempt to relate dislo cation evolution with metal rheological forming was done. By the attempt, it is learned that the evolution of dislocation density p( x, y, t ) is essentially the change of n independent internal variables qα (α = 1, 2, …n ) with material. The preliminary research in theory and experiments showed that dislocations piling-up could be avoided. One can improve the internal microstructure and mechanical properties of products by rheological forming method.

  4. Effect of dislocations on helium retention in deformed pure iron

    Science.gov (United States)

    Gong, Y. H.; Cao, X. Z.; Jin, S. X.; Lu, E. Y.; Hu, Y. C.; Zhu, T.; Kuang, P.; Xu, Q.; Wang, B. Y.

    2016-12-01

    The effects of dislocations created by deformation on helium retention in pure iron, including the helium atoms diffusion along the dislocation line and desorption from dislocation trapping sites, were investigated. The dislocation defect was introduced in specimens by cold-rolling, and then 5 keV helium ions were implanted into the deformed specimens. Slow positron beam technology and thermal desorption spectroscopy were used to investigate the evolution of dislocation defects and the desorption behavior of helium atoms under influence of dislocation. The behaviors of S-E, W-E and S-W plots indicate clearly that lots of helium atoms remain in the deformed specimen and helium atoms combining with dislocation change the distribution of electron density. The helium desorption plot indicates that dislocation accelerates helium desorption at 293 K-600 K and facilitates helium dissociation from HenVm (n/m = 1.8) cluster.

  5. Dislocation in heteroepitaxial diamond visualized by hydrogen plasma etching

    Energy Technology Data Exchange (ETDEWEB)

    Ichikawa, K.; Kodama, H. [Department of Electrical Engineering and Electronics, Aoyama Gakuin University, Sagamihara 229-0206 (Japan); Suzuki, K. [TOPLAS ENGINEERING Co., Ltd., Chofu, Tokyo 182-0006 (Japan); Sawabe, A. [Department of Electrical Engineering and Electronics, Aoyama Gakuin University, Sagamihara 229-0206 (Japan)

    2016-02-01

    The classification of etch pits formed by hydrogen plasma etching on heteroepitaxial diamond has been done by cross-sectional transmission electron microscope (TEM). We demonstrated that the origin of etch pit was mainly [001] threading dislocation. From invisibility criterion of dislocation contrast in TEM observation, this dislocation was identified as edge and 45° mixed dislocation. The correlation between dislocation types and etch pit shape was discussed. - Highlights: • The etch pits formed by plasma etching on heteroepitaxial diamond have been clarified by TEM. • The origin of etch pit was mainly [001] threading dislocation. • These dislocations were identified as edge and 45° mixed type. • The correlation between dislocation types and etch pit shape.

  6. Dislocation Nucleation and Pileup under a Wedge Contact at Nanoscale

    Directory of Open Access Journals (Sweden)

    Y. F. Gao

    2008-01-01

    Full Text Available Indentation responses of crystalline materials have been found to be radically different at micrometer and nanometer scales. The latter is usually thought to be controlled by the nucleation of dislocations. To explore this physical process, a dislocation mechanics study is performed to determine the conditions for the nucleation of a finite number of dislocations under a two-dimensional wedge indenter, using the Rice-Thomson nucleation criterion. The configurational force on the dislocation consists of the applied force, the image force, and the interaction force between dislocations. Dislocations reach equilibrium positions when the total driving force equals the effective Peierls stress, giving a set of nonlinear equations that can be solved using the Newton-Raphson method. When the apex angle of the wedge indenter increases, the critical contact size for dislocation nucleation increases rapidly, indicating that dislocation multiplication near a blunt wedge tip is extremely difficult. This geometric dependence agrees well with experimental findings.

  7. Dislocations in magnetohydrodynamic waves in a stellar atmosphere.

    Science.gov (United States)

    López Ariste, A; Collados, M; Khomenko, E

    2013-08-23

    We describe the presence of wave front dislocations in magnetohydrodynamic waves in stratified stellar atmospheres. Scalar dislocations such as edges and vortices can appear in Alfvén waves, as well as in general magnetoacoustic waves. We detect those dislocations in observations of magnetohydrodynamic waves in sunspots in the solar chromosphere. Through the measured charge of all the dislocations observed, we can give for the first time estimates of the modal contribution in the waves propagating along magnetic fields in solar sunspots.

  8. Dislocations in magnetohydrodynamic waves in a stellar atmosphere

    CERN Document Server

    Ariste, A López; Khomenko, E

    2013-01-01

    We describe the presence of wavefront dislocations in magnetohydrodynamic waves in stratified stellar atmospheres. Scalar dislocations such as edges and vortices can appear in Alfv\\'en waves, as well as in general magneto-acoustic waves. We detect those dislocations in observations of magnetohydrodynamic waves in sunspots in the solar chromosphere. Through the measured charge of all the dislocations observed, we can give for the first time estimates of the modal contribution in the waves propagating along magnetic fields in solar sunspots.

  9. Operative treatment for cervical fracture and dislocation with blunt unilateral vertebral artery injury

    Institute of Scientific and Technical Information of China (English)

    JIANG Tao; REN Xian-jun; WANG Wei-dong; ZHANG Xia; LI Chang-qing; HAO Yong

    2010-01-01

    Objective: To investigate risks and clinical effects of operative treatment for cervical vertebral fracture and dislocation associated with unilateral vertebral artery injury.Methods: This group consisted of 76 cases of closed cervical spine trauma combined with unilateral vertebral artery injury (23 cases of bilateral facet dislocation, 28 unilateral facet dislocation and 25 fracture). All patients underwent prospective examination of cervical spine MRI and vertebral artery two-dimensional time-of-flight (2D TOF)magnetic resonance angiography (MRA), and anterior cervical decompression. The healthy vertebral artery paths were evaluated before the surgery, and were protected during the surgery according to the anatomical signs.Results: There were no acute or chronic clinical damage symptoms in 76 cases after surgery. No neural damage symptoms were observed in patients with normal neural functions. The neural functions of incomplete paralyzed patients were improved in different grades.Conclusions: Reliable anterior operation can produce good results for cervical fracture and dislocation with unilateral vertebral artery injury. Detecting the course of uninjured vertebral artery before operation and locating the anatomical site during operation are effective to avoid damaging vertebral artery of uninjured side.

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

    Science.gov (United States)

    Regauer, Markus; Polzer, Hans; Mutschler, Wolf

    2014-01-18

    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 general anaesthesia, the brachial vein was injured and an increasing hematoma subsequently caused brachial plexus paresis by pressure. After surgery for decompression and vascular suturing, symptoms declined rapidly, but brachial plexus paresis still was not fully reversible after 3 mo of follow-up. The hazardousness of using the Hippocrates method can be explained by traction on the outstretched arm with force of the operator's body weight, direct trauma to the axillary region by the physician's heel, and the topographic relations of neurovascular structures and the dislocated humeral head. As there is a variety of alternative reduction techniques which have been evaluated scientifically and proofed to be safe, we strongly caution against the use of the Hippocrates method as a first line technique for reducing anterior shoulder dislocations, especially in elder patients with fragile vessels or under anticoagulant therapy, and recommend the scapular manipulation technique or the Milch technique, for example, as a first choice.

  11. Knee-extension-assist for knee-ankle-foot orthoses.

    Science.gov (United States)

    Spring, Alexander; Kofman, Jonathan; Lemaire, Edward

    2011-01-01

    Individuals with quadriceps muscle weakness often have difficulty generating the knee-extension moments required for common mobility tasks. A new device that provides a knee-extension moment was designed to help individuals perform sit-to-stand and stand-to-sit. The knee-extension-assist (KEA) was designed as a modular component to be incorporated into existing knee-ankle-foot-orthoses (KAFO). The KEA loads a set of springs as the knee flexes under bodyweight and returns the stored energy as an extension moment during knee extension. The springs can be locked in place at the end of flexion to prevent unwanted knee extension while seated. When the affected leg is unloaded, the device disengages, allowing free joint motion. A prototype KEA underwent mechanical testing and biomechanical evaluation on an able-bodied individual during sit-to-stand and stand-to-sit.

  12. Anterior decompression, structural bone grafting, and Caspar plate stabilization for unstable cervical spine fractures and/or dislocations.

    Science.gov (United States)

    Garvey, T A; Eismont, F J; Roberti, L J

    1992-10-01

    Fourteen patients who sustained acute cervical spine fractures and/or dislocations with associated posterior ligamentous disruption had anterior decompressions, structural bone grafting, and anterior Caspar plate stabilization. With an average 30-month follow-up, no patient has had loss of fixation. Despite criticism raised from biomechanical testing, the Caspar anterior plate system (Aesculape, Tuttlingen, Germany) may be added to structural bone grafting of unstable cervical fractures and/or dislocations, yielding an in vivo solid construct, which obviates the need for simultaneous posterior stabilization.

  13. Metatarsal Shaft Fracture with Associated Metatarsophalangeal Joint Dislocation

    Directory of Open Access Journals (Sweden)

    Taranjit Singh Tung

    2016-01-01

    Full Text Available Metatarsophalangeal joint dislocations of lesser toes are often seen in the setting of severe claw toes. Traumatic irreducible dislocations have been reported in rare cases following both low-energy and high-energy injuries to the forefoot. In this case report, I present a previously unreported association of a metatarsal shaft fracture with metatarsophalangeal joint dislocation of a lesser toe.

  14. 21 CFR 890.3665 - Congenital hip dislocation abduction splint.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Congenital hip dislocation abduction splint. 890....3665 Congenital hip dislocation abduction splint. (a) Identification. A congenital hip dislocation abduction splint is a device intended for medical purposes to stabilize the hips of a young child...

  15. Bypassing of a barrier by dissociated and superlattice dislocations

    DEFF Research Database (Denmark)

    Bhushan, Karihaloo

    1975-01-01

    Very simple procedures are used to calculate the upper and lower bounds for the applied stress required for the leading extended (superlattice) dislocation in a group of n coplanar screw dislocations of like sign with Burgers vector b to bypass a noncoplanar perfect screw dislocation with Burgers...... vector mb (m...

  16. An Irreducible Ankle Fracture Dislocation: The Bosworth Injury

    NARCIS (Netherlands)

    T. Schepers (Tim); T. Hagenaars (Tjebbe); D. den Hartog (Dennis)

    2012-01-01

    textabstractIrreducible fracture dislocations of the ankle are rare and represent true orthopedic emergencies. We present a case of a fracture dislocation that was irreducible owing to a fixed dislocation of the proximal fibular fragment posterior to the lateral ridge of the tibia. This particular t

  17. Bauschinger effect in thin metal films: Discrete dislocation dynamics study

    NARCIS (Netherlands)

    Davoudi, K.M.; Nicola, L.; Vlassak, J.J.

    2014-01-01

    The effects of dislocation climb on plastic deformation during loading and unloading are studied using a two-dimensional discrete dislocation dynamics model. Simulations are performed for polycrystalline thin films passivated on both surfaces. Dislocation climb lowers the overall level of the stress

  18. Dislocations in stripes and lattice Dirac fermions

    NARCIS (Netherlands)

    Mesaroš, Andrej

    2010-01-01

    The central topic in this thesis is the effect of topological defects in two distinct types of condensed matter systems. The first type consists of graphene and topological insulators. By studying the long-range effect of lattice defects (dislocations and disclinations) we find that the graphene

  19. Traumatic Dislocation of the Elbow Joint

    NARCIS (Netherlands)

    J. de Haan (Jeroen)

    2011-01-01

    textabstractThis thesis addresses the major issues encountered in the diagnosis and treatment of adult elbow dislocation. Firstly, a literary review (Chapters Five and Eight) makes it clear that there is much uncertainty regarding trauma mechanism, biomechanics, and even anatomy (Chapter Two). Furth

  20. Dislocation Microstructures in Fatiqued Copper Polycrystals

    DEFF Research Database (Denmark)

    Winter, A.T.; Pedersen, Ole Bøcker; Rasmussen, K.V.

    1981-01-01

    Dislocation structures characteristic of persistent slip bands were observed in the interior of polycrystalline copper after fatigue. At low strain amplitudes, within the plateau on the cyclic stress-strain curve, only structures identical to those seen in single crystals were observed. This allows...

  1. Dislocations in stripes and lattice Dirac fermions

    NARCIS (Netherlands)

    Mesaroš, Andrej

    2010-01-01

    The central topic in this thesis is the effect of topological defects in two distinct types of condensed matter systems. The first type consists of graphene and topological insulators. By studying the long-range effect of lattice defects (dislocations and disclinations) we find that the graphene ele

  2. Manubriosternal joint dislocation in contact sport.

    Science.gov (United States)

    Smith, M; Lenehan, B; O'Keefe, D; Martin, A

    2001-11-01

    A 17 year old man developed chest pain and shortness of breath immediately after a scrummage while playing rugby football. A lateral chest radiograph showed a dislocated manubriosternal joint, with no associated injuries. This has not been previously reported in a sporting setting. This injury should be considered in flexion-compression injury of the thorax.

  3. Ab initio phonon scattering by dislocations

    Science.gov (United States)

    Wang, Tao; Carrete, Jesús; van Roekeghem, Ambroise; Mingo, Natalio; Madsen, Georg K. H.

    2017-06-01

    Heat management in thermoelectric and power devices as well as in random access memories poses a grand challenge and can make the difference between a working and an abandoned device design. Despite the prevalence of dislocations in all these technologies, the modeling of their thermal resistance is based on 50-year-old analytical approximations, whose simplicity was driven by practical limitations rather than physical insight. We introduce an efficient ab initio approach based on Green's functions computed by two-dimensional reciprocal space integration. By combining elasticity theory and density functional theory, we calculate the scattering strength of a 90∘ misfit edge dislocation in Si. Because of the breakdown of the Born approximation, earlier literature models fail, even qualitatively. We find that a dislocation density larger than 109cm-2 is necessary to substantially influence thermal conductivity at room temperature and above. We quantify how much of the reduction of thermal conductivity measured in nanograined samples can be explained by realistic dislocation concentrations.

  4. Missed isolated volar dislocation of the scaphoid

    DEFF Research Database (Denmark)

    Kolby, Lise; Larsen, Søren; Jørring, Stig;

    2007-01-01

    A patient presented with volar dislocation of the scaphoid, the diagnosis of which had been missed for two weeks. He was treated with open reduction through a combined volar and dorsal approach with decompression of the median nerve, internal fixation, and a cast for eight weeks. One year postope...

  5. Effect of Weight-bearing Too Early in Lower Limbs on Extensor Muscle Spasm and Knee Hyperextension of Affected Limb in Acute Stroke Patients with Hemiplegia%急性脑卒中患者过早下肢负重与患肢伸肌痉挛及膝过伸的关系研究

    Institute of Scientific and Technical Information of China (English)

    谭永霞; 刘建国; 戚晓昆

    2012-01-01

    Objective: To investigate the effect of weight-bearing too early in the lower limbs on extensor muscle spasm and knee hyperextension of affected limbs in acute stroke patients with hemiplegia. Methods; Eighty acute stroke patients with hemiplegia were recruited and the clinical data was analyzed. Results: All the cases were divided into control and weight-bearing groups according to their compliance in rehabilitation training. All the cases were given canonical rehabilitation program for 2 months, and the cases in the weight-bearing group started weight-bearing too early. Results: The number of cases with extensor muscle spasm and knee hyperextension of affected limbs in the weight-bearing group was higher than that in the control group (P<0. 05) after 2 months of treatment. Conclusion: Weight-bearing too early could increase the risk of extensor muscle spasm and knee hyperextension in acute stroke patients with hemiplegia.%目的:研究下肢过早负重对脑卒中偏瘫患者下肢功能的影响.方法:急性脑卒中患者80例,对全部患者的临床资料进行回顾性分析.结果:根据患者康复过程中的依从性,分为规范康复组和过早负重组,各40例,2组均接受康复治疗2个月,但过早负重组患者康复治疗期间过早下肢负重;治疗2个月后,过早负重组患者下肢出现伸肌痉挛及膝过伸的例数均高于规范康复组(P<0.05).结论:过早下肢负重容易使脑卒中偏瘫患者下肢出现伸肌痉挛及膝过伸.

  6. Causal Stroh formalism for uniformly-moving dislocations in anisotropic media: Somigliana dislocations and Mach cones

    CERN Document Server

    Pellegrini, Yves-Patrick

    2016-01-01

    In this work, Stroh's formalism is endowed with causal properties on the basis of an analysis of the radiation condition in the Green tensor of the elastodynamic wave equation. The modified formalism is applied to dislocations moving uniformly in an anisotropic medium. In practice, accounting for causality amounts to a simple analytic continuation procedure whereby to the dislocation velocity is added an infinitesimal positive imaginary part. This device allows for a straightforward computation of velocity-dependent field expressions that are valid whatever the dislocation velocity ---including supersonic regimes--- without needing to consider subsonic and supersonic cases separately. As an illustration, the distortion field of a Somigliana dislocation of the Peierls-Nabarro-Eshelby-type with finite-width core is computed analytically, starting from the Green tensor of elastodynamics. To obtain the result in the form of a single compact expression, use of the modified Stroh formalism requires splitting the Gr...

  7. Total carpometacarpal joint dislocation combined with trapezium fracture, trapezoid dislocation and hamate fracture

    DEFF Research Database (Denmark)

    Gvozdenovic, R; Vadstrup, Lars Soelberg

    2015-01-01

    Multiple metacarpal dislocations combined with carpal fracture - dislocations are rare injuries. We report a new combination of these injuries where fracture-dislocation of the base of the 1st metacarpal bone occurred simultaneously with a comminuted fracture of the trapezium, dislocation...... of the trapezoid and metacarpal joints (2nd to 5th) and an avulsion fracture of the hamate. This specific carpal injury has not been previously described and our description will contribute to understanding the mechanism of these complex injuries. The injury pattern in the case featured here was multifaceted...... and resulted from rupture of both transverse and longitudinal carpal columns. According to the Garcia-Elias classification of axial carpal disruptions, this particular injury mechanism was a combined axial-radial-ulnar type injury. These injuries are extremely rare and are only sporadically described...

  8. Interaction of 〈1 0 0〉 dislocation loops with dislocations studied by dislocation dynamics in α-iron

    Energy Technology Data Exchange (ETDEWEB)

    Shi, X.J.; Dupuy, L. [CEA, DEN, SRMA, F-91191 Gif-sur-Yvette (France); Devincre, B. [Laboratoire d’Etude des Microstructures, CNRS-ONERA, 29 av. de la Division Leclerc, 92322 Châtillon Cedex (France); Terentyev, D. [SCK–CEN, Nuclear Materials Science Institute, Boeretang 200, B-2400 Mol (Belgium); Vincent, L. [CEA, DEN, SRMA, F-91191 Gif-sur-Yvette (France)

    2015-05-15

    Highlights: • Interactions between edge dislocations and radiation-induced loops were studied by dislocation dynamics. • Dislocation dynamics results are directly compared to molecular dynamics results. • The complex elementary reactions are successfully reproduced. • The critical shear stress to overcome individual loops if reproduced quantitatively. - Abstract: Interstitial dislocation loops with Burgers vector of 〈1 0 0〉 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.

  9. Subacute dislocation of the elbow following Galeazzi fracture-dislocation of the radius: A case report

    Directory of Open Access Journals (Sweden)

    Rajeev Aysha

    2011-12-01

    Full Text Available Abstract Introduction The Galeazzi fracture-dislocation was originally described by Sir Astley Cooper in 1822 but was named after Italian surgeon Ricardo Galeazzi in 1934. It is an injury classified as a radial shaft fracture with associated dislocation of the distal radioulnar joint and disruption of the forearm axis joint. The associated distal radioulnar joint injury may be purely ligamentous in nature, tearing the triangular fibrocartilaginous complex, or involve bony tissue (that is, ulnar styloid avulsions or both. We report this case because of the rare association of posterior dislocation of the elbow along with Galeazzi fracture-dislocation. To the best of our knowledge, this has not been previously reported in the English literature. Case presentation A 26-year-old Caucasian man presented to our department after a fall from a motorbike. He sustained a closed, isolated Galeazzi fracture-dislocation of the right forearm and no associated elbow injuries, and this necessitated open reduction and internal fixation of the radius. Post-operative radiographs films were satisfactory. However, clinical and radiological evidence of ipsilateral elbow dislocation was noted at a five-week follow-up, subsequently requiring open reduction of the joint and collateral ligament repair. Our patient was noted to have full elbow and forearm function at three months. Conclusions Although the Galeazzi fracture-dislocation has been classically described as involving only the distal radioulnar joint, traumatic forces can be transmitted to the elbow via the interosseous membrane of the forearm. This can lead to instability of the elbow joint. Therefore, we recommend that, in every case of forearm fracture, both elbow and wrist joints be assessed clinically as well as radiologically for subluxation or dislocation.

  10. Subacute dislocation of the elbow following Galeazzi fracture-dislocation of the radius: A case report.

    Science.gov (United States)

    Rajeev, Aysha; Senevirathna, Shanaka; Harrison, John

    2011-12-20

    The Galeazzi fracture-dislocation was originally described by Sir Astley Cooper in 1822 but was named after Italian surgeon Ricardo Galeazzi in 1934. It is an injury classified as a radial shaft fracture with associated dislocation of the distal radioulnar joint and disruption of the forearm axis joint. The associated distal radioulnar joint injury may be purely ligamentous in nature, tearing the triangular fibrocartilaginous complex, or involve bony tissue (that is, ulnar styloid avulsions) or both. We report this case because of the rare association of posterior dislocation of the elbow along with Galeazzi fracture-dislocation. To the best of our knowledge, this has not been previously reported in the English literature. A 26-year-old Caucasian man presented to our department after a fall from a motorbike. He sustained a closed, isolated Galeazzi fracture-dislocation of the right forearm and no associated elbow injuries, and this necessitated open reduction and internal fixation of the radius. Post-operative radiographs films were satisfactory. However, clinical and radiological evidence of ipsilateral elbow dislocation was noted at a five-week follow-up, subsequently requiring open reduction of the joint and collateral ligament repair. Our patient was noted to have full elbow and forearm function at three months. Although the Galeazzi fracture-dislocation has been classically described as involving only the distal radioulnar joint, traumatic forces can be transmitted to the elbow via the interosseous membrane of the forearm. This can lead to instability of the elbow joint. Therefore, we recommend that, in every case of forearm fracture, both elbow and wrist joints be assessed clinically as well as radiologically for subluxation or dislocation.

  11. Arthroscopically assisted treatment of traumatic patellar dislocation%关节镜辅助治疗创伤性髌骨脱位

    Institute of Scientific and Technical Information of China (English)

    孙笑非; 林建宁; 王德利; 阮狄克

    2011-01-01

    [Objective]To explore the clinical methods and effects of arthroscopically assisted treatment of traumatic patellar dislocation.[Method]From January 2001 to July 2008,25 patients with traumatic patellar dislocation were treated,including 18 males and 7 females with an average age of 20.7 ±4.6 years.All had history of knee trauma, knee laxity and dysplasia of patellofemoral joint.Thirteen patients had primary acute patellar dislocatin and 12 cases had redislocation.All the patients experienced arthroscopic examination first and removing of hemarthrosis and tackle of injured artificial surface.Then lateral rims of patella were pushed to median to determine whether there were any obstacles in the process of patella reduction.If so,only the operation of reconstruction of medial retinaculum was performed.If not, lateral patellofemoral ligament would be released first and then reconstruction of medial retinaculum was performed.[Result]Twenty-five patients were followed up postoperatively from 9 - 96 months with an average of 26.7 months.The patients had no recurrence of dislocation after operation, their apprehensive tests were negative and their ranges of motion returned to normal.Four of them got a slight feeling of stress when the knee was overflexed but all resumed the pre-trauma life state.The structures of patellofemoral joint were normal and the areas of injured cartilage got neither enlarged nor further degenerated on radiographs and MRI.Lysholm scores were 46.5 preoperatively and 93.5 postoperatively (P <0.05).[Conclusion]It might be not necessary to release lateral retinaculum in the treatment of primary traumatic patellar dislocation without the condition of the dysplasia of patellofemoral joint.Reconstruction of medial retinaculum only could resume the position of patella.Different ways of reconstruction of medial retinaculum could be used for not only lessening operative trauma but also maintaining treatment effect in the treatment of primary and multiple

  12. A survival analysis of 1084 knees of the Oxford unicompartmental knee arthroplasty

    Science.gov (United States)

    Bottomley, N.; Jones, L. D.; Rout, R.; Alvand, A.; Rombach, I.; Evans, T.; Jackson, W. F. M.; Beard, D. J.; Price, A. J.

    2016-01-01

    Aims The aim of this to study was to compare the previously unreported long-term survival outcome of the Oxford medial unicompartmental knee arthroplasty (UKA) performed by trainee surgeons and consultants. Patients and Methods We therefore identified a previously unreported cohort of 1084 knees in 947 patients who had a UKA inserted for anteromedial knee arthritis by consultants and surgeons in training, at a tertiary arthroplasty centre and performed survival analysis on the group with revision as the endpoint. Results The ten-year cumulative survival rate for revision or exchange of any part of the prosthetic components was 93.2% (95% confidence interval (CI) 86.1 to 100, number at risk 45). Consultant surgeons had a nine-year cumulative survival rate of 93.9% (95% CI 90.2 to 97.6, number at risk 16). Trainee surgeons had a cumulative nine-year survival rate of 93.0% (95% CI 90.3 to 95.7, number at risk 35). Although there was no differences in implant survival between consultants and trainees (p = 0.30), there was a difference in failure pattern whereby all re-operations performed for bearing dislocation (n = 7), occurred in the trainee group. This accounted for 0.6% of the entire cohort and 15% of the re-operations. Conclusion This is the largest single series of the Oxford UKA ever reported and demonstrates that good results can be achieved by a heterogeneous group of surgeons, including trainees, if performed within a high-volume centre with considerable experience with the procedure. Cite this article: Bone Joint J 2016;(10 Suppl B):22–7. PMID:27694512

  13. Arthrography in sport injuries of the knee joint

    Energy Technology Data Exchange (ETDEWEB)

    Schaefer, H.

    1983-09-01

    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 frequent 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.

  14. Arthroscopic surgery for degenerative knee

    DEFF Research Database (Denmark)

    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....... RESULTS: The search identified nine trials assessing the benefits of knee arthroscopic surgery in middle aged and older patients with knee pain and degenerative knee disease. The main analysis, combining the primary endpoints of the individual trials from three to 24 months postoperatively, showed a small...... included symptomatic deep venous thrombosis (4.13 (95% confidence interval 1.78 to 9.60) events per 1000 procedures), pulmonary embolism, infection, and death. CONCLUSIONS: The small inconsequential benefit seen from interventions that include arthroscopy for the degenerative knee is limited in time...

  15. Stress-free states of continuum dislocation fields : Rotations, grain boundaries, and the Nye dislocation density tensor

    NARCIS (Netherlands)

    Limkumnerd, Surachate; Sethna, James P.

    2007-01-01

    We derive general relations between grain boundaries, rotational deformations, and stress-free states for the mesoscale continuum Nye dislocation density tensor. Dislocations generally are associated with long-range stress fields. We provide the general form for dislocation density fields whose stre

  16. Anterior knee pain

    Science.gov (United States)

    ... Armstrong B. Rehabilitation of the knee following sports injury. Clin Sports Med. 2010;29:81-106. PMID: 19945588 www. ... by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic ... and Disorders Browse the Encyclopedia A.D.A. ...

  17. Unicompartmental knee arthroplasty

    NARCIS (Netherlands)

    Kort, Nanne Pieter

    2007-01-01

    This thesis concerns technical aspects of unicompartmental knee arthroplasty. Recent years have witnessed a resurgence of interest in unicompartmental arthroplasty, particularly with the introduction of the minimally invasive technique. In the light of the excellent long-term results of the total kn

  18. Knee injuries in football

    African Journals Online (AJOL)

    estimated 240 million (in 2000)1 to 265 million (in 2006)2 players ... injuries during a season, but due to variations in the definition of ... a risk for a major knee injury, with 20% of illegal activity-related ... Rob Collins is a lecturer in the Section Sports Medicine at the University of .... full return to football is between 6 and 9.

  19. CURBSIDE CONSULTATION IN KNEE ARTHROPLASTY: 49 CLINICAL QUESTIONS

    Directory of Open Access Journals (Sweden)

    Craig J. Della Vale

    2008-12-01

    Full Text Available A user- friendly reference for decision making in complicated cases of knee arthroplasty desingned in a question and answers format composed of articles containing current concepts and preferences of experts in total knee replacement surgery, enhanced by several images, diagrams and references and written in the form of a casual advice by Craig J. Della Vale, MD. and his collaborators. PURPOSE By this practical reference of knee arthroplasty, the editor and the contributors have aimed providing straightforward and brief answers, evidence-based advices, their preference and opinions containing current concepts for unanswered questions about complicated cases in total knee replacement surgery which are often controversial and not addressed clearly in traditional knee arthroplasty references. FEATURES There are 49 subjects each written by a different expert designed in 4 sections in a question and answers format including several images and diagrams and also essential references at the end of each article. In the first section preoperative questions is subjected including indications, unicompartmental osteoarthritis of the knee, patient with vascular problems, donating blood, bilateral arthroplasty, patellar resurfacing, range of motion, bearing surface, contraindications, teaching class for patients prior surgery. The second section is about intraoperative questions including skin incision, patella femoral maltracking, femoral component rotation, tibial component rotation, lateral release, femoral component sizing, flexion instability, varus deformity, and valgus deformity, tightness in extension, iatrogenic MCL injury, antibiotic-loaded cement, and perioperative pain. The third section subjects postoperative questions including wound drainage, preventing tromboembolic events, vascular complications, foot drop, manipulation under anesthesia, patella fractures, supracondylar femur fractures, acute extensor mechanism disruptions. In the fourth

  20. Shifting bone marrow edema of the knee

    Energy Technology Data Exchange (ETDEWEB)

    Moosikasuwan, Josh B.; Schultz, Elizabeth [Department of Radiology, North Shore University Hospital, 300 Community Drive, NY 11030, Manhasset (United States); Miller, Theodore T. [Department of Radiology, North Shore University Hospital, 300 Community Drive, NY 11030, Manhasset (United States); Department of Radiology, North Shore University Hospital, 825 Northern Boulevard, NY 11021, Great Neck (United States); Math, Kevin [Department of Radiology, Beth Israel Medical Center, First Avenue at 16th Street, NY 10003, New York (United States)

    2004-07-01

    The purpose of our study is to describe shifting bone marrow edema in the knee as the MR imaging feature of intra-articular regional migratory osteoporosis of the knee. Five men, aged 45-73 years, were referred by orthopedic surgeons for MR imaging evaluation of knee pain, which had been present for 2 weeks to 6 months. One patient had a prior history of blunt trauma. None had risk factors for osteonecrosis. Four patients had two MR examinations and the patient with prior blunt trauma had four. Plain radiographs were obtained in all patients. In all cases, a large area of marrow edema initially involved a femoral condyle, with migration of the bone marrow edema to the other femoral condyle, tibia, and/or patella occurring over a 2- to 4-month period. Adjacent soft tissue edema was present in all five patients, while none had a joint effusion. Radiographs of two patients showed generalized osteopenia. In the absence of acute trauma or clinical suspicion of infection, a large area of bone marrow edema without a zone of demarcation may represent intra-articular regional migratory osteoporosis. Demonstration of shifting bone marrow edema on follow-up examinations suggests this diagnosis. (orig.)

  1. Alterations in walking knee joint stiffness in individuals with knee osteoarthritis and self-reported knee instability

    Science.gov (United States)

    Gustafson, Jonathan A.; Gorman, Shannon; Fitzgerald, G. Kelley; Farrokhi, Shawn

    2017-01-01

    Increased walking knee joint stiffness has been reported in patients with knee osteoarthritis (OA) as a compensatory strategy to improve knee joint stability. However, presence of episodic self-reported knee instability in a large subgroup of patients with knee OA may be a sign of inadequate walking knee joint stiffness. The objective of this work was to evaluate the differences in walking knee joint stiffness in patients with knee OA with and without self-reported instability and examine the relationship between walking knee joint stiffness with quadriceps strength, knee joint laxity, and varus knee malalignment. Overground biomechanical data at a self-selected gait velocity was collected for 35 individuals with knee OA without self-reported instability (stable group) and 17 individuals with knee OA and episodic self-reported instability (unstable group). Knee joint stiffness was calculated during the weight-acceptance phase of gait as the change in the external knee joint moment divided by the change in the knee flexion angle. The unstable group walked with lower knee joint stiffness (p=0.01), mainly due to smaller heel-contact knee flexion angles (pknee flexion excursions (pknee stable counterparts. No significant relationships were observed between walking knee joint stiffness and quadriceps strength, knee joint laxity or varus knee malalignment. Reduced walking knee joint stiffness appears to be associated with episodic knee instability and independent of quadriceps muscle weakness, knee joint laxity or varus malalignment. Further investigations of the temporal relationship between self-reported knee joint instability and walking knee joint stiffness are warranted. PMID:26481256

  2. Alterations in walking knee joint stiffness in individuals with knee osteoarthritis and self-reported knee instability.

    Science.gov (United States)

    Gustafson, Jonathan A; Gorman, Shannon; Fitzgerald, G Kelley; Farrokhi, Shawn

    2016-01-01

    Increased walking knee joint stiffness has been reported in patients with knee osteoarthritis (OA) as a compensatory strategy to improve knee joint stability. However, presence of episodic self-reported knee instability in a large subgroup of patients with knee OA may be a sign of inadequate walking knee joint stiffness. The objective of this work was to evaluate the differences in walking knee joint stiffness in patients with knee OA with and without self-reported instability and examine the relationship between walking knee joint stiffness with quadriceps strength, knee joint laxity, and varus knee malalignment. Overground biomechanical data at a self-selected gait velocity was collected for 35 individuals with knee OA without self-reported instability (stable group) and 17 individuals with knee OA and episodic self-reported instability (unstable group). Knee joint stiffness was calculated during the weight-acceptance phase of gait as the change in the external knee joint moment divided by the change in the knee flexion angle. The unstable group walked with lower knee joint stiffness (p=0.01), mainly due to smaller heel-contact knee flexion angles (pknee flexion excursions (pknee stable counterparts. No significant relationships were observed between walking knee joint stiffness and quadriceps strength, knee joint laxity or varus knee malalignment. Reduced walking knee joint stiffness appears to be associated with episodic knee instability and independent of quadriceps muscle weakness, knee joint laxity or varus malalignment. Further investigations of the temporal relationship between self-reported knee joint instability and walking knee joint stiffness are warranted.

  3. Observation of dislocation dynamics in the electron microscope

    Energy Technology Data Exchange (ETDEWEB)

    Lagow, B W; Robertson, I M; Jouiad, M; Lassila, D H; Lee, T C; Birnbaum, H K

    2001-01-17

    Deformation experiments performed in-situ in the transmission electron microscope have led to an increased understanding of dislocation dynamics. To illustrate the capability of this technique two examples will be presented. In the first example, the processes of work hardening in Mo at room temperature will be presented. These studies have improved our understanding of dislocation mobility, dislocation generation, and dislocation-obstacle interactions. In the second example, the interaction of matrix dislocations with grain boundaries will be described. From such studies predictive criteria for slip transfer through grain boundaries have been developed.

  4. Observation of Dislocation Dynamics in the Electron Microscope

    Energy Technology Data Exchange (ETDEWEB)

    Lagow, B W; Robertson, I M; Jouiad, M; Lassila, D H; Lee, T C; Birnbaum, H K

    2001-08-21

    Deformation experiments performed in-situ in the transmission electron microscope have led to an increased understanding of dislocation dynamics. To illustrate the capability of this technique two examples will be presented. In the first example, the processes of work hardening in Mo at room temperature will be presented. These studies have improved our understanding of dislocation mobility, dislocation generation, and dislocation-obstacle interactions. In the second example, the interaction of matrix dislocations with grain boundaries will be described. From such studies predictive criteria for slip transfer through grain boundaries have been developed.

  5. Specific inferior dislocation of the hip: one case report

    Institute of Scientific and Technical Information of China (English)

    XU Chao

    2007-01-01

    @@ Hip joint dislocations are generally classified as anterior, posterior, and central dislocations. In 1970s, the anterior dislocation was divided into pubic type and obturator type.1 It is generally recognized that for anterior dislocation of the hip joint, the femoral head is located at anteriorinferior part of the acetabulum, characterized clinically as abduction, extorsion, slight flexion deformity, and longer limb than the opposite side. When posterior dislocation is present, the femoral head is located at posteriorsuperior part of the acetabulum and manifested clinically as flexion, adduction, intorsion, and shortening deformity.

  6. Photoluminescence of Dislocations in Nitrogen Doped Czochralski Silicon

    Institute of Scientific and Technical Information of China (English)

    LI Dong-Sheng; YANG De-Ren; E.Leoni; S.Binetti; S.Pizzini

    2004-01-01

    @@ We investigate optical properties of dislocations in nitrogen-doped and nitrogen-free Czochralski silicon. The dislocations are formed during crystal growth, but not formed during deformation. The results show that in nitrogen-doped samples, a broad band replaced the D1 band of dislocation, regardless of dislocation density. The replacement ofD1 band is caused by the non-irradiation combination induced by oxygen precipitation. Moreover,a new emission at 0.975 eV is observed in both the nitrogen-free and doped samples when the dislocation density is lower than 104 cm-2.

  7. Custom Knee Device for Knee Contractures After Internal Femoral Lengthening.

    Science.gov (United States)

    Bhave, Anil; Shabtai, Lior; Ong, Peck-Hoon; Standard, Shawn C; Paley, Dror; Herzenberg, John E

    2015-07-01

    The development of knee flexion contractures is among the most common problems and complications associated with lengthening the femur with an internal device or external fixator. Conservative treatment strategies include physical therapy, serial casting, and low-load prolonged stretching with commercially available splinting systems. The authors developed an individually molded, low-cost custom knee device with polyester synthetic conformable casting material to treat knee flexion contractures. The goal of this study was to evaluate the results of treatment with a custom knee device and specialized physical therapy in patients who had knee flexion contracture during femoral lengthening with an intramedullary lengthening femoral nail. This retrospective study included 23 patients (27 limbs) who underwent femoral lengthening with an internal device for the treatment of limb length discrepancy. All patients had a knee flexion contracture raging from 10° to 90° during the lengthening process and were treated with a custom knee device and specialized physical therapy. The average flexion contracture before treatment was 36°. The mean amount of lengthening was 5.4 cm. After an average of 3.8 weeks of use of the custom knee device, only 2 of 27 limbs (7.5%) had not achieved complete resolution of the flexion contracture. The average final extension was 1.4°. Only 7 of 27 limbs (26%) required additional soft tissue release. The custom knee device is an inexpensive and effective method for treating knee flexion contracture after lengthening with an internal device.

  8. Component rotation and anterior knee pain after total knee arthroplasty.

    Science.gov (United States)

    Barrack, R L; Schrader, T; Bertot, A J; Wolfe, M W; Myers, L

    2001-11-01

    All patients undergoing cruciate-retaining primary total knee arthroplasty for degenerative osteoarthritis at one center were studied prospectively. Clinical and radiographic followup was obtained at a minimum 5 years in 102 knees in 73 patients. Patients were asked specifically about the presence of the pain in the anterior aspect of the knee in the vicinity of the patella and rated the severity of the pain on a visual analog scale. Significant anterior knee pain rating at least 3 of 10 on the visual analog scale was present in 16 knees (13 patients). Eleven patients with 14 symptomatic knees agreed to undergo computed tomography scanning to accurately determine the rotation of the tibial and femoral components. The epicondylar axis and tibial tubercle were used as references using a previously validated technique. A control group of 11 asymptomatic patients (14 knees), matched for age, gender, and length of followup also underwent computed tomography scanning. All patients in both groups had normal axial alignment. There was a highly significant difference in tibial component rotation between the two groups with the patients with anterior knee pain averaging 6.2 degrees internal rotation compared with 0.4 degrees external rotation in the control group. There also was a significant difference in combined component rotation with the patients with anterior knee pain averaging 4.7 degrees internal rotation compared with 2.6 degrees external rotation in the control group. There was no significant difference in the degree of radiographic patellar tilt or patellar subluxation between the two groups. Patients with combined component internal rotation were more than five times as likely to experience anterior knee pain after total knee arthroplasty compared with those with combined component external rotation. Component malrotation is a significant factor in the development of anterior knee pain after total knee arthroplasty.

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

    Science.gov (United States)

    Zhang, Jing-Wei; Li, Min; He, Xian-Feng; Yu, Yi-Hui; Zhu, Li-Mei

    2014-01-01

    To evaluate clinical outcome of suture anchors in strengthening both acromioclavicular and coracoclavicular ligaments in the surgical treatment of acromioclavicular joint dislocation. 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 Constant- Murley shoulder score. Clinical and radiographic shoulder ratings were evaluated using Taft criteria at 3, 6 and 12 months. 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. 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.

  10. No economic benefit of early knee reconstruction over optional delayed reconstruction for ACL tears

    DEFF Research Database (Denmark)

    Kiadaliri, Aliasghar A; Englund, Martin; Stefan Lohmander, L.

    2016-01-01

    Background To analyse 5-year cost-effectiveness of early versus optional delayed acute anterior cruciate ligament (ACL) reconstruction. Methods 121 young, active adults with acute ACL injury to a previously uninjured knee were randomised to early ACL reconstruction (n=62, within 10 weeks of injury...

  11. Electron energy can oscillate near a crystal dislocation

    Science.gov (United States)

    Li, Mingda; Cui, Wenping; Dresselhaus, Mildred S.; Chen, Gang

    2017-01-01

    Crystal dislocations govern the plastic mechanical properties of materials but also affect the electrical and optical properties. However, a fundamental and quantitative quantum field theory of a dislocation has remained undiscovered for decades. Here we present an exactly-solvable one-dimensional quantum field theory of a dislocation, for both edge and screw dislocations in an isotropic medium, by introducing a new quasiparticle which we have called the ‘dislon’. The electron-dislocation relaxation time can then be studied directly from the electron self-energy calculation, which is reducible to classical results. In addition, we predict that the electron energy will experience an oscillation pattern near a dislocation. Compared with the electron density’s Friedel oscillation, such an oscillation is intrinsically different since it exists even with only single electron is present. With our approach, the effect of dislocations on materials’ non-mechanical properties can be studied at a full quantum field theoretical level.

  12. Sports-related shoulder dislocations: a state-hospital experience.

    Science.gov (United States)

    Hazmy, C H Wan; Parwathi, A

    2005-07-01

    This retrospective study was conducted in a state hospital set-up and aimed at identifying the incidence of sports-related shoulder dislocations and their characteristics and the sports events involved. All patients with shoulder dislocation related to sporting activities admitted to the hospital from January 1999 to December 2002 were included in the study. There were 18 sports-related shoulder dislocations out of 106 all shoulder dislocations admitted during this 4-year period. The average age of the patients was 25.4 years. All but two were male. All were anterior dislocations. Recurrent dislocation constitutes 78% of the cases with an average of 3 times re-dislocation. Rugby and badminton were the major contributors to the injuries followed by volleyball, soccer and swimming. Conservative treatment was successfully instituted for 88% of the patients and 12% opted for surgical intervention.

  13. Clinical, roentgenographic, and scintigraphic results after interruption of the superior lateral genicular artery during total knee arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Ritter, M.A.; Keating, E.M.; Faris, P.M. (Center for Hip and Knee Surgery, Mooresville, IN (USA))

    1989-11-01

    Forty-eight patients treated by primary bilateral simultaneous total knee arthroplasty, in which one knee had a lateral release and the other did not, were evaluated clinically and roentgenographically from one to 12 years postoperatively. Thirty of these patients also had a technetium-99 bone scan. Mean clinical scores at the last follow-up examination were 90 for both groups. Roentgenographically, there were no subluxations, dislocations, or fractures in either group. There were two metal-backed patellae (one in each group) with signs of polyethylene wear and developed debris. Bone scans showed no difference between the two groups and no signs of osteonecrosis of the patella.

  14. 21 CFR 888.3590 - Knee joint tibial (hemi-knee) metallic resurfacing uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint tibial (hemi-knee) metallic resurfacing... 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...

  15. 21 CFR 888.3580 - Knee joint patellar (hemi-knee) metallic resurfacing uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint patellar (hemi-knee) metallic... § 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...

  16. Comparative study on treating complete dislocation of acromioclavicular joint with three different methods

    Institute of Scientific and Technical Information of China (English)

    林斌; 练克俭; 郭林新; 郭志民; 庄泽民; 刘庆军; 周亮

    2004-01-01

    Objective: To comparatively study complete dislocation of acromioclavicular joint treated with three different methods.Methods:A total of 96 patients (81 males and 15 females, aged 16-59 years, mean =45 years) with complete dislocation of acromioclavicular joint were treated with Dewar's operation ( Group A, n = 32), internal fixation with Kirschner tension band wires ( Group B, n = 44), or internal fixation with Wolter plates ( Group C, n = 20 ),respectively, in this study. Eighty-five patients suffered from acute dislocations and eleven from chronic dislocations. Results: The patients were followed up for 50 months on an average. According to Karlsson's standard, in Group A, 26 patients were assessed as good, 5 as fair and 1 as poor. In Group B, 20 patients were assessed as good, 13 as fair and 11 as poor. In Group C, 15 patients were assessed as good, 4 as fair and 1 as poor. The good and fair rates were significantly different between Group A and Group B, and between Group C and Group B, but no statistical difference was found between Group A and Group C. The operating time was ( 52.36 ± 7.24 ) minutes, ( 67.43 ± 8.11) minutes and (69.73 ±8.04) minutes in Groups A, B and C, respectively. And the hospitalizing fees were (2 400 ±270) yuan, (2 100±190) yuan and (8450±360) yuan in Groups A, B and C, respectively. Conclusions: Dewar's operation is a good and safe method with shorter operating time and lower hospitalizing fee for treating complete dislocation of acromioclavicular joint. The method is simple without the need of a second operation to remove the implants and with few complications.

  17. Does knee awareness differ between different knee arthroplasty prostheses?

    DEFF Research Database (Denmark)

    Thomsen, Morten G; Latifi, Roshan; Kallemose, Thomas

    2016-01-01

    BACKGROUND: Low knee awareness after Total Knee Arthroplasty (TKA) has become the ultimate goal in trying to achieve a natural feeling knee that meet patient expectations. To accommodate this manufacturers of TKAs have developed new prosthetic designs that potentially could give patients a more...... natural feeling knee during activities. The purpose af this study was to compare the Forgotten Joint Score (FJS) and Oxford Knee Score (OKS) of patients treated with a previous generation standard Cruciate Retaining (CR) TKA to the scores obtained by patients treated with a newer generation CR TKA...... and pre- and postoperative knee alignment. Patients were asked to complete the FJS and OKS questionnaires. Of the 316 patients completing the survey 64 standard CR TKAs to 35 new generation CR TKAs and 121 standard CR TKAs to 68 mobile bearing TKAs were matched. The FJS and OKS scores of the three TKA...

  18. Pyogenic knee arthritis caused by group A β-hemolytic Streptococcus: a toxic shock-prevented case.

    Science.gov (United States)

    Goto, Masafumi; Gotoh, Masafumi; Mitsui, Yasuhiro; Shibata, Hideaki; Okawa, Takahiro; Higuchi, Fujio; Shiba, Naoto

    2014-01-01

    Pyogenic knee arthritis caused by group A β-hemolytic Streptococcus (GAS) is rare. GAS sometimes causes group A β-hemolytic streptococcal toxic shock syndrome. We encountered a case of pyogenic knee arthritis caused by GAS that resolved after appropriate treatment (emergency arthroscopic synovectomy and medication) administered within 48 h of onset. In cases of a history of another infection with acute knee joint pain, the possibility of GAS-induced pyogenic knee arthritis should be considered, and proper treatment should be administered immediately.

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

    DEFF Research Database (Denmark)

    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...... evaluation was performed before the arthroscopic examination, and the images were interpreted by an experienced magnetic resonance radiologist. No information from the MRI examination was available to the orthopedic surgeons before arthroscopy. The standard of reference for comparison was arthroscopy...

  20. Talocrural dislocation with associated weber type C fibular fracture in a collegiate football player: a case report.

    Science.gov (United States)

    Ricci, R Daniel; Cerullo, James; Blanc, Robert O; McMahon, Patrick J; Buoncritiani, Anthony M; Stone, David A; Fu, Freddie H

    2008-01-01

    To present the case of a talocrural dislocation with a Weber type C fibular fracture in a National Collegiate Athletic Association Division I football athlete. The athlete, while attempting to make a tackle during a game, collided with an opponent, who in turn stepped on the lateral aspect of the athlete's ankle, resulting in forced ankle eversion and external rotation. On-field evaluation showed a laterally displaced talocrural dislocation. Immediate reduction was performed in the athletic training room to maintain skin integrity. Post-reduction radiographs revealed a Weber type C fibular fracture and increased medial joint clear space. A below-knee, fiberglass splint was applied to stabilize the ankle joint complex. Subtalar dislocation, Maisonneuve fracture, malleolar fracture, deltoid ligament rupture, syndesmosis disruption. The sports medicine staff immediately splinted and transported the athlete to the athletic training room to reduce the dislocation. The athlete then underwent an open reduction and internal fixation procedure to stabilize the injury: 2 syndesmosis screws and a fibular plate were placed to keep the ankle joint in an anatomically reduced position. With the guidance of the athletic training staff, the athlete underwent an accelerated physical rehabilitation protocol in an effort to return to sport as quickly and safely as possible. Most talocrural dislocations and associated Weber type C fibular fractures are due to motor vehicle accidents or falls. We are the first to describe this injury in a Division I football player and to present a general rehabilitation protocol for a high-level athlete. Sports medicine practitioners must recognize that this injury can occur in the athletic environment. Prompt reduction, early surgical intervention, sufficient resources, and an accelerated rehabilitation protocol all contributed to a successful outcome in the patient.

  1. Radiographic and scintigraphic evaluation of total knee arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, R.; Soudry, M.

    1986-04-01

    Various radiographic and scintigraphic methods are used to supplement clinical findings in the evaluation of total knee arthroplasty and its complications. Serial roentgenograms offer reliable information for diagnosing mechanical loosening. Wide and extensive radiolucency at the cement-bone interface and shift in position and alignment of prosthetic components can be seen in almost all cases by the time revision is necessary. Radiographic abnormalities are usually not present in acute infection, but are often present in chronic infection. Bone scanning has a high sensitivity for diagnosis of infection or loosening, but is nonspecific because increased uptake is often present around asymptomatic total knee arthroplasties with normal radiographs. Differential bone and Gallium scanning and scanning with Indium 111-labeled leukocytes have a greater specificity for diagnosis of infection than does bone or Gallium scanning alone. Routine radiographic and scintigraphic studies have shown a high incidence of deep vein thrombosis in the calf after total knee arthroplasty. Clinically significant pulmonary embolization is infrequent.

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

    OpenAIRE

    2015-01-01

    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 lengtheni...

  3. Transtriquetral perihamate fracture-dislocation: case report

    Directory of Open Access Journals (Sweden)

    Frederico Barra de Moraes

    2016-08-01

    Full Text Available ABSTRACT The wrist is a region that is very vulnerable to injuries of the extremities. Among these injuries, fractures of the pyramidal bone (or triquetrum in association with dislocation of the hamate and carpal instability are uncommon. They are generally correlated with high-energy trauma and may be associated with neurovascular deficits, muscle-tendon disorders, skin lesions or injuries to other carpal bones. Thus, in this report, one of these rare cases of transtriquetral perihamate fracture-dislocation with carpal instability is presented, diagnosed by means of radiography on the right wrist of the patient who presented pain, edema and limitation of flexion-extension of the carpus after trauma to the region. The stages of attending to the case are described, from the initial consultation to the surgical treatment and physiotherapy, which culminated in restoration of the strength and range of motion of the wrist.

  4. Treatment of Galeazzi fracture-dislocations.

    Science.gov (United States)

    Maculé Beneyto, F; Arandes Renú, J M; Ferreres Claramunt, A; Ramón Soler, R

    1994-03-01

    Among 33 patients with a Galeazzi-type fracture-dislocation of the forearm, there were two children and 26 adults with a classic Galeazzi injury, and five patients with a Galeazzi-equivalent lesion. The worst results were obtained in type-I lesions. Closed reduction was primarily successful in children. The results of surgical treatment were much better in adults. It is advisable to treat this complex injury by anatomic reduction and internal fixation of the radial shaft fracture. Immobilization in a fully supinated position is recommended to reduce the dislocation of the distal radioulnar joint. Additional temporary radioulnar fixation with Kirschner wires is also necessary in cases of severe derangement of the distal radioulnar joint.

  5. Ipsilateral dislocation of the shoulder and elbow.

    Science.gov (United States)

    Khan, M R; Mirdad, T M

    2001-11-01

    Ipsilateral dislocation of shoulder and elbow joints is a rare injury. Only 2 such cases have been reported in the English literature. We report a case of a 35-year-old man involved in a road traffic accident under the influence of alcohol. He sustained posterior left elbow and anterior left shoulder dislocation with minimally displaced greater tuberosity fracture. He also had partial median nerve palsy. Under intramuscular pethidine and intravenous diazepam, close reduction of elbow followed by shoulder was carried out. At 2 months, median nerve function returned to normal. At 3 months, almost full elbow and shoulder joint movement returned. Although rare and complex, this ipsilateral injury can be treated conservatively.

  6. Femoral head fracture without hip dislocation

    Institute of Scientific and Technical Information of China (English)

    Aditya K Aggarwal; Ashwani Soni; Daljeet Singh

    2013-01-01

    Femoral head fractures without dislocation or subluxation are extremely rare injuries.We report a neglected case of isolated comminuted fracture of femoral head without hip dislocation or subluxation of one year duration in a 36-year-old patient who sustained a high energy trauma due to road traffic accident.He presented with painful right hip and inability to bear full weight on right lower limb with Harris hip score of 39.He received cementless total hip replacement.At latest follow-up of 2.3 years,functional outcome was excellent with Harris hip score of 95.Such isolated injuries have been described only once in the literature and have not been classified till now.The purpose of this report is to highlight the extreme rarity,possible mechanism involved and a novel classification system to classify such injuries.

  7. Results of Operative and Nonoperative Treatment of Rockwood Types III and V Acromioclavicular Joint Dislocation

    Science.gov (United States)

    Joukainen, Antti; Kröger, Heikki; Niemitukia, Lea; Mäkelä, E. Antero; Väätäinen, Urho

    2014-01-01

    Background: The optimal treatment of acute, complete dislocation of the acromioclavicular joint (ACJ) is still unresolved. Purpose: To determine the difference between operative and nonoperative treatment in acute Rockwood types III and V ACJ dislocation. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: In the operative treatment group, the ACJ was reduced and fixed with 2 transarticular Kirschner wires and ACJ ligament suturing. The Kirschner wires were extracted after 6 weeks. Nonoperatively treated patients received a reduction splint for 4 weeks. At the 18- to 20-year follow-up, the Constant, University of California at Los Angeles Shoulder Rating Scale (UCLA), Larsen, and Simple Shoulder Test (SST) scores were obtained, and clinical and radiographic examinations of both shoulders were performed. Results: Twenty-five of 35 potential patients were examined at the 18- to 20-year follow-up. There were 11 patients with Rockwood type III and 14 with type V dislocations. Delayed surgical treatment for ACJ was used in 2 patients during follow-up: 1 in the operatively treated group and 1 in the nonoperatively treated group. Clinically, ACJs were statistically significantly less prominent or unstable in the operative group than in the nonoperative group (normal/prominent/unstable: 9/4/3 and 0/6/3, respectively; P = .02) and in the operative type III (P = .03) but not type V dislocation groups. In operatively and nonoperatively treated patients, the mean Constant scores were 83 and 85, UCLA scores 25 and 27, Larsen scores 11 and 11, and SST scores 11 and 12 at follow-up, respectively. There were no statistically significant differences in type III and type V dislocations. In the radiographic analysis, the ACJ was wider in the nonoperative than the operative group (8.3 vs 3.4 mm; P = .004), and in the type V dislocations (nonoperative vs operative: 8.5 vs 2.4 mm; P = .007). There was no statistically significant difference between study groups in

  8. Dislocations: 75 years of Deformation Mechanisms

    Science.gov (United States)

    Schneider, Judy

    2009-01-01

    The selection of papers presented in this section reflect on themes to be explored at the "Dislocations: 75 years of Deformation Mechanisms" Symposium to be held at the Annual 2009 TMS meeting. The symposium was sponsored by the Mechanical Behavior of Materials Committee to give tribute to the evolution of a concept that has formed the basis of our mechanistic understanding of how crystalline solids plastically deform and how they fail.

  9. Dislocation Concepts in Friction and Wear.

    Science.gov (United States)

    1980-12-01

    one well-investigated case is explained in this manner, using a work-hardening law that appears to be common in wire drawing . (xi) Dislocation cells...different slip systems. The discussed principles may be illustrated by experimental evidence for the case of wire drawing : In wire drawing the wire axis of...fault energies shift the f cc wire drawing texture so as to favor the > component, as was first pointed out by N. Brown~4 ~ Similarly, therefore, one

  10. Dislocation Etching Solutions for Mercury Cadmium Selenide

    Science.gov (United States)

    2014-09-01

    manufacturer’s or trade names does not constitute an official endorsement or approval of the use thereof. Destroy this report when it is no longer...dislocation—thus enabling EPD measurement of Hg1-xCdxSe. 15. SUBJECT TERMS Mercury cadmium selenide, etch pits, dislocations, preferential etching...by the US Army Research Laboratory and was accomplished under Cooperative Agreement # W911NF-12-2-0019. vi

  11. Surgical management of intraocular lens dislocations

    Directory of Open Access Journals (Sweden)

    Adem Gul

    2015-10-01

    Full Text Available ABSTRACTPurpose:To report and compare the surgical, visual, and anatomical outcomes following treatment of dislocated intraocular lenses (IOLs.Methods:The medical records of 28 eyes of 28 patients were evaluated. Age, gender, pre-and postoperative best-corrected visual acuity (BCVA, surgical methods, and complications were recorded.Results:Pre-and postoperative BCVA ranged from counting fingers to 20/32 and from counting fingers to 20/25, respectively. Late-onset dislocations were the most frequently observed complication. The most frequent surgical method was IOL repositioning in 15 of 28 patients, followed by IOL exchange in 11 patients, and IOL removal in 2 patients. Only 1 patient required surgical re-intervention with IOL capture.Conclusions:Visual acuity improved following the use of either IOL repositioning or IOL exchange. No superiority of one method over the other was observed. In the present retrospective case series, management of dislocated IOLs with repositioning or exchange of the primary implant conferred comparable surgical and visual outcomes.

  12. Open Galeazzi fracture with ipsilateral elbow dislocation.

    Science.gov (United States)

    Adanır, Oktay; Yüksel, Serdar; Beytemur, Ozan; Güleç, M Akif

    2016-08-01

    Combination of the Galeazzi fracture and dislocation of the elbow joint in same extremity is very rare. In this article, we report a 26-year-old male patient with a posterolateral dislocation of the elbow and ipsilateral volar type Galeazzi fracture. We performed closed reduction for the elbow dislocation during admission to the emergency department. Patient was taken to the operating room in the sixth hour of his application to emergency department and open wound on the ulnovolar region of the wrist was closed primarily after irrigation and debridement. We performed open reduction and internal fixation of the radial fracture with a dynamic compression plate. After fixation, we evaluated the stability of the elbow joint and distal radioulnar joint. Distal radioulnar joint was unstable under fluoroscopic examination and fixed with one 1.8 mm Kirschner wire in a pronated position. Then, elbow joint was stable. One year after surgery, patient had no pain or sings of instability. At the last follow-up, range of motion of the elbow was 10°-135° and forearm pronation and supination were 70°.

  13. Thoracic fractures and dislocations in motorcyclists

    Energy Technology Data Exchange (ETDEWEB)

    Daffner, R.H.; Deeb, Z.L.; Rothfus, W.E.

    1987-06-01

    Motorcyclists who are involved in accidents generally suffer severe multiple injuries, some of which are not readily apparent on initial examination. One such subtle injury is fracture, with or without dislocation, in the upper thoracic spine. The severe spinal cord damage produced by the injury is often overshadowed by cerebral or cervical injury. Proper diagnosis is further hampered by the fact that the upper thoracic region is difficult to examine radiographically on plain films, particularly when using portable equipment. Of a group of 14 motorcyclists having 26 fractures and/or dislocations in the thoracic region, 12 had 24 injuries between T3 and T8. These 24 injuries represented 56% of the fractures and/or dislocations encountered in a larger study of trauma to the thoracic vertebral column. All of these were flexion injuries, suffered when the individual was thrown from the motorcycle and struck a large, solid object. In three cases, the diagnosis was delayed as much as 48 h because proper films were not obtained initially. Because of the serious consequences of delayed treatment, we recommended that all motorcyclists who have sustained severe trauma be examined by overpenetrated film of the upper thoracic region.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  15. Knee Replacement: What you can Expect

    Science.gov (United States)

    ... improves function lessen with each additional surgery. Artificial knees can wear out Another risk of knee replacement ... replacement surgery to last about two hours. After knee replacement surgery After surgery, you're wheeled to ...

  16. Probing the character of ultra-fast dislocations

    Science.gov (United States)

    Ruestes, C. J.; Bringa, E. M.; Rudd, R. E.; Remington, B. A.; Remington, T. P.; Meyers, M. A.

    2015-11-01

    Plasticity is often controlled by dislocation motion, which was first measured for low pressure, low strain rate conditions decades ago. However, many applications require knowledge of dislocation motion at high stress conditions where the data are sparse, and come from indirect measurements dominated by the effect of dislocation density rather than velocity. Here we make predictions based on atomistic simulations that form the basis for a new approach to measure dislocation velocities directly at extreme conditions using three steps: create prismatic dislocation loops in a near-surface region using nanoindentation, drive the dislocations with a shockwave, and use electron microscopy to determine how far the dislocations moved and thus their velocity at extreme stress and strain rate conditions. We report on atomistic simulations of tantalum that make detailed predictions of dislocation flow, and find that the approach is feasible and can uncover an exciting range of phenomena, such as transonic dislocations and a novel form of loop stretching. The simulated configuration enables a new class of experiments to probe average dislocation velocity at very high applied shear stress.

  17. Arthrography of the knee joint

    Energy Technology Data Exchange (ETDEWEB)

    Keyl, W.; Jaeger, M.

    1981-10-01

    The standardized examination technique and the clinical problems of the arthrographic mehtod applied on the knee joint is explained by the results obtained in 3000 examinations. Whereas the accuracy of the knee-joint arthrography provides a high degree in cases of meniscus lesions, computer tomography presents in chondral and capsular ligament lesions, and sonography in popliteal cysts better diagnostic information; but in any case arthroscopy gains more and more importance in knee-joint diagnostics.

  18. Acute injuries of the axis vertebra

    Energy Technology Data Exchange (ETDEWEB)

    Burke, J.T. (United General Hospital, Sedro Woolley, WA (USA)); Harris, J.H. (Texas Univ., Houston, TX (USA). Dept. of Radiology)

    1989-08-01

    A retrospective analysis of 165 patients admitted to Hermann Hospital with acute injuries of the axis vertebra revealed 68 (41%) dens fractures, 62 (38%) cases of traumatic spondylolisthesis ('hangman's' fracture), 21 (13%) extension teardrop fractures, 10 (6%) hyperextension dislocations, and 2 (1.0%) fractures each of the laminae and spinous processes. Of the axis injuries 31 (18%) were limited to the axis body alone. Of these, 21 (61%) were hyperextension teardrop fractures and 10 (32%) were hyperextension dislocations. Axis injuries were associated with acute injuries of other cervical vertebrae in 14 (8%) of the patients. (orig./GDG).

  19. Sternoclavicular dislocation: case report and surgical technique☆

    Science.gov (United States)

    Terra, Bernardo Barcellos; Rodrigues, Leandro Marano; Pádua, David Victoria Hoffmann; Martins, Marcelo Giovanini; Teixeira, João Carlos de Medeiros; De Nadai, Anderson

    2015-01-01

    Sternoclavicular dislocations account for less than 5% of all dislocations of the scapular belt. Most cases of anterior dislocation of the sternoclavicular joint do not present symptoms. However, some patients may develop chronic anterior instability and remain symptomatic, and surgical treatment is indicated in these cases. There is a scarcity of reports in the literature relating to reconstruction using the long palmar tendon in cases of traumatic anterior instability. Although rare, these injuries deserve rapid diagnosis and efficient treatment in order to avoid future complications. The aim of this report was to report on a case of a motocross competitor who developed chronic traumatic anterior instability of the sternoclavicular joint and underwent surgical reconstruction using the autogenous long palmar tendon. The patient was a 33-year-old man with a history of anterior dislocation of the sternoclavicular subsequent to a fall during a maneuver in a motocross competition. Conservative treatment was instituted initially, consisting of use of a functional sling to treat the symptoms for 3 weeks, along with physiotherapeutic rehabilitation for 3 months. We chose to use a modification of the “figure of eight” technique based on the studies by Spencer and Kuhn. A longitudinal incision of approximately 10 cm was made at the level of the sternoclavicular joint. The graft from the ipsilateral long palmar tendon was passed through the orifices in the form of a modified “figure of eight” and its ends were sutured together. The patient was immobilized using an American sling for 4 weeks. After 6 months of follow-up, the patient no longer presented pain or instability when movement of the sternoclavicular joint was required. Minor discomfort and slight prominence of the sternoclavicular joint continued to be present but did not affect the patient's activities. Thus, the patient was able to return to racing 6 months after the operation. Our study presented a case

  20. Sternoclavicular dislocation: case report and surgical technique.

    Science.gov (United States)

    Terra, Bernardo Barcellos; Rodrigues, Leandro Marano; Pádua, David Victoria Hoffmann; Martins, Marcelo Giovanini; Teixeira, João Carlos de Medeiros; De Nadai, Anderson

    2015-01-01

    Sternoclavicular dislocations account for less than 5% of all dislocations of the scapular belt. Most cases of anterior dislocation of the sternoclavicular joint do not present symptoms. However, some patients may develop chronic anterior instability and remain symptomatic, and surgical treatment is indicated in these cases. There is a scarcity of reports in the literature relating to reconstruction using the long palmar tendon in cases of traumatic anterior instability. Although rare, these injuries deserve rapid diagnosis and efficient treatment in order to avoid future complications. The aim of this report was to report on a case of a motocross competitor who developed chronic traumatic anterior instability of the sternoclavicular joint and underwent surgical reconstruction using the autogenous long palmar tendon. The patient was a 33-year-old man with a history of anterior dislocation of the sternoclavicular subsequent to a fall during a maneuver in a motocross competition. Conservative treatment was instituted initially, consisting of use of a functional sling to treat the symptoms for 3 weeks, along with physiotherapeutic rehabilitation for 3 months. We chose to use a modification of the "figure of eight" technique based on the studies by Spencer and Kuhn. A longitudinal incision of approximately 10 cm was made at the level of the sternoclavicular joint. The graft from the ipsilateral long palmar tendon was passed through the orifices in the form of a modified "figure of eight" and its ends were sutured together. The patient was immobilized using an American sling for 4 weeks. After 6 months of follow-up, the patient no longer presented pain or instability when movement of the sternoclavicular joint was required. Minor discomfort and slight prominence of the sternoclavicular joint continued to be present but did not affect the patient's activities. Thus, the patient was able to return to racing 6 months after the operation. Our study presented a case of

  1. Sternoclavicular dislocation: case report and surgical technique

    Directory of Open Access Journals (Sweden)

    Bernardo Barcellos Terra

    2015-08-01

    Full Text Available Abstract Sternoclavicular dislocations account for less than 5% of all dislocations of the scapular belt. Most cases of anterior dislocation of the sternoclavicular joint do not present symptoms. However, some patients may develop chronic anterior instability and remain symptomatic, and surgical treatment is indicated in these cases. There is a scarcity of reports in the literature relating to reconstruction using the long palmar tendon in cases of traumatic anterior instability. Although rare, these injuries deserve rapid diagnosis and efficient treatment in order to avoid future complications. The aim of this report was to report on a case of a motocross competitor who developed chronic traumatic anterior instability of the sternoclavicular joint and underwent surgical reconstruction using the autogenous long palmar tendon. The patient was a 33-year-old man with a history of anterior dislocation of the sternoclavicular subsequent to a fall during a maneuver in a motocross competition. Conservative treatment was instituted initially, consisting of use of a functional sling to treat the symptoms for 3 weeks, along with physiotherapeutic rehabilitation for 3 months. We chose to use a modification of the "figure of eight" technique based on the studies by Spencer and Kuhn. A longitudinal incision of approximately 10 cm was made at the level of the sternoclavicular joint. The graft from the ipsilateral long palmar tendon was passed through the orifices in the form of a modified "figure of eight" and its ends were sutured together. The patient was immobilized using an American sling for 4 weeks. After 6 months of follow-up, the patient no longer presented pain or instability when movement of the sternoclavicular joint was required. Minor discomfort and slight prominence of the sternoclavicular joint continued to be present but did not affect the patient's activities. Thus, the patient was able to return to racing 6 months after the operation. Our

  2. [Postoperative management of hip and knee endoprostheses].

    Science.gov (United States)

    Seitz, S; Rüther, W

    2012-10-01

    Rheumatoid arthritis is often accompanied by massive destruction of the smaller and larger joints even with early therapy using antirheumatic drugs. In these cases total joint arthroplasty is the only surgical option, especially for the knee and hip joint. Knowledge of the specific disease-related postoperative characteristics is a prerequisite for the successful treatment of patients with rheumatoid arthritis. As dislocation of the arthroplastic joint does not occur more often in rheumatoid arthritis, the risk of periprosthetic infection is increased due to the use of biologicals. Therefore, a perioperative optimization is obligatory. In order to facilitate independence in daily living physiotherapy in combination with aids such as arthritis crutches, gripping pliers or raised toilet seat need to be started as soon as possible after surgical treatment. To achieve this goal it is recommended to refer patients with inflammatory arthritis to inpatient rehabilitation facilities. With respect to the specific postoperative treatment after joint replacement the long-term results are comparable with those from patients with primary osteoarthritis.

  3. Treatment of knee osteoarthritis.

    Science.gov (United States)

    Ringdahl, Erika; Pandit, Sandesh

    2011-06-01

    Knee osteoarthritis is a common disabling condition that affects more than one-third of persons older than 65 years. Exercise, weight loss, physical therapy, intra-articular corticosteroid injections, and the use of nonsteroidal anti-inflammatory drugs and braces or heel wedges decrease pain and improve function. Acetaminophen, glucosamine, ginger, S-adenosylmethionine (SAM-e), capsaicin cream, topical nonsteroidal anti-inflammatory drugs, acupuncture, and tai chi may offer some benefit. Tramadol has a poor trade-off between risks and benefits and is not routinely recommended. Opioids are being used more often in patients with moderate to severe pain or diminished quality of life, but patients receiving these drugs must be carefully selected and monitored because of the inherent adverse effects. Intra-articular corticosteroid injections are effective, but evidence for injection of hyaluronic acid is mixed. Arthroscopic surgery has been shown to have no benefit in knee osteoarthritis. Total joint arthroplasty of the knee should be considered when conservative symptomatic management is ineffective.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Contribution to the study of screw dislocations; Contribution a l'etude des dislocations helicoidales

    Energy Technology Data Exchange (ETDEWEB)

    Grilhe, J. [Commissariat a l' Energie Atomique, Fontenay aux Roses (France). Centre d' Etudes Nucleaires

    1965-03-01

    The aim of this work is to study the germination, growth and properties of screw dislocations. In the introduction (first chapter), we describe briefly the main experimental results obtained by various authors (observations of screws by Amelinckx and Bontinck in ionic crystals, by Dash in silicon crystals and by Thomas and Whelan in aluminium based alloys). We then make a few considerations concerning characteristic geometry of screws and the various methods used for calculating the energy of a dislocation. In the second chapter we study the problems involving only slip of the screw around its cylinder. We calculate the equilibrium step as a function of the forces acting on the extremities. We determine the critical stress required to disrupt the screw and study the interactions between the screw and other dislocations of the lattice. In the third chapter we consider the problem of the stability when the dislocation can climb by absorption or emission of vacancies. We study separately the stability of the size which only involves volume diffusion and the stability of the shape which depends only on the rearrangement of the vacancies along the dislocation. In chapter four we put forward a germination model for the screws: since the vacancies are not absorbed by the screw dislocations, they form clusters which take up a spiral form. The formation of these spirals is studied from the geometrical point of view in face-centered cubic systems. In chapter five we make use of the results obtained in chapters two and three for studying the growth of the spirals. (author) [French] Le but de ce travail est d'etudier la germination, la croissance et les proprietes des dislocations helico ales. Dans l'introduction (premier chapitre), nous exposons brievement les principaux resultats experimentaux obtenus par differents auteurs (observations d'helice par Amelinckx et Bontinck dans les cristaux ioniques, par Dash dans des cristaux de silicium et par Thomas et

  6. Quantitative stress radiography of the patella and evaluation of patellar laxity before and after lateral release for recurrent dislocation patella.

    Science.gov (United States)

    Niimoto, Takuya; Deie, Masataka; Adachi, Nobuo; Usman, Muhammad Andry; Ochi, Mitsuo

    2014-10-01

    The aims of the present controlled clinical study were to (1) compare patella laxity determined in the outpatient clinic with that in anaesthetized patients and (2) evaluate patella laxity before and after lateral release. The study evaluated data on 33 knees from 33 patients (average age 19.7 years) between 2007 and 2011. All patients were diagnosed with recurrent dislocation of the patella. Patellar stability was evaluated in each patient thrice: patellas were first imaged in the outpatient clinic prior to surgery at 45° knee flexion with 20 N stress from the medial to lateral side and from the lateral to medial side; then, at the time of surgery, patella stress images were obtained in the same manner before and after the lateral release procedure. Radiological assessments were performed using the medial stress shift ratio (MSSR) and lateral stress shift ratio (LSSR). There were no significant differences in the LSSR and MSSR before surgery (outpatient data) and in anaesthetized patients before the lateral release procedure. Furthermore, there was no significant difference in MSSR at the time of surgery before and after the lateral release procedure. However, LSSR increased significantly after the lateral release procedure. The results of the present study suggest that quantitative patella stress radiography in the outpatient clinic is useful when it comes to investigating laxity of the patella, and that lateral release significantly increases lateral, but not medial, laxity in patients with recurrent patellar dislocation. IV.

  7. Development of a knee joint motion simulator to evaluate deep knee flexion of artificial knee joints.

    Science.gov (United States)

    Takano, Y; Ueno, M; Kiguchi, K; Ito, J; Mawatari, M; Hotokebuchi, T

    2008-01-01

    A purpose of this study is to examine the effect that quadriceps femoris force gives to rotation angle and joint reaction force of total knee prosthesis during deep knee flexion such as a unique sitting style called 'seiza' in Japanese. For the evaluation, we developed the knee motion simulator which could bend to 180 degrees continually simulating the passive flexion performed by clinicians. A total knee prosthesis, which is a specially-devised posterior stabilized type and capable of flexion up to 180 degrees, was inserted into bone model. And this prosthesis pulled by three kinds of quadriceps femoris forces to perform parameter study. The results obtained in this study were showed the same tendency with those in the past cadaveric experiment. It is suggested that the rotation angle and joint reaction force of total knee prosthesis are affected by shape of prosthesis, a vector of quadriceps femoris force, and bony aliments during deep knee flexion.

  8. Optimized cartilage visualization using 7-T sodium ((23)Na) imaging after patella dislocation.

    Science.gov (United States)

    Widhalm, Harald K; Apprich, Sebastian; Welsch, Goetz H; Zbyn, Stefan; Sadoghi, Patrick; Vekszler, György; Hamböck, Martina; Weber, Michael; Hajdu, Stefan; Trattnig, Siegfried

    2016-05-01

    Retropatellar cartilage lesions often occur in the course of recurrent patella dislocation. Aim of this study was to develop a more detailed method for examining cartilage tissue, in order to reduce patient discomfort and time of care. For detailed diagnosing, a 7-T MRI of the knee joint and patella was performed in nine patients, with mean age of 26.4 years, after patella dislocation to measure the cartilage content in three different regions of interest of the patella. Axial sodium ((23)Na) images were derived from an optimized 3D GRE sequence on a 7-T MR scanner. Morphological cartilage grading was performed, and sodium signal-to-noise ratio (SNR) values were calculated. Mean global sodium values and SNR were compared between patients and volunteers. Two out of nine patients showed a maximum cartilage defect of International Cartilage Repair Society (ICRS) grade 3, three of grade 2, three of  grade 1, and one patient showed no cartilage defect. The mean SNR in sodium images for cartilage was 13.4 ± 2.5 in patients and 14.6 ± 3.7 in volunteers (n.s.). A significant negative correlation between age and global sodium SNR for cartilage was found in the medial facet (R = -0.512; R (2) = 0.26; p = 0.030). Mixed-model ANOVA yielded a marked decrease of the sodium SNR, with increasing grade of cartilage lesions (p < 0.001). Utilization of the (23)Na MR imaging will make earlier detection of alterations to the patella cartilage after dislocation possible and will help prevent subsequent disease due to start adequate therapy earlier in the rehabilitation process. II.

  9. Riemann–Cartan Geometry of Nonlinear Dislocation Mechanics

    KAUST Repository

    Yavari, Arash

    2012-03-09

    We present a geometric theory of nonlinear solids with distributed dislocations. In this theory the material manifold-where the body is stress free-is a Weitzenböck manifold, that is, a manifold with a flat affine connection with torsion but vanishing non-metricity. Torsion of the material manifold is identified with the dislocation density tensor of nonlinear dislocation mechanics. Using Cartan\\'s moving frames we construct the material manifold for several examples of bodies with distributed dislocations. We also present non-trivial examples of zero-stress dislocation distributions. More importantly, in this geometric framework we are able to calculate the residual stress fields, assuming that the nonlinear elastic body is incompressible. We derive the governing equations of nonlinear dislocation mechanics covariantly using balance of energy and its covariance. © 2012 Springer-Verlag.

  10. Interaction of two edge dislocations in free-space propagation

    Institute of Scientific and Technical Information of China (English)

    He De; Gao Zeng-Hui; Yan Hong-Wei; Lü Bai-Da

    2011-01-01

    This paper studies in detail the interaction of two edge dislocations nested in a Gaussian beam propagating in free space. It shows that in free-space propagation the edge dislocations are unstable and vanish, and two noncanonical vortices with opposite topological charge take place when off-axis distances c1 and c2 of two edge dislocations are nonzero, and the condition k2w80 + 32c1c2(w20 - 2c1c2)z2 > 0 is fulfilled (k-wave number, w0-waist width). A noncanonical vortex appears when one off-axis distance is zero. However, one edge dislocation is stable when two edge dislocations are perpendicular and one off-axis distance is zero. Two perpendicular edge dislocations both with zero off-axis distance are also stable. The analytical results are illustrated by numerical examples.

  11. Dislocations in the Spacetime Continuum: Framework for Quantum Physics

    Directory of Open Access Journals (Sweden)

    Millette P. A.

    2015-10-01

    Full Text Available This paper provides a framework for the physical description of physical processes at the quantum level based on dislocations in the spacetime continuum within STCED (Spacetime Continuum Elastodynamics. In this framework, photon and particle self- energies and interactions are mediated by the strain energy density of the dislocations, replacing the role played by virtual particles in QED. We postulate that the spacetime continuum has a granularity characterized by a length b 0 corresponding to the smallest STC elementary Burgers dislocation-displacement vector. Screw dislocations corre- sponding to transverse displacements are identified with photons, and edge dislocations corresponding to longitudinal displacements are identified with particles. Mixed dislo- cations give rise to wave-particle duality. The strain energy density of the dislocations are calculated and proposed to explain the QED problem of mass renormalization.

  12. Scapular dislocation from trivial trauma: a rare case

    Directory of Open Access Journals (Sweden)

    Landge Vikrant

    2012-04-01

    Full Text Available 【Abstract】Dislocation of the scapula between the ribs and into the thoracic cage is a very rare event. Scapulothoracic dissociation though has been reported, usually occurs after a severe injury and is often associated with other serious injuries like brachial plexus or chest injury, etc. Ainscow has described a rare type that may occur due to slight violence with a pre-existing condition. Cases of isolated scapular dislocation after minor trauma have not been reported frequently in the literature. It is a distinct clinical entity and needs to be differentiated from other similar conditions. Here, we present a case of painless scapular dislocation associated with trivial trauma followed by spon-taneous reduction in a 10 years old girl. The patient had a recurrence of the dislocation before presenting to us. But she did not have any pre-existing condition for scapular dislocation. Key words: Scapula; Thorax; Shoulder dislocation

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

    NARCIS (Netherlands)

    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 obj

  14. Do thigh circumference and mass changes alter knee biomechanics during walking?

    Science.gov (United States)

    Westlake, Carolyn G; Milner, Clare E; Zhang, Songning; Fitzhugh, Eugene C

    2013-03-01

    Obese adults walk with different biomechanics compared to healthy weight adults. Previous studies have focused on knee biomechanics because they are associated with development and progression of osteoarthritis. Changes in thigh mass and circumference that occur as body weight increases may influence gait. The purpose of this study was to determine if increases in thigh mass and circumference alter gait biomechanics. For 20 healthy weight young adults (10 male and 10 female) knee kinematic, kinetic and gait temporospatial variables were collected using a three-dimensional motion capture system and a force platform during over ground walking. Data were collected during control, increased thigh mass, increased thigh circumference, and both increased mass and circumference conditions. Increases in thigh segment parameters reflected changes expected with a 10 point increase in body mass index. Step width was wider during the added circumference and combination conditions compared to the control condition. Increases in thigh circumference associated with obesity increase step width. This suggests the greater step width observed in obese adults compared to healthy weight adults is a result of the physical constraints introduced by their wider thigh segments. Peak knee flexion angle, peak knee extension moment, peak knee adduction angle, and peak knee abduction moment were similar in all conditions. Thus, acute changes in thigh segment parameters did not result in knee biomechanics suggestive of an increased risk of knee osteoarthritis.

  15. Disorientations in dislocation structures: Formation and spatial correlation

    DEFF Research Database (Denmark)

    Pantleon, W.

    2002-01-01

    During plastic deformation, dislocation boundaries are formed and orientation differences across them arise. Two different causes lead to the formation of two kinds of deformation-induced boundaries: a statistical trapping of dislocations in incidental dislocation boundaries and a difference...... agreement with experimental observations. The theoretically obtained distribution functions for the disorientation angles describe the experimental findings well and explain their scaling behavior. The model also predicts correlations between disorientations in neighboring boundaries, and evidence...

  16. Pediatric open elbow dislocation without fracture: A case report

    OpenAIRE

    Gökhan Polat; Gökhan Karademir; Turgut Akgül; Hasan Hüseyin Ceylan

    2014-01-01

    INTRODUCTION: Elbow dislocations in children are rare injuries. These injuries are often in the form of complex injuries that is accompanied by the median nerve damage and medial epicondyle fracture in the pediatric age group. Open elbow dislocation without fracture in the pediatric age group has been reported very rarely in the literature. PRESENTATION OF CASE: The purpose of this study is to present an 8-year-old patient who has open elbow dislocation without fracture accompanying with b...

  17. Does knee awareness differ between different knee arthroplasty prostheses?

    DEFF Research Database (Denmark)

    Thomsen, Morten G; Latifi, Roshan; Kallemose, Thomas

    2016-01-01

    BACKGROUND: Low knee awareness after Total Knee Arthroplasty (TKA) has become the ultimate goal in trying to achieve a natural feeling knee that meet patient expectations. To accommodate this manufacturers of TKAs have developed new prosthetic designs that potentially could give patients a more...... natural feeling knee during activities. The purpose af this study was to compare the Forgotten Joint Score (FJS) and Oxford Knee Score (OKS) of patients treated with a previous generation standard Cruciate Retaining (CR) TKA to the scores obtained by patients treated with a newer generation CR TKA...... or a mobile bearing CR TKA. METHODS: We identified all patients receiving a new generation CR TKA or mobile bearing TKA at our institution between 2010 and 2012. These were matched to a population of patients receiving a standard CR TKA regarding age, gender, year of surgery, Kellgren-Lawrence (KL) grade...

  18. Magnification bone scan of knees for knee pain evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Myoung Hoon; Park, Chan H.; Yoon, Seok Nam; Hwang, Kyung Hoon [College of Medicine, Ajou Univ., Suwon (Korea, Republic of)

    2001-07-01

    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.

  19. Interfacial dislocation motion and interactions in single-crystal superalloys

    Energy Technology Data Exchange (ETDEWEB)

    Liu, B. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Raabe, D. [Max Planck Inst. fur Eisenforshung. Dusseldorf (Germany); Roters, F. [Max Planck Inst. fur Eisenforshung. Dusseldorf (Germany); Arsenlis, A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2014-10-01

    The early stage of high-temperature low-stress creep in single-crystal superalloys is characterized by the rapid development of interfacial dislocation networks. Although interfacial motion and dynamic recovery of these dislocation networks have long been expected to control the subsequent creep behavior, direct observation and hence in-depth understanding of such processes has not been achieved. Incorporating recent developments of discrete dislocation dynamics models, we simulate interfacial dislocation motion in the channel structures of single-crystal superalloys, and investigate how interfacial dislocation motion and dynamic recovery are affected by interfacial dislocation interactions and lattice misfit. Different types of dislocation interactions are considered: self, collinear, coplanar, Lomer junction, glissile junction, and Hirth junction. The simulation results show that strong dynamic recovery occurs due to the short-range reactions of collinear annihilation and Lomer junction formation. The misfit stress is found to induce and accelerate dynamic recovery of interfacial dislocation networks involving self-interaction and Hirth junction formation, but slow down the steady interfacial motion of coplanar and glissile junction forming dislocation networks. The insights gained from these simulations on high-temperature low-stress creep of single-crystal superalloys are also discussed.

  20. Dislocation field theory in 2D: Application to graphene

    Energy Technology Data Exchange (ETDEWEB)

    Lazar, Markus, E-mail: lazar@fkp.tu-darmstadt.de [Heisenberg 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)

    2013-01-17

    A two-dimensional (2D) dislocation continuum theory is being introduced. The present theory adds elastic rotation, dislocation density, and background stress to the classical energy density of elasticity. This theory contains four material moduli. Two characteristic length scales are defined in terms of the four material moduli. Non-singular solutions of the stresses and elastic distortions of an edge dislocation are calculated. It has been pointed out that the elastic strain agrees well with experimental data found recently for an edge dislocation in graphene.