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1.
BMC Musculoskelet Disord ; 23(1): 753, 2022 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-35932028

RESUMO

BACKGROUND: Corona virus infectious pandemic makes outdoors rehabilitation a potential hazard. Patient education to perform simple home-based exercises seems to be an interesting and sometimes a mandatory option. This study provides a comparison between the conventional and home-based virtual rehabilitation after surgical repair of medial meniscus root tears. METHODS: In this prospective study, all patients who underwent medial meniscus posterior root repair with a modified trans-tibial pull-out technique from March 2019 to March 2021 were evaluated. Those who underwent surgery after December 2019 were trained to perform self-rehabilitation. The rest had undergone outdoors specialized rehabilitation according to a unified protocol and these were used as a historical control group. All patients were followed up for a minimum of 2 year after surgery. Final Lysholm scores were utilized to compare functional outcomes after considering the effect of age, body mass index and time from surgery by multivariate linear regression analysis. RESULTS: Forty-three consecutive patients with medial meniscal root tears were studied. Thirty-nine (90.7%) were women and 4 (9.3%) were men. The mean age of participants was 53.2 ± 8.1 years. The total Lysholm knee score, and all its items were significantly improved in both groups at a two-year follow-up (p < 0.05), except the "Using cane or crutches" item (p = 0.065). Nevertheless, the final Lysholm knee score improvement was higher in patients who performed outdoors specialized rehabilitation and in patients with shorter time-to-surgery. CONCLUSION: Regardless of age and gender, home-based rehabilitation after meniscal root repair with the modified trans-tibial pull-out technique improved the patients' function at a two-year follow-up. Nonetheless, this effect was still significantly lower than that of the outdoors specialized rehabilitation. Future work is required to clarify basic protocols for home-based tele-rehabilitation programs and determine clinical, radiological and functional results. LEVEL OF EVIDENCE: Level IV, therapeutic, historically controlled study.


Assuntos
Doenças das Cartilagens , Traumatismos do Joelho , Lesões do Menisco Tibial , Artroscopia/efeitos adversos , Artroscopia/métodos , Feminino , Humanos , Traumatismos do Joelho/cirurgia , Masculino , Meniscos Tibiais/cirurgia , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Retrospectivos , Lesões do Menisco Tibial/cirurgia
3.
Ulus Travma Acil Cerrahi Derg ; 28(8): 1148-1155, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35920416

RESUMO

BACKGROUND: Return to sports rate of chronic meniscus repair concurrent with Anterior Cruciate Ligament (ACL) reconstruction remains unclear, especially there is no well-defined return to sports criteria for evaluation. The purpose of this retrospective study was to determine the success rate of chronic locked bucket-handle meniscal tear (BHMT) repair with concomitant ACL reconstruction. METHODS: This study includes 51 chronic ACL injury patients with a locked meniscal tear of at least 6 weeks who underwent surgery. All cases were treated with arthroscopic BHMT repair and ACL reconstruction between 2017 and 2020. Patient demograph-ics, chronicity, pre-operative, and intraoperative surgical variables which associated with return to sports were defined. BHMT was repaired with an all-in-side meniscus repair and/or combined repair procedure first, then an anatomic outside-in ACL reconstruction using a suspension device for femoral fixation was performed. Patients underwent same rehabilitation program with the goal of return-ing to sport at approximately 4-8 months. A modified return-to-sport criterion was performed in this study. RESULTS: Fifty-one patients with an average age of 27.4 (range 18-48) years were included in the study. The average time elapsed from the occurrence of locked knee symptoms to surgery was 10.5±4.4 weeks. The mean follow-up time was 25.3±4.5 months. Sig-nificant improvement was observed in all patient-reported outcomes from baseline to the final follow-up. The mean modified Lysholm knee score increased from 45.5 points to 91.5 at the final follow-up (p<0.001). The 43 out of 51 patients (84.3%) were return to their recreational activities (amateur sports). The mean time to return to sport was 5.9±0.8 (5-8) months. CONCLUSION: Majority of the patients who underwent ACL reconstruction with BHMT repair return to their pre-operative activity levels in 8 months. All neglected BHMTs with concomitant chronic ACL rupture should be repaired in a single-stage surgery if the half plane-concave shape of the menisci has been preserved regardless of the delay in time to surgery.


Assuntos
Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior , Traumatismos do Joelho , Menisco , Lesões do Menisco Tibial , Adolescente , Adulto , Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior/métodos , Humanos , Traumatismos do Joelho/cirurgia , Menisco/cirurgia , Pessoa de Meia-Idade , Estudos Retrospectivos , Volta ao Esporte , Ruptura/cirurgia , Lesões do Menisco Tibial/complicações , Lesões do Menisco Tibial/diagnóstico , Lesões do Menisco Tibial/cirurgia , Adulto Jovem
4.
Am J Sports Med ; 50(10): 2722-2732, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35834942

RESUMO

BACKGROUND: Meniscal tears in the avascular region are thought to rarely heal and are a considerable challenge to treat. Although the therapeutic effects of a pulsed electromagnetic field (PEMF) have been extensively studied in a variety of orthopaedic disorders, the effect of a PEMF on meniscal healing has not been reported. HYPOTHESIS: PEMF treatment would promote meniscal healing and prevent osteoarthritis progression. STUDY DESIGN: Controlled laboratory study. METHODS: A total of 72 twelve-week-old male Sprague-Dawley rats with full-thickness longitudinal medial meniscal tears in the avascular region were divided into 3 groups: control (Gcon), treatment with a classic signal PEMF (Gclassic), and treatment with a high-slew rate signal PEMF (GHSR). Macroscopic observation and histological analysis of the meniscus and articular cartilage were performed to evaluate the meniscal healing and progression of osteoarthritis. The synovium was harvested for histological and immunofluorescent analysis to evaluate the intra-articular inflammation. Meniscal healing, articular cartilage degeneration, and synovitis were quantitatively evaluated according to their scoring systems. RESULTS: Dramatic degenerative changes of the meniscus and articular cartilage were noticed during gross observation and histological evaluation in Gcon at 8 weeks. However, the menisci in the 2 treatment groups were restored to normal morphology, with a smooth surface and shiny white color. Particularly, the HSR signal remarkably enhanced the fibrochondrogenesis and accelerated the remodeling process of the regenerated tissue. The meniscal healing scores of the PEMF treatment groups were significantly higher than those in Gcon at 8 weeks. Specifically, the HSR signal showed a significantly higher meniscal repair score than did the classic signal at week 8 (P < .01). Additionally, the HSR signal significantly downregulated the secretion levels of interleukin 1 beta (IL-1ß) and tumor necrosis factor alpha (TNF-α) in the meniscus and synovium as compared with the control group. When compared with the 2 treatment groups, Gcon had significantly higher degeneration scores (Gcon vs Gclassic, P < .0001; Gcon vs GHSR, P < .0001). The HSR signal also exhibited significantly lower synovitis scores compared with the other two groups (Gcon vs Gclassic, P < .0001; Gclassic vs GHSR, P = .0002). CONCLUSION: A PEMF promoted the healing of meniscal tears in the avascular region and restored the injured meniscus to its structural integrity in a rat model. As compared with the classic signal, the HSR signal showed increased capability to promote fibrocartilaginous tissue formation and modulate the inflammatory environment, therefore protecting the knee joint from posttraumatic osteoarthritis development. CLINICAL RELEVANCE: Adjuvant PEMF therapy may offer a new approach for the treatment of meniscal tears attributed to the enhanced meniscal repair and ameliorated osteoarthritis progression.


Assuntos
Doenças das Cartilagens , Traumatismos do Joelho , Osteoartrite , Sinovite , Animais , Doenças das Cartilagens/patologia , Campos Eletromagnéticos , Traumatismos do Joelho/patologia , Masculino , Meniscos Tibiais/patologia , Osteoartrite/patologia , Ratos , Ratos Sprague-Dawley
5.
Am J Sports Med ; 50(10): 2705-2713, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35787211

RESUMO

BACKGROUND: Primary device fixation and the resistance against gap formation during repetitive loading influence the quality of meniscal repair. There are limited biomechanical data comparing primary tensioning and cyclic behavior of all-inside versus inside-out repair. HYPOTHESIS: All-inside devices provide higher initial load on the meniscal repair than inside-out fixation, and stiffer constructs show higher resistance against gap formation during cyclic loading. STUDY DESIGN: Controlled laboratory study. METHODS: In total, 60 longitudinal bucket-handle tears in human cadaveric menisci were created and repaired with a single stitch and randomly assigned to 4 all-inside groups (TrueSpan, FastFix 360, Stryker AIR, FiberStich) and 2 inside-out groups (suture repair [IO-S], suture tape [IO-ST]). Residual load after repair tensioning (50 N) and relief displacement were measured. Constructs underwent cyclic loading between 2 and 20 N over 500 cycles (0.75 Hz) with cyclic stiffness, gap formation, and final peak elongation measured. Ultimate load and stiffness were analyzed during pull to failure (3.15 mm/s). RESULTS: All-inside repair demonstrated significantly higher primary fixation strength than inside-out repair. The significantly highest load (mean ± SD; 20.1 ± 0.9 N; P < .037) and relief displacement (-2.40 ± 0.32 mm; P < .03) were for the knotless soft anchoring FiberStich group. The lowest initial load (9.0 ± 1.5 N; P < .001) and relief displacement (-1.39 ± 0.26 mm; P < .045) were for the IO-S repair group. The final gap formation (500th cycle) of FiberStich (0.75 ± 0.37 mm; P < .02) was significantly smaller than others and that of the IO-S (1.47 ± 0.33 mm; P < .045) significantly larger. The construct stiffness of the FiberStich and IO-ST groups was significantly greater at the end of cyclic testing (16.7 ± 0.80 and 15.5 ± 1.42 N/mm; P < .042, respectively) and ultimate failure testing (23.4 ± 3.6 and 20.6 ± 2.3 N/mm; P < .005). The FastFix 360 (86.4 ± 4.8 N) and Stryker AIR (84.4 ± 4.6 N) groups failed at a significantly lower load than the IO-S group (P < .02) with loss of anchor support. The FiberStich (146.8 ± 23.4 N), TrueSpan (142.0 ± 17.8 N), and IO-ST (139.4 ± 7.3 N) groups failed at significantly higher loads (P < .02) due to suture tearing. CONCLUSION: Overall, primary fixation strength of inside-out meniscal repair was significantly lower than all-inside repair in this cadaveric tissue model. Although absolute differences among groups were small, meniscal repairs with higher construct stiffness (IO-ST, FiberStich) demonstrated increased resistance against gap formation and failure load. CLINICAL RELEVANCE: Knotless single-stitch all-inside meniscal repair with a soft anchor resulted in less gapping, but the overall clinical significance on healing rates remains unclear.


Assuntos
Doenças das Cartilagens , Traumatismos do Joelho , Lesões do Menisco Tibial , Fenômenos Biomecânicos , Cadáver , Doenças das Cartilagens/cirurgia , Humanos , Traumatismos do Joelho/cirurgia , Meniscos Tibiais/cirurgia , Técnicas de Sutura , Lesões do Menisco Tibial/cirurgia
6.
JAMA Netw Open ; 5(7): e2220394, 2022 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-35802374

RESUMO

Importance: There is a paucity of high-quality evidence about the long-term effects (ie, 3-5 years and beyond) of arthroscopic partial meniscectomy vs exercise-based physical therapy for patients with degenerative meniscal tears. Objectives: To compare the 5-year effectiveness of arthroscopic partial meniscectomy and exercise-based physical therapy on patient-reported knee function and progression of knee osteoarthritis in patients with a degenerative meniscal tear. Design, Setting, and Participants: A noninferiority, multicenter randomized clinical trial was conducted in the orthopedic departments of 9 hospitals in the Netherlands. A total of 321 patients aged 45 to 70 years with a degenerative meniscal tear participated. Data collection took place between July 12, 2013, and December 4, 2020. Interventions: Patients were randomly allocated to arthroscopic partial meniscectomy or 16 sessions of exercise-based physical therapy. Main Outcomes and Measures: The primary outcome was patient-reported knee function (International Knee Documentation Committee Subjective Knee Form (range, 0 [worst] to 100 [best]) during 5 years of follow-up based on the intention-to-treat principle, with a noninferiority threshold of 11 points. The secondary outcome was progression in knee osteoarthritis shown on radiographic images in both treatment groups. Results: Of 321 patients (mean [SD] age, 58 [6.6] years; 161 women [50.2%]), 278 patients (87.1%) completed the 5-year follow-up with a mean follow-up time of 61.8 months (range, 58.8-69.5 months). From baseline to 5-year follow-up, the mean (SD) improvement was 29.6 (18.7) points in the surgery group and 25.1 (17.8) points in the physical therapy group. The crude between-group difference was 3.5 points (95% CI, 0.7-6.3 points; P < .001 for noninferiority). The 95% CI did not exceed the noninferiority threshold of 11 points. Comparable rates of progression of radiographic-demonstrated knee osteoarthritis were noted between both treatments. Conclusions and Relevance: In this noninferiority randomized clinical trial after 5 years, exercise-based physical therapy remained noninferior to arthroscopic partial meniscectomy for patient-reported knee function. Physical therapy should therefore be the preferred treatment over surgery for degenerative meniscal tears. These results can assist in the development and updating of current guideline recommendations about treatment for patients with a degenerative meniscal tear. Trial Registration: ClinicalTrials.gov Identifier: NCT01850719.


Assuntos
Traumatismos do Joelho , Osteoartrite do Joelho , Lesões do Menisco Tibial , Feminino , Seguimentos , Humanos , Meniscectomia/efeitos adversos , Meniscectomia/métodos , Pessoa de Meia-Idade , Osteoartrite do Joelho/cirurgia , Modalidades de Fisioterapia , Lesões do Menisco Tibial/etiologia , Lesões do Menisco Tibial/cirurgia
8.
Comput Math Methods Med ; 2022: 5447509, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35855835

RESUMO

Background: Because active functional training and management after knee cartilage sports injury is the key to treatment, care of patients after an operation with knee cartilage sports injury is critical. Aims: To explore the effect of feedforward control combined with 4F management and after an operation nursing effect on patients with knee cartilage sports injury. Materials and Methods: According to the random number table method, 100 patients with knee cartilage sports injury who were nursed in our hospital from June 2019 to June 2021 were selected as the research objects and divided into the control group and the instance of watching, noticing, or making a statement group with 50 cases in each group according to the different nursing order. Among them, the control group adopted 4F management combined with feedforward control nursing mode: all-weather, whole-process, whole-system, and all-around services for patients. On this basis, the instance of watching, noticing, or making a statement group cooperated with early healing/repairing training to compare fear and stress-related self-test of the two groups of patients after an operation. Knee function and quality of care are scored using tables. Results: After nursing, the knee joint function score of the instance of watching, noticing, or making a statement group was higher than that of the control group, while the pain after the operation, sleep quality, fear, and stress self-rating scale scores were significantly lower than the control group (P < 0.05). The whole-process management, body position placement, risk evaluation, repairing training, all-weather service, whole-system management, and comprehensive service of the two groups of patients were very much improved. The nursing quality of watching, noticing, or making a statement group was significantly higher than the control group (P < 0.05). Conclusion: Feedforward control combined with 4F management combined with early repairing training can effectively reduce the fear and stress after an operation pain and sleep quality of knee cartilage sports injury and help increase the recovery of knee combined function in a good way.


Assuntos
Traumatismos em Atletas , Traumatismos do Joelho , Menisco , Traumatismos em Atletas/cirurgia , Humanos , Traumatismos do Joelho/cirurgia , Articulação do Joelho/cirurgia , Menisco/cirurgia , Dor , Resultado do Tratamento
9.
Bone Joint J ; 104-B(7): 894-901, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35775178

RESUMO

AIMS: The aim of this study was to investigate the rate of revision for distal femoral arthroplasty (DFA) performed as a primary procedure for native knee fractures using data from the Australian Orthopaedic Association National Joint Arthroplasty Registry (AOANJRR). METHODS: Data from the AOANJRR were obtained for DFA performed as primary procedures for native knee fractures from 1 September 1999 to 31 December 2020. Pathological fractures and revision for failed internal fixation were excluded. The five prostheses identified were the Global Modular Arthroplasty System, the Modular Arthroplasty System, the Modular Universal Tumour And Revision System, the Orthopaedic Salvage System, and the Segmental System. Patient demographic data (age, sex, and American Society of Anesthesiologists grade) were obtained, where available. Kaplan-Meier estimates of survival were used to determine the rate of revision, and the reasons for revision and mortality data were examined. RESULTS: The AOANJRR identified 153 primary DFAs performed for native knee fractures in 151 patients during the study period, with 63.3% of these (n = 97) performed within the last five years. The median follow-up was 2.1 years (interquartile range 0.8 to 4.4). The patient population was 84.8% female (n = 128), with a mean age of 76.1 years (SD 11.9). The cumulative percent revision rate at three years was 10%. The most common reason for revision was loosening, followed by infection. Patient survival at one year was 87.5%, decreasing to 72.8% at three years postoperatively. CONCLUSION: The use of DFA to treat native knee fractures is increasing, with 63.3% of cases performed within the last five years. While long-term data are not available, the results of this study suggest that DFA may be a reasonable option for elderly patients with native knee fractures where fixation is not feasible, or for whom prolonged non-weightbearing may be detrimental. Cite this article: Bone Joint J 2022;104-B(7):894-901.


Assuntos
Artroplastia do Joelho , Artroplastia de Substituição , Fraturas do Fêmur , Traumatismos do Joelho , Ortopedia , Idoso , Austrália/epidemiologia , Feminino , Fraturas do Fêmur/cirurgia , Humanos , Traumatismos do Joelho/cirurgia , Masculino , Sistema de Registros , Reoperação
10.
J Orthop Trauma ; 36(Suppl 3): S21-S22, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35838571

RESUMO

SUMMARY: A 46-year-old man presents with left knee bucking 3 months after open reduction and internal fixation of a left knee inferior pole patella fracture. Radiograph and magnetic resonance imaging evaluation reveal displacement and comminution of the inferior pole of the patella confirming failure of the repair. The purpose of this video is to demonstrate the surgical management of failed inferior pole patella fractures using suture anchors for repair of the patella tendon and augmentation with ipsilateral autologous hamstring grafts.


Assuntos
Fraturas Ósseas , Tendões dos Músculos Isquiotibiais , Traumatismos do Joelho , Ligamento Patelar , Autoenxertos , Fixação Interna de Fraturas/métodos , Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/cirurgia , Humanos , Traumatismos do Joelho/cirurgia , Masculino , Pessoa de Meia-Idade , Redução Aberta , Patela/diagnóstico por imagem , Patela/cirurgia , Ligamento Patelar/cirurgia , Estudos Retrospectivos
11.
J Orthop Trauma ; 36(Suppl 3): S27-S28, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35838574

RESUMO

SUMMARY: We present the surgical technique for arthrodesis of the subtalar and calcaneocuboid joints of a Sanders type IV calcaneal fracture nonunion via a distraction bone block arthrodesis technique with tricortical iliac crest allograft combined with reamer/irrigator/aspirator autograft from the patient's femur. A lateral extensile approach to the calcaneus was used for the exposure, which allowed the surgeon to follow the stepwise complex surgical plan outlined here. Calcaneal nonunions are difficult to treat, but good outcomes can be achieved if proper technique with bone grafting is used.


Assuntos
Traumatismos do Tornozelo , Calcâneo , Traumatismos do Pé , Fraturas Ósseas , Fraturas não Consolidadas , Traumatismos do Joelho , Articulação Talocalcânea , Aloenxertos , Artrodese/métodos , Autoenxertos , Transplante Ósseo/métodos , Calcâneo/cirurgia , Fêmur/transplante , Fraturas Ósseas/cirurgia , Fraturas não Consolidadas/diagnóstico por imagem , Fraturas não Consolidadas/cirurgia , Humanos , Ílio , Articulação Talocalcânea/cirurgia
12.
Cartilage ; 13(2): 19476035221109242, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35815409

RESUMO

OBJECTIVE: Despite an increased interest in treatment options for cartilage lesions of the knee, the relationship between lesion characteristics and the symptoms they elicit is not well understood. We evaluated the relationship between lesion characteristics and the patient-reported outcome measures (PROMs) and compared this with symptoms reported by patients scheduled for knee ligament reconstruction and knee arthroplasty. DESIGN: Preoperative data, including Lysholm score and The Knee Injury and Osteoarthritis Outcome Score (KOOS), in 90 consecutive patients scheduled for surgery for symptomatic isolated cartilage lesions were prospectively collected. RESULT: The patients had a mean age of 33.2 years. There were 62 (69%) males. There was no statistically significant difference in PROMs between patients with cartilage lesions smaller or larger than 2 cm2, except for the KOOS subscale symptoms, with patients with smaller lesions reporting higher scores, 62.8 (95% confidence interval [CI] 58.3-67.3) vs. 51.9 (95% CI 45.5-58.4), P = 0.005. There was a small correlation between lesion size and Lysholm score. However, when adjusted for age, sex, body mass index, and lesion localization, this effect was not statistically significant. The International Cartilage Regeneration & Joint Preservation Society grade did not affect preoperative PROMs. Cartilage patients reported worse preoperative symptoms than patients scheduled for knee ligament reconstruction, and approaching the symptoms reported by patients scheduled for knee arthroplasty. CONCLUSION: The size, depth, and location of cartilage lesions have little impact on the symptoms experienced by the patients. Cartilage patients have comparable symptoms to patients scheduled for knee arthroplasty.


Assuntos
Reconstrução do Ligamento Cruzado Anterior , Cartilagem Articular , Traumatismos do Joelho , Adulto , Feminino , Humanos , Traumatismos do Joelho/cirurgia , Articulação do Joelho/cirurgia , Masculino , Dor
13.
Biomed Res Int ; 2022: 5610627, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35782082

RESUMO

Purpose: K-wire with tension band (KTB) technique has long been the primary surgical method for transverse patella fractures; however, it also has shortcomings. This study is aimed at evaluating the three different techniques to see whether the cannulated screw tension band (CSTB) or ring pin tension band (RPTB) techniques could decrease complications and achieve better knee function compared with KTB. Methods: We conducted a retrospective comparison of the KTB, CSTB, and RPTB fixation techniques. We selected and reviewed 90 patients (30 patients in each fixation group) with follow-up at least 2 years. Duration of operation, intraoperative blood loss, mean healing time, visual analog scale score, range of motion, Böstman score, Iowa knee score, modified Lysholm rating scale, and postoperative complications were compared. Multivariate analyses were performed to identify the independent risk factors for fracture healing time, postoperative complications, and knee function recovery. Results: After adjusting for confounding factors, multivariate regression analysis revealed that CSTB was 0.26 times (95% CI: 0.08-0.86, p = 0.027) less likely to prolong fracture healing time, 0.20 times (95% CI: 0.06-0.64, p = 0.007) lesser risk of postoperative complications, and more than four times (95% CI: 1.41-13.56, p = 0.011) as likely to improve the knee function score compared with KTB. Besides, RPTB were also superior to KTB in reducing the incidence of postoperative complications (OR: 0.21, 95% CI: 0.07-0.64, p = 0.006) and improved knee function score (OR: 3.96, 95% CI: 1.30-12.08, p = 0.016); however, the CSTB group being more superior. In addition, AO/OTA C2 fractures (OR, odds ratio: 10.68, 95% CI: 1.30-87.70, p = 0.027) and high-energy fracture (OR: 8.78, 95% CI: 1.57-49.17, p = 0.013) were also associated with prolonged fracture healing time but not with postoperative complications and knee function. No significant differences in related indicators such as gender, age, BMI, AO/OTA classification, fracture side, injury mechanism, duration of operation, and intraoperative blood loss were detected among the three groups. Conclusion: This study demonstrated that the CSTB technique is superior to KTB and RPTB techniques in reducing the incidence of postoperative complications, and it also has advantages in accelerating fracture healing, achieving better VAS, ROM, and functional recovery. Further long-term large-sized prospective randomized trials are needed to evaluate the efficacy of the KTB in treating transverse patellar fractures.


Assuntos
Fraturas Ósseas , Traumatismos do Joelho , Perda Sanguínea Cirúrgica , Pinos Ortopédicos , Estudos de Casos e Controles , Seguimentos , Fraturas Ósseas/cirurgia , Humanos , Complicações Pós-Operatórias , Estudos Prospectivos , Estudos Retrospectivos
14.
Comput Math Methods Med ; 2022: 5706341, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35860186

RESUMO

Purpose: To explore the comparison of the reduction of the subtalar articular surface and other postoperative effects of the minimally invasive tarsal sinus approach and lateral L-shaped incision conventional approach for the treatment of calcaneal fracture with 3D printing technology. Methods: Patients who received surgical treatment for calcaneal fractures in the First Affiliated Hospital of Henan University of Science and Technology from June 2019 to December 2020 were collected. 3D printing equipment produced the affected side reduction heel bone fracture model and navigation template model. The tarsal sinus approach was used in the experimental group, and the lateral L-shaped incision approach was used in the control group. Patients were followed up 3 days, 1 month, 3 months, 6 months, and 12 months after the operation. Imaging indicators were measured 12 months after surgery, and scores from American Foot and Ankle Orthopaedic Society (AOFAS) and MSF were performed. Results: Operation time was 70.52 ± 13.16 in the control group and 55.24 ± 12.25 minutes in the experimental group (P < 0.001). Intraoperative blood loss was 98.77 ± 18.65 in the control group and 89.56 + 17.54 in the experimental group (P > 0.05). The duration of antibiotic use was 5.53 ± 3.24 days in the control group and 5.48 ± 4.18 days in the experimental group (P > 0.05). The frequency of fluoroscopy was 6.56 ± 1.72 in the control group and 3.88 ± 1.05 in the experimental group (P < 0.001). Fracture healing time was 3.24 ± 0.52 months in the control group and 3.08 ± 0.58 months in the experimental group (P > 0.05). The postoperative Böhler angle was 28.31 ± 3.14 in the control group and 29.24 ± 2.76 in the experimental group (P > 0.05). Postoperative subtalar articular displacement (step > 2 mm) was observed in 4 patients in the control group and 1 in the experimental group (P < 0.05). MSF score was 90.12 ± 4.85 in the control group and 91.36 ± 2.58 in the experimental group (P > 0.05). Conclusion: The study found that the experimental group was significantly better than the control group in terms of the operation time, intraoperative fluoroscopy times, and success rate of reduction of the subtalar articular surface. 3D printing technology can shorten the operation time, accurately reduce the fracture block, and reduce the secondary trauma, which is conducive to the functional recovery of the affected foot.


Assuntos
Traumatismos do Tornozelo , Calcâneo , Fraturas Ósseas , Traumatismos do Joelho , Calcâneo/diagnóstico por imagem , Calcâneo/cirurgia , Fixação Interna de Fraturas/métodos , Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/cirurgia , Calcanhar , Humanos , Impressão Tridimensional , Resultado do Tratamento
16.
Occup Ther Int ; 2022: 6227377, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35854943

RESUMO

This paper provides an in-depth study of occupational therapy and the prevention of common sports injuries in special physical training. The issue of sports injuries and rehabilitation has always been a hot topic in special training. With the continuous development of sports, the increasing intensity of competition, and more stringent requirements for special techniques, the increase in difficulty and intensity of training has led to the increasing frequency of sports injuries, so how to prevent injuries in special physical training and rehabilitation and recovery of athletes after the injury is particularly important. Since the most common musculoskeletal injuries occur in the lower quadrant, this paper proposes a lower extremity functional test (LEFT) model as a means of identifying injury risk and guiding the implementation of training programs to prevent sports injuries. In this paper, a knee injury is used as an example, and an occupational therapy program of TCM physical therapy + aquatic rehabilitation is adopted for the already occurred sports injuries. Through interviews and clinical examinations of athletes, coaches, and medical personnel, this paper summarizes the sites, types, characteristics, and probability of occurrence of common sports injuries in special physical training. Experiments were conducted through clinical rehabilitation of common sports injuries with the addition of TCM manual massage. A series of effects of this modality on the rehabilitation of sports injuries were examined by monitoring physiological and biochemical indexes and by comparative analysis before and after testing physical function indexes using the Omega Wave system. Sports injuries are diverse. Traditional Chinese medicine physical therapy + water rehabilitation therapy is an effective physical therapy method. According to the relevant theories of traditional Chinese medicine treatment, diagnosis and treatment through meridians and related acupuncture points have significant curative effects. Traditional Chinese medicine, massage, and acupuncture have irreplaceable roles in the rehabilitation and treatment of sports injuries and can effectively improve and cure sports injuries.


Assuntos
Traumatismos em Atletas , Traumatismos do Joelho , Terapia Ocupacional , Esportes , Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/epidemiologia , Traumatismos em Atletas/prevenção & controle , Exercício Físico , Humanos
17.
Rev Med Suisse ; 18(790-2): 1455-1459, 2022 Jul 20.
Artigo em Francês | MEDLINE | ID: mdl-35856513

RESUMO

Numerous studies highlight the psychological aspect being the most frequent factors limiting the resumption of sport, following an anterior cruciate ligament reconstruction surgery, even before strength, the capacity of performing high impact pivoting movements, endurance, or joint stability. Scores that quantify apprehension, have been developed as clinical tool to monitor psychological readiness and in some cases to delay the moment for return to sport. Unfortunately, there are no established cut-off values for these scores to predict when and if return to sport at the same level as pre-traumatically can be resumed. The psychological aspect of return to sport remains individual, and influenced by age, type, and level of physical activity.


De nombreuses études mettent en avant l'aspect psychologique comme étant l'un des principaux facteurs limitant la reprise de sport après reconstruction du ligament croisé antérieur, même avant le manque de force, les sauts et mouvements en pivot à haute intensité, l'endurance ou la stabilité mécanique du genou. Des scores, permettant de quantifier le degré d'appréhension, ont été élaborés afin de suivre la confiance ressentie du patient lors de mouvements liés au sport et de retarder la reprise sportive si nécessaire. Malheureusement, pour l'instant, aucun consensus n'est établi dans la littérature autour d'une valeur seuil de ces différents scores pour la reprise de sport. L'interprétation de ces scores reste pour l'instant une évaluation individualisée, influencée par l'âge, le type et le niveau du sport pratiqué par le patient.


Assuntos
Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior , Ansiedade , Volta ao Esporte , Ligamento Cruzado Anterior/cirurgia , Lesões do Ligamento Cruzado Anterior/complicações , Lesões do Ligamento Cruzado Anterior/psicologia , Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior/métodos , Reconstrução do Ligamento Cruzado Anterior/psicologia , Ansiedade/diagnóstico , Ansiedade/etiologia , Humanos , Traumatismos do Joelho/complicações , Traumatismos do Joelho/psicologia , Traumatismos do Joelho/cirurgia , Articulação do Joelho/cirurgia , Volta ao Esporte/psicologia
18.
Acta Biomed ; 93(3): e2022139, 2022 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-35775769

RESUMO

Background and aim sport activity has been largely correlated to the development of knee osteoarthritis, but only few papers have investigated the long-term impact of a rugby career on the knee joint. The aim of this retrospective study was to evaluate the incidence and epidemiology of knee osteoarthritis and general health in a population of 65 retired semi-professional rugby players. Methods demographic and anamnestic analysis was recorded and Oxford Knee score, SF-12 and VAS were submitted to all veterans in order to assess current knee function, general health condition and level of pain. Parametric analysis of Spearman was used to evaluate the statistical significance on these results and the Kruskal-Wallis test was used to assess the significant differences between the questionnaire results and the demographic and anamnestic records. Results we found that players who sustained a knee injury during their career have a current reduction of the knee function compared to veterans who did not suffer any injury and who showed values comparable with those of the health population. In terms of general and mental health, athletes who retired later have now a better condition than those who retired from the sport  earlier. Conclusions: we concluded that knee injury prevention should be an unequivocal priority because although rugby is a high energy sport, it does not increase the risk of knee osteoarthritis in absence of serious knee injuries.


Assuntos
Futebol Americano , Traumatismos do Joelho , Osteoartrite do Joelho , Veteranos , Futebol Americano/lesões , Humanos , Traumatismos do Joelho/epidemiologia , Articulação do Joelho , Osteoartrite do Joelho/epidemiologia , Aposentadoria , Estudos Retrospectivos , Rugby
19.
Sci Rep ; 12(1): 9587, 2022 06 10.
Artigo em Inglês | MEDLINE | ID: mdl-35688938

RESUMO

This study aims to investigate whether an augmented wire in the treatment of patella distal pole fracture could improve knee range of motion (ROM) and radiographic features. Thirty-five consecutive patients with patellar distal pole fracture were analyzed from January 2014 to July 2019. The treatment is divided into two groups according to the presence or absence of augmented wire. Knee ROM, bone union, extension lag, and patellar height were compared between these two groups as the clinical and radiological outcomes. There was no significant difference in mean knee ROM (110° vs. 108°, p = 0.79), proportion of patella baja or bone union. More extension lag was noted in the augmentation group (5/20, 25%) than in the tendon reattachment group (1/15, 6.7%) with no statistically significant difference. In the augmentation group, four cases (20%) would need to remove the fixator due to irritation or broken hardware. Maintaining the patella length by preserving the distal pole and repairing the torn retinaculum allowed early motion to avoid knee stiffness safely without augmentation wire, which doesn't improve knee ROM. The patellar tendon reattachment alone could achieve a great recovery and prevent the need for a second surgery due to broken wire or irritation.


Assuntos
Fraturas Ósseas , Traumatismos do Joelho , Ligamento Patelar , Fios Ortopédicos , Fraturas Ósseas/cirurgia , Humanos , Traumatismos do Joelho/cirurgia , Patela/cirurgia , Ligamento Patelar/cirurgia , Amplitude de Movimento Articular , Estudos Retrospectivos , Resultado do Tratamento
20.
Arthroscopy ; 38(6): 1930-1932, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35660186

RESUMO

Treatment of radial tears of the lateral meniscus is challenging. Previous studies after repairing radial tears showed low healing rates. Various suture techniques are now being developed, and biomechanical and clinical studies using these new techniques are underway. Amid development, the all-inside double vertical cross-suture technique seemed to be effective. However, limited evaluations after meniscal repair might not fully reveal whether the repaired meniscus can maintain its function. Because the best single method that can completely evaluate meniscal healing and its function after repair is still lacking, we should introduce various assessments and consider them in a comprehensive way.


Assuntos
Traumatismos do Joelho , Lacerações , Lesões do Menisco Tibial , Fenômenos Biomecânicos , Humanos , Traumatismos do Joelho/cirurgia , Lacerações/cirurgia , Meniscos Tibiais/cirurgia , Ruptura/cirurgia , Técnicas de Sutura , Suturas , Lesões do Menisco Tibial/cirurgia
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