The aim of this study was to investigate the biomechanical effect of the anterolateral ligament (ALL), anterior cruciate ligament (ACL), or both ALL and ACL on kinematics under dynamic loading conditions using dynamic simulation subject-specific knee models. Five subject-specific musculoskeletal models were validated with computationally predicted muscle activation, electromyography data, and previous experimental data to analyze effects of the ALL and ACL on knee kinematics under gait and squat loading conditions.Objectives
Methods
To investigate treatment patterns and efficacy of postoperative strong opioids in patients who underwent total knee arthroplasty (TKA) in Korea A prospective, non-interventional study of 301 patients who underwent TKA and received strong opioids following patient controlled analgesia (PCA) was conducted by reviewing patient charts and diaries from 19 teaching hospitals. Clinical characteristics, strong opioid treatment patterns, efficacy of strong opioid on a scale of 0–10, and opioid-related adverse events (AEs) were investigated during hospitalization and at first outpatient visit. Safety analysis was conducted on 301 patients, and efficacy analysis was conducted on full analysis set (FAS) which consisted of all the patients who had at least 1 efficacy result among 301 patients.Purpose:
Methods:
The treatment of very distal tibial fractures and pilon fractures is difficult. There is a wide variation in the severity of injury and the options for surgical management. Plates and external fixation each have their advantages. This retrospective study looks at complications and technical tips for anterolateral plating. 35 consecutive distal There were 32 anterolateral platings and 3 medial platings. The union rate was 95%. There were two deep infections which required surgical treatment. There were two wound breakdowns, one of which required plastic surgical intervention. Two patients had prominent metalwork, requiring removal. Other complications included deep The complication rate found was similar to that reported in the literature. The few complications were however very significant for the patient and also for the surgeon as they required bone transport. Complications other than infection occurred in the few cases performed by surgeons low on their learning curve. We present technical tips for surgery. The presence of callus only after mobilisation indicates that union is slow. Anterolateral plating is a viable option for distal
We have analyzed the long-term clinical and radiological results of 169 total knee replacements(TKRs) for rheumatoid arthritis over 10 years. The average follow up period was 12.8(10–17.6) years. The flexion contracture was improved from average 25.0 to 2.9 degrees. But the angle of great flexion had decreased from average 128.0 to 114.7 degrees. At the final follow up, the American Knee Society knee score was 87.5 and function score 76.5 in average. The revision arthroplasty was performed in 20 cases, but only 4 cases were done before 10 years after the primary TKRs. The survival rate of the implant was 97.9% at 10 years and 85.3% at 14 years in Kaplan-Meier survivorship analysis. But just after 10 years, problems such as osteolysis and periprosthetic fractures started to occur increasingly. 10-year follow up results is just the 10-year results only, not the long-term or final results of TKRs for rheumatoid arthritis.
The purpose of this study was to evaluate the effect of decreasing tibial slope on extention gap during posterior stabilized total knee arthroplasty. 110 posterior stabilized total knee arthroplasties were studied for 2 groups;
having flexion contractures(n=35), having no flexion contracture(n=75). In each group, we measured the decrease of tibial slope and frequency of additional distal femoral resecions that were done due to insufficient extension gap in comparison with flexion gap during posterior stabilized total knee arthroplasty. We also compared frequencies of additional distal femoral resections between 2 parts having more and less slope decrease in each groups. In each group, tibial slope decrease were 8.7 degrees, 7.4 degrees(p=0.145) and frequencies of additional resection were 51.4%, 24%(p=0.005) in average. In 2 parts having more and less slope decrease in each group, frequencies of additional resection were 44.4% vs 58.8%(p=0.505), 13.2% vs 35.1%(p=0.032). Results suggested that more decrease of tibial slope reduced frequency of additional distal femoral resection during posterior stabilized total knee arthroplasty in group having no flexion contracture. Decreasing tibial slope can be considered as a factor influencing on extension gap during posterior stabilized total knee arthroplasty. The estimation of predictable tibia slope decrease through preoperative radiologic findings can be beneficial in performing succeful posterior stabilized total knee arthroplasty.
Arthroscopic subacromial decompression was carried out in one hundred and four consecutive patients who had stage II subacromial impingement with failed conservative treatment. The results were assessed preoperatively and at follow up using the UCLA score. After an average of 8.4 years follow up, the final results were as following; fifty-seven shoulders (55%) in excellent, twenty-five (24%) in good, sixteen (15%) in fair and six (6%) in poor. Late full thickness tears developed in 9% of patients and can be treated with an open repair of rotator cuff. Arthroscopic subacromial decompression was very effective for stage II impingement syndrome. To assess the long term results of arthroscopic subacromial decompression in stage II subacromial impingement. Arthroscopic subacromial decompression was very effective for stage II impingement. Late full thickness tears developed in 9% of patients and can be treated with an open repair of rotator cuff. This technique is a viable treatment for the condition. This is a prospective cohort study carried out in a University setting. Arthroscopic subacromial decompression was carried out in one hundred and twenty consecutive patients who had stage II subacromial impingement with failed conservative treatment. Sixteen were lost to follow up. The results were assessed preoperatively and at follow up using the UCLA score. After an average of 8.4 years follow up, the final results were fifty-seven shoulders (55%) excellent, twenty- five (24%) good, sixteen (15%) fair and six (6%) poor. All parameters – pain, function, muscle strength and motion – were improved significantly (p<
0.001). In the six poor results, two had late rotator cuff tears, three had recurrence of impingement with degenerative change and one had reflex sympathetic dystrophy. Late full thickness rotator cuff tears developed in ten shoulders after decompression. Re-operations were performed in four shoulders – three late open repairs of the rotator cuff tear resulted in good results with one poor rating. Arthroscopic subacromial decompression was very effective for stage II impingement syndrome. Late full thickness tears developed in 9% of patients and can be treated with an open repair of rotator cuff.
