Abstract:
BACKGROUND:When associated with a knee dislocation, management of the medial ligamentous injury is challenging, with little literature available to guide treatment. QUESTIONS/PURPOSES:We (1) compared MRI findings of medial ligament injuries between Schenck KDIIIM and KDIV injuries, (2) compared clinical outcomes and health-related quality of life as determined by Lysholm and Veterans Rand 36-Item Health Survey (VR-36) scores, respectively, of reconstructed KDIIIM and KDIV injured knees, and (3) determined reoperation rates of reconstructed KDIIIM and KDIV injured knees. METHODS:Over a 12-year period, we treated 65 patients with knee dislocations involving bicruciate ligament injury and concomitant medial ligament injuries, without or with posterolateral corner injuries (Schenck KDIIIM and KDIV, respectively); 57% were available for followup at a mean of 6.2 years (range, 1.1-11.6 years). These patients were contacted, and prospectively measured clinical outcomes scores (Lysholm and VR-36) were obtained and compared between subsets of patients. Preoperative MRIs (available for review on 49% of the patients) were rereviewed to characterize the medial ligament injuries. RESULTS:KDIIIM injuries more frequently had complete deep medial collateral ligament tears and posterior oblique ligament tears compared to KDIV injuries. KDIIIM knees had better Lysholm scores (88 versus 67, p = 0.027) and VR-36 scores (88 versus 70, p = 0.022) than KDIV knees. Female sex (Lysholm: 55 versus 85, p = 0.005; VR-36: 59 versus 85, p = 0.003) and an ultra-low-velocity mechanism (injury that occurs during activity of daily living in obese patients) (Lysholm: 55 versus 80-89, p = 0.002-0.013; VR-36: 60 versus 79-88, p = 0.001-0.017) were associated with worse outcomes. The overall reoperation rate was 28%, and the most common indication for reoperation was stiffness. CONCLUSIONS:Medial ligament injury is common in knee dislocations. Females who sustain these injuries and patients who have an ultra-low-velocity mechanism should be counseled at the time of injury about the likelihood of inferior outcomes. As ROM deficits are the most commonly encountered complication, postoperative rehabilitation should focus on early ROM exercises as stability and wound healing allow. Future prospective studies are needed to definitively determine whether operative or nonoperative management is appropriate for particular medial ligamentous injury patterns.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Werner BC,Hadeed MM,Gwathmey FW Jr,Gaskin CM,Hart JM,Miller MDdoi
10.1007/s11999-014-3483-3subject
Has Abstractpub_date
2014-09-01 00:00:00pages
2658-66issue
9eissn
0009-921Xissn
1528-1132journal_volume
472pub_type
杂志文章abstract::Recent surgical advancements in anterior cruciate ligament reconstructions have led to better results in the treatment of knee injuries. Functional knee braces have been prescribed in greater number, leading to an increased production of commercially available braces. The effectiveness of braces remains controversial ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1995-08-01 00:00:00
abstract::Semitendinosus anatomic reconstruction (STAR) rebuilds the major anatomic bands of the anterior cruciate ligament (ACL) and provides isometric ligamentous relationships. STAR secures a graft firmly enough to allow intraoperative testing and early motion. It provides a graft comparable in strength with a normal ACL and...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract::Long-term effects (104 weeks) of 2 extremes of gap size on the mechanical behavior of the rabbit medial collateral ligament were examined. In the midsubstance of each right medial collateral ligament, either an 8 mm gap injury was created or a 4 mm Z plasty injury was created and repaired. Each group was subdivided in...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199704000-00031
更新日期:1997-04-01 00:00:00
abstract:BACKGROUND:Management of the cuff-deficient arthritic shoulder has long been challenging. Early unconstrained shoulder arthroplasty systems were associated with high complication and implant failure rates. The evolution toward the modern reverse shoulder arthroplasty includes many variables of constrained shoulder arth...
journal_title:Clinical orthopaedics and related research
pub_type: 历史文章,杂志文章
doi:10.1007/s11999-010-1733-6
更新日期:2011-09-01 00:00:00
abstract::Femoral head vitality was evaluated by tetracycline labeling and 99mTc-MDP scintimetry in 317 femoral neck fractures before and after internal fixation with two hook-pins. The preoperative vitality was about the same as that observed by others using comparable methods. The postoperative vitality was reduced in five of...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1984-12-01 00:00:00
abstract:BACKGROUND:Revision TKA is a serious adverse event with substantial consequences for the patient. As the demand for TKA rises, reducing the risk of revision TKA is becoming increasingly important. Predictive tools based on machine-learning algorithms could reform clinical practice. Few attempts have been made to combin...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/CORR.0000000000001343
更新日期:2020-09-01 00:00:00
abstract:UNLABELLED:Metastatic bone disease of the humerus may require surgery for treatment of an impending or existing pathologic fracture or for alleviating disabling pain. Prompt restoration of function is a main goal of surgery, although published results do not reveal if that goal is being met. We retrospectively reviewed...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000165857.12676.00
更新日期:2005-08-01 00:00:00
abstract::The design features of an implant system can be crucial to the success of cementless total knee arthroplasty (TKA). The implant system described in this study incorporates anatomic features including an asymmetric tibial tray that is smaller laterally than medially, and a deep trochlear-grooved femoral component. Two ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1991-08-01 00:00:00
abstract::Twenty-nine patients with 30 intraarticular proximal tibial fractures were treated with early application of a cast brace. All fractures united, knee motion was excellent or good in all but one patient. The fracture fragments did not lose position after cast brace application. Varus or valgus deformities could be corr...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1976-09-01 00:00:00
abstract::The ultrastructural localization of calcium in the articular cartilage, meniscus, and synovium of patients with calcium pyrophosphate dihydrate (CPPD) crystal deposition disease was examined by using potassium pyroantimonate. Focal areas with deposition of CPPD crystals in each tissue showed electron-dense precipitate...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1991-03-01 00:00:00
abstract::One hundred consecutive unicondylar knee arthroplasties were reviewed after eight to 12 years of follow-up evaluation. Eighteen patients (19 knees) had died, four patients (four knees) were lost to follow-up evaluation, and 13 patients (13 knees) had revision. Survivorship analysis revealed 90% survivorship of the pro...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1991-10-01 00:00:00
abstract::Complete open-talar dislocation irreducible by virtue of entrapment by the tibialis posterior and flexor digitorum longus tendons occurred in a 41-year-old woman. Two-year follow-up examination revealed no evidence of avascular necrosis. A cursory review of the literature suggests that recovery of a complete range of ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:Local drug delivery has substantial potential to prevent infections compared with systemic delivery. Although calcium sulfate (CaSO(4)) has been studied for local drug delivery and two types are commercially available, it is unknown whether they differentially release antibiotics. QUESTIONS/PURPOSES:We dete...
journal_title:Clinical orthopaedics and related research
pub_type:
doi:10.1007/s11999-011-1911-1
更新日期:2011-11-01 00:00:00
abstract::An approach to mild, moderate, and severe fixed valgus deformities of the knee is described. The sequential approach to soft-tissue releases in the fixed valgus knee allows the surgeon to regain a neutral alignment in valgus deformities of up to 90 degrees. An additional benefit of the approach is spontaneous correcti...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1990-11-01 00:00:00
abstract:BACKGROUND:Open reduction and stabilization of dorsal pelvic ring injuries is accompanied by a high rate of soft tissue complications. Minimally invasive techniques have the potential to decrease soft tissue trauma, but the risk of iatrogenic nerve and vessel damage through the reduced surgical exposure should be consi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-1922-y
更新日期:2011-11-01 00:00:00
abstract::Removal of cement from the femoral canal during total hip revision arthroplasty continues to be very challenging. The technique is described using multiple 9-mm perforations placed at least 5 cm apart on the anterior surface of the femoral shaft. The tip of the revision stem should be at least 5 cm distal to the most ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1990-04-01 00:00:00
abstract::Because of the nature of the alignment the joints of the lower extremity, any significant loss of alignment or function will place increased stress on the remaining joints. An ankle arthrodesis must be carefully aligned into slight valgus and neutral dorsiflexion, plantar flexion and the same degree of external rotati...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1980-01-01 00:00:00
abstract::The Wilmington brace is a custom-molded thoracolumbosacral orthosis for decompensated adolescent idiopathic curves. Using the roentgenographic measurement of Rudicel and Renshaw, 71 patients with pretreatment curves that were decompensated greater than 1.0 cm were investigated in detail. The average follow-up period w...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-10-01 00:00:00
abstract:UNLABELLED:Accurate preoperative templating can facilitate precise, efficient, and reproducible total knee arthroplasty. We determined whether acetate templating accurately predicted knee implants used and compared the accuracy of digital templating. Preoperative planning was performed on 50 consecutive preoperative ra...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:2007-11-01 00:00:00
abstract::The introduction of alumina ceramic combined with the self-locking principle by surface increase has many followers. There is no manufacturing company in the world that does not produce self-locking hip prostheses with ceramic components. Despite increased interim results with conventional prostheses by improved cemen...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1992-09-01 00:00:00
abstract:BACKGROUND:Osteogenesis imperfecta (OI) is a heterogeneous group of collagen-related disorders characterized by osteopenia, bone fractures, spine deformities, and nonskeletal complications. Cardiopulmonary complications are the major cause of morbidity and mortality in adults with OI. The cause of such problems was oft...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/CORR.0000000000001400
更新日期:2020-12-01 00:00:00
abstract::The purpose of the current investigation was to present a standard method by which an orthopaedic practice can analyze its practice expenses. To accomplish this, a five-step process was developed to analyze practice expenses using a modified version of activity-based costing. In this method, general ledger expenses we...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200003000-00033
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:Modern hip implants typically feature modular heads, which allow for easy exchange and removal from the femoral stem at the time of revision. However, owing to fretting, corrosion, or cold welding, the modular head may be difficult or impossible to separate from the underlying trunnion, especially if the imp...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,多中心研究
doi:10.1007/s11999-016-4774-7
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:High tibial osteotomy (HTO) and unicompartmental arthroplasty (UKA) are reconstructive surgeries advocated for younger patients. In case of failure or progression of osteoarthritis, they can both be converted to a total knee arthroplasty (TKA). QUESTIONS/PURPOSES:We used registry data to answer if the risks...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-014-3712-9
更新日期:2015-01-01 00:00:00
abstract::A bolt-plate device for fixation of distal thoracic and proximal lumbar vertebral bodies has proved effective in a variety of surgical situations. The instrumentation is designed to obtain the optimum conditions for the healing of cancellous bone, namely, rigid immobilization and, if possible, close apposition of surf...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-02-01 00:00:00
abstract::In 20 dogs olecranon osteotomies fixed with tension band wires were studied histologically to reveal the pattern of healing. Different degrees of stability existed in different areas of the osteotomy. Under stable conditions cancellous bone healed by direct formation of woven bone. Instability resulted in an internal ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1989-08-01 00:00:00
abstract::Scheuermann's juvenile kyphosis may be considered a form of vertebral osteochondrosis. Although the etiology remains unknown, the ultimate effect is a disorderliness of vertebral growth in the growth plate cartilage. The biomechanical effects of increased kyphosis on saggital plane deformity, especially in a growing c...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1981-07-01 00:00:00
abstract:BACKGROUND:Patients with local recurrence of soft-tissue sarcomas have a poor overall survival. High-grade, soft-tissue sarcomas in deep locations may have a poorer prognosis regarding local recurrence than low-grade sarcomas or those located superficially. Although previous reports evaluated tumors at various depths, ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-2017-5
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Vitamin D plays an essential role in bone health and muscle function. Some studies have shown a widespread rate of vitamin D deficiency in the general population, but few have reported on the vitamin D status of orthopaedic patients. QUESTIONS/PURPOSES:We investigated (1) the extent of hypovitaminosis D in ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-013-2996-5
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Compressive osseointegration is a promising modality for limb salvage in distal femoral oncologic tumors. However, few studies have explored short-term survival rates in a large patient cohort of distal femur compressive endoprostheses or highlighted the risk factors for spindle failures. QUESTIONS/PURPOSES...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-016-4839-7
更新日期:2016-07-01 00:00:00