Knee functions and a return to sports activity in competitive athletes following anterior cruciate ligament reconstruction.
(33/1048)
We investigated knee functions and a return to sports in 50 competitive athlete patients treated with arthroscopic anterior cruciate ligament reconstruction using double-looped STG augmented by woven polyester at a 1-year follow-up. There were 25 males and 25 females with a mean age of 24.3 years (range: 19-39 years). The majority of preinjury sports were basketball, volleyball and soccer. Athletic rehabilitation including agility training and sports-specific training was started at 12 weeks. Fourty patients (80%) was rated as normal or nearly normal on the assessment of International Knee Documentation Commitee postoperatively. Fourty-eight patients (96%) obtained full range of motion, and the mean quadriceps muscle strength of the injured side was 91.3%of that of the uninjured side. As for a return to sports, 46 patients (92%) were able to do fully competitive sports at a mean of 8.1 postoperative months. These results suggest that arthroscopic reconstruction using augmented double-looped STG allows early athletic rehabilitation, and lead satisfactory outcome as well as a reliable and early return to preinjury level of sport activity for the majority of the competitive athlete patients. (+info)
Recurrent posterior dislocation following primary posterior-stabilized total knee arthroplasty.
(34/1048)
In our series of 136 patients with primary total knee arthroplasty using posterior-stabilized prosthesis, a female patient with Parkinson disease developed posterior dislocation of the knee 9 months after surgery. Eventually, the dislocation became recurrent, occurring several times a day. The patient made the reposition always by herself. Two months after the first dislocation, we performed the revision of the polyethylene tibial insert and found wearing of the tibial insert's cam as an hitherto unreported cause of the mechanical instability of the total knee prosthesis. (+info)
Biomechanical comparison of fixation of type-I fractures of the lateral tibial plateau. Is the antiglide screw effective?
(35/1048)
Type-I fractures of the lateral tibial plateau were simulated by osteotomy in 18 pairs of unembalmed cadaver tibiae. One fracture of each pair was fixed with two lag screws whereas the contralateral site was stabilised with three lag screws, or two lag screws plus an antiglide screw. The lateral plateau was displaced downwards using a servohydraulic materials testing machine and the resulting force and articular surface gap were recorded. Yield load was defined as the maximum load needed to create a 2.0 mm articular offset at the fracture line. The yield loads of the three-lag-screw (307 +/- 240 N) and antiglide constructs (342 +/- 249 N) were not significantly different from their two-screw control constructs (231 +/- 227 and 289 +/- 245 N, respectively). We concluded that adding an antiglide screw or a third lag screw did not provide any biomechanical advantage in stabilising these fractures. (+info)
The management of medial ligament tears in patients with combined anterior cruciate and medial ligament lesions.
(36/1048)
The management of patients with combined medial collateral (MCL) and anterior cruciate (ACL) rupture remains controversial. We studied 25 such patients who elected to have the ACL lesion treated conservatively; 14 underwent MCL repair with early mobilization and 11 were treated with immobilization for two weeks. The mean follow up was 5.9 years (2 to 11). There was no difference in the clinical assessment of ligamentous laxity, KT-1000 measurements or Tegner activity scores between the two groups but there were significantly higher Lysholm function scores in the operated group. (+info)
Occupational physical activities and osteoarthritis of the knee.
(37/1048)
OBJECTIVE: To assess the risk of knee osteoarthritis (OA) associated with kneeling, squatting, and other occupational activities. METHODS: We compared 518 patients who were listed for surgical treatment of knee OA and an equal number of control subjects from the same communities who were matched for sex and age. Histories of knee injury and occupational activities were ascertained at interview, height and weight were measured, and the hands were examined for Heberden's nodes. Data were analyzed by conditional logistic regression. RESULTS: After adjustment for body mass index (BMI), history of knee injury, and the presence of Heberden's nodes, risk was elevated in subjects who reported prolonged kneeling or squatting (odds ratio [OR] 1.9; 95% confidence interval [95% CI] 1.3-2.8), walking >2 miles/day (OR 1.9; 95% CI 1.4-2.8), and regularly lifting weights of at least 25 kg (OR 1.7; 95% CI 1.2-2.6) in the course of their work. The risks associated with kneeling and squatting were higher in subjects who also reported occupational lifting, and appeared to interact multiplicatively with the risk conferred by obesity. People with a BMI of > or =30 kg/m2 whose work had entailed prolonged kneeling or squatting had an OR of 14.7 (95% CI 7.2-30.2), compared with subjects with a BMI <25 kg/m2 who were not exposed to occupational kneeling or squatting. CONCLUSION: There is now strong evidence for an occupational hazard of knee OA resulting from prolonged kneeling and squatting. One approach to reducing this risk may lie in the avoidance of obesity in people who perform this sort of work. (+info)
The menisci: basic science and advances in treatment.
(38/1048)
Once described as a muscle remnant, and therefore treated with disrespect, the meniscus is now known to be a vital structure within the knee. Minimal partial meniscectomy performed arthroscopically, or meniscal repair when practical, have become the standard treatments. In spite of the advancements in understanding meniscal function and its preservation, much remains to be studied. In the future, availability of better repair techniques and the option of meniscal replacement with allograft or prosthetic menisci are expected to improve outcomes. (+info)
The sliding stop: a technique of fielding in cricket with a potential for serious knee injury.
(39/1048)
The sliding stop method of fielding in cricket is gaining popularity in schools and club cricket through its frequent exposure on television. The case history is reported of a cricketer who suffered a torn medial meniscus in his knee, a rare cricketing injury, while performing this technique incorrectly in a club game. The correct method of performing the technique is described in coaching manuals but is not commonly instructed at club or school level. The sliding stop should be discouraged in school and for club cricketers unless appropriately coached. (+info)
Factors associated with osteoarthritis of the hip and knee in Hong Kong Chinese: obesity, joint injury, and occupational activities.
(40/1048)
In 1998, a case-control study was conducted in Hong Kong on hospital patients with osteoarthritis of the hip (n = 138) and osteoarthritis of the knee (n = 658). Age- and sex-matched controls were recruited consecutively from general practice clinics in the same region. The following three risk factors were found to be associated with osteoarthritis of both the hip and the knee: first, a history of joint injury: for osteoarthritis of the hip, the odds ratio = 25.1 (95% confidence interval (CI): 3.5, 181) in men and 43.3 (95% CI: 11.7, 161) in women; for osteoarthritis of the knee, the odds ratio = 12.1 (95% CI: 3.4, 42.5) in men and 7.6 (95% CI: 3.8, 15.2) in women; second, climbing stairs frequently: for osteoarthritis of the hip, the odds ratio = 12.5 (95% CI: 1.5, 104.3) in men and 2.3 (95% CI: 0.6, 8.1) in women; for osteoarthritis of the knee, the odds ratio = 2.5 (95% CI: 1.0, 6.4) in men and 5.1 (95% CI: 2.5, 10.2) in women; third, lifting heavy weight frequently: for osteoarthritis of the hip, the odds ratio = 3.1 (95% CI: 0.7, 14.3) in men and 2.4 (95% CI: 1.1, 5.3) in women; for osteoarthritis of the knee, the odds ratio = 5.4 (95% CI: 2.4, 12.4) in men and 2.0 (95% CI: 1.2, 3.1) in women. In addition, subjects whose height and weight were in the highest quartile were at increased risk of osteoarthritis of the hip and knee, respectively (p < 0.05). (+info)