Surgical treatment of acl-pcl-medial side-lateral-side injuries of the knee

2003 ◽  
Vol 11 (4) ◽  
pp. 263-274 ◽  
Author(s):  
Gregory C Fanelli
Keyword(s):  
Surgical Treatment ◽  
Lateral Side ◽  
Medial Side

scholarly journals Congenital club foot

2010 ◽  
Vol 57 (1) ◽  
pp. 73-76 ◽  
Author(s):  
Z.S. Vukasinovic ◽  
N.S. Slavkovic ◽  
Z.M. Zivkovic ◽  
V.D. Bascarevic
Keyword(s):  
Surgical Treatment ◽  
Club Foot ◽  
Soft Tissues ◽  
Plantar Flexion ◽  
Lateral Side ◽  
Foot Deformity ◽  
Congenital Clubfoot ◽  
Medial Side ◽  
Success Of Treatment ◽  
Bone Deformities

Congenital club foot is the most frequent foot deformity. It occurs in 1% of newborns, two times more frequently in boys, with family inheritance. Patoanatomicaly, entity consists of bone deformities, articular malpositions and soft tissues retraction. All these produce adduction of the forefoot and varus and equinovarus of the hindfoot. Lateral side of the foot is convex and medial side is concave. Forefoot is in adduction and plantar flexion in relation to the hindfoot. The heel is rotated medially which induces varus and eqinus of the foot. The aim of the treatment is to establish anatomically normal foot, painless, with moderate movements, which is suitable for normal shoes. At the beginning treatment is nonsurgical. If nonsurgical treatment fails further step should be surgical treatment. The success of treatment of congenital clubfoot depends on the time of diagnosis and treatment beginning.

scholarly journals Differential Contribution of the Medial and the Lateral Side of the Joint to Symptoms in Knee Osteoarthritis: A Radiographic and Laboratory Analysis in the Nagahama Study

Cartilage ◽  
2021 ◽  
pp. 194760352110258
Author(s):  
Kazuya Nigoro ◽  
Hiromu Ito ◽  
Tomotoshi Kawata ◽  
Shinichiro Ishie ◽  
Yugo Morita ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Clinical Outcomes ◽  
Knee Pain ◽  
High Sensitivity ◽  
Analysis Of Covariance ◽  
Radiographic Evaluation ◽  
Radiographic Feature ◽  
Lateral Side ◽  
Cross Sectional ◽  
Medial Side

Objective: This cross-sectional study aimed to explore the differences of the medial and lateral sides of the knee joint and precise radiographic abnormalities in contribution to the knee pain and clinical outcomes. Design: Participants 60 years or older who underwent radiographic evaluation were included. Knee radiography was assessed using grading systems of the Osteoarthritis Research Society International (OARSI) atlas. The Japanese Knee Osteoarthritis Measure (JKOM) was evaluated as clinical outcomes. Serum high-sensitivity C-reactive protein (hsCRP) was used to evaluate systemic inflammation. We divided the participants into normal, medial-, lateral-, and medial & lateral-OA types and compared their JKOM using an analysis of covariance. Furthermore, we analyzed the relationship between the knee pain and stiffness of JKOM and the grading of each radiographic feature using a multiple regression model. Results: Lateral- and medial & lateral-OA groups had a significantly worse symptoms in the total and the pain score, especially in movement subscales, in JKOM score. Lateral-OA groups had higher hsCRP than medial-OA group. Multivariate analysis showed that medial joint space narrowing (JSN), and lateral femoral and tibial osteophytes significantly affected knee pain (adjusted odds ratios: 1.73, 1.28, and 1.55, respectively). The radiographic changes are associated with pain more in JSN in the medial side and osteophytes in the lateral side. Conclusion: Lateral- and medial & lateral-OA groups showed worth symptom. In addition, medial JSN and lateral osteophytes have potent effects on the knee pain.

scholarly journals Assessment of Acetabulum Deformity During Preoperative Planning for Hip Arthroplasty

2019 ◽  
Vol 25 (3) ◽  
pp. 153-164
Author(s):  
D. V. Martynenko ◽  
V. P. Voloshin ◽  
L. A. Sherman ◽  
K. V. Shevyrev ◽  
S. A. Oshkukov ◽  
...  
Keyword(s):  
Acetabular Component ◽  
Hip Joint ◽  
Preoperative Planning ◽  
Bone Defects ◽  
Lateral Side ◽  
X Rays ◽  
Two Dimensional ◽  
Acetabular Coverage ◽  
Anatomical Features ◽  
Medial Side

Purpose of the study — to improve the two-dimensional planning of total hip joint arthroplasty to ensure precise positioning of the acetabular component in the deformed acetabulum. Materials and methods. Features of roentgenological anatomy of acetabulum and its coverage were studied on 1058 hip joint x-rays in the AP view in accordance with the procedure developed by the authors to define acetabular square — the site of standard positioning of a spherical femoral head in the acetabulum or of a hemispherical acetabular component. The method consisted of identifying the apex of “teardrop” figure; the most lateral points of the pelvic terminal line and roof of the acetabulum; superior part of the acetabular cavity; medial and inferior points of acetabular coverage, and building the sides of acetabular square — medial, inferior, lateral and superior boundary lines. Connection of “teardrop” apex and lateral point of the pelvic terminal line formed the medial side of acetabular square, and a perpendicular to that line drawn through the “teardrop” apex to its inferior side. The lateral side was drawn either through the intersection of the ascending diagonal line — bisector from the top of the “teardrop” figure with the contour of the acetabulum roof, or was a part of the projection of the most lateral point of the acetabular roof on the inferior side of the square. The superior side was a perpendicular connecting the intersection of the ascending diagonal and lateral bounding lines with the medial side of the acetabular square. The area of the deformed acetabular cavity located outside of the acetabular square was assessed as the acetabular defect. Results. Method of defining the acetabular square allowed to identify types of ratios between acetabular cavity and acetabular coverage in transverse (9 types) and longitudinal (7 types) direction. Combination of transverse ratio of acetabular cavity and coverage with longitudinal type allowed to define the options of acetabular deformities in two-dimensional view. The authors identified 25 types of acetabular deformities. Bone defects of acetabular walls were of the major importance among all anatomical features. Cranial defect of acetabulum was observed in 450 cases, medial wall defect — in 38 cases, defect including cranial and medial areas — in 7 cases. Conclusion. The method suggested by the authors to determine acetabular square and acetabular deformity variations allows to screen the anatomical features of the acetabulum during two-dimensional preoperative planning and to make an informed decision on the need to use other planning techniques. The type of acetabular deformity identified during preoperative planning allows to elaborate the indications for replacement of acetabular bone defects and/or resection of acetabular osteophytes.

Surgical Treatment of Combined ACL PCL Medial Side Injuries: Acute and Chronic

2019 ◽  
pp. 273-282
Author(s):  
Benjamin Freychet ◽  
Nicholas I. Kennedy ◽  
Bruce A. Levy ◽  
Michael J. Stuart
Keyword(s):  
Surgical Treatment ◽  
Medial Side

Medial-Sided Injuries in the Multiple Ligament Knee Injury

2020 ◽  
Vol 33 (05) ◽  
pp. 431-439
Author(s):  
Gilbert Moatshe ◽  
Alexander R. Vap ◽  
Alan Getgood ◽  
Robert F. LaPrade ◽  
Lars Engebretsen
Keyword(s):  
Surgical Treatment ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Treatment Method ◽  
Systematic Evaluation ◽  
Functional Rehabilitation ◽  
Medial Side ◽  
Good Healing ◽  
Posteromedial Corner ◽  
Valgus Instability

AbstractMultiligament knee injuries (MLKI) are complex and challenging to treat. The posteromedial corner (PMC) structures are commonly torn in MLKI. A thorough and systematic evaluation is imperative to avoid a missed diagnosis and for planning treatment. With several structures injured, the treatment method (operative vs. nonoperative, repair vs. reconstruction), availability of allografts, timing of surgery, and rehabilitation are some of the factors that have to be considered in the decision-making. Persistent valgus instability because of untreated or not healed medial collateral ligament (MCL) tears will increase graft forces on the cruciate ligament grafts, thus increasing the risk of reconstruction graft failure. In recent years, there has been a growing body of literature on the anatomy and biomechanics of the medial structures that has aided in the development of biomechanically and clinically validated anatomic PMC reconstructions. Despite good healing potential of the MCL, in MLKI, surgical treatment is recommended for grade III PMC injuries to aid early rehabilitation and reduce the risk of surgical failure. Several studies have reported satisfactory outcomes after surgical treatment of MLKI involving the medial side. Early functional rehabilitation is imperative to reduce the risk of arthrofibrosis.

Surgical Treatment of Acute and Chronic ACL/PCL/Medial Side Injuries of the Knee

2004 ◽  
pp. 63-94
Author(s):  
Craig H. Bennett ◽  
Kevin E. Coates ◽  
Corey Wallach ◽  
Ronald A. Hall
Keyword(s):  
Surgical Treatment ◽  
Medial Side

scholarly journals Medial and Lateral Malleoli Impose Anatomical Constraints on Total Ankle Arthroplasty Design

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0010
Author(s):  
Jeffrey E. Bischoff ◽  
Sandra Snyder ◽  
J. Chris Coetzee ◽  
Stuart Miller ◽  
Terrence Philbin
Keyword(s):  
Total Ankle Arthroplasty ◽  
Lateral Side ◽  
Talar Dome ◽  
Taper Angle ◽  
Ankle Arthroplasty ◽  
Medial Side ◽  
Paired Student ◽  
Significant Difference ◽  
Lateral Lines ◽  
Statistical Shape

Category: Ankle Introduction/Purpose: Contemporary total ankle arthroplasty (TAA) techniques reconstruct the tibiotalar articulation while preserving the medial and lateral malleoli. The malleoli place anatomic constraints on the design of the talar component of the TAA system. If these constraints are not respected, then proper placement of the talar component may be compromised intra- operatively, or unintended contact between the prosthesis and bone may occur post-operatively. The goal of this study was therefore to quantify the medial and lateral malleolar boundaries. Methods: The orientation of the talus from a frontal view was quantified based on CT scans of left leg, non-arthritic specimens (n=89; 52M/37F) (Figure 1a). The talar dome was identified as the portion of the talus superior to the talar neck. The frontal profile of the dome defined by a plane positioned through the medial and lateral high points was extracted for each specimen. Statistical shape analysis was performed to identify the modes of variation of the frontal profile. Medial and lateral lines were fit to each profile, and resulting angles relative to the superior-inferior axis were measured. A paired student t-test (P<.05) was used to assess differences between the medial and lateral malleolus. Results: Figure 1b shows the average frontal profile of the talar dome, as well as ±1 and ±2 standard deviations. The average medial and lateral taper angles of the talus were 15.5° ± 5.9° and 7.6° ± 2.9°, respectively, with the lateral taper angle being significantly smaller than the medial taper angle (P<.001). The medial taper increased with talus size (as measured by the medial- lateral width of the dome) whereas the lateral taper decreased with talus size (Figure 1c), though both regressions were weak (R2 < 0.1). No statistically significant difference in taper angles was found between genders. Conclusion: Restoration of the bicondylar articulation geometry of the tibiotalar joint is an important design goal for TAA. One aspect of this geometry is the anatomic constraints imposed by the medial and lateral malleoli, to minimize unexpected impingement of the TAA prostheses with surrounding anatomic structures. Here, we have quantified those constraints through analysis of the medial and lateral taper of the talus, showing an increased taper angle on the medial side of the talus as compared to the lateral side.

The Relationship of the Position of the Metatarsal Heads and Peak Plantar Pressure

2003 ◽  
Vol 24 (4) ◽  
pp. 349-353 ◽  
Author(s):  
René E. Weijers ◽  
Geert H.I.M. Walenkamp ◽  
Henk van Mameren ◽  
Alphons G.H. Kessels
Keyword(s):  
Plantar Pressure ◽  
Lateral Side ◽  
Ct Scanner ◽  
Plantar Pressures ◽  
Medial Side ◽  
Plantar Pressure Distribution ◽  
Peak Plantar Pressure ◽  
The Right ◽  
Relationship Of ◽  
The Relationship

We test the premise that peak plantar pressure is located directly under the bony prominences in the forefoot region. The right foot of standing volunteers was examined in three different postures by a CT-scanner. The plantar pressure distribution was simultaneously recorded. The position of the metatarsal heads and the sesamoids could be related to the corresponding local peak plantar pressures. The metatarsal heads 1, 4, and 5 had a significantly different position than the local peak plantar pressures. The average difference in distance between the position of the metatarsal heads and the peak plantar pressure showed a significant correlation: on the medial side the head was located more distally to the local peak plantar pressure, on the lateral side more proximally. The findings suggest that normal plantar soft tissue is able to deflect a load. The observations might improve insight into the function of the normal forefoot and might direct further research on the pathological forefoot and on the design of footwear.

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