scholarly journals Early Functional Rehabilitation after Meniscus Surgery: Are Currently Used Orthopedic Rehabilitation Standards Up to Date?

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Matthias Koch ◽  
Clemens Memmel ◽  
Florian Zeman ◽  
Christian G. Pfeifer ◽  
Johannes Zellner ◽  
...  
Keyword(s):  
Surgical Procedure ◽  
Weight Bearing ◽  
Meniscus Repair ◽  
Partial Meniscectomy ◽  
Early Rehabilitation ◽  
Daily Routine ◽  
Functional Rehabilitation ◽  
Orthopedic Surgeons ◽  
Meniscus Replacement ◽  
Rehabilitation Concepts

Meniscus therapy is a challenging process. Besides the respective surgical procedure such as partial meniscectomy, meniscus repair, or meniscus replacement, early postoperative rehabilitation is important for meniscus regeneration and return to sport and work as well as long-term outcome. Various recommendations are available. However, the current literature lacks information concerning the actual early rehabilitation in daily routine recommended by orthopedic surgeons. Thus, the purpose of this study was to investigate currently used standard early rehabilitation protocols in the daily routine of orthopedic surgeons. This study investigated the recommendations and concepts for early rehabilitation after meniscus therapy given by German, Austrian, and Swiss orthopedic institutions. Standardized criteria such as weight bearing, range of motion, use of an orthosis, and rehabilitation training were analyzed according to the conducted surgical procedure: partial meniscectomy, meniscus repair, or meniscus replacement. The analysis of standard rehabilitation concepts for partial meniscectomy (n=15), meniscus repair (n=54), and meniscus replacement (n=7) showed significantly earlier functional rehabilitation in all criteria after partial meniscectomy in contrast to meniscus repair techniques (p<0.001). In addition, significant restrictions were found in full weight bearing, full range of motion, and the use of braces. In summary, a wide range of recommendations for weight bearing, ROM, brace therapy, and mobilization is available, particularly after meniscus repair and meniscus replacement. Most concepts are in accordance with those described in the current literature. Further research is necessary to enhance the scientific evidence on currently used early rehabilitation concepts after meniscus therapy.

scholarly journals MRI Evaluation of Patella Alignment Before and After Anatomical Reconstruction of ACL Undergoing Unified Rehabilitation Programme Introduced by CMC Physical Therapy Team

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0014
Author(s):  
Dariusz Straszewski ◽  
Marcin Plenzler ◽  
Joanna Szczepaniak ◽  
Robert Śmigielski ◽  
Beata Ciszkowska-Łysoń ◽  
...  
Keyword(s):  
Patellar Tendon ◽  
Muscle Activation ◽  
Weight Bearing ◽  
Tendon Graft ◽  
Rehabilitation Programme ◽  
Anatomical Reconstruction ◽  
Patella Baja ◽  
Functional Rehabilitation ◽  
Patellar Tendon Graft ◽  
The Impact

Objectives: The aim of the study was to asses the impact of the functional rehabilitation on patella alignment with MRI imaging in patients who underwent the ACL reconstruction. The surgical approach with the use of patellar tendon graft is known to carry the risk of lowering patella height (patella baja), which, in turn, may lead to accelerated cartilage wear in patellofemoral joint. Methods: 30 patients after the anatomical reconstruction of ACL took part in this study (23 male, and 7 female, mean age = 28 ± 10,6 years). During the procedure a patellar tendon graft was used. The Insali-Salvati ratio measured with MRI (images taken pre-procedural, and 9 months after the surgery) was used for the assessment of patellar alignment. The measurements were taken by one radiology specialist on MRI scans in sagittal view in PD sequence. During the examination, patellar joint was in flexion (approx.10 degrees). As the point of reference for patella’s position ISR ratio was in the range of 0.8 - 1.2. All patients were operated on by the same team of surgeons and underwent an unified rehabilitation programme led by a team of selected physiotherapists. The main features of the programme were: an early muscle activation (second day after the procedure); mobilisation of the patella and tissues of the anterior compartment of the knee; weight bearing co-contraction exercises, and the sensomotoric training of the entire kinetic chain of the lower limb. The data recorded was statistically analysed using the Wilcoxon signed-rank test in order to establish parameters’ changes within the study group.. Results: The mean ISR value before the procedure was 0.84 (± 0,1), whereas 9 months after the surgery it was 0.85 (± 0,1). The results’ analysis did not show any statistically significant changes between ISR values. Nine months after the procedure patella baja has not been observed in any of the evaluated patients. Conclusion: The functional rehabilitation programme designed by the CMC team had no negative impact on patella alignment, as no patella baja, which is a common complication after these kinds of surgeries, has been observed. The applied functional rehabilitation programme enabled patients to keep the proper patella alignment, similar to the alignment recorded before the surgery.

scholarly journals The modified anterior ellipsoidal cap titanium cable tension band for comminuted patellar fractures

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901987401
Author(s):  
Fasheng Wang ◽  
Tianyi David Luo ◽  
Chunyong Chen ◽  
Yun Xie ◽  
Zhangxiong Lin ◽  
...  
Keyword(s):  
Weight Bearing ◽  
Tension Band ◽  
High Rate ◽  
Wound Complications ◽  
Functional Rehabilitation ◽  
Postoperative Function ◽  
Patella Fractures ◽  
The Mean ◽  
Patellar Fractures

Purpose: The purpose of this study was to assess the outcomes in a series of patients, who underwent cerclage and figure-of-eight tension band wiring using a single titanium cable for comminuted patellar fractures. Methods: We describe a modified tension band technique using a single titanium cable to create an ellipsoidal cap structure that combines the circumferential and figure-of-eight wrapping in the fixation of closed Association for the Study of Internal Fixation/Orthopaedic Trauma Association 34C2 and 34C3 patellar fractures. We retrospectively reviewed 25 patients (16 males and 9 females, mean age 54 years) who underwent the described fixation technique between 2015 and 2017. Postoperative function was evaluated using the Böstman score. Results: At the mean follow-up of 25 months (range 17–39 months), the mean Böstman score was 27.3 ± 2.6 points (range 23–30). Eighteen patients (72%) had excellent results (score ≥28); seven patients (28%) had good results (score 20–27); and no patients had an unsatisfactory result (score < 20). All surgical incisions healed without major wound complications. Two patients reported minor complications (soft tissue irritation, cellulitis). No patients demonstrated loss of reduction or implant failure during the follow-up period. Conclusion: The modified anterior ellipsoidal cap tension band using a single titanium cable created an effective tension band structure in the treatment of comminuted patella fractures. It is a simple operative technique that produced a stable fixation construct, which allowed early functional rehabilitation and weight-bearing with a high rate of excellent outcomes at 2 years after surgery.

scholarly journals The A-test: Assessment of functional recovery during early rehabilitation of patients in an orthopedic ward - content, criterion and construct validity

2014 ◽  
Vol 71 (8) ◽  
pp. 715-722 ◽  
Author(s):  
Aleksandra Vukomanovic ◽  
Aleksandar Djurovic ◽  
Zoran Popovic ◽  
Vesna Pejovic
Keyword(s):  
Hip Fracture ◽  
Construct Validity ◽  
Functional Recovery ◽  
Test Score ◽  
Weight Bearing ◽  
Hip Osteoarthritis ◽  
Early Rehabilitation ◽  
Ordinal Scale ◽  
Test Results ◽  
Orthopedic Ward

Background/Aim. The A-test was designed for assessment of functional recovery during early rehabilitation of patients in an orthopedic ward. This performance-based test consists of 10 items for assessing basic activities by a six level ordinal scale (0-5). Total scores can range from 0 to 50, i.e. from inability to perform any activity despite the help of therapists to complete independence and safety in performing all activities. The aim of this study was to examine the A-test validity. Methods. This prospective study was conducted in an orthopedic ward and included 120 patients [60 patients with hip osteoarthritis that underwent arthroplasty and 60 surgically treated patients with hip fracture (HF)] during early inpatient rehabilitation (1st-5th day). Validity was examined through 3 aspects: content validity - floor and ceiling effect, range, skewness; criterion validity - concurrent validity [correlation with the University of Iowa Level of Assistance Scale (ILAS) for patients with hip osteoarthritis, and with the Cumulated Ambulation Score (CAS) for patients with HF, Spearman rank correlation] and predictive validity [the New Mobility Score (NMS) 4 weeks after surgery, Mann-Whitney U test]; construct validity - 4 hypotheses: 1) on the fifth day of rehabilitation in patients underwent arthroplasty due to hip osteoarthritis, the A-test results will strongly correlate with those of ILAS, while the correlation with the Harris hip score will be less strong; 2) in patients with HF, the A-test results will be significantly better in those with allowed weight bearing as compared to patients whom weight bearing is not allowed while walking; 3) results of the A-test will be significantly better in patients with hip osetoarthritis than in those with HF; 4) the A-test results will be significantly better in patients younger than 65 years than in those aged 65 years and older. Results. The obtained results were: low floor (1%) and ceiling (2%) effect, range 0-50, skewness 0.57, strong correlation with ILAS for the patients with hip osteoarthritis (r = -0.97, p = 0.000) and with CAS for the patients with hip fracture (r = 0.91, p = 0.000) The patients with the A-test score 35 and more on the fifth day of rehabilitation (n = 46, Md = 4) had significantly higher NMS rank 4 weeks after surgery than the patients with the A-test score less than 35 (n = 59, Md = 2), (U = 379, z = -6.47, p = 0.000, r = 0.63). All 4 hypotheses were confirmed. Conclusion. The A-test is simple and valid instrument for everyday evaluation of pace and degree of functional recovery during early rehabilitation of patients surgically treated in an orthopedic ward.

scholarly journals PO 18195 - Publication trends of research on hallux valgus (1998 - 2018)

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 41S
Author(s):  
Kelly Cristina Stéfani ◽  
Gabriel Ferraz Ferreira ◽  
Vinicius Quadros Borges ◽  
Leonardo Vinícius De Matos Moraes
Keyword(s):  
United States ◽  
Hallux Valgus ◽  
The United States ◽  
Daily Routine ◽  
R Software ◽  
Orthopedic Surgeons ◽  
Data Compilation ◽  
Leading Position ◽  
The Subject ◽  
Number Of Publications

Introduction: Hallux valgus (HV) is a very common deformity among affections of the foot, and interest in the subject is persistent in the daily routine of orthopedic surgeons. We investigated the trend in HV publications in the literature. Methods: The research was carried out by searching the Web of Science database between 1998 - 2018, analyzed using a bibliometric methodology. We used the "Bibliometrix" package for R software for the data compilation and VOSviewer for graphic creation. Results: A total of 703 articles were found from the electronic search until December 21, 2018, with 6266 citations. The major scholar in this field was Coughlin M.J., with the largest number of publications (17). The United States led in number of articles published with 26.74%, with Brazil ranked in 26 place. There was an increase in the number of publications, with the highest number of articles published in 2016 (78). Conclusion: The amount of published work on HV has grown rapidly since 2011. The United States has the leading position in global research. The journal with more articles was Foot and Ankle International.  

scholarly journals WEIGHT-BEARING CONE BEAM CT SCANS AND ITS USES IN ANKLE, FOOT, AND KNEE: AN UPDATE ARTICLE

2021 ◽  
Vol 29 (2) ◽  
pp. 105-110
Author(s):  
CARLOS FELIPE TEIXEIRA LÔBO ◽  
MARCELO BORDALO-RODRIGUES ◽  
Alexandre Leme Godoy-Santos ◽  
Riccardo Gomes Gobbi ◽  
Cesar de Cesar Netto ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Cone Beam Ct ◽  
Weight Bearing ◽  
Cone Beam ◽  
Extensive Literature ◽  
Level Of Evidence ◽  
Orthopedic Surgeons ◽  
Quality Costs ◽  
Potential Applications ◽  
High Resolution Images

ABSTRACT Imaging plays a key role in the preoperative diagnosis, surgical planning, and postsurgical assessment of the foot, ankle, and knee pathologies. Interpreting diagnostic imaging accurately is crucial for the clinical practice of orthopedic surgeons. Although among the most used imaging modalities, radiographic assessments are amenable to errors for various technical reasons and superposition of bones. Computed tomography (CT) is a conventional imaging procedure that provides high-resolution images, but fails in considering a truly weight-bearing (WB) condition. In an attempt to overcome this limitation, WB cone beam CT technology has being successfully employed in the clinical practice for the past decade. Besides economically viable and safe, the WB cone beam CT considers WB conditions and provides high-quality scans, thus allowing an equitable and correct interpretation. This review aims to address extensive description and discussion on WBCT, including imaging quality; costs; time consumption; and its applicability in common foot, ankle, and knee, conditions. With this technology increasing popularity, and considering the extensive literature on medical research, radiologists and orthopedic surgeons need to understand its potential applications and use it optimally. Level of Evidence III, Systematic review of level III studies.

ANTHROPOMETRIC STUDY OF FEMUR IN SOUTH INDIA

2021 ◽  
pp. 19-20
Author(s):  
S. Saravana Baskar ◽  
S. Karthick
Keyword(s):  
Sex Determination ◽  
South India ◽  
Weight Bearing ◽  
Long Bone ◽  
Legal Practice ◽  
Left Femur ◽  
Orthopedic Surgeons ◽  
Anatomical Knowledge ◽  
Different Dimensions ◽  
Anthropometric Study

Background: Anthropometry provides scientic method and technique for taking various measurements in different geographic regions and races. The femur is the weight bearing typical long bone of lower limb which extends from the pelvis to the knee. The anatomical knowledge of different dimensions of femur specially head and neck of the femur is very essential in anthropological and medico-legal practice for sex determination and as well as to radiologists, rheumatologists and orthopaedic surgeons for diagnosis and planning of treatment. Objectives: The objectives of present study to nd out the measurements of Platymeric index,Robusticity index and Foraminal index. Materials And Methods: In present study have used 250 femurs from different colleges in south India. The following measurements were conducted Platymeric index, Robusticity index and Foraminal index for both right and left femur. Results: The results of present study are the Physiological length of left femur was 44.15+2.35 and right was 43.98+2.15, the Rubusticity index of left femur was 15.26+1.17 and right was 14.34+1.21the Platymetric index of left femur was 85.70+6.35 and right was 86.32+6.15, the Foraminal index of left femur was between 37-65% and right was 35-62%. Conclusion: The present study shows that there is signicance different in between right and left femurs measurements. The anatomical knowledge of different dimensions of femur is very essential in anthropological and medico-legal practice for sex determination and as well as to radiologists, rheumatologists and orthopedic surgeons for diagnosis and planning of treatment.

Arthroscopically assisted fixation of Hawkins type II talar neck fractures

2018 ◽  
Vol 100-B (4) ◽  
pp. 461-467 ◽  
Author(s):  
J. Wagener ◽  
C. Schweizer ◽  
L. Zwicky ◽  
T. Horn Lang ◽  
B. Hintermann
Keyword(s):  
Screw Fixation ◽  
Weight Bearing ◽  
Type Ii ◽  
Percutaneous Screw Fixation ◽  
Functional Rehabilitation ◽  
Fracture Fragment ◽  
Neck Fracture ◽  
Arthroscopically Assisted ◽  
Arthroscopically Assisted Reduction ◽  
Talar Neck Fractures

Aims Arthroscopically controlled fracture reduction in combination with percutaneous screw fixation may be an alternative approach to open surgery to treat talar neck fractures. The purpose of this study was thus to present preliminary results on arthroscopically reduced talar neck fractures. Patients and Methods A total of seven consecutive patients (four women and three men, mean age 39 years (19 to 61)) underwent attempted surgical treatment of a closed Hawkins type II talar neck fracture using arthroscopically assisted reduction and percutaneous screw fixation. Functional and radiological outcome were assessed using plain radiographs, as well as weight-bearing and non-weight-bearing CT scans as tolerated. Patient satisfaction and pain sensation were also recorded. Results Primary reduction was obtained arthroscopically in all but one patient, for whom an interposed fracture fragment had to be removed through a small arthrotomy to permit anatomical reduction. The quality of arthroscopic reduction and restoration of the talar geometry was excellent in the remaining six patients. There were no signs of talar avascular necrosis or subtalar degeneration in any of the patients. In the whole series, the functional outcome was excellent in five patients but restricted ankle movement was observed in two patients. All patients had a reduction in subtalar movement. At final follow-up, all patients were satisfied and all but one patient were pain free. Conclusion Arthroscopically assisted reduction and fixation of talar neck fractures was found to be a feasible treatment option and allowed early functional rehabilitation. Cite this article: Bone Joint J 2018;100-B:461–7.

scholarly journals Automating classification of osteoarthritis according to Kellgren-Lawrence in the knee using deep learning in an unfiltered adult population

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Simon Olsson ◽  
Ehsan Akbarian ◽  
Anna Lind ◽  
Ali Sharif Razavian ◽  
Max Gordon
Keyword(s):  
Deep Learning ◽  
Knee Osteoarthritis ◽  
Adult Population ◽  
Weight Bearing ◽  
Correct Diagnosis ◽  
University Hospital ◽  
Knee Oa ◽  
Orthopedic Surgeons ◽  
Visual Disturbances

Abstract Background Prevalence for knee osteoarthritis is rising in both Sweden and globally due to increased age and obesity in the population. This has subsequently led to an increasing demand for knee arthroplasties. Correct diagnosis and classification of a knee osteoarthritis (OA) are therefore of a great interest in following-up and planning for either conservative or operative management. Most orthopedic surgeons rely on standard weight bearing radiographs of the knee. Improving the reliability and reproducibility of these interpretations could thus be hugely beneficial. Recently, deep learning which is a form of artificial intelligence (AI), has been showing promising results in interpreting radiographic images. In this study, we aim to evaluate how well an AI can classify the severity of knee OA, using entire image series and not excluding common visual disturbances such as an implant, cast and non-degenerative pathologies. Methods We selected 6103 radiographic exams of the knee taken at Danderyd University Hospital between the years 2002-2016 and manually categorized them according to the Kellgren & Lawrence grading scale (KL). We then trained a convolutional neural network (CNN) of ResNet architecture using PyTorch. We evaluated the results against a test set of 300 exams that had been reviewed independently by two senior orthopedic surgeons who settled eventual interobserver disagreements through consensus sessions. Results The CNN yielded an overall AUC of more than 0.87 for all KL grades except KL grade 2, which yielded an AUC of 0.8 and a mean AUC of 0.92. When merging adjacent KL grades, all but one group showed near perfect results with AUC > 0.95 indicating excellent performance. Conclusion We have found that we could teach a CNN to correctly diagnose and classify the severity of knee OA using the KL grading system without cleaning the input data from major visual disturbances such as implants and other pathologies.

Evaluation of clinical results after arthroscopic meniscus repair and partial meniscectomy

2020 ◽  
Vol 27 (5) ◽  
pp. 1464
Author(s):  
Ali Canbay ◽  
Resit Sevimli ◽  
Gokay Gormeli ◽  
Yunus Oklu ◽  
Ekrem Ozdemir
Keyword(s):  
Clinical Results ◽  
Meniscus Repair ◽  
Partial Meniscectomy
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