scholarly journals Preliminary diagnosis of medial meniscus posterior root tears using the Rosenberg radiographic view

2019 ◽  
Vol 31 (1) ◽  
Author(s):  
Yuya Kodama ◽  
Takayuki Furumatsu ◽  
Yusuke Kamatsuki ◽  
Takaaki Hiranaka ◽  
Tomohiro Takahata ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Medial Meniscus ◽  
Femoral Condyle ◽  
Weight Bearing ◽  
Magnetic Resonance Images ◽  
Control Group ◽  
Posterior Root ◽  
Level Of Evidence ◽  
Group A ◽  
Group B

Abstract Purpose To verify the effectiveness of detecting medial meniscus posterior root tears (MMPRTs) using weight-bearing posterior-anterior (PA) radiographs. Materials and methods Twenty-three patients were diagnosed with an MMPRT using magnetic resonance imaging (Group A), with 23 matched individuals forming the control group (Group B). The distance between medial tibial eminence and the lateral edge of the medial femoral condyle (MTE–MFC distance) and medial joint space (MJS) width were measured on weight-bearing PA radiographs, with the knee flexed at 45° (Rosenberg view). Absolute medial meniscus extrusion (MME) was measured on magnetic resonance images. Results The MTE–MFC distance was greater and the MJS width was smaller in Group A than Group B (7.7 ± 1.7 mm versus 6.0 ± 1.24 mm and 3.2 ± 0.8 mm versus 4.5 ± 0.7 mm, respectively; P < 0.05). The MTE–MFC distance and MJS width correlated with MME (r = 0.603 and 0.579, respectively; P < 0.05), and the extent of MME was greater in Group A than Group B (4.1 ± 1.1 mm versus 1.8 ± 1.5 mm, respectively; P < 0.05). Conclusions MMPRTs increase the MTE–MFC distance and decrease the MJS width, with these measurements correlating to the MME. Therefore, measurement of the MTE–MFC distance and MJS width on the Rosenberg view could be a useful preliminary method for the diagnosis of an MMPRT. Level of evidence IV

Sports Hernia in National Hockey League Players

2012 ◽  
Vol 41 (1) ◽  
pp. 107-110 ◽  
Author(s):  
Andre Jakoi ◽  
Craig O’Neill ◽  
Christopher Damsgaard ◽  
Keith Fehring ◽  
James Tom
Keyword(s):  
Statistical Significance ◽  
Return To Play ◽  
National Hockey League ◽  
Control Group ◽  
Sports Hernia ◽  
Level Of Evidence ◽  
Athletic Pubalgia ◽  
Hockey Players ◽  
Group A ◽  
Group B

Background: Athletic pubalgia is a complex injury that results in loss of play in competitive athletes, especially hockey players. The number of reported sports hernias has been increasing, and the importance of their management is vital. There are no studies reporting whether athletes can return to play at preinjury levels. Purpose: The focus of this study was to evaluate the productivity of professional hockey players before an established athletic pubalgia diagnosis contrasted with the productivity after sports hernia repair. Study Design: Cohort study; Level of evidence, 3. Methods: Professional National Hockey League (NHL) players who were reported to have a sports hernia and who underwent surgery from 2001 to 2008 were identified. Statistics were gathered on the players’ previous 2 full seasons and compared with the statistics 2 full seasons after surgery. Data concerning games played, goals, average time on ice, time of productivity, and assists were gathered. Players were divided into 3 groups: group A incorporated all players, group B were players with 6 or fewer seasons of play, and group C consisted of players with 7 or more seasons of play. A control group was chosen to compare player deterioration or improvement over a career; each player selected for the study had a corresponding control player with the same tenure in his career and position during the same years. Results: Forty-three hockey players were identified to have had sports hernia repairs from 2001 to 2008; ultimately, 80% would return to play 2 or more full seasons. Group A had statistically significant decreases in games played, goals scored, and assists. Versus the control group, the decreases in games played and assists were supported. Statistical analysis showed significant decreases in games played, goals scored, assists, and average time on ice the following 2 seasons in group C, which was also seen in comparison with the control group. Group B (16 players) showed only statistical significance in games played versus the control group. Conclusion: Players who undergo sports hernia surgeries return to play and often perform similar to their presurgery level. Players with over 7 full seasons return but with significant decreases in their overall performance levels. Less veteran players were able to return to play without any statistical decrease in performance and are likely the best candidates for repair once incurring injury.

Disruption of the Finger Flexor Pulley System in Elite Rock Climbers

1998 ◽  
Vol 26 (5) ◽  
pp. 651-655 ◽  
Author(s):  
Markus Gabl ◽  
Christoph Rangger ◽  
Martin Lutz ◽  
Christian Fink ◽  
Ansgar Rudisch ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Nonoperative Treatment ◽  
Proximal Interphalangeal Joint ◽  
Magnetic Resonance Images ◽  
Resonance Imaging ◽  
Pulley System ◽  
Group A ◽  
Complete Disruption ◽  
Group B

We treated 13 elite rock climbers for isolated disruptions of the pulleys of the long fingers. Diagnosis and treatment were based on the clinical finding of bowstringing, which was confirmed by magnetic resonance imaging. Eight patients had bowstringing indicating incomplete disruption of the major pulley A2 and were treated nonoperatively (group A). Five patients showed bowstringing indicating complete disruption of the pulley A2. After failed nonoperative treatment, the pulleys were reconstructed (group B). The mechanism of injury and clinical and subjective results were evaluated. At a 31-month follow-up (range, 18 to 43 months), loss of extension in the proximal interphalangeal joint measured 5.6° (range, 0° to 10°) in group A and 4° (range, 0° to 10°) in group B. Circumference of the finger section was increased 4.2 mm in group A (range, 0 to 10 mm) and 4.8 mm in group B (range, 0 to 10 mm). Grip strength decreased 20 N in group A (range, 10 to 50 N) and 12 N in group B (range, 10 to 30 N). Four patients in group A and one in group B had bowstringing at clinical evaluation. On follow-up magnetic resonance images, bowstringing remained unchanged in group A but was reduced in all patients in group B. Good subjective results were seen in both groups.

scholarly journals Effect of Teriparatide in Fracture Healing in Lower Limbs- An Interventional Study

2021 ◽  
Author(s):  
Sanjeev Kumar ◽  
Girish Sahni ◽  
Harjit K Singh Chawla ◽  
Daljinder Singh
Keyword(s):  
Functional Outcome ◽  
Adverse Reactions ◽  
Weight Bearing ◽  
Test Group ◽  
Control Group ◽  
Dash Score ◽  
Early Weight Bearing ◽  
Group A ◽  
Group B ◽  
Radiological Union

Introduction: Many of the trauma patients presenting to the orthopaedic departments suffer from lower limb fractures. This often leads to prolonged period of morbidity and absence from work. Fracture healing can be delayed in elderly patients, postmenopausal women and in communited fractures. Teriparatide (TPH) given subcutaneously for 6 to 9 months, in such cases, may promote clinical and radiological union of bone. Aim: To know the effect of TPH in improving clinical and radiological union and also to evaluate early weight bearing, improvement in pain and functional outcome. Materials and Methods: In this prospective interventional study, a total of 125 patients were initially enrolled for the study and then after meeting inclusion criteria total 104 patients were selected for the study. They were allocated into two groups by randomisation by 1:1 method-group A was test group of 52 cases in which subcutaneous injection TPH 20 mcg daily (for six months) was given along with standard dosage of calcium and vitamin D; while in 52 cases in group B (control group) only calcium and vitamin D were given. Injection TPH was started within 10 days of fracture and given for six months. No placebo injection was given in control group. Time to weight bearing, time to clinical and radiological union and pain by Visual Analogue Score (VAS) were noted at regular follow-up at one month, three months, six months and 12 months and were compared in both the groups. Functional outcome by Disabilities of the Arm, Shoulder and Hand (DASH) score was noted as an additional tool, as DASH score questionnaire shows many activities of daily living that require mobility and stability of lower limb too. Adverse reactions were noted and compared within test and control groups. The collected data were analysed using International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) version 22.0 software and Mann-Whitney U test was used to calculate p-value. Results: Average time period for full weight bearing with or without support for test group A was 11±2.7 weeks and 16±1.8 weeks in control group B (p-0.001). Average time to clinical union in test group was 12±1.9 weeks and in control group 16±2.2 weeks (p-0.001). Average time to radiological union was 13±1.4 weeks in test group while 22±2.2 weeks in control group (p-0.001). Pain score by VAS and functional outcome by DASH were improved in test group (p-0.001). There was no difference in adverse reactions in both the groups (p>0.05). Conclusion: Regular intake of TPH 20 mcg subcutaneous daily for six months can reduce time to clinical and radiological fracture union, promote early weight bearing and provide better pain control. Hence, better functional outcome and prefracture ambulatory status can be achieved with no significant adverse events.

scholarly journals The treatment of chondral lesions of the knee with the microfracture technique and platelet-rich plasma

Joints ◽  
2013 ◽  
Vol 01 (04) ◽  
pp. 167-170 ◽  
Author(s):  
Andrea Manunta ◽  
Anna Manconi
Keyword(s):  
Platelet Rich Plasma ◽  
Femoral Condyle ◽  
Healing Process ◽  
International Knee Documentation Committee ◽  
Level Of Evidence ◽  
Chondral Lesions ◽  
Randomized Clinical Study ◽  
Group A ◽  
Ikdc Score ◽  
Group B

Purpose: to assess the efficacy of associating the microfracture technique with platelet-rich plasma (PRP) injections in the treatment of chondral lesions to promote acceleration and optimization of the healing process compared with the traditional microfracture approach. Methods: from September 2011 to August 2012, 20 patients (9 males and 11 females, aged 30-55 years) were treated. All presented with chondral lesions of the medial femoral condyle of the knee and a pain duration ranging from 8 to 12 months.The patients were randomized into two groups (A and B). Group A was treated with the microfracture technique and a total of three intra-articular injections of PRP. Group B was treated with microfractures alone. Clinical follow-up was performed at 3, 6 and 12 months after treatment. Clinical function was assessed on the basis of the International Knee Documentation Committee (IKDC) score. Pain was evaluated using a visual analogue scale (VAS) Results: the patients in group A had a mean baseline IKDC score of 31.2, which rose to 84.2 at 12 months. The IKDC scores in group B were at 30.1 at baseline and 81 at 12 months. Conclusions: the results of our study suggest that functional recovery and resolution of pain are obtained more quickly in PRP-treated patients. We also observed a better functional outcome in the patients treated with the combination of PRP and microfractures, even at 12 months, although the difference was not statistically significant. Level of evidence: level II, randomized clinical study.

Application of Gold Nanoparticles in Magnetic Resonance Imaging for Targeted Diagnosis and Treatment of Breast Cancer

2021 ◽  
Vol 13 (9) ◽  
pp. 1595-1602
Author(s):  
Yuli Wu ◽  
Junwei Song ◽  
Shengcui Liu ◽  
Xianglei Wei ◽  
Weiwei Chen
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Targeted Therapy ◽  
Magnetic Resonance ◽  
Diagnosis And Treatment ◽  
Control Group ◽  
Breast Cancer Patients ◽  
Resonance Imaging ◽  
Group A ◽  
Group B

This study aimed to explore the application of super paramagnetic gold magnetic nanoparticles (Au-M-NPs) in the magnetic resonance imaging (MRI) images for targeted diagnosis and treatment of breast cancer. The reducibility of ethylene glycol to ferric chloride (FeCl3) was adopted to synthesize the Au-M-NPs by solvothermal method by taking acetic acid as the base source and trisodium citrate as the stabilizer. Besides, the synthesized Au-M-NPs were applied in the MRI images for targeted therapy of breast cancer. Patients from a blank group (group A), a control group (group B), and an experimental group (group C) received the traditional clinical diagnosis treatment, MRI diagnosis, and Au-M-NPs targeted therapy with MRI in turn. The results showed that the prepared Au-M-NPs were featured with small particle size and good dispersibility, and were monodispersive after surface modification. The intraoperative blood loss of patients from group A (115.3±9.33 mL) and group B (94.6±9.72 mL) was obviously higher than the loss of group C (68.4±8.7 mL) (P < 0.05). The drainage volume of patients from group B (162.4±12.3 mL) and group C (131.9±11.8 mL) decreased sharply after surgery compared with group A (193.7±11.8 mL), and that in group C was the lowest (P < 0.05). The proportion of local recurrence in patients from group B (12.3%) and group C (6.4%) dropped steeply in contrast to the proportion of group A (13.2%) (P < 0.05). The proportion of tumor metastasis in patients from group B (11.2%) and group C (8.4%) was greatly lower than that of group A (14.8%) (P < 0.05). In conclusion, the application of Au-M-NPs in the diagnosis and treatment of breast cancer with MRI could effectively reduce the incidence of intraoperative and postoperative adverse reactions.

scholarly journals Second-look arthroscopic findings after medial open-wedge high tibial osteotomy combined with all-inside repair of medial meniscus posterior root tears

2019 ◽  
Vol 28 (1) ◽  
pp. 230949901988883 ◽  
Author(s):  
Lizhong Jing ◽  
Kun Liu ◽  
Xiaole Wang ◽  
Xiaotan Wang ◽  
Zhen Li ◽  
...  
Keyword(s):  
Medial Meniscus ◽  
Lysholm Score ◽  
Tibial Osteotomy ◽  
Posterior Root ◽  
Second Look ◽  
Significant Difference ◽  
Wedge High Tibial Osteotomy ◽  
Group A ◽  
Group B ◽  
Healing Group

Purpose: To examine the results of medial open-wedge high tibial osteotomy (MOWHTO) combined with all-inside repair focusing on medial meniscus posterior root tears (MMPRT) by second-look arthroscopy and determine the clinical relevance of the findings. Methods: From June 2015 to June 2017, 27 consecutive patients underwent MOWHTO and meniscal treatment for MMPRT using all-inside repair. All were available for second-look arthroscopy evaluation at the time of plate removal. Cartilage regeneration in the medial condyles and healing status of the MMPRT were assessed at the time of second-look arthroscopy. Clinical outcomes were evaluated by the Hospital for Special Surgery (HSS) scores and the Lysholm score scale. The potential factors affecting the healing of MMPRT, including age, body mass index (BMI), weight-bearing line rate (WBLR) and femorotibial angle (FTA) were discussed. Results: There were 11 (41%) cases with complete healing (group A) and 16 (59%) cases with lax healing (group B). A complete cartilage coverage of chondral lesions was observed at second-look arthroscopy. Improvements of HSS in both groups were 41.25 ± 6.18 and 38.82 ± 5.43, while improvements in Lysholm score seen in both groups were 30.40 ± 4.84 and 32.65 ± 4.11. There was no significant difference in the postoperative clinical results between the two groups. In group A, the age (months), BMI, WBLR, and FTA are 54.61 ± 2.53, 23.58 ± 2.39, 66.10 ± 2.86% and 169.00 ± 2.62°, respectively, while in group B, they are 55.16 ± 4.92, 29.58 ± 3.91, 57.51 ± 5.49% and 175.21 ± 2.87°, respectively. A significant difference has been identified between two groups except for age. Conclusion: As seen in this retrospective study, a higher healing rate of MMPRT using all-inside repair and regeneration of degenerated articular cartilage in the medial condyles after MOWHTO can be expected. Healing of the MMPRT was not related to a better clinical outcome. Moreover, it can be inferred that BMI, WBLR and FTA may affect the healing status of MMPRT.

scholarly journals Isolated arthroscopic treatment of intra-articular pathologies in mild hip dysplasia: a short-term case control study

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Enrico Tassinari ◽  
Federica Mariotti ◽  
Francesco Castagnini ◽  
Stefano Lucchini ◽  
Francesco Perdisa ◽  
...  
Keyword(s):  
Labral Repair ◽  
Control Group ◽  
Level Of Evidence ◽  
Capsular Plication ◽  
Small Series ◽  
Center Edge ◽  
Group A ◽  
Group B ◽  
Lateral Center Edge Angle

Abstract Purpose The aim is to compare the results of isolated hip arthroscopy in patients with borderline dysplasia with Lateral center edge angle (LCEA) between 18° and 25° with a control group of patients with normal LCEA (> 25°). Methods Fifty hip arthroscopies performed in 45 patients were retrospectively evaluated. Exclusion criteria were: age > 40, hip arthritis > grade 2 according to Tonnis classification, femoral head avascular necrosis, pediatric’s orthopaedics conditions and true dysplasia with LCEA < 18°.Two groups were identified: group A with 15 hips with LCEA between 25° and 18° and Group control B made of 35 hips with LCEA > 25°. Results The groups were homogeneous for demography and pre-operative WOMAC and HOOS. Osteoplasty for CAM were performed in 100% of patients in both groups, only in 12 hips (34.4%) in group B we had both femoral and acetabular osteoplasty. Labral repair was performed in 86% of patients in group A, in 60% of patients in group B, capsular plication in 93% of group A, in 5% of case of group B. WOMAC and HOOS statically significant improved in both groups at final follow-up (24 months). No cases in both groups required conversion to total hip arthroplasty. Clinical outcomes of study group were comparable to the control group. Conclusion Even if the present small series is not conclusive, we suggest isolated arthroscopic management of patients with FAI and LCEA between 18° and 25°, but capsular plication and careful labral management are strongly recommended. Level of evidence Level IV.

scholarly journals Segmentation Algorithm for Intracranial Magnetic Resonance Images for Cerebral Stroke Identification and Nursing Evaluation

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Wenjing Shi ◽  
Xiangyu Kong ◽  
Wei Tian ◽  
Yujin Yan ◽  
Yusi Chen
Keyword(s):  
Magnetic Resonance ◽  
Therapeutic Effect ◽  
Magnetic Resonance Images ◽  
Segmentation Algorithm ◽  
Cerebral Stroke ◽  
Therapeutic Effects ◽  
Neurological Damage ◽  
Satisfaction Rate ◽  
Group A ◽  
Group B

This study aimed to investigate the therapeutic effect and nursing evaluation of patients with cerebral stroke (CS) through intracranial magnetic resonance imaging (MRI) images under the condition of segmentation algorithm. 199 CS patients were selected and divided randomly into a control group (group A) and an experimental group (group B) based on different treatment methods. Patients of group A were given routine antithrombotic therapy, and patients of group B were treated with intravenous thrombolytic therapy under evaluation of segmentation algorithm-based MRI images. Then, there were comparisons on clinical therapeutic effect, neurological damage score, and daily living ability index score of all patients. After treatment, the total effective rate (92.12%) and daily life index (41.45 ± 11.24) of patients in group B were higher than those of group A ( P  < 0.05). However, neurological damage scores (3.36 ± 1.13 points) of patients in group B after treatment were lower than those of group A (5.85 ± 2.31 points) ( P  < 0.05). The routine clinical nursing satisfaction rate (79.8%) was lower than the overall satisfaction rate (97%) of the combination of clinical and imaging nursing ( P  < 0.05). Therefore, there were greatly clinical therapeutic effects of intravenous thrombolysis evaluated by intracranial MRI images under segmentation algorithm for CS patients, and routine nursing could improve patients’ satisfaction, which were worthy of clinical promotion.

scholarly journals Potential of the non-weight-bearing tunnel view in diagnosing medial meniscus posterior root tear: a pilot study of X-ray characteristics

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Hiroki Okamura ◽  
Hiroki Ishikawa ◽  
Takuya Ohno ◽  
Shogo Fujita ◽  
Shigeo Yamakami ◽  
...  
Keyword(s):  
Pilot Study ◽  
Medial Meniscus ◽  
Femoral Condyle ◽  
Weight Bearing ◽  
Disease Diagnosis ◽  
Posterior Root ◽  
Root Tear ◽  
X Ray ◽  
Posterior Root Tear ◽  
Significant Difference

Abstract Purpose Early detection of medial meniscus posterior root tear (MMPRT) is important in preventing the rapid onset and progression of degenerative knee disease. Diagnosis is facilitated by the availability of non-weight-bearing X-ray view, but information on the X-ray characteristics of MMPRT is scarce. Here, we conducted a pilot study of the X-ray characteristics of MMPRT on non-weight-bearing tunnel view. Methods We retrospectively reviewed 43 consecutive patients treated in the outpatient department for medial knee pain or popliteal pain. Patients were divided into MMPRT (21 knees) and non-MMPRT groups (22 knees). We investigated X-ray characteristics and magnetic resonance imaging findings. Femorotibial angle, posterior tibial slope, medial tibial eminence (MTE)–medial femoral condyle (MFC) distance (contralateral and affected sides, and difference between the two), medial tibiofemoral joint (MTFJ) width (contralateral and affected sides, and difference between the two), and meniscus radial dislocation between the groups were evaluated using the Mann–Whitney U test. The association between X-ray characteristics and MMPRT was determined using univariate and multivariate logistic regression analyses. Results A highly significant difference between the affected and contralateral sides was seen in MTFJ width and MTE–MFC distance on non-weight-bearing tunnel view between the MMPRT and non-MMPRT groups. Moreover, a difference in MTFJ width of <−0.575 mm and in MTE–MFC distance of >0.665 mm between the affected and contralateral sides was useful in predicting MMPRT. Conclusions The non-weight-bearing tunnel view is useful for the initial diagnosis of MMPRT. Prospective evaluation in a larger population is warranted.

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