Knee joint dislocation: overview and current concepts

2021 ◽  
pp. 1-10
Author(s):  
Fitzgerald C Anazor ◽  
Kwaku Baryeh ◽  
Neville C Davies
Keyword(s):  
Knee Joint ◽  
Functional Limitation ◽  
Knee Injuries ◽  
X Rays ◽  
Specialist Care ◽  
Ligament Repair ◽  
Joint Dislocation ◽  
High Index Of Suspicion ◽  
Knee Dislocations

Knee joint dislocation is a relatively uncommon injury but its management is important because of the associated high risk of vascular, neurological and multi-ligamentous knee injuries. Clinicians must be aware that not all knee dislocations are diagnosed on plain X-rays; a high index of suspicion is required based on clinical evaluation. Multidisciplinary specialist care is required in all cases to achieve best outcomes. Early one-stage or multiple staged ligament repair and reconstruction offer better outcomes, but most patients have some long-term functional limitation. This article provides insights into the epidemiology and management of this injury and its devastating effects.

scholarly journals ARTHROSCOPIES

2015 ◽  
Vol 22 (02) ◽  
pp. 191-194
Author(s):  
Fayyaz Ahmad Orfi ◽  
Shahid Majeed
Keyword(s):  
Retrospective Study ◽  
Knee Joint ◽  
Knee Pain ◽  
Knee Injuries ◽  
Clinical Suspicion ◽  
X Rays ◽  
Ligamentous Injury ◽  
Common Presentation ◽  
Arthroscopic Findings ◽  
Basic Investigation

Knee pain due to injury is a common presentation in orthopedic outpatientdepartment. X-rays, MRI and arthroscopy are the basic investigation tools when meniscoligametousinjury is suspected. If MRI is normal usually arthroscopy is withheld. In this studywe analyzed the arthroscopic findings of such cases in which X rays and MRI were normalor near normal. Objectives: 1- To find out knee injuries in patients with painful knees. 2- Tofind out any other pathology of knee joint. Design: It’s a retrospective study in which 42 suchcases were analyzed who underwent arthroscopy with a normal or near normal MRI. Setting:This study includes cases done at CMH Rawalpindi, Muzaffarabad, Kharian and Malir. Periodincludes May 2005 to August 2014. A total number of 209 arthroscopies were done by thesame orthopedic surgeon. Results: Out of 42 cases 31 were males while 11 were females.Mean age was 31.4 years (range 18-54 years).In all cases arthroscopy was done by the sameorthopedic surgeon within 6 weeks of MRI. MRI films were reported by a qualified radiologist. Inall cases there was a strong clinical suspicion of menisco-ligamentous injury while X-rays andMRI were near normal or normal. Out of 42 cases in 36 (85.7%) cases, one or more findingswere detected on arthroscopy which were not picked by MRI. Conclusions: It is concludedthat if a menisco-ligamentous injury is strongly suspected in a knee on clinical examination,arthroscopic evaluation should not be denied to a patient even if X-rays and MRI are normal.

Intact Knee and ACL Forces for the Human and Ovine Model During Simulated In Vivo Human and In Vivo Ovine Motions

2011 ◽  
Author(s):  
Safa T. Herfat ◽  
Daniel V. Boguszewski ◽  
Jason T. Shearn
Keyword(s):  
Animal Model ◽  
Knee Joint ◽  
Daily Living ◽  
Knee Injuries ◽  
Joint Degeneration ◽  
Ovine Model ◽  
Joint Forces ◽  
Intact Knee

Patients frequently experience knee injuries, with the ACL being one of the most commonly injured structures requiring surgery [1]. ACL tears typically lead to osteoarthritis in the long term, even after surgical treatment [2]. This chronic joint degeneration has been attributed to the failure of current ACL reconstructions to restore the native biomechanics of the knee joint [3]. To design more effective treatments, investigators must first understand normal knee function for multiple activities of daily living (ADLs). The 3D in vivo forces and moments of the normal intact knee, as well as those for just the ACL have not yet been determined for any ADL. These in vivo forces and moments can potentially be measured for multiple ADLs in an animal model. A biomechanical surrogate allows for 1) sensors or marker systems to be rigidly fixed to the knee joint to accurately measure the 6 degree of freedom (DOF) kinematics, and for 2) the kinematics to be simulated and applied to the harvested limb to measure the corresponding joint forces and moments.

Evidence-Based Treatment for the Eating Disorders

2010 ◽  
pp. 451-451
Author(s):  
Phillipa J. Hay ◽  
Angélica de M. Claudino
Keyword(s):  
Primary Care ◽  
Eating Disorders ◽  
Evidence Base ◽  
Good Evidence ◽  
Distinct Advantage ◽  
Specialist Care ◽  
Feeding And Eating Disorders ◽  
Online Therapies ◽  
Primary Care Practitioners

This chapter comprises a focused review of the best available evidence for psychological and pharmacological treatments of choice for anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified and unspecified feeding and eating disorders (OSFED and UFED), discusses the role of primary care and online therapies, and presents treatment algorithms. In AN, although there is consensus on the need for specialist care that includes nutritional rehabilitation in addition to psychological therapy, no single approach has yet been found to offer a distinct advantage. In contrast, manualized cognitive behavior therapy (CBT) for BN has attained “first-line” treatment status with a stronger evidence base than other psychotherapies. Similarly, CBT has a good evidence base in treatment of BED and for BN, and BED has been successfully adapted into less intensive and non-specialist forms. Behavioral and pharmacological weight loss management in treatment of co-morbid obesity/overweight and BED may be helpful in the short term, but long-term maintenance of effects is unclear. Primary care practitioners are in a key role, both with regard to providing care and with coordination and initiation of specialist care. There is an emerging evidence base for online therapies in BN and BED where access to care is delayed or problematic.

Evidence-Based Treatment for the Eating Disorders

2012 ◽  
Author(s):  
Phillipa J. Hay ◽  
Angélica de M. Claudino
Keyword(s):  
Primary Care ◽  
Eating Disorders ◽  
Evidence Base ◽  
Good Evidence ◽  
Distinct Advantage ◽  
Specialist Care ◽  
Feeding And Eating Disorders ◽  
Online Therapies ◽  
Primary Care Practitioners

This chapter comprises a focused review of the best available evidence for psychological and pharmacological treatments of choice for anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified and unspecified feeding and eating disorders (OSFED and UFED), discusses the role of primary care and online therapies, and presents treatment algorithms. In AN, although there is consensus on the need for specialist care that includes nutritional rehabilitation in addition to psychological therapy, no single approach has yet been found to offer a distinct advantage. In contrast, manualized cognitive behavior therapy (CBT) for BN has attained “first-line” treatment status with a stronger evidence base than other psychotherapies. Similarly, CBT has a good evidence base in treatment of BED and for BN, and BED has been successfully adapted into less intensive and non-specialist forms. Behavioral and pharmacological weight loss management in treatment of co-morbid obesity/overweight and BED may be helpful in the short term, but long-term maintenance of effects is unclear. Primary care practitioners are in a key role, both with regard to providing care and with coordination and initiation of specialist care. There is an emerging evidence base for online therapies in BN and BED where access to care is delayed or problematic.

Acquired tracheo-oesophageal fistula in a child with unrecognised tracheal foreign body

2021 ◽  
Vol 14 (4) ◽  
pp. e240947
Author(s):  
Kanokpan Ruangnapa ◽  
Wanaporn Anuntaseree ◽  
Kantara Saelim ◽  
Pharsai Prasertsan
Keyword(s):  
Foreign Body ◽  
Young Children ◽  
Respiratory Symptoms ◽  
Growth Failure ◽  
Late Diagnosis ◽  
Feeding Intolerance ◽  
Recurrent Pneumonia ◽  
High Index Of Suspicion ◽  
Careful Investigation

We report the case of a 6-month-old girl who presented with recurrent pneumonia and growth failure. After full examination, she was diagnosed with long-standing, unrecognised tracheal foreign body, which was then successfully removed. However, her chronic respiratory symptoms did not improve, and she also had feeding intolerance. The persistence of symptoms indicated a second bronchoscopy and finally an acquired tracheo-oesophageal fistula was diagnosed. This case emphasises the challenges in diagnosis of an inhaled foreign body in young children. Late diagnosis of this condition can cause significant morbidities. A high index of suspicion and careful investigation are very important to prevent long-term complications.

scholarly journals AB0867 INCREASED ADIPONECTIN LEVELS ARE ASSOCIATED WITH HIGHER RADIOGRAPHIC SCORES IN THE KNEE JOINT, BUT NOT IN THE HAND JOINT: THE DONG-GU STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1740.1-1740
Author(s):  
J. H. Kang ◽  
S. E. Choi ◽  
H. Xu ◽  
D. J. Park ◽  
S. S. Lee
Keyword(s):  
Body Mass Index ◽  
Knee Joint ◽  
Body Mass ◽  
Linear Regression Analysis ◽  
Joint Space ◽  
Serum Adiponectin ◽  
Hand Osteoarthritis ◽  
X Rays ◽  
Subchondral Cyst ◽  
The Relationship

Background:Several studies have evaluated the association between serum adiponectin levels and knee and hand osteoarthritis (OA), with mixed results.Objectives:The aim of this study was to investigate the relationship between OA and serum adiponectin levels according to the radiographic features of knee and hand OA.Methods:A total of 2,402 subjects were recruited from the Dong-gu Study. Baseline characteristics were collected via a questionnaire, and X-rays of knee and hand joints were scored by a semi-quantitative grading system. The relationship between serum adiponectin levels and radiographic severity was evaluated by linear regression analysis.Results:Subjects with higher tertiles of serum adiponectin were older and had a lower body mass index than those with lower tertiles. In the knee joint scores, serum adiponectin levels were positively associated with the total score (P<0.001), osteophyte score (P=0.003), and joint space narrowing (JSN) score (P<0.001) among the three tertiles after adjustment for age, sex, body mass index, smoking, alcohol consumption, education, and physical activity. In the hand joint scores, no association was found between serum adiponectin levels and the total score, osteophyte score, JSN score, subchondral cyst score, sclerosis score, erosion score, and malalignment score among the three tertiles after adjustment.Conclusion:In this study, we found that increased adiponectin levels were associated with higher radiographic scores in the knee joint, but not in the hand joint, suggesting different pathophysiologic mechanisms in the development of OA.Disclosure of Interests:None declared

Becoming an empowered parent. How do parents successfully take up their role as a collaborative partner in their child’s specialist care?

2020 ◽  
pp. 136749352091083
Author(s):  
Jim Reeder ◽  
Jane Morris
Keyword(s):  
Therapeutic Relationship ◽  
Health Professionals ◽  
Constructivist Grounded Theory ◽  
Collaborative Partnership ◽  
Specialist Care ◽  
National Health Service Trust ◽  
Data Collection And Analysis ◽  
Depth Interviews ◽  
Novel Model

The purpose of this article is to offer an improved understanding of how parents of children with long-term disabilities are empowered to successfully take up their role as decision-making partners in the design and delivery of the care of their child. The intention is to stimulate dialogue, encourage reflection and provide practical suggestions for health professionals working with children and their families. The reported findings are from a study which was guided by a constructivist grounded theory methodology. This involved an iterative process of repeated cycles of data collection and analysis, which comprised 12 semi-structured, in-depth interviews with 14 parents of children accessing paediatric services within a single National Health Service Trust. A novel model, explaining how the power im/balance and the perceived state of the therapeutic relationship influence how successfully a parent takes up their position in the collaborative partnership, is presented and discussed. It is suggested that by thoughtfully addressing the traditional hierarchy that exists within healthcare, health professionals might facilitate the development of a ‘truly’ therapeutic relationship, which can help promote parental empowerment.

Dynamic Response Analyses of Rabbit Knee Joint

1999 ◽  
Author(s):  
M. Kasra ◽  
M. D. Grynpas ◽  
A. Shirazi-Adl
Keyword(s):  
Knee Joint ◽  
Dynamic System ◽  
Experimental Studies ◽  
Knee Injuries ◽  
Nonlinear Dynamic System ◽  
Rabbit Knee ◽  
Prediction And Prevention ◽  
Joint Load ◽  
Dynamic Loading Conditions ◽  
Knee Disorders

Abstract The knee joint is a complex nonlinear dynamic system. It is generally known that mechanical factors play an important role in the etiology of knee injuries and diseases such as osteoarthritis. While performing daily activities such as walking, running, and climbing as well as during occupational operations, the joint is exposed to vibrations and multiple impacts. During these activities, according to an individual’s condition (e.g., age, fitness, weight), the joint load and stiffness may reach critical limits initiating or accelerating different knee disorders. This is the case in athletes or workers during occupational activities (1). Therefore, understanding the dynamic characteristics of the knee joint is essential in prediction and prevention of knee disorders as well as in subsequent joint replacement and rehabilitation procedures. There have been very few reported experimental studies investigating the dynamic behavior of the whole knee joint as a dynamic system (2). The objective of this study was to investigate the changes in mechanical properties of the rabbit knee joint under different compressive dynamic loading conditions. Rabbit has frequently been used as an osteoarthritic knee model (3). The data obtained in this study, hence, will also be beneficial in our future studies of osteoarthritic rabbit models.

Classification of Fresh Fractures of the Lunate

1988 ◽  
Vol 13 (4) ◽  
pp. 458-462
Author(s):  
H. TEISEN ◽  
J. HJARBAEK
Keyword(s):  
Vascular Anatomy ◽  
X Rays ◽  
Lunate Bone ◽  
X Ray

The X-rays of 17 patients with fresh fractures of the lunate bone have been reviewed. The fractures were classified according to their radiological appearances and according to the vascular anatomy of the lunate. A long term X-ray follow-up examination was performed.

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