scholarly journals Examination of the proximodistal patellar position in small dogs in relation to anatomical features of the distal femur and medial patellar luxation

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0252531
Author(s):  
Sawako Murakami ◽  
Masakazu Shimada ◽  
Yasuji Harada ◽  
Yasushi Hara
Keyword(s):  
Distal Femur ◽  
Femoral Condyle ◽  
Case Series ◽  
Ligament Length ◽  
Patellar Ligament ◽  
Control Group ◽  
Retrospective Case ◽  
Anatomical Features ◽  
Stifle Joint ◽  
Patellar Position

Objective To determine the influence of anatomical features of the distal femur on the proximodistal patellar position and compare the proximodistal patellar position between dogs with and without medial patellar luxation (MPL). Study design Retrospective case series (n = 71). Methods Mediolateral-view radiographs of clinical cases of dogs weighing less than 15 kg were obtained. The stifle joint angle, patellar ligament length, patellar length, size of the femoral condyle, trochlear length, and trochlear angle were measured and included in multiple linear regression analyses to ascertain their effects on the proximodistal patellar position. Radiographs were divided into MPL and control groups. The effects of MPL on the proximodistal patellar position and morphological factors were also examined. Results The final model for the proximodistal patellar position revealed that the patella became distal as the ratio of the patellar ligament length to patellar length decreased, the trochlear angle relative to the femur increased, the trochlear length relative to the patellar length increased, or the trochlear length relative to the femoral condyle width decreased. The proximodistal patellar position in the MPL group was not significantly different from that in the control group despite the trend towards a distally positioned patella (p = 0.073). The MPL group showed a significantly shorter trochlea (p<0.001) and greater trochlear angle relative to the femur (p = 0.029) than the control group. Conclusion The proximodistal patellar position depends on multiple factors, and its determination based on PLL/PL alone may not be appropriate. Dogs with MPL did not have a proximally positioned patella compared with dogs without MPL. Although hindlimbs with MPL had a shorter trochlea than those without patellar luxation, this difference did not appear to be sufficient to displace the patellar position proximally in small dogs, possibly compensated by increased trochlear angle relative to the femur.

Proximo-distal patellar position in three small dog breeds with medial patellar luxation

2015 ◽  
Vol 28 (04) ◽  
pp. 270-273 ◽  
Author(s):  
L. F. H. Theyse ◽  
H. A. W. Hazewinkel ◽  
C. Wangdee
Keyword(s):  
Clinical Significance ◽  
Ligament Length ◽  
Patellar Ligament ◽  
Trochlear Groove ◽  
Stifle Joint ◽  
Patellar Position ◽  
The Mean

SummaryIntroduction: Medial patellar luxation is thought to be associated with a high proximal position of the patella in the trochlear groove.Objective: To determine whether the ratio of patellar ligament length and patellar length (L:P) is influenced by the stifle angle (75°, 96°, 113°, 130°, and 148°) in small dog breeds and to compare the L:P ratio in dogs of three small dog breeds with and without medial patellar luxation.Methods: A mediolateral radiograph of the stifle joint was used to measure the L:P ratio in the stifle joints of dogs of three small breeds with and without medial patellar luxation. The L:P ratio was evaluated at five stifle angles (75°, 96°, 113°, 130°, and 148°) in 14 cadavers (26 stifle joints) of small dog breeds in order to identify the best stifle angle to measure the L:P ratio. Then the mean ± SD L:P ratio was calculated for normal stifles and stifles with medial patellar luxation grades 1, 2, and 3 in 194 Pomeranians, 74 Chihuahuas, and 41 Toy or Standard Poodles.Results: The L:P ratio was the same for all five stifle angles in the cadavers (p = 0.195). It was also not significantly different in the three breeds (p = 0.135), in normal and medial patellar luxation-affected stifles overall (p = 0.354), and in normal and medial patellar luxation-affected joints within each breed (p = 0.19).Clinical significance: We conclude that a proximo-distal patellar position is not associated with medial patellar luxation in Pomeranians, Chihuahuas, and Toy or Standard Poodles. Thus a longer patellar ligament length does not play a role in the pathophysiology of medial patellar luxation in these small dog breeds.

Down-Expression of Kinin Receptors in Allergic Nasal Polyps Epithelia: An Immunohistochemistry Study

2020 ◽  
Vol 162 (3) ◽  
pp. 375-381
Author(s):  
Meir Warman ◽  
Yonatan Lahav ◽  
Monica Huszar ◽  
Liad Hadad ◽  
Doron Halperin ◽  
...  
Keyword(s):  
Immunohistochemical Staining ◽  
Nasal Polyps ◽  
Expression Patterns ◽  
Case Series ◽  
Control Group ◽  
Retrospective Case ◽  
Kinin Receptors ◽  
Immunohistochemistry Staining ◽  
Academic Center ◽  
B2 Receptors

Objectives To investigate the expression of B1 and B2 receptors in patients with nasal polyps (NPs) compared to controls. Study Design Retrospective case series. Settings Single academic center. Subjects and Methods Nasal biopsies of patients with NPs were compared to inferior turbinates of control patients. Comparisons included basic demographics and comorbidities, intensity of inflammation, and immunohistochemical staining of B1 and B2 receptors measured by immunohistochemistry staining scores (ISSs). Results A total of 41 patients were enrolled, with 21 patients (51.2%) in the NP group and 20 patients as controls. No differences were found in the prevalence of allergic comorbidities and smoking between the groups. The NP group demonstrated significantly higher prevalence of moderate and severe mononuclear infiltrates compared to the control group (57.1% vs 5.3%, P < .001). The NP group had significantly lower B1 expression in smooth muscle compared to the control group (mean ISS 0.22 vs 1.56, P < .001, respectively) and significantly more B2 expression in epithelial cells (mean ISS 1.81 vs 0, P < .001, respectively). Conclusion Patients with NPs exhibit different expression patterns of B1 and B2 compared to control patients. This implies that bradykinin receptor regulation participates in the pathogenesis of NPs.

scholarly journals A systematic review on conservative and non-operative treatment options for Osgood-Schlatter disease

2020 ◽  
Author(s):  
Cornelia Neuhaus ◽  
Christian Appenzeller-Herzog ◽  
Oliver Faude
Keyword(s):  
Systematic Review ◽  
Operative Treatment ◽  
Treatment Options ◽  
Grey Literature ◽  
Case Series ◽  
Outcome Data ◽  
Control Group ◽  
Retrospective Case ◽  
Review Articles ◽  
Knee Pathology

Background: Osgood-Schlatter disease (OSD) is a sport- and growth-associated knee pathology with painful osteochondrosis around the tibial tuberosity. Up to 10% of adolescents are affected by OSD. Treatment is primarily conservative or non-operative and includes injections, ice, braces, casts, tape and/or physiotherapy. However, treatment outcomes are often insufficiently described and there is lack of evidence for current best practice.Objective: The aims of this systematic review are to comprehensively identify conservative or non-operative treatment options for OSD, to compare their effectiveness in selected outcomes, and to describe potential research gaps. and to describe potential research gaps.Methods: This systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. CENTRAL, CINAHL, EMBASE and MEDLINE via Ovid, and PEDro were searched through to January 6, 2020. In addition, ongoing and unpublished clinical studies, dissertations, and other grey literature on OSD were retrieved. We included prospective, retrospective, case control, randomised, and non-randomised studies reporting on the effectiveness of any conservative or non-operative treatment of 6- to 28-year-old OSD patients. Studies written in English, German, or French were included. The quality of the included studies was assessed using the PEDro scale and extracted outcome data were narratively synthesized. In addition, we also systematically retrieved review articles for extraction of treatment recommendations.Results: Of 767 identified studies, thirteen were included: two randomised controlled trials (RCTs), two prospective and eight retrospective observational studies, and one case series. Eight studies had no control group. The included studies were published from 1948 to 2019 and included 747 patients (563 male, 119 female, 65 sex not reported) with 937 affected knees. The study quality was poor to moderate. The two included RCTs examined the effectiveness of surplus dextrose-injection in OSD patients treated with local anaesthetics injection and came to opposite conclusions. Other than that, inter-study heterogeneity prohibited any descriptive cumulative analyses. Among the 15 review articles, the most prevalent treatment recommendations were activity modification (15/15), quadriceps and hamstring stretching (13/15), medication (11/15), ice (11/15), strengthening of the quadriceps (9/15), and knee straps or brace (8/15).Conclusion: Conflicting evidence exists to support the use of dextrose injections. Certain therapeutic approaches, such as stretching, seem to work, but no RCT comparing specific exercises with sham or usual care treatment exists. Carefully controlled studies on well- described treatment approaches are needed to establish which conservative or non-operative treatment options are most effective for patients with OSD.

C02 Laser-assisted Phonosurgery for Benign Glottic Lesions

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P48-P48
Author(s):  
Marcel Geyer ◽  
Gian-Peppino Ledda ◽  
Neil C Tan ◽  
Roberto Puxeddu Consultant
Keyword(s):  
Co2 Laser ◽  
Vocal Fold ◽  
Voice Quality ◽  
Case Series ◽  
Functional Results ◽  
Disease Recurrence ◽  
Wilcoxon Test ◽  
Control Group ◽  
Retrospective Case ◽  
False Vocal

Objective (1) To determine glottic function following carbon dioxide (CO2) laser-assisted phonosurgery of benign laryngeal disease. (2) To evaluate post-operative glottic morphology and disease recurrence rate. Methods Comparative retrospective case series of patients with benign glottic pathology treated by laser-assisted phonosurgery over 10 years. 235 consecutive patients had pre- and postoperative data collected from objective laryngeal examination, videostroboscopy recording of vocal fold mucosal wave movement, electroacoustic voice analysis of fundamental frequency, jitter, shimmer, and harmonics to noise ratio, as well as perceptual voice evaluation. This data was also compared to that of 20 healthy volunteers. (Statistical analysis: Wilcoxon test and Mann-Whitney test respectively). Definitive voice and morphologic evaluation was completed after 6 months. Results Evaluation of the pre- and postoperative functional results demonstrated a statistically significant improvement in all spectrographically analysed objective voice parameters (p<0.001), with a restored voice quality as good as the control group (p<0.001). Postoperative morphological analysis using videostroboscopic examination confirmed 3 recurrences of granuloma and 1 of Reinke's oedema. Recurrence was estimated objectively if the lesion was analogous to the original pathology. Glottic closure was complete in 96.5% of cases. False vocal fold adduction was normal in 88.5% of cases, with forced hyper-adduction being present in 11.5%. Phonatory vibration was cord-cord type in 100% of cases. Conclusions Our study demonstrates a statistically significant improvement in all acoustic parameters recorded. Postoperative vocal fold function and mucosal wave morphology were largely restored. CO2 laser-assisted voice restoration for benign glottic disease is effective.

Outcomes of Prophylactic Epiglottic Petiole Suspension at the Time of Complete Laryngofissure

2019 ◽  
Vol 161 (4) ◽  
pp. 652-657 ◽  
Author(s):  
Mathieu Bergeron ◽  
Alessandro de Alarcon ◽  
Catherine K. Hart ◽  
Michael J. Rutter
Keyword(s):  
Case Series ◽  
Group Versus ◽  
Exercise Intolerance ◽  
Control Group ◽  
Study Group ◽  
Pediatric Hospital ◽  
Retrospective Case ◽  
Obstructive Sleep ◽  
Airway Reconstruction

ObjectivesTo compare the clinical outcomes of patients with prophylactic petiole suspension (PPS) at the time of laryngofissure and patients without PPS.Study DesignRetrospective case series.SettingTertiary pediatric hospital from May 2003 to August 2017.Subjects and MethodsPatients included those undergoing airway reconstruction with complete laryngofissure. Patients in the study group had PPS at the time of laryngofissure, while control group patients did not.ResultsEighty-one patients underwent complete laryngofissure (22 study patients, 59 controls) at a median age of 4.8 years (interquartile range, 2.1-9.7). Patients in the control group were younger at the time of the surgery (3.7 vs 6.5 years, P = .04). Other demographic and clinical data, including subglottic stenosis (SGS) grades, were similar. For patients with SGS, 53.8% and 46.2% in the study group had a grade 1-2 and 3-4 SGS, respectively, as compared with 46.2% and 53.8% in the control group ( P = .65). Manifestations of petiole prolapse included failure of decannulation (8.6%), exercise intolerance (16.0%), and obstructive sleep apnea (11.1%). After 4 years of follow-up, 4.5% of the study group versus 27.1% of the control group had prolapse of the petiole ( P = .04). Petiole prolapsed affected >50% of patients with no PPS after 10 years of follow-up. Patients with petiole prolapse at the first surveillance microlaryngoscopy and bronchoscopy after stent removal had an odds ratio of 10.2 (95% CI, 1.1-94.8; P = .04) of becoming symptomatic.ConclusionPatients with PPS had significantly fewer symptoms after complete laryngofissure as compared with patients without PPS. PPS should be considered when a complete laryngofissure is being performed during airway reconstruction.

scholarly journals Intra-articular Physeal Fractures of the Distal Femur: A Frequently Missed Diagnosis in Adolescent Athletes

2017 ◽  
Vol 5 (10) ◽  
pp. 232596711773156 ◽  
Author(s):  
Andrew T. Pennock ◽  
Henry B. Ellis ◽  
Samuel C. Willimon ◽  
Charles Wyatt ◽  
Samuel E. Broida ◽  
...  
Keyword(s):  
Distal Femur ◽  
Femoral Condyle ◽  
Case Series ◽  
Injury Pattern ◽  
Advanced Imaging ◽  
Level Of Evidence ◽  
Physeal Fracture ◽  
Surgical Data ◽  
Salter Harris ◽  
Physeal Fractures

Background: Intra-articular physeal fractures of the distal femur are an uncommon injury pattern, with only a few small case series reported in the literature. Purpose: To pool patients from 3 high-volume pediatric centers to better understand this injury pattern, to determine outcomes of surgical treatment, and to assess risk factors for complications. Study Design: Case series; Level of evidence, 4. Methods: A multicenter retrospective review of all patients presenting with an intra-articular physeal fracture between 2006 and 2016 was performed. Patient demographic and injury data, surgical data, and postoperative outcomes were documented. Radiographs were evaluated for fracture classification (Salter-Harris), location, and displacement. Differences between patients with and without complications were compared by use of analysis of variance or chi-square tests. Results: A total of 49 patients, with a mean age of 13.5 years (range, 7-17 years), met the inclusion criteria. The majority of fractures were Salter-Harris type III fractures (84%) involving the medial femoral condyle (88%). Football was responsible for 50% of the injuries. The initial diagnosis was missed in 39% of cases, and advanced imaging showed greater mean displacement (6 mm) compared with radiographs (3 mm). All patients underwent surgery and returned to sport with “good to excellent” results after 2 years. Complications were more common in patients with wide-open growth plates, patients with fractures involving the lateral femoral condyle, and patients who were casted ( P < .05). Conclusion: Clinicians evaluating skeletally immature athletes (particularly football players) with acute knee injuries should maintain a high index of suspicion for an intra-articular physeal fracture. These fractures are frequently missed, and advanced imaging may be required to establish the diagnosis. Leg-length discrepancies and angular deformities are not uncommon, and patients should be monitored closely. Surgical outcomes are good when fractures are identified, with high rates of return to sport.

scholarly journals Is Routine Use of Drain Really Necessary for Posterior Lumbar Interbody Fusion Surgery? A Retrospective Case Series with a Historical Control Group

2021 ◽  
pp. 219256822110018
Author(s):  
Hae-Dong Jang ◽  
Seong San Park ◽  
Kyungbum Kim ◽  
Eung-Ha Kim ◽  
Jae Chul Lee ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Case Series ◽  
Posterior Lumbar Interbody Fusion ◽  
Neurological Deficits ◽  
Control Group ◽  
Lumbar Interbody Fusion ◽  
Retrospective Case ◽  
Hematoma Evacuation ◽  
Additional Surgery ◽  
Drain Group

Study Design: A retrospective case-control study. Objectives: The usefulness of a drain in spinal surgery has always been controversial. The purposes of this study were to determine the incidence of hematoma-related complications after posterior lumbar interbody fusion (PLIF) without a drain and to evaluate its usefulness. Methods: We included 347 consecutive patients with degenerative lumbar disease who underwent single- or double-level PLIF. The participants were divided into 2 groups by the use of a drain or not; drain group and no-drain group. Results: In 165 cases of PLIF without drain, there was neither a newly developed neurological deficit due to hematoma nor reoperation for hematoma evacuation. In the no-drain group, there were 5 (3.0%) patients who suffered from surgical site infection (SSI), all superficial, and 17 (10.3%) patients who complained of postoperative transient recurred leg pain, all treated conservatively. Days from surgery to ambulation and length of hospital stay (LOS) of the no-drain group were faster than those of the drain group ( P < 0.001). In a multiple regression analysis, a drain insertion was found to have a significant effect on the delayed ambulation and increased LOS. No significant differences existed between the 2 groups in additional surgery for hematoma evacuation, or SSI. Conclusions: No hematoma-related neurological deficits or reoperations caused by epidural hematoma and SSI were observed in the no-drain group. The no-drain group did not show significantly more frequent postoperative complications than the drain use group, hence the routine insertion of a drain following PLIF should be reconsidered carefully.

Arthroscopy of the normal cadaveric ovine femorotibial joint: a systematic approach to the cranial and caudal compartments

2014 ◽  
Vol 27 (05) ◽  
pp. 387-394 ◽  
Author(s):  
K. A. Mansmann ◽  
T. P. Schaer ◽  
R. B. Modesto
Keyword(s):  
Femoral Condyle ◽  
Cruciate Ligament ◽  
Common Peroneal Nerve ◽  
Patellar Ligament ◽  
Large Animal ◽  
Valgus Stress ◽  
Cranial Cruciate Ligament ◽  
Large Animal Models ◽  
Stifle Joint ◽  
Tibial Condyle

SummaryObjectives: Preclinical studies using large animal models play an intergral part in translational research. For this study, our objectives were: to develop and validate arthroscopic approaches to four compartments of the stifle joint as determined via the gross and arthroscopic anatomy of the cranial and caudal aspects of the joint.Methods: Cadaveric hindlimbs (n = 39) were harvested from mature ewes. The anatomy was examined by tissue dissection (n = 6), transverse sections (n = 4), and computed tomography (n = 4). The joint was arthroscopically explored in 25 hindlimbs.Results: A cranio-medial portal was created medial to the patellar ligament. The craniolateral portal was made medial to the extensor digitorum longus tendon. The medial femoral condyle was visible, as well as the cranial cruciate ligament, caudal cruciate ligament and both menisci with the inter-meniscal ligament. Valgus stress improved visibility of the caudal horn of the medial meniscus and tibial plateau. To explore the caudal compartments, a portal was created 1 cm proximal to the most caudal aspect of the tibial condyle. Both femoral condyles, menisci, caudal cruciate ligament, the popliteal tendon and the menisco-femoral ligament were visible. The common peroneal nerve and popliteal artery and vein are vulnerable structures to injury during arthroscopy.Clinical significance: The arthroscopic approach developed in this research is ideal to evaluate the ovine stifle joint.

scholarly journals Complex Spinal Dorso-Ventral Stabilization in the Elderly – Is Age a Limiting Factor? Retrospective Case Series of 53 patients

2020 ◽  
pp. 1-9
Author(s):  
Christian Ewelt ◽  
Murat Yavuz ◽  
Nils Warneke ◽  
Michael Schwake ◽  
Juliane Schröteler ◽  
...  
Keyword(s):  
Case Series ◽  
Length Of Hospital Stay ◽  
The Elderly ◽  
Neurological Deficits ◽  
Motor Deficit ◽  
Control Group ◽  
Limiting Factor ◽  
Retrospective Case ◽  
Medical Progress ◽  
Duration Of Surgery

Objective: Medical progress is increasingly confronting us with the question of whether complex surgical spinal care can be performed safely, even in older patients. This study is intended to contribute to the clarification of this question. Methods: 53 patients with a minimum age of 70 years at time of surgery were retrospectively enrolled in a single center setting. All patients were treated with complex dorsoventral instrumentation and corpectomy due to different pathologies. Because of neurological deficits and untreatable pain, no control group of patients could be defined in advanced age by withholding necessary surgery. The ethical committee would not accept this. Results: Most patients benefited from the procedure with regard to pain (97%), sensori-motor deficit (89%), and finally, immobility (82%). The duration of surgery, the amount of transfused red blood cell concentrates, and the length of hospital stay were not predictors of a poor overall outcome. It was shown that the risk of postoperative complications increased due to the number of preoperative secondary diagnoses. Conclusion: Therefore, not the patients’ age alone is of prime importance for individual surgical treatment decisions, but the number of secondary diagnoses plays a more important role. Especially in that older population, patients benefit from surgical therapy; regardless, it could be complex.

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