Bioabsorbable Anchors for Medial Patellofemoral Ligament Reconstruction

2017 ◽  
Vol 745 ◽  
pp. 101-110
Author(s):  
Razvan Ene ◽  
Zsombor Panti ◽  
Mihai Nica ◽  
Marian Pleniceanu ◽  
Patricia Ene ◽  
...  

Acute dislocation of the patella is a very common injury of the knee. In more than 90% of the cases the medial patellofemoral ligament (MPFL) is injured. Reconstruction of the MPFL has become a popular soft tissue procedure, which reduces hospitalization and the rehabilitation period. Bioabsorbable materials, in form of screws and anchors are ideal for soft fixation to bones in orthopedics. We would like to present our experience and short-term results after MPFL reconstruction with semitendinous autograft and bioabsorbable fixation devices. 10 patients were involved in this study with PF joint instability, who underwent to MPFL reconstruction. In order to evaluate the functional outcome of the procedure we applied the Tegner Lysholm scoring system before and after 3 Months of surgery. MPFL reconstruction significantly improved the functionality of the PF joint. Gender distribution of the studied group was: 7 female with an average age of 25 5,03 SD and 3 male patients with an average age of 29 1 SD. The key for the success in MPFL reconstruction is the positioning of the femoral tunnel, followed by an isometric tensioning of the graft. Bioabsorbable materials reduce inflammatory, and foreign body response facilitating biointegration of the autograft.

2021 ◽  
Vol 20 (4) ◽  
pp. 90-98
Author(s):  
Anna Yu. Litus ◽  
Gennadiy P. Feskov

Aim. To explore the possibility of using the GMFM-88 scale for the evaluation of the effectiveness of short-term (21 days) intensiverehabilitation of children with motor impairment. Material and methods. The study included a combination of statistical and analytical methods. 83 children with cerebral palsy underwentintensive physical rehabilitation at the Centre of Medical Technology and Rehabilitation (CMTR. The level of the children’sfunctioning was assessed in accordance with the Gross Motor Function Classification System (hereinafter GMFCS). The GMFM-88 scalehas been employed for the planning of the intervention and the assessment of rehabilitation effectiveness. Results. Statistical analysis of the average values on GMFM-88, before and after rehabilitation and according to the Student t-criterion,shows significant changes in functioning after rehabilitation (t = -6.493, significance level less than 0.0001). This suggests the possibility of using the scale as a tool for assessing short-term interventions. At the same time, the use of this scale justifies the assumptionabout the effectiveness of short-term intensive rehabilitation in the form of significant improvements in the functional capabilities ofchildren with motor disorders. Conclusion. The use of the standardized GMFM-88 scale in this study confirms our assumption regarding the need for periodic, intensiverehabilitation for children with movement disorders. An integrated approach to the detailed assessment of the current state ofthe child makes it possible more accurately identify current problems, determine the nearest development zones, and, consequently,identify the goals and objectives for the rehabilitation period.


2018 ◽  
Vol 6 (12_suppl5) ◽  
pp. 2325967118S0019
Author(s):  
Germán A. Jaramillo ◽  
Diego F. Luna ◽  
Narly V. Gómez ◽  
Rubén D. Arias

The medial patellofemoral ligament (MPFL) is one of the most important anatomical structure that stabilize the patella, during its injury a repetitive dislocation occurs. The reconstruction of this ligament, it seeks to avoid the recurrence of these episodes, for which there are various surgical techniques, one of these the arthroscopy, it can reduce adverse events of the procedure. The aim of this study is to describe the clinical follow-up of patients who had a reconstruction of the MPFL arthroscopically assisted. This is a prospective case series carried out in two hospitals of Medellín city, between 2010 and 2016. For the clinical follow-up, Lysholm, Kujala and Tegner knee scores were performed before and 12 months after the surgical procedure. Were applied Shapiro Wilk tests to evaluate normality and T-student to compare the results of the scores. We follow fifteen patients, 16 reconstructions of MPFL, of these 12 were female. The average time between the first dislocation and surgery was 12 months. Statistically significant differences were found when comparing the three scores before and after surgery (p= <0.05). Most patients improved pain and no patient required reoperation in the follow-up period. The reconstruction of MPFL arthroscopically assisted is a minimal access method that allows identifying the anatomical insertions of the MPFL, and is a safe technique that causes low morbidity and satisfactory clinical evolution of the patients.


Author(s):  
Jae Ik Lee ◽  
Mohd Shahrul Azuan Jaffar ◽  
Han Gyeol Choi ◽  
Tae Woo Kim ◽  
Yong Seuk Lee

AbstractThe purpose of this study was to evaluate the outcomes of isolated medial patellofemoral ligament (MPFL) reconstruction, regardless of the presence of predisposing factors. A total of 21 knees that underwent isolated MPFL reconstruction from March 2014 to August 2017 were included in this retrospective series. Radiographs of the series of the knee at flexion angles of 20, 40, and 60 degrees were acquired. The patellar position was evaluated using the patellar tilt angle, sulcus angle, congruence angle (CA), and Caton-Deschamps and Blackburne-Peel ratios. To evaluate the clinical outcome, the preoperative and postoperative International Knee Documentation Committee (IKDC) and Lysholm knee scoring scales were analyzed. To evaluate the postoperative outcomes based on the predisposing factors, the results were separately analyzed for each group. Regarding radiologic outcomes, 20-degree CA was significantly reduced from 10.37 ± 5.96° preoperatively to −0.94 ± 4.11° postoperatively (p = 0.001). In addition, regardless of the predisposing factors, delta values of pre- and postoperation of 20-degree CA were not significantly different in both groups. The IKDC score improved from 53.71 (range: 18–74) preoperatively to 94.71 (range: 86–100) at the last follow-up (p = 0.004), and the Lysholm score improved from 54.28 (range: 10–81) preoperatively to 94.14 (range: 86–100) at the last follow-up (p = 0.010). Isolated MPFL reconstruction provides a safe and effective treatment for patellofemoral instability, even in the presence of mild predisposing factors, such as trochlear dysplasia, increased patella height, increased TT–TG distance, or valgus alignment. This is a Level 4, case series study.


Author(s):  
Ashish Kumar Agarwal ◽  
Daulat Singh Meena ◽  
Vijay Pathak ◽  
Anoop Jain ◽  
Rakesh Kumar Ola

Background: The aim of the present study was to study the effect of percutaneous balloon mitral  valvuloplasty (PBMV) on P wave dispersion and to test the correlation between P-maximum and  P-dispersion to right ventricular function and pulmonary artery pressure before and after PMBV. Also to study the impact of P-maximum and P-wave dispersion on the short term clinical outcome after successful PBMV in patients with mitral stenosis (MS) and sinus rhythm. Methods: 75 patients undergoing PMBV were enrolled in this study. We evaluated P-maximum, P-minimum and P-wave dispersion before and one month and one year after PBMV . We studied the changes in pulmonary arterial pressure (PAP), left atrial (LA) dimension, mitral diastolic gradient, and mitral valve area, in addition to the changes in right ventricular function utilizing tissue Doppler assessment both before and after PMBV, in addition the role of the P-wave dispersion in prediction of late cardiac events. Results: There were significant decrease in mean diastolic gradient, PAP, and LA size and significant improvement in right ventricular tissue Doppler indices after PMBV. Accompany these hemodynamic changes after PMBV. P-maximum and P-wave dispersion were found to be decreased (P < 0.001). Conclusion: Successful PBMV was associated with a decrease in Pmax and PWD. These simple electrocardiographic indices may predict the success of the procedure immediately after PBMV.  The P-maximum and P-wave dispersion changes were correlated with significant impairment of right dysfunction and the degree of pulmonary artery pressure. Keywords: PBMV.PAP,LA


2020 ◽  
pp. 1-6
Author(s):  
Paul Park ◽  
Victor Chang ◽  
Hsueh-Han Yeh ◽  
Jason M. Schwalb ◽  
David R. Nerenz ◽  
...  

OBJECTIVEIn 2017, Michigan passed new legislation designed to reduce opioid abuse. This study evaluated the impact of these new restrictive laws on preoperative narcotic use, short-term outcomes, and readmission rates after spinal surgery.METHODSPatient data from 1 year before and 1 year after initiation of the new opioid laws (beginning July 1, 2018) were queried from the Michigan Spine Surgery Improvement Collaborative database. Before and after implementation of the major elements of the new laws, 12,325 and 11,988 patients, respectively, were treated.RESULTSPatients before and after passage of the opioid laws had generally similar demographic and surgical characteristics. Notably, after passage of the opioid laws, the number of patients taking daily narcotics preoperatively decreased from 3783 (48.7%) to 2698 (39.7%; p < 0.0001). Three months postoperatively, there were no differences in minimum clinically important difference (56.0% vs 58.0%, p = 0.1068), numeric rating scale (NRS) score of back pain (3.5 vs 3.4, p = 0.1156), NRS score of leg pain (2.7 vs 2.7, p = 0.3595), satisfaction (84.4% vs 84.7%, p = 0.6852), or 90-day readmission rate (5.8% vs 6.2%, p = 0.3202) between groups. Although there was no difference in readmission rates, pain as a reason for readmission was marginally more common (0.86% vs 1.22%, p = 0.0323).CONCLUSIONSThere was a meaningful decrease in preoperative narcotic use, but notably there was no apparent negative impact on postoperative recovery, patient satisfaction, or short-term outcomes after spinal surgery despite more restrictive opioid prescribing. Although the readmission rate did not significantly increase, pain as a reason for readmission was marginally more frequently observed.


2009 ◽  
Vol 58 (2) ◽  
pp. 266-270
Author(s):  
Koji Sakuraba ◽  
Hiromasa Miura ◽  
Shuichi Matsuda ◽  
Ken Okazaki ◽  
Shinji Fukuoka ◽  
...  

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 559-559
Author(s):  
Sara Freed ◽  
Briana Sprague ◽  
Lesley Ross

Abstract Interventions using exercise video games, or exergames, have shown short-term cognitive and physical benefits to older adults, though long-term effects are less promising. Enjoyment of exergames may promote exergame use after the intervention period, though little work has examined older adults’ views of exergames before and after gameplay experience. We invited 20 older adults between 65 and 84 years of age (M=73.30, SD=5.95) to play two Xbox Kinect games, Just Dance and Kinect Sports Rivals, for twenty minutes. In our presentation, we will present qualitative and quantitative findings of this pilot study, including findings that older adults reported that they were not likely to play similar exergames in the future and that they did not find the exergames to be more fun compared to other ways of exercising. We will discuss implications for game design and research relevant to game developers, manufacturers, and researchers. Part of a symposium sponsored by Technology and Aging Interest Group.


2017 ◽  
Vol 31 (7) ◽  
pp. 1077-1086 ◽  
Author(s):  
Hanna Jangö ◽  
Søren Gräs ◽  
Lise Christensen ◽  
Gunnar Lose

Alternative approaches to reinforce native tissue in reconstructive surgery for pelvic organ prolapse are warranted. Tissue engineering combines the use of a scaffold with the regenerative potential of stem cells and is a promising new concept in urogynecology. Our objective was to evaluate whether a newly developed long-term degradable polycaprolactone scaffold could provide biomechanical reinforcement and function as a scaffold for autologous muscle fiber fragments. We performed a study with three different rat abdominal wall models where the scaffold with or without muscle fiber fragments was placed (1) subcutaneously (minimal load), (2) in a partial defect (partial load), and (3) in a full-thickness defect (heavy load). After 8 weeks, no animals had developed hernia, and the scaffold provided biomechanical reinforcement, even in the models where it was subjected to heavy load. The scaffold was not yet degraded but showed increased thickness in all groups. Histologically, we found a massive foreign body response with numerous large giant cells intermingled with the fibers of the scaffold. Cells from added muscle fiber fragments could not be traced by PKH26 fluorescence or desmin staining. Taken together, the long-term degradable polycaprolactone scaffold provided biomechanical reinforcement by inducing a marked foreign-body response and attracting numerous inflammatory cells to form a strong neo-tissue construct. However, cells from the muscle fiber fragments did not survive in this milieu. Properties of the new neo-tissue construct must be evaluated at the time of full degradation of the scaffold before its possible clinical value in pelvic organ prolapse surgery can be evaluated.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Xiaorong Yan ◽  
Huiqing Wang ◽  
Cai Li ◽  
Yuanxiang Lin ◽  
Lin Lin ◽  
...  

Abstract Background To present a surgical technique for the treatment of intradural extramedullary (IDEM) tumors by using endoscopically controlled surgery with open hemilaminectomy technique. Methods In this study, 20 patients with 22 IDEM tumors were enrolled. An endoscopically controlled surgery with open hemilaminectomy was employed to remove the tumors. Data related to clinical symptoms and medical images before and after surgery were collected for perioperative evaluation and follow-up analysis. Results All the tumors in 20 patients were well removed. The clinical symptoms were significantly reduced in all the patients as well. The short-term follow-up data showed that there was no tumor recurrence or spinal deformity. Conclusion The endoscopically controlled surgery with open hemilaminectomy technique provided favorable exposure and satisfactory resection to the IDEM tumors. It may be an effective surgical method for treating IDEM tumors. Larger samples and longer follow-up data are needed to verify its long-term effectiveness.


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