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At least 469 records · Page 26Linked to original sources
PubMed2001

[Dislocation of the knee with isolated posterior cruciate ligament rupture].

We report a case of posterior femorotibial dislocation with an isolated lesion of the posterior cruciate ligament. Outcome was favorable after reduction and conservative treatment for six weeks and was satisfactory at six months follow-up. Acceptable functional results can be obtained after non-operative treatment of this very severe knee injury.

Accidents, Traffic↗
PubMedDate not supplied

Traumatic dislocation of the knee. A review of the literature and our experience.

It is the purpose of this study to analyze the data found in the literature and to compare our experience with that of other traumatology centers. A series of patients observed between 1985 and 1996 were reviewed. Nine out of 12 patients with sequelae related to dislocation of the knee were re-evaluated. Based on an analysis of the results, obtained by using the International Knee Documentation Committee (IKDC) form, it was concluded that the patients treated surgically are better overall. It is possible only rarely to obtain satisfactory recovery in work and/or sports activity, as the lesion is severe and even when treated it leaves functional and/or structural sequelae of varying importance.

Adolescent↗
PubMed1990

Popliteal vascular trauma. A community experience.

Preventing amputation continues to be a significant challenge when popliteal vascular injuries occur. A retrospective review of cases from the San Diego County (California) Trauma System identified 108 patients with 76 blunt and 32 penetrating arterial injuries. The limb preservation rate was 88%; there were 13 amputations. The fracture-dislocated knee injury and close-range shotgun blasts were particularly limb threatening. In general, the trauma system achieved rapid evaluation of injuries and early operative intervention. All 13 patients who underwent amputations presented with signs of severe ischemia. Concomitant injuries to the popliteal vein, tibial nerves, and soft tissue were significantly more frequent in patients who underwent amputations. The importance of complete fasciotomy for compartment hypertension, early reconstructive management of soft-tissue injuries, and expeditious arterial repair, frequently without preoperative roentgenographic suite arteriography, is emphasized. An aggressive, multidisciplinary approach is required to achieve a functional extremity when popliteal vascular trauma occurs.

Adolescent↗
PubMed2006

Change in joint space width: hyaline articular cartilage loss or alteration in meniscus?

OBJECTIVE: To explore the relative contribution of hyaline cartilage morphologic features and the meniscus to the radiographic joint space. METHODS: The Boston Osteoarthritis of the Knee Study is a natural history study of symptomatic knee osteoarthritis (OA). Baseline and 30-month followup assessments included knee magnetic resonance imaging (MRI) and fluoroscopically positioned weight-bearing knee radiographs. Cartilage and meniscal degeneration were scored on MRI in the medial and lateral tibiofemoral joints using a semiquantitative grading system. Meniscal position was measured to the nearest millimeter. The dependent variable was joint space narrowing (JSN) on the plain radiograph (possible range 0-3). The predictor variables were MRI cartilage score, meniscal degeneration, and meniscal position measures. We first conducted a cross-sectional analysis using multivariate regression to determine the relative contribution of meniscal factors and cartilage morphologic features to JSN, adjusting for body mass index (BMI), age, and sex. The same approach was used for change in JSN and change in predictor variables. RESULTS: We evaluated 264 study participants with knee OA (mean age 66.7 years, 59% men, mean BMI 31.4 kg/m(2)). The results from the models demonstrated that meniscal position and meniscal degeneration each contributed to prediction of JSN, in addition to the contribution by cartilage morphologic features. For change in medial joint space, both change in meniscal position and change in articular cartilage score contributed substantially to narrowing of the joint space. CONCLUSION: The meniscus (both its position and degeneration) accounts for a substantial proportion of the variance explained in JSN, and the change in meniscal position accounts for a substantial proportion of change in JSN.

Aged↗
PubMed1989

Longitudinal tibial epiphyseal bracket in Nievergelt syndrome.

A patient is described with lower extremity mesomelic dwarfism associated with bilateral congenital elbow, hip, and knee dislocations. Rhomboid-shaped tibiae and delayed ossification of the primary fibular ossification centers were demonstrated at birth. Plain films and magnetic resonance imaging revealed that the tibial deformities were due to the presence of longitudinal epiphyseal brackets. These brackets were observed at surgery and confirmed histologically. Recognition of the longitudinal epiphyseal bracket and its relationship to the tibial deformities seen in this patient with Nievergelt syndrome is important for planning surgical treatment.

Child, Preschool↗
PubMed2002

Avulsion fractures and chronic avulsion injuries of the knee: role of MR imaging.

Avulsion fractures and chronic avulsion injuries of the knee are common lesions in sports-related trauma, especially among adolescents. Magnetic resonance imaging may prove useful in detecting and characterizing such lesions, and has several advantages with regard to other imaging modalities. We review, illustrate, and discuss the MR imaging features of some of the more frequent avulsion fractures and chronic avulsion injuries of the knee, including avulsion fractures of the cruciate ligaments, avulsion fractures of lateral and medial stabilizers, avulsion fractures and chronic avulsion injuries of the extensor mechanism, and avulsive cortical irregularities of the distal femur. The role of MR imaging in evaluating such lesions is emphasized.

Diagnosis, Differential↗
PubMed2005

Achieving ligament stability and correct rotational alignment of the femur in knee arthroplasty: a study using the Medial Pivot knee.

In a series of 90 Medial Pivot arthroplasties rotational alignment of the femur was achieved by provisionally reconstructing the lateral side of the joint and tensioning the medial side with feeler gauges. Axial CT scans were employed to measure the rotational alignment relative to surgical epicondylar axis. In valgus knees the cutting block was externally rotated to adjust for posterolateral bone loss. The mean rotational alignment of the femur was 0.6 degrees of external rotation (S.D. 1.3, range 3 degrees of ER to 4 degrees of IR). The mean laxity of the medial ligament was 1 mm in flexion (SD 1, range 0-5 mm) and 0.5 mm in flexion (S.D. 0.5, range 0-2 mm) In those knees in which the medial ligament had been released the CT alignment was perfect, but when internally rotated against the hip 3-4 mm of gapping was noted. In valgus knees the mean rotation of the femoral component was 0.8 degrees of internal rotation (S.D. 1.5, range 1 degrees of IR to 4 degrees of ER). In spite of externally rotating the cutting block there was still a tendency to internally rotate the femur in some knees. This simple technique achieves the two goals of ligament stability and correct rotational alignment in a high proportion of cases. It may be applicable to any instrument system which employs posterior referencing.

Arthroplasty, Replacement, Knee↗
PubMed1979

Management of popliteal artery injuries.

In a series of seven popliteal artery injuries including two concomitant popliteal vein injuries and three knee dislocations, only one failure occurred. With appropriate training of emergency medical technicians and adequate supportive services such as blood banking and arteriography, the vascular surgeon in a small hospital setting can manage peripheral vascular trauma with acceptable results.

Colorado↗
PubMed1988

Popliteal artery trauma: update and recent advances in management.

Management of vascular trauma has been standardized in the past two decades with a significant increase in limb salvage, but trauma to the popliteal artery still remains a challenge. A seven-year experience at San Bernardino County Medical Center was comprised of 20 popliteal artery injuries in 19 patients. Thirteen injuries (65%) were from blunt trauma, four injuries (20%) were from gunshot wounds, two injuries (10%) were from close-range shotgun blasts, and one (5%) was from a stab wound. Limb salvage was 100%. Liberal use of vein interposition grafts, routine intraoperative postreconstructive arteriogram, recognition of compartmental hypertension, and performance of fasciotomy were important steps taken to ensure a high limb salvage rate. Our standard technique at this time consists of repair of the artery with simultaneous repair of the dislocated knee and internal fixation of fractures.

Adolescent↗
PubMed2004

Valgus knee injuries: evaluation and documentation using a simple technique of stress radiography.

Clinical assessment of post traumatic ligament laxity is subjective. Stress radiographs provide an objective and permanent record of the laxity. We describe a simple method of stress radiography to help evaluate and to document valgus knee injuries. In this study we have correlated the X-ray findings with those at arthroscopy. No specialised equipment is required and radiation exposure to the patient and the surgeon is minimal. With the patient under general anaesthesia the injured and the normal knee are firmly bound together. A valgus stress is applied to both the knees simultaneously and a radiograph is taken. The opening of the medial joint space is measured as in the figure 1, i.e. the perpendicular distance between the tangent drawn to the subchondral bone of the femoral condyles, and the most medial point of the tibial plateau. The opening of the medial joint space provides a direct measure of valgus laxity. The ratio of the medial joint opening to the normal knee is calculated. A ratio of two or more is indicative of an associated anterior or posterior cruciate ligament rupture in addition to medial collateral ligament injury.

Adolescent↗
PubMedDate not supplied

Posterolateral rotatory instability treated by a modified biceps rerouting technique: technical considerations and results in cases with and without posterior cruciate ligament insufficiency.

PURPOSE: This study compared the clinical results of modified biceps femoris tenodesis with posterolateral rotatory instability (PLRI) injuries and PLRI combined with PCL injuries. TYPE OF STUDY: Case series. METHODS: Of 46 patients treated for PLRI, 21 had isolated PLRI (group 1), and 25 had PLRI with PCL injuries (group 2). The most common cause of injury was motor vehicle accident. The PCL was reconstructed using an arthroscopic 1-incision technique. The advantages of the modified Clancy technique include fixation of the biceps tendon to the isometric position and reduced surgical damage to the iliotibial band by dissection to the lateral femoral epicondyle through the interval between the iliotibial band and biceps muscle. RESULTS: All knees tested positive in the preoperative reverse pivot shift test, and 43 patients (93%) tested negative postoperatively. The side-to-side difference of an average external rotation thigh-foot angle (ERTFA) at both 30 degrees and 90 degrees of knee flexion was 15 degrees and 11 degrees in group 1 and 21 degrees and 26 degrees in group 2 preoperatively. Postoperative ERTFA tested at 30 degrees and 90 degrees of knee flexion were 10 degrees less than the uninvolved knee in both groups. At a mean follow-up of 40.3 months, the postoperative Lysholm knee score was 93.6 in group 1 and 90.4 in group 2. The postoperative HSS mean value was 91.1 in group 1 and 87.9 in group 2. A correction loss of more than 5 degrees was found in 3 patients of group 1 and in 5 patients of group 2 at an average 12 months after surgery. In 5 of 8 patients, severe scar tissues were found at the insertion site of the biceps tendon to the fibula during surgery. These tissues were associated with damage of the involved structures at the time of injury. CONCLUSIONS: Based on our experience, we recommend the modified biceps tenodesis for the reconstruction of both PLRI injuries and PLRI combined with PCL injuries except in patients with severe damage at the attachment site of the biceps tendon.

Adolescent↗