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PubMed1988

On geographical variations in the normal range of joint motion.

Fifty Saudi Arabian men 30 to 40 years of age without present or previous history of injury or disease related to the lower extremities were randomly selected for measurement of the range of motion in the basic planes of hip, knee, and ankle joint. The results were compared to a similar study from Scandinavia. There was a highly significant difference in external rotation of the hip, flexion of the knee, and dorsiflexion of the ankle. Cultural differences in the activities of daily life are suggested to explain the differences in the range of motion.

Adult↗
PubMed1988

Arthritis/arthralgia and hypermobility of the joints in schoolchildren.

Studies of pediatric clinic populations have shown that a high proportion of children with rheumatic complaints demonstrate hypermobility of the joints. In order to compare the frequency and nature of articular complaints in children with hypermobility to that seen in nonhypermobile controls, we examined 192 normal students aged 5-19 years. Overall, 34% (41/109 girls and 25/83 boys) were found to be hypermobile. Consenting parents of hypermobile children were given a questionnaire and interview designed to detect a history of arthritis/arthralgia, as were parents of age and sex matched nonhypermobile controls. Fifty percent of the hypermobile group had a history of arthralgia, compared to 20% of controls. Ten percent in each group had had arthritis. Data from our comparative study supports the possible association between joint hypermobility and the development of articular complaints in children.

Adolescent↗
PubMed1987

The shoulder joint. An arthroscopist's perspective of anatomy and pathology.

Arthroscopy has had a great impact on shoulder surgery by adding another dimension to the surgical anatomy. The present benefits of arthroscopy of the shoulder include the establishment of an accurate diagnosis in the glenohumeral joint, subacromial space, and acromioclavicular joint. Various pathologic entities can be visualized. The efficacy and end results of several arthroscopic surgical procedures are under investigation. Patient selection, the pathologic diagnosis, and end results are important considerations in evaluating newly devised arthroscopic methods of treatment of shoulder syndromes.

Arthroscopy↗
PubMed1987

Salvage procedures for complications of total ankle arthroplasty.

Total ankle arthroplasty (TAA) has been a satisfactory procedure with a low failure rate only when applied to the rheumatoid patient. For the active, posttraumatic patient, ankle joint fusion is superior and avoids the attendant high failure rate. In general, salvage of failed TAA is best solved by ankle fusion. Only in one of five cases (a compliant patient with a clear-cut correctable technical error) was a good result achieved with a revision arthroplasty. To maintain limb length, the authors transplanted iliac crest autogenic bone to fill a large defect. When tightly packed with bone, the joint is slightly distracted and compression enhances fusion. For septic loosening, osteotomy of the malleoli and fusion without grafting is recommended. Persistent pain unassociated with loosening an infection may be treated by removal of impingement of bone overgrowth. Soft tissue release to improve motion is rarely successful. Marginal skin slough was a problem in 8.5% of 71 cases. To facilitate healing, debridement of nonfunctional exposed tendons may be advisable.

Adult↗
PubMed1987

Radiologic case study. Neuropathic osteoarthropathy.

Diabetic osteoarthropathy is the most common neuropathic condition seen clinically in the foot. It can develop rapidly with a time course of weeks to months. Soft tissue swelling and erythema with deformity are noted clinically, usually with decreased pain sensation. However, it is important to realize that these patients frequently do have pain; it may only be disproportionate to the degree of injury. Radiographic diagnosis can predate clinical suspicion and is based on recognizing the resorptive and the productive patterns of the osteoarthropathy. Often, the first clue is recognizing the radiographic features of joint instability. Remembering that overt trauma may precipitate neuropathic osteoarthropathy will also help its recognition in the follow up of fractures.

Adult↗
PubMed1986

[The thumb saddle joint].

In the management of patients with osteoarthritis of the carpometacarpal joint of the thumb, good to very good results can be achieved both subjectively and objectively by surgical intervention. In young patients who do manual hard work and have isolated post-traumatic osteoarthritis of the trapeziometacarpal joint, the treatment method of choice is still arthrodesis. However, in women with postclimacteric osteoarthritis, which is very frequent, we prefer arthroplasty. Resection of the trapezium is a technique only used in selected cases, as it results in considerable loss of stability and strength. We prefer Silastic interposition arthroplasty to cemented total replacement. In patients with major involvement of the joints at the trapezium (especially where it connects with the scaphoid), the treatment of choice is implantation of a Swanson trapezium prosthesis, accompanied by surgical stabilization of the soft tissue. The good results we have achieved with this method, as reported in this paper, also justify its application in the future. In patients with isolated osteoarthritis of the carpometacarpal joint of the thumb we shall use the modified Swanson prosthesis more frequently in the future.

Adult↗
PubMedDate not supplied

Bovine tendon lateral ankle stabilization procedure: xenograft bioprosthesis model GR 6 mm.

A surgical technique utilizing a bovine xenograft bioprosthesis has been developed for stabilizing a chronically unstable lateral ankle. With this new technique, minimal dissection of adjacent soft tissue is required, and the method allows for tissue ingrowth for strength and anastomosis to bone. However, a longer period of non-weightbearing is required to prevent inadequate incorporation of the graft.

Adult↗
PubMed1987

Pain on the ulnar side of the wrist.

Pain on the ulnar side of the wrist is frequently encountered in clinical practice. Its causes may be difficult to diagnose and are best evaluated using a systematic sequence of clinical, radiographic, and special procedures. Soft tissue, articular, and osseous causes of ulnar wrist pain are reviewed.

Arthritis↗
PubMed1985

The GORE-TEX expanded polytetrafluoroethylene prosthetic ligament. An in vitro and in vivo evaluation.

For assessment of the accelerated in vitro and in vivo performance of the GORE-TEX Prosthetic Ligament, mechanical testing included cyclic creep and bending fatigue. Elongation of less than 3% after 20,000,000 cycles under load conditions was used to simulate the functioning human anterior cruciate ligament (ACL). Device tensile strength was 4830 N +/- 280 N. The device was tested in 17 sheep as an ACL replacement. No immobilization was used postoperation. Implant time ranged from 0 to 369 days. Joint stability was maintained in all animals. Fixation strength resulting from osseous ingrowth reached an average of 1380 N at a mean implant duration of 218 days. Clinical trials are underway at 15 centers in the United States. The indication for polytetrafluoroethylene (PTFE) reconstruction is chronic insufficiency of the ACL in knees worthy of salvage. The following evaluation of 130 patients at 15 months or less shows improved stability in 129. Two grafts have been removed--one secondary to infection and the other as a result of improper placement.

Animals↗
PubMedDate not supplied

[Indications for emergency operations in rheumatoid orthopedics].

In arthritis surgery "urgent" indications are a relatively subjective definition--apart from few exceptions. The aim of this paper is to give a substantiated classification--under practical aspects--for frequently occurring rheumatoid lesions in all parts of the locomotor system requiring surgical treatment.

Arthritis, Rheumatoid↗
PubMedDate not supplied

Ankle joint evaluation--an overview of arthroscopic technique.

Arthroscopy is useful in diagnosing and treating ankle pathology. It is comparatively atraumatic, which makes early postoperative ambulation possible and eliminates the problems resulting from casting and immobility. Familiarity with arthroscopic instruments and technique is essential and close attention to details is mandatory to avoid damage to the joint and other complications.

Ankle Injuries↗
PubMed1983

[Possibilities for orthopedico-surgical reconstruction in joint damage in elderly patients].

If no higher risk operation for the older patient is involved, indication for an arthroplastic joint prosthesis is given on the basis of today's large and world-wide experience. The postoperative mortality is naturally higher than with the younger patients and amounts to 2% in our statistics. A smooth cooperation between the internist and the orthopaedic surgeon enables also to the older patients with higher risk operations, especially thanks to the modern anaesthetic possibilities (f.i. lumbar anaesthetics), a functional recovery of the joint. We should, however, use already with the younger patients all possible joint preserving and supporting surgical operations in order to save the old patients in many cases from the need of implanting a prosthesis.

Aged↗
PubMed1984

A hypermobility study in ballet dancers.

Hypermobility, using Beighton's mobility score, was present in 9.5% of 377 ballet dancers. Females were more mobile than males. A direct relationship was found between forward flexion and both the duration of dance training and age. This suggests that forward flexion is acquired, and unlike generalized hypermobility, which was found among family members of the hypermobile group. None of the hypermobile dancers studied had evidence of mitral valve prolapse but injuries were significantly more common compared to controls (p less than 0.05). We regard hypermobility as a liability to the ballet dancer.

Adolescent↗