Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Joint Instability”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 829 records · Page 46Linked to original sources
PubMed2004

[Posterior occipitocervical fixation using C2 pedicle screws and occipitocervical plate systems].

OBJECTIVE: To observe the clinical effect of a occipitocervical fixation systems using C(2) pedicle screws and plates. METHODS: An occipitocervical fixation system was designed. Since June 2001 to March 2003, 38 patients with instability of atlantoaxial joint underwent reconstructive surgery using this systems. Twenty-four patients were associated with congenital occipitalization. The pedicle screws were inserted into C(2) pedicles in the direction as its axis. The occipitocervical plate was slightly bent to fit the occipital contour and fixed onto the occiput. Hyperflexion alignment of the occipitoatlantoaxial complex was corrected by application of extensional force created by tightening of the nut on the pedicle screws. The autogenous cancellous bones were grafted between the occiput and the axis. RESULTS: In this series, neither vertebral artery nor spinal cord was injured. 36 of 38 cases were followed up for an average of 18 months, all cases achieved solid bony fusion. No implant failure was found. CONCLUSIONS: Occipitocervical reconstruction by the combination of C(2) pedicle screws and occipitocervical plate systems can provide sufficient correction of malalignment in the occipitoatlantoaxial region and achieve high fusion rate.

Adolescent↗
PubMed1991

Stabilization of the distal ulna.

Stabilization of the remaining distal ulna following its resection for various disorders resulting in pain and instability of this joint is necessary for long-term satisfactory results. The method described uses a distally based flap of the extensor carpi ulnaris to provide stability of the distal ulna and support to the carpus along its ulnar border.

Arthritis, Rheumatoid↗
PubMed1985

Complications of Variable Axis total knee arthroplasty.

Three hundred seventy-six patients were treated by a Variable Axis total knee arthroplasty between 1974 and 1980 and were reviewed for mechanical and orthopedic complications of their surgery. Sixty-five patients had significant complications. Twenty-eight (7.4%) patients developed significant problems with their patellae, 13 (3.4%) patients required reoperation for patellar realignment, and four (1.0%) patients had a patellar resurfacing for retropatellar pain. Two (0.5%) cases of aseptic loosening of the femoral component required revision surgery. There was no aseptic loosening of the tibial component. Other complications included a ligamentous instability (2.9%), postoperative joint stiffness (1.6%), peroneal nerve palsy (1.3%), supracondylar fractures (1.0%), and postoperative joint infection (1.8%).

Femoral Fractures↗
PubMedDate not supplied

Acetabular rim pathology secondary to congenital hip dysplasia in the adult. A radiographic study.

Major rim pathology is a precursor of osteoarthritis of the hip secondary to residual acetabular dysplasia. The symptoms are acute pain in the groin and impaired function; the anatomopathologic lesions consist in avulsions of the labrum from the bony rim, and separated bone fragments or "Os acetabuli", as well. A detailed radiographic, comparative inquiry to assess the preoperative morphology of 178 dysplastic hips which underwent a multiplanar periacetabular osteotomy was undertaken. The study showed that the 37 hips with a labral avulsion had a less pronounced anterior and lateral insufficiency of the acetabulum and a less pronounced lateral subluxation than dysplastic hips without these lesions. No specific radiologic features could be found in the 23 hips with bony fragments of the acetabular rim. The instability of the joint exerts abnormal stress on the acetabular rim which tends to tear it. This condition leads to rapid arthrotic degeneration of the hip; early diagnosis increases our ability to preserve the integrity of the joint through reliable reconstructive surgery.

Acetabulum↗
PubMed1986

Posterior instability of the knee joint. An experimental study.

We investigated the importance of the posterior cruciate ligament (PCL) and the medial and lateral compartmental structures for translatory and simultaneous axial rotatory instability in 25 osteoligamentous knee preparations. Instability was registered continuously from 0 degree to 90 degrees of flexion with application of a constant force to the tibia. Isolated transection of the PCL increased the posterior tibial displacement with flexion to a maximum of 10 mm at 90 degrees of flexion; when combined lesions to the lateral structures were included, the popliteal tendon (PT) in particular turned out to have a major secondary stabilizing function. The posterior tibial displacement in flexion was doubled when all lateral structures were included in the lesions. Transection of the PCL and all the medial structures led to a notable increment in posterior displacement increasing with flexion. Major increments in simultaneous tibial rotation were recorded only after combined lesions to either medial or lateral structures. A reverse pivot shift was provoked after combined lateral lesions when the PT was included. Even an anteromedial subluxation was released after lesions to the medial structures. Regardless of the type of lesion, the specimens remained stable concerning anterior-posterior displacement in extension. No changes in the anterior tibial displacement were observed.

Biomechanical Phenomena↗
PubMed1991

[Possibilities of diagnostic sonography in assessment of instability of the shoulder joint].

In a prospective study we evaluated diagnostic ultrasound investigation for shoulder instabilities. We measured the passive antero-posterior translation in 150 healthy persons in relation to the dorsal glenoid as well as the inferior subluxation in relation to the acromion. After establishing these normative data, we examined 23 patients with anterior unidirectional instabilities and 34 with multidirectional instabilities by ultrasound. Our results showed that the dorsal humeral head circumference of a normal joint is located about 8 to 10 mm dorsally to the glenoid. In the control group with non-injured shoulder is significantly higher as in the nondominant shoulder (p less than 0.01). Patients with anterior instabilities showed a highly significant increase of anterior translation in the injured shoulder (p less than 0.0001). In comparison with the control group there is a highly significant increase of downward subluxation under load in patients with multidirectional instabilities (p less than 0.001). In patients with multidirectional instabilities, there is also a significant increase of spontaneous downward subluxation of the dominant shoulder (p less than 0.01). In habitual or voluntary dislocations the relation of the humeral head to the glenoid can be judged staticly and dynamically. Secondary signs of dislocation (Hill-Sachs lesions, joint effusion) are evident. 13 patients of a total number of 22 patients we operated on, had bony or cartilaginous Hill-Sachs lesion. The specificity of preoperative ultrasound in detecting these Hill-Sachs lesions was 100% and the sensitivity was 89%.

Adolescent↗
PubMed2004

Sprains--residual instability of subtalar, Lisfranc joints, and turf toe.

Sprains of the hindfoot, midfoot and forefoot are being diagnosed with more regularity in athletes. Each of these injuries can go on to develop chronic instability with associated disability. With early diagnosis and appropriate treatment significant morbidity and loss of playing time can be avoided. Knowledge of the relevant anatomy, mechanism of injury, and available diagnostic tools is essential for making the proper diagnosis. Once the correct diagnosis is made, proper treatment can be implemented to avoid long term complications of instability.

Humans↗
PubMedDate not supplied

Instability of the patellofemoral joint in Rubinstein-Taybi syndrome.

Twenty-five (3.4%) of 732 individuals with Rubinstein-Taybi syndrome were noted to have instability of the patellofemoral joint. We believe that this is in fact an underrepresentation of the true incidence, as we were able to identify only those patients whose symptoms were most severe. These individuals typically had symptoms before or during their adolescent growth spurt, had bilateral involvement, and in some instances, ceased to ambulate because of their patellofemoral problems. A subset of these individuals underwent patellar realignment surgery, with those whose treatment did not include extensive quadriceps mobilization/quadricepsplasty having a 2.7 times higher risk of requiring revision patellar surgery. Patellofemoral instability associated with Rubinstein-Taybi syndrome demands early recognition and treatment to prevent potentially catastrophic gait disturbances.

Adolescent↗
PubMed2001

[Chronic recurrent instability of the shoulder joint].

The article gives an analysis of results of conservative treatment of 503 patients with a primary traumatic dislocation of the shoulder. High frequency of the development of chronic instability of the shoulder joint was shown to be 31.2%. The using of arthroscopy, noninvasive methods of diagnosis (rentgenography, USI) allowed to diagnose the typical complex of morphological injuries following dislocations of the shoulder. General and local factors responsible for the development of chronic instability of the shoulder joint were established. Arthroscopy and early surgical stabilization of the joint are thought to be expedient in cases of a combination of these factors. Conservative treatment is indicated to patients older than 40 without high physical needs.

Adolescent↗
PubMed1989

[Surgical treatment of instability of the ankle joint caused by inveterate injuries of the ligaments of the lateral malleolus].

The results of surgical Chrisman-Snook reconstruction of the lateral malleolus ligaments in 9 patients, aged 19-37 years, have been discussed. The follow-up ranged from 2 to 4 years. In all the patients, good functional results were obtained. Among many methods of reconstruction of the lateral malleolus ligaments, the Chrisman-Snook method distinguishes itself because of simplicity of procedure and furthermore, it can be used for reconstruction of injuries of the tarsus ligaments in the region of the malleolus. It can be recommended in the treatment of patients with the symptoms of instability of the talocrural joint.

Adult↗
PubMed2001

Long-term outcome of anatomical reconstruction versus tenodesis for the treatment of chronic anterolateral instability of the ankle joint: a multicenter study.

The long-term clinical outcome after anatomical reconstruction and tenodesis in the treatment of chronic anterolateral ankle instability was assessed in a retrospective multicentre study. The first group (AR) consisted of 25 patients (mean age at operation 22 yrs +/- 5.7) who underwent anatomical reconstruction and the second group (TE) of 29 patients (mean age 23 yrs +/- 6.6) who underwent tenodesis. For both groups, the mean follow-up period was 12.3 yrs (AR +/- 2.5 yrs, TE +/- 2.7 yrs). At physical examination, there were significantly more patients in the TE group (n=18) with a positive anterior drawer sign as compared with the AR group (n=7) (p=0.02). Medially located degenerative changes in the ankle joint as seen on standard radiographs were seen more often in the TE group (n=7) than in the AR group (n=1) (p=0.03). The mean talar tilt, 4.7 degrees in the AR group vs 6.9 degrees in the TE group, (p=0.02) and anterior talar translation, 2.9 mm in the AR group vs 4.3 mm in the TE group, (p=0.04) were significantly higher in the TE group at radiographic stress examination. According to the rating system developed by Good et al. (1975), significantly fewer patients in the TE group (n=8) had an excellent result as compared with the AR group (n=15) (p=0.03) and more patients in the TE group (n=9) had a fair or poor result (p=0.04) as compared with the AR group (n=2). We conclude that a tenodesis procedure does not restore the normal anatomy of the lateral ankle ligaments. When compared with anatomical reconstruction, a tenodesis leads to inferior results in terms of functional and mechanical stability, as well as overall satisfaction at long-term follow-up.

Adult↗
PubMed1993

Prospective preoperative evaluation of anterior cruciate ligament instability of the knee joint and results of reconstruction with patellar ligament.

Of 54 patients with chronic (n = 49) or acute (n = 5) anterior cruciate ligament instability, 52 were evaluated after mean 16 months' follow-up interval after open (n = 18) or arthroscopic assisted (n = 36) bone-tendon-bone patellar ligament reconstruction. Preoperative Knee Signature System side-to-side difference in anterior displacement decreased from 7.9 mm to 3.5 min at follow-up evaluation (p < 0.0001). An objectively satisfactory limit of 5 mm in side-to-side difference was achieved in 73% of the patients. At follow-up evaluation, there was a positive pivot shift sign in eight knees (one definite and seven trace). Average Lysholm knee scores improved from 69 to 83. The only significant difference between the arthroscopic assisted and open groups was smaller side-to-side anterior displacement difference in the arthroscopic group (2.2 mm versus 4.8 mm, p = 0.002). Results suggest that more accurate and isometric placement of the graft is possible with the arthroscopic-assisted technique.

Adolescent↗
PubMed1991

[Computerized tomography in instability of the femoropatellar joint].

Compared with normal X-ray examination, a CT scan can give more information about patellar alignment, especially close to full extension of the knee-joint. We compared the normal knee-joints of 10 volunteers with the knee-joints of 15 patients (19 recurrent luxations, 5 habitual subluxations). We were able to distinguish between instabilities with and without changes seen on the X-ray pictures, making it possible to develop a systematic concept of treatment. In the case of recurrent dislocation with radiologically visible instability, surgical repair is the treatment of choice, while for habitual subluxation without radiologically visible instability the primary treatment of choice is conservative therapy with physiotherapy and muscle training. This is successful in most cases. If physiotherapy fails surgical repair is the next step in treatment. This dynamic type of investigation (the patella is stabilized by tension of the quadriceps femoris muscle) makes an objective judgement of the result of therapy possible.

Adult↗
PubMed1998

Double semitendinosus anterior cruciate ligament reconstruction: 10-year results.

In a series of 30 consecutive patients who suffered from chronic instability of the knee joint, reconstruction of the torn anterior cruciate ligament was performed with a looped semitendinosus tendon, reinforced by an extra-articular anterolateral procedure. Of these 30, 27 could be followed up 9-11 years after the operation. The evaluation included the International Knee Documentation Committee (IKDC) questionnaire and was completed by testing with a Kneelax arthrometer at 132 N and by anteroposterior standing X-ray, in order to evaluate the degenerative changes. At the time of the check-up: 96% of the study group considered that they had normal or nearly normal knees, and 81% had recovered to the same sports activity level as before their injury. The degenerative changes noted at the index operation did not progress notably, except in two cases. Laxities of 7 knees were normal, with a side-to-side difference of less than 2 mm; 15 were nearly normal, with a mean difference of 3.45 mm; and 5 were abnormal, with a mean difference of 6.2 mm. The study shows that the procedure is efficient in restoring a satisfactory stability for most patients and stabilises the evolution of the degenerative lesions as shown by standing X-ray.

Adolescent↗
PubMed1989

[Chronic instability of the knee].

During the last few years, major advances have been achieved in our understanding and treatment of chronic instability of the knee joint. The central hub (ACL and PCL) is the most important stabilizing element, and its rupture usually results in slipping knee, pain and recurrent hydrarthrosis, which are particularly frequent and severe in athletes. However, in some circumstances the loss of the anterior cruciate ligament can be compensated for by other stabilizing elements or by an excellent musculature. In patients with slipping knee, clinical, radiological and even arthroscopic examinations are necessary to decide on the treatment to be applied. This treatment depends on the importance and type of laxity, on the presence or absence of meniscal and cartilaginous lesions, on the degree of functional impairment and on the patient's life style. Several methods can be used, from rehabilitation alone to the replacement of the deficient ligament(s) by autografts or artificial ligaments. Treatment should not be stereotyped, and only specialist can determine the best method for each individual patient.

Chronic Disease↗