Our results for arthroscopic-assisted double-tibial tunnel fixation in patients with displaced eminentia fractures are presented here. A cohort of twenty patients who had undergone surgery for eminentia fracture between January 2010 and May 2014 were subjects of this study. simian immunodeficiency Type II was the designated classification for all fractures, as per Meyers. Reduction of Eminentia was accomplished by securing two nonabsorbable sutures across the ACL. Two tibial tunnels were established using a 24mm cannulated drill, situated over the medial proximal tibia. The two tibial tunnels were connected via an osseous bridge upon which the sutured ends were fastened. Employing the Lysholm, Tegner, and IKDC scores, and comprehensive clinical and radiological examinations, patients were assessed for evidence of bony union. The schedule for quadriceps exercises commenced on the third day. Three weeks after the surgical procedure, patients were fitted with locked knee braces set in extension, and subsequently encouraged to move around as their pain allowed. Before the operation, the Lysholm score was 75 and 33, and afterward, it increased to 945 and 3. The Tegner score before the operation was 352102 and, after the procedure, it was 6841099. The International Knee Documentation Committee (IKDC) score, abnormal in all 20 patients before their operation, was found to be normal in each patient post-operatively. A statistically significant difference (p<0.00001) was observed between the postoperative and preoperative activity scores of the patients. Pain, knee instability, malunion, laxity of surrounding structures, and an extension deficit are potential consequences of tibial eminence fractures. Clinical outcomes may be positive when implementing our described technique alongside early rehabilitation efforts.
The popularity of electric scooters is largely due to their low cost and rapid speed as a transportation method. The COVID-19 pandemic's impact on public transit options, combined with a concurrent increase in publications about e-scooter accidents, has resulted in a rise in e-scooter usage during recent years. Current publications fail to include an analysis of the potential connection between e-scooter riding and anterior cruciate ligament (ACL) damage. We propose to study the connection between e-scooter accidents and the prevalence of anterior cruciate ligament injuries. Patients aged 18 or over, having sustained an ACL injury and registered at our orthopedic outpatient clinic between January 2019 and June 2021, underwent systematic evaluation procedures. Eighty e-scooter accidents, resulting in ACL tears, were examined in a study. A historical analysis of the patients' electronic medical records was performed. Patient records were reviewed to obtain information about their age, gender, trauma history, and the type of trauma they had experienced. Stopping their scooters led to falls in 58 patients; 22 more patients fell after colliding with something. A total of 62 patients (77.5%) in the study had anterior cruciate ligament reconstruction performed using hamstring tendon grafts. Following their decision against surgery, 18 (225%) patients engaged in functional physical therapy exercises for follow-up. The medical literature has, up to this point, detailed cases of bone and soft tissue injuries associated with e-scooter riding. Post-trauma, ACL tears are a prevalent concern, necessitating informative and cautionary messages for users to reduce the likelihood of such injuries.
Studies on primary total knee arthroplasty (TKA) have documented alterations in the patellar tendon (PT) dimensions, including changes in its length and thickness. The purpose of this study is to ascertain the structural changes in both the length and thickness of the PT following primary TKA using ultrasound (US), and to examine the relationship between these modifications and subsequent clinical outcomes, after a minimum of 48 months of follow-up. This prospective study investigated the 60 knees of 32 patients (aged 54-80, mean age 64.87 years) pre- and post-primary total knee arthroplasty (TKA), focusing on patellar tendon length and thickness changes. Clinical efficacy was measured by the HSS and Kujala score evaluations. The latest follow-up assessment revealed a considerable 91% decrease in PT (p<0.0001) and a substantial 20% enhancement in global thickening (p<0.0001). Correspondingly, the proximal one-third (p < 0.001) segment of PT displayed a 30% thickening, while the middle one-third (p < 0.001) segment exhibited a 27% thickening. The tendon's thickening in all three regions was inversely related to the clinical outcome measures, demonstrating statistical significance (p < 0.005). Post-primary TKA, the study revealed notable changes in patellar tendon (PT) length and thickness. Specifically, increased PT thickness demonstrated a stronger and more substantial association with inferior clinical results, such as decreased functionality and anterior knee pain, than did a shorter PT. Serial scans employed by the US method in this study show its potential as a non-invasive approach to monitor changes in the length and thickness of the PT post-TKA.
This study investigates the mid-term results of individuals who received medial pivot total knee arthroplasty at a single surgical center. Data from our center was retrospectively examined to analyze 304 total knee replacements, using a medial pivot prosthesis, on 236 patients (40 male, 196 female) between January 2010 and December 2014. These patients exhibited a mean operative age of 66.64 years (standard deviation of 7.09 years), with a range of 45 to 82 years. Pre- and postoperative evaluations included data collection on the American Knee Society Score, the Oxford Knee Score, and flexion angle measurements. The percentage breakdown of operated knees reveals 712% with unilateral involvement and 288% with bilateral involvement. The average duration of the follow-up process was calculated as 79,301,476 months. A statistically significant improvement was observed in the postoperative Functional Score, Knee Score, Oxford Score, Total Knee Society Score, and flexion angles, compared to baseline values (p < 0.001). Postoperative scores exhibited a statistically significant decline in patients aged 65 and above, compared to those under 65 years of age (p < 0.001). In patients having undergone resection of both the anterior and posterior cruciate ligaments, the mean flexion angle demonstrated a rise, statistically significant (p < 0.001). The results of our study reveal that medial pivot knee prostheses are reliable in the mid-term, offering improved function and increasing patient satisfaction. Retrospective research utilizing Level IV evidence standards.
For secure fixation in modern uncemented unicompartmental knee arthroplasty (UKA), the implant design's mechanics and the biological connection at the bone-implant interface are essential. This systematic review aimed to ascertain implant survivorship, clinical outcomes, and revision indications in uncemented UKAs. Keywords regarding UKAs and uncemented fixation were implemented within the search strategy to identify appropriate studies. Retrospective and prospective studies, requiring a minimum average follow-up duration of two years, were selected for the analysis. Data was gathered pertaining to study design elements, implant types, patient profiles, survival outcomes, clinical evaluation scores, and the indications prompting a revision. The ten-point risk of bias scoring tool served to assess methodological quality. After rigorous evaluation, eighteen studies formed part of the final review process. The studies exhibited a mean follow-up period, ranging from 2 to 11 years. Autoimmune vasculopathy A significant primary outcome, survival, showed 5-year survivorship ranging between 917% and 1000% and 10-year survivorship between 910% and 975%. The majority of studies revealed excellent clinical and functional outcome scores, while a smaller portion demonstrated good results. Revisions represented 27 percent of the entire set of operations conducted. A total of 145 revisions were observed, yielding a revision rate of 0.08 per one hundred component years. The most common causes of implant failure were the progression of osteoarthritis (302%) and bearing dislocations (238%). This review of uncemented UKAs suggests comparable survival rates, clinical outcomes, and safety profiles when compared to cemented UKAs, supporting their consideration as a suitable alternative in clinical practice.
Fixation failure in intertrochanteric fractures addressed by cephalomedullary nailing (CMN) was the subject of this study, which sought to determine the associated variables. Our retrospective analysis encompassed 251 consecutive surgical patients treated between January 2016 and July 2019. We investigated the relationship between factors such as gender, age, fracture stability (AO/OTA classification), femoral neck angle (FNA), contralateral FNA comparison, lag screw position, and tip-apex distance (TAD) and the occurrence of failure (cut-out, cut-through, or nonunion). The failure rate was a significant 96%, composed of 10 cut-outs (accounting for 4%), 7 non-unions (representing 28%), and 7 cut-throughs (also comprising 28%). Through univariate logistic regression, the study found that female sex (p=0.0018) and FNA 25mm (p=0.0016) were associated with a higher risk of fixation failure. selleck chemicals Multivariate analysis indicated that female gender (OR 1292; p < 0.00019), the divergence in FNA results on the lateral view (OR 136; p < 0.0001), and the anterior positioning of the femoral head screw (OR 1401; p < 0.0001) were independently associated with failure. This study underscored the need for precise lateral reduction and avoidance of anterior screw positioning on the femoral head to mitigate failures in intertrochanteric hip fractures treated via CMN.