Surgical Treatment of Insufficiency Fractures of the Knee

Publication date: Available online 11 October 2019Source: Arthroscopy TechniquesAuthor(s): Joseph N. Liu, Troy G. Shields, Anirudh K. Gowd, Nirav H. AminAbstractBone marrow lesions (BMLs) in the knee represent focal edema caused by subchondral bone attrition and microfractures to the trabecular bone. These lesions are poor prognostic indicators for several orthopaedic procedures but also have been associated with the progression of osteoarthritis. Current research is aimed at treating BMLs with the intent to improve the overall structural integrity of the subchondral bone and delay the need for arthroplasty. The injection of calcium phosphate bone substitute has been proposed to treat BMLs because animal models have shown its potential to stimulate bone repair. This technical note describes the key steps involved in performing percutaneous fixation of BMLs with a hard-setting bone substitute, as well as associated pearls and pitfalls. Although continued research with prospective comparative cohorts and long-term follow-up is needed to determine the efficacy of this procedure, this intervention holds promise in delaying the need for total knee replacement in the arthritic patient with a focal lesion.
Source: Arthroscopy Techniques - Category: Surgery Source Type: research

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ConclusionReported cases of PTRCT and its surgical repair have both increased substantially over time. Approximately 11.70% of patients with PTRCT undergo either open or arthroscopic procedure as a means of surgical repair. With the growing popularity of arthroscopic procedures for rotator cuff repair, further investigation should be performed to analyze trends and risk factors for PTRCT, a seemingly underrepresented orthopedic condition.
Source: Journal of Orthopaedics - Category: Orthopaedics Source Type: research
ConclusionTwenty years after open rotator cuff repair, the rate of osteoarthritis was 29%. Massive rotator cuff tears were significantly associated with a higher rate of osteoarthritis. Less osteoarthritis was observed when suprasupinatus healed.Level of evidenceIV.
Source: Orthopaedics and Traumatology: Surgery and Research - Category: Orthopaedics Source Type: research
Abstract PURPOSE:: To evaluate the short-term clinical and radiological outcomes with degenerative changes in patients over 40 years old following isolated vertical medial meniscal tear repair. METHODS:: Between 2007 and 2015, 438 patients underwent arthroscopic meniscal repair. Thirty-three patients aged over 40 years with isolated vertical medial meniscal repair (23 males and 10 females, mean age 46.1 ± 7.0; range 40-67) were included in the study. Preoperative and postoperative physical examination findings, Lysholm knee score, the International Knee Documentation Committee score, magnetic resonance...
Source: Journal of Orthopaedic Surgery - Category: Orthopaedics Authors: Tags: J Orthop Surg (Hong Kong) Source Type: research
Authors: Lee JW, Hwang DS, Kang C, Hwang JM, Chung HJ Abstract Background: The purpose of this study is to report the long-term follow-up results of arthroscopic repair of acetabular labral tears with femoroacetabular impingement (FAI). Methods: Of 45 patients who underwent arthroscopic labral repair under the diagnosis of acetabular labral tears with FAI from January 2008 to December 2010 and met our inclusion criteria, 41 patients who were available for a long-term follow-up were included in the analysis. We compared the long-term follow-up results with the previously reported short-term follow-up results of ...
Source: Clinics in Orthopedic Surgery - Category: Orthopaedics Tags: Clin Orthop Surg Source Type: research
Publication date: Available online 7 September 2018Source: PM&RAuthor(s): Paul S. Chirichella, Steven Jow, Stephen Iacono, Hannah E. Wey, Gerard A. MalangaAbstractThe meniscal tear treatment paradigm traditionally begins with conservative measures such as physical therapy with referral for operative management for persistent or mechanical symptoms. As a result, the partial meniscectomy is performed more than any other orthopedic procedure in the United States. This treatment paradigm has shifted as recent literature supports the attempt to preserve or repair the meniscus whenever possible given its importance for the struc...
Source: PMandR - Category: Rehabilitation Source Type: research
ConclusionsOsteochondral lesions of the distal tibia represent a challenge for the orthopedic surgeon because of their difficulty diagnostic and rarities. The high incidence of good outcome in our series indicates that the one-step BMDCT could be a valid option for the treatment of this rare type of lesions. Further studies with a longer follow-up and more accurate imaging studies are necessary to confirm these results.
Source: European Journal of Orthopaedic Surgery and Traumatology - Category: Orthopaedics Source Type: research
Conclusions The cartilage surface of the acetabulum, where FAI-related chondral lesions appear, is considerably smaller than the weight-bearing cartilage surface of the knee joint. However, as in the knee joint, MACT is the therapy of choice for full-thickness cartilage defects of more than 1.5 - 2 cm(2). Minimally invasive types of MACT (e.g. injectable chondrocyte implants) should be preferred in the hip joint. In cases where a single-stage procedure is indicated or there are other compelling reasons for not performing a MACT, a bone marrow-stimulating technique in combination with a biomaterial covering is pr...
Source: Zeitschrift fur Orthopadie und Unfallchirurgie - Category: Orthopaedics Tags: Z Orthop Unfall Source Type: research
SPECIAL FROM Next Avenue Whether it came on suddenly when you were playing tennis or more gradually over many years, knee pain can keep you from doing even the most basic of activities. At the very least, it can limit your ability to move as easily or quickly, or sit in one place for an extended time.   Arthritis is the most common cause of knee pain for older adults, said Dr. Julie Switzer, an orthopedic surgeon at Regions Hospital in St. Paul, Minn. Arthritis comes in three main forms, she said: osteoarthritis, inflammatory arthritis and post-traumatic arthritis. We’ll examine these types, as well as other ...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
Snapping Hip Snapping hip is an audible clicking or snapping sensation caused by hip movement that can be painful. There are a variety of reasons patients present with a clicking or snapping sensation in the hip. A click in the hip can be the result of the following: a labral tear, iliotibial band syndrome, psoas bursitis, psoas tendon snap, and arthritis of the hip. It is essential for physicians to understand each cause to provide an effective course of treatment. Labral Tear A labral tear is a common cause for clicking sensations in the hip joint. The labrum refers to the ring of cartilage surrounding the socket of ...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
CONCLUSIONS:  The findings of Claes et al reflected a radiographic knee OA prevalence at a minimum average of 10 years' postautologous ACL reconstruction that was lower than commonly perceived (up to 79%). In addition, meniscectomy was an important risk factor (3.54-fold increase) for developing OA after ACL reconstruction. PMID: 26930022 [PubMed - as supplied by publisher]
Source: Journal of Athletic Training - Category: Sports Medicine Tags: J Athl Train Source Type: research
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