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1.
Background
There are limited reports about management of Knee flexion contracture (KFC) in haemophiliacs with Ilizarov technique. The aim of this study was to retrospectively analyzed the results of Ilizarov technique to treat KFC.Methods
Six patients with haemophilia A and one with haemophilia B were included in this study, with an average age of 17?years old. The mean preoperative KFC and flexion angle of the knee were 58?±?21° (mean ± standard deviation) and 127?±?12°, respectively. Preoperative HSS score (hospital for special surgery knee score) was 51?±?4. The average time of follow-up was 39.3?±?23.3?months.Results
All the patients achieved full correction of flexion contracture at the end of distraction and maintained at the last follow-up. The mean flexion angle at the end of distraction and at the last follow-up were 41?±?35° and 38?±?19° respectively, which were significantly lower than preoperative flexion angle. The mean HSS score at the end of distraction and at the last follow-up were 65?±?4 and 64?±?2 respectively, which were significantly higher than the preoperative HSS score. One patient suffered from transient numbness of left leg, and all the patients had loss of range of knee flexion at last follow-up.Conclusions
Ilizarov is an effective and safe procedure to treat KFC in haemophiliacs. However, loss of knee flexion was the most common complication. 相似文献2.
Cody Goessl Paul Estabrooks Wen You Denise Britigan Armando DeAlba Fabio Almeida 《Patient education and counseling》2019,102(5):968-975
Objective
This study evaluates the effectiveness of technology versus in-person, group-initiated diabetes prevention to enhance comprehension of learning objectives between patients with differing health literacy (HL).Methods
Evidence-based content through either a DVD (n?=?217) or in-person, group class (n?=?225) to initiate the intervention. A teach-back call was used to assess comprehension of, and reinforce, learning objectives. Chi-squared was used to determine differences between conditions (DVD vs Class) and HL levels (High n?=?361 vs. Low n?=?81) and regression analyses were used to examine relationships.Results
DVD participants performed significantly better across teach back questions (15.4?±?2.5 v. 14.8?±?2.6, p?<?0.01), demonstrated comprehension in fewer teach-back rounds (1.9?±?0.7 v. 2.1?±?0.7, p?<?0.01), and answered more questions correctly on the first try (4.2?±?1.6 v. 3.4?±?1.8, p?<?0.01). Models for HL levels and modality by HL level were statistically significant (p?<?0.01) favoring the DVD.Conclusion
Initiating a diabetes prevention program with the use of a DVD appears to be a superior option to in-person, class sessions. Teach-back and teach-to-goal strategies enables participants of both high and low health literacy levels to receive and confirm mastery of diabetes prevention objectives.Practice Implications
A teach-back call may improve information uptake increasing the likelihood of health behavior uptake. 相似文献3.
Background
The purpose of this study was to characterise the histopathological changes in the infrapatellar fat pad (IPFP) in the early stage of patellofemoral osteoarthritis (PFOA).Methods
Sixty-four New Zealand white rabbits were randomly divided into experimental (n?=?24), sham (n?=?16), and control groups (n?=?24). In the experimental group, denoted as the patellar ligament uneven shortening group (US group), the patellar ligament (PL) was folded eight millimetres and sutured. After eight weeks, all animals were euthanised, and magnetic resonance imaging (MRI) evaluation, wet IPFP weight measurement, and histopathological and immunohistochemistry analysis were performed to analyse the histopathological changes in the IPFPs.Results
The maximum cross-sectional area (CSA) of the IPFPs in the sagittal position of MRI in the control group, sham group, and US group were 45.50?±?7.19?mm2, 45.88?±?6.60?mm2 (vs. control group, P?=?0.907), and 53.83?±?8.24?mm2 (vs. control group, P?=?0.015; vs. sham group, P?=?0.035), respectively. The MRI intensity of the IPFPs in the control group, sham group, and US group were 115.53?±?28.85, 108.53?±?26.73 (vs. control group, P?=?0.589), and 154.52?±?18.48 (vs. control group, P?=?0.002; vs. sham group, P?=?0.002), respectively. The wet weight of the IPFPs in the control group, sham group, and US group were 0.32?±?0.05?g, 0.32?±?0.04?g (vs. control group, P?=?0.895), and 0.38?±?0.06?g (vs. control group, P?=?0.017; vs. sham group, P?=?0.033), respectively. The Osteoarthritis Research Society International (OARSI) scores of the IPFPs in the US group were 6.00?±?1.91, which was higher than the scores of 2.50?±?2.02 (P?<?0.001) in the control group and of 2.75?±?1.67 (P?=?0.001) in the sham group.Conclusions
The histopathological changes of the IPFPs as determined via MRI and microscopic structure appeared to occur much earlier than cartilage damage in PFOA. Furthermore, detecting and treating the IPFP changes may offer aid in the diagnosis and treatment of PFOA. 相似文献4.
Tiana Raoul Shahnaz Klouche Baptiste Guerrier Badr El-Hariri Serge Herman Antoine Gerometta Nicolas Lefevre Yoann Bohu 《The Knee》2019,26(1):155-164
Background
The decision to return to sport following anterior cruciate ligament (ACL) reconstruction should not only be based on time since surgery. This study aimed to assess, using isokinetic and neuromuscular (hops) testing in a large group, postoperative objective functional recovery of the knee. The secondary objective was to determine the relationship between psychological, functional scores, and these postoperative tests.Methods
This prospective study included athletes who underwent surgery between 2013 and 2016 for an isolated full-thickness ACL tear. They received a complete evaluation of functional performance of the knee by isokinetic tests performed on a dynamometer to measure quadriceps and hamstring strength, and neuromuscular assessment based on single-leg hop tests. The main judgment criterion was satisfactory functional recovery (yes/no) defined as a difference of ≤ 10% both in the quadriceps 60°/s and the single hop at a minimum of four months of follow-up.Results
A total of 234 athletes were analyzed. The mean age was 28.4?±?8.6?years. At 6.5?±?1.7?months mean follow-up, 44 (18.5%) patients had satisfactory functional recovery of the knee. The correlations between isokinetic/hop tests and the different scores were variable. During follow-up, two patients presented with a graft tear and two with a contralateral ACL tear, all in the group with unsatisfactory functional recovery.Conclusion
At a mean of six months after ACL reconstruction, objective functional recovery of the knee was generally unsatisfactory and this seemed to be a risk factor for recurrent tears.Level of evidence
IV; case series. 相似文献5.
Background
While surgical reconstruction restores mechanical stability following anterior cruciate ligament (ACL) rupture, many experience early-onset osteoarthritis despite surgery. Neurophysiological changes are hypothesized to contribute to knee osteoarthritis progression. Proprioceptive deficits have been reported following ACL injury/reconstruction; however, vibration perception threshold (VPT) has been less studied. This study explored relationships between pain, VPT, proprioception, function, and strength following ACL-reconstruction.Methods
Twenty individuals (27?±?6 years; 10 males) (standard deviation) status-post ACL-reconstruction were compared with a control group. Measurements included VPT, proprioception (threshold to detect passive movement), pain, function (Knee Outcome Survey (KOS)) and isometric quadriceps strength. Group differences were assessed using Mann-Whitney U tests, side-to-side differences with Wilcoxon Signed Rank tests, and associations evaluated using Spearman correlations.Results
The ACL-reconstruction group had minor functional deficits (15?±?11%) and resting pain (1.8?±?1.7). Impaired VPT and proprioception (hypoesthesia) were demonstrated on surgical compared to contralateral and control limbs (p?≤?0.008). Proprioception was significantly different between contralateral and control knees, but not VPT. Surgical knee proprioceptive deficits and VPT deficits were positively correlated (ρ?=?0.462, p?=?0.047) but not in controls (ρ?=??0.042, p?=?0.862). Strength was negatively correlated to pain (ρ?=??0.589; p?=?0.006), but not to KOS scores, proprioception or VPT (p?≥?0.099).Conclusion
Proprioceptive deficits following ACL injury have been ascribed to loss of afferent input from the torn ligament. Alternatively, multi-modality as well as contralateral sensory deficits suggest a spinal/supraspinal source of neurophysiological findings which may predispose to early osteoarthritis.Level of evidence
III. 相似文献6.
Objectives
To investigate the effects of various diets on structure and function of the bladder in both normal and obstructed bladders of male Wistar rats.Methods
Sham-operated rats and rats with experimentally-induced bladder outlet obstruction (BOO) were fed with standard rats’ feed (control), High-carbohydrate (HCD), High-fat (HFD) and High-protein (HPD) diets. Feeding was continued for 4 weeks after BOO surgery. Bladder weight, detrusor contractility, Rho-Kinase (ROK) and Myosin Light Chain Kinase (MLCK) expressions were determined using standard methods.Results
In comparison with control, bladder weight was increased in HFD (164?±?9?mg), BOO (437?±?21?mg), HFD-BOO (523?±?19?mg) and HPD-BOO (268?±?18?mg). Detrusor contractility was reduced in BOO and HFD-BOO. The ROK- I and II expressions were high in HCD-BOO and low in HPD-BOO but ROK-I was also elevated in BOO. However, MLCK increased only in HCD-BOO.Conclusion
The results of the study reveal that diets with varying macronutrient compositions have variable effects on the bladder with and without obstruction. High-fat diets especially, affect detrusor morphology and function in both obstructed and unobstructed bladders. 相似文献7.
Salman Nazary-Moghadam Mahyar Salavati Ali Esteki Behnam Akhbari Sohrab Keyhani Afsaneh Zeinalzadeh 《The Knee》2019,26(1):88-96
Background
Several investigations have studied gait variability of individuals with anterior cruciate ligament (ACL) deficiency; however, the effect of dual-tasking on the gait variability of these individuals remained unclear. The aim of the present study was to determine the effect of gait speed and dual-tasking on knee flexion–extension variability in subjects with and without ACL deficiency.Methods
The knee flexion–extension Lyapunov exponent (LyE) was measured in 22 ACL-deficient (Mean±SD) (25.95?±?4.69?years) and 22 healthy subjects (24.18?±?3.32?years). They walked at three levels of gait speed in isolation or concurrently with a cognitive task.Results
Repeated-measure analyses of variance (ANOVAs) demonstrated that the interaction of group by gait speed was statistically significant. As the gait speed increased from low to high, the knee flexion–extension LyE significantly decreased for the subjects with ACL deficiency (effect size: 0.57, P?=?0.01). The interaction of group by cognitive load was not statistically significant (P?=?0.07). In addition, the ACL-deficient subjects had statistically slower reaction times than healthy subjects during the dual-task compared with the single-task condition.Conclusions
The ACL-deficient and healthy individuals had a tendency to maintain safe gait. It seems that the ACL-deficient subjects sacrificed the cognitive task more than the healthy individuals to pay more attention toward gait. Additionally, it seems that the gait speed was more challenging than cognitive load on the stride-to-stride variability in the individuals with ACL deficiency. 相似文献8.
David Latz Erik Schiffner Johannes Schneppendahl Konstantin Klein Lisa Oezel Lars Fabian Seiler Pascal Jungbluth Robert Alexander Kaufmann Joachim Windolf Sebastian Viktor Gehrmann 《The Knee》2019,26(1):33-39
Background
One of the most important activities of daily living is operating a motor vehicle. With increasing age the prevalence of musculoskeletal disorders such as knee osteoarthritis may interfere with an individual's ability to do so safely. Physicians are tasked with determining a patient's ability to drive and yet the necessary joint range of motion required for driving a car has not been characterized.Methods
The range of motion of the right and left knees was recorded using electrogoniometers in 20 healthy subjects while driving a car on three route types (a) city streets, b) country roads and c) highways). Special emphasis was placed on the left knee associated with changing a gear.Results
The range of motion while driving is 40–80° for the right and 20–85° flexion for the left knee. A significant difference was noted for each side (p?<?0.01) with a higher flexion occurring in the left knee (p?<?0.01). The average position of the knee while changing a gear (beginning, maximum, ending) was: right: 55°±10°, 62°±10°, 53°±10°; left: 67°±7°, 39°±8°, 66°±8° (mean flexion±standard deviation).Conclusion
This study characterized the knee range of motion that occurs while driving a car. Our data suggests that common driving activities such as accelerating a vehicle or braking can be achieved with the right knee through a limited range of motion. The greater range of motion and the higher flexion of the left knee are mainly attributed to the gear changing. The present data may benefit physicians in their evaluation of driving capability. 相似文献9.
Takashi Kitagawa Junsuke Nakase Yasushi Takata Kengo Shimozaki Kazuki Asai Hiroyuki Tsuchiya 《The Knee》2019,26(1):14-19
Background
Patellar tendinopathy is difficult to successfully treat. This study aimed to characterize the pathological changes of the infrapatellar fat pad (IPFP) in patellar tendinopathy (PT), and to investigate the influence of PT on the development of fibrotic changes in the IPFP.Methods
Forty male Wistar rats were randomly divided into PT (n?=?20) and control groups (n?=?20). Bacterial collagenase I (patellar tendinopathy group) or saline (control) was injected, intratendinous, into the patellar tendon. Rats were sacrificed at week 12. The whole knee joint was sagittally sectioned and stained with hematoxylin–eosin and Masson's trichrome. The IPFP samples were graded according to cellularity, fibrosis, and vascularity. The whole IPFP and blue-stained area was measured. Mann–Whitney U tests were used to compare the between-group differences of each score and quantitative value.Results
Scores for cellularity were three (2–3) and 0 (0–1) in the PT and control groups, respectively (P?<?0.01). Mean scores for fibrosis were two (1–3) and 0 (0–1) in the PT and control groups, respectively (P?<?0.01). Mean scores for vascularity were two (2–3) and one (1–1) in the PT and control groups, respectively (P?<?0.01). There was a significant difference in the total score between the PT and control groups (seven (5–8) and two (1–3), respectively) (P?<?0.01). Average percentages of the fibrous area of the IPFP were 38.2?±?26.5% and 11.2?±?3.9% in the patellar tendinopathy and control groups, respectively (P?<?0.01).Conclusion
The IPFP in the patellar tendinopathy group showed greater cellularity, fibrosis, and vascularity than the control group. 相似文献10.
Ken Dewitte Marc Claeys Emeline Van Craenenbroeck Koen Monsieurs Hein Heidbuchel Vicky Hoymans Tibor Stoop 《Pathophysiology》2019,26(1):53-59
Aims
We explored the effect of remote ischaemic conditioning (RIC) on endothelial function and on circulating mediators.Methods and results
In 20 healthy male volunteers (mean age 31?±?10 years), flow-mediated dilation (FMD) was measured before and after 20?min of arm ischaemia, followed by reperfusion. Remote ischaemic conditioning (RIC) was performed by applying 3 cycles of 5?min of ischaemia of the leg at the onset of index arm ischaemia. Each volunteer underwent the IR-induced vascular injury protocol with and without RIC in a crossover study design.In the control group, IR significantly reduced FMD (5.9?±?2.9% before IR vs. 2.2?±?3.7% after IR; p?<?0.001). This effect was significantly attenuated by performing RIC (FMD of 5.5?±?3.1% before IR vs. 4.0?±?3.4% % after IR; p for interaction?=?0.01). Serum levels of SOD and ADMA increased significantly whereas MCP-1 and VEGF levels decreased significantly.Only changes in SOD levels were significantly related to the degree of RIC induced protection (r²?=?0.34; p?=?0.018).Conclusion
RIC has protective effects against endothelial IR injury. Our biomarker study suggests that anti-oxidative stress mediators, such as SOD, seem to be more involved in the pathogenesis of RIC-induced protection in humans than angiogenesis factors or chemo-attractant cytokines. 相似文献11.
Mai Katakura Masafumi Horie Toshifumi Watanabe Hiroki Katagiri Koji Otabe Toshiyuki Ohara Kaori Nakamura Kenta Katagiri Hiroko Ueki Stefano Zaffagnini Ichiro Sekiya Takeshi Muneta Hideyuki Koga 《The Knee》2019,26(1):124-131
Background
Some types of meniscus tear, especially lateral meniscus tear, have been reported to be associated with rotatory knee laxity. However, precise information regarding the effect of meniscus repair on rotatory laxity is limited. The purpose of this study was to investigate the effects of lateral and medial meniscus repair on rotatory laxity in anterior cruciate ligament (ACL) injured knees.Methods
Forty-one patients who underwent ACL reconstruction were included in the study. The tibial acceleration during the pivot shift test was measured using a triaxial accelerometer preoperatively under anesthesia and intraoperatively before and after medial and lateral meniscus repair and ACL reconstruction during surgery. Effects of meniscus tear and its repair on rotatory laxity were analyzed.Results
Preoperative measurements revealed that patients with lateral meniscus tear showed significantly higher tibial acceleration compared to the patients without meniscus tear (P?=?0.006). Intraoperative measurements revealed that medial and lateral meniscus repair significantly reduced tibial acceleration by 1.46?m/s2 (P?=?0.002) and 1.91?m/s2 (P?<?0.001), respectively.Conclusion
In ACL injured knees, knees with lateral meniscus tear showed greater rotatory laxity compared to the knees without meniscus tear. In addition, lateral meniscus repair, and to a lesser degree medial meniscus repair, reduced rotatory laxity during ACL reconstruction surgery. Therefore, the meniscus should be repaired as much as possible for its role as a secondary stabilizer of rotatory laxity. Besides, the effect of meniscus repair on rotatory laxity should be considered when the indication of anterolateral augmentation is determined. 相似文献12.
Annemie Smeets Bart Malfait Bart Dingenen Mark A. Robinson Jos Vanrenterghem Koen Peers Stefaan Nijs Styn Vereecken Filip Staes Sabine Verschueren 《The Knee》2019,26(1):40-51
Background
There is limited evidence on neuromuscular risk factors for anterior cruciate ligament (ACL) injuries, with most work mainly focusing on hamstrings and quadriceps muscle strength. This prospective pilot study explored if neuromuscular activation patterns of the quadriceps and hamstrings during a drop vertical jump influence ACL injury risk.Methods
Forty-six female athletes performed a drop vertical jump at baseline. Injuries were monitored throughout a one-year follow-up. Neuromuscular activation patterns of the vastus medialis, vastus lateralis, hamstrings medialis and hamstrings lateralis, and selected landing kinematic and kinetic profiles (knee flexion, knee abduction and hip flexion angles, and knee abduction moments), were compared between athletes who sustained a non-contact ACL injury and those who remained injury free. Electromyogram vector fields were created to represent neuromuscular activation patterns of muscle pairs around the knee joint rather than only considering individual muscle activations, and compared using Statistical Parametric Mapping.Results
Four athletes sustained an ACL injury. Significantly greater {hamstrings medials, hamstrings lateralis}, {vastus lateralis, hamstrings lateralis} and {hamstrings lateralis, vastus medialis} activations, mainly due to greater hamstrings lateralis activation, were found in the injured group around peak loading and just before take-off (P?<?0.001). No group differences were found in knee flexion, knee abduction and hip flexion angles, or knee abduction moments.Conclusions
This pilot study revealed initial evidence that athletes already showed altered neuromuscular activation patterns prior to sustaining an ACL injury, namely increased lateral and posterior muscle activations. 相似文献13.
Objectives
Pregnancy options counseling, or nondirective counseling of patients with unintended pregnancy, is a “necessary competency” for medical students according the Association of Professors of Gynecology and Obstetrics. Narrative Medicine (NM) utilizes stories of illness to inform clinical practice and promotes self-reflection in medical education. The authors analyzed the effect of a NM workshop on medical students’ ability to provide pregnancy options counseling.Methods
The authors randomized students in the major clinical year at Columbia University Medical Center (CUMC) to either a 2-hour NM workshop or to a control intervention. The NM group participated in reading and reflective writing exercises addressing varying perspectives on pregnancy. Students then completed a video-taped and numerically-scored OSCE (Objective Structured Clinical Examination) regarding pregnancy options counseling. The authors compared mean OSCE scores between the groups.Results
The study analyzed 103 participants. Overall mean OSCE scores were higher in the NM group (11.9?±?1.5, n?=?51) than the control group (11.3?±?1.6, n?=?52) (p?=?0.049).Conclusions
Students undergoing a NM workshop had higher scores on a pregnancy options counseling OSCE.Practice implications
This brief intervention may aid future physicians in providing nondirective pregnancy options. This novel approach to teaching is an easily shared learning tool. 相似文献14.
Background
The effect of the changes in the femoral posterior condylar offset (PCO) on anterior–posterior (AP) translation and internal–external (IE) rotation in cruciate-retaining (CR) and posterior-stabilized (PS) total knee arthroplasty (TKA) remains unknown. The purpose of this study was to compare the kinematics in CR and PS TKA with respect to the difference in prosthetic design and PCO change through a computational simulation.Methods
We developed three-dimensional finite element models with the different PCOs of ± 1, ± 2 and ± 3?mm in the posterior direction using CR and PS TKA. We performed the simulation with different PCOs under a deep knee bend condition and evaluated the kinematics for the AP and IE in CR and PS TKA.Results
The more tibiofemoral (TF) translation in the posterior direction was found as PCO translated in posterior direction for both CR and PS TKA compared to the neutral position. However, the change of the AP translation with respect to the PCO change in CR TKA was greater than PS TKA. The more TF external rotation was found as PCO translated in the anterior direction for both CR and PS TKA compared to the neutral position. However, unlike the TF translation, the TF rotation was not influenced by the PCO change in both CR and PS TKA.Conclusion
The PCO magnitude was influenced by a postoperative change in the kinematics in CR TKA although a relatively smaller effect was observed in PS TKA. Hence, surgeons should be aware of the PCO change, especially for CR TKA. 相似文献15.
J. Fürmetz J. Sass T. Ferreira J. Jalali L. Kovacs F. Mück N. Degen P.H. Thaller 《The Knee》2019,26(1):185-193
Introduction
Three-dimensional (3D) surgical planning and patient-specific implants are becoming increasingly popular in orthopedics and trauma surgery. In contrast to the established and standardized alignment assessment on two-dimensional (2D) long standing radiographs (LSRs) there is neither a standardized nor a validated protocol for the analysis of 3D bone models of the lower limb. This study aimed to create a prerequisite for pre-operative planning.Methods
According to 2D analysis and after meticulous research, 24 landmarks were defined on 3D bone models obtained from computed axial tomography (CT) scans for a 3D alignment assessment. Three observers with different experience levels performed the test three different times on three specimens. Intraobserver and interobserver variability of the landmarks and the intraclass correlation coefficient (ICC) of the resulting axes and joint angles were evaluated.Results
Overall, the intraobserver and interobserver variability was low, with a mean deviation < 5?mm for all landmarks. The ICC of all joint angles and axis deviations was > 0.8, except for tibial torsion (ICC?=?0.69). All knee joint angles showed excellent ICC (> 0.95).Conclusions
Using the defined landmarks, a standardized 3D alignment assessment with low intraobserver and interobserver variability and high ICC values for the knee joint angles can be performed regardless of examiner's experience. The described method serves as a reliable standardized protocol for a 3D malalignment test of the lower limb. Three-dimensional pre-operative analysis might enhance understanding of deformities and lead to a new focus in surgical planning. 相似文献16.
Sophie Heywood Jodie McClelland Paula Geigle Ann Rahmann Elizabeth Villalta Benjamin Mentiplay Ross Clark 《The Knee》2019,26(1):61-72
Background
Closed kinetic chain and plyometric exercises are commonly used in aquatic rehabilitation because they are believed to reduce joint loading whilst replicating functional tasks. However, the forces and relationship to land-based functional movement is unknown. This study aims to compare vertical ground reaction force during squats, calf raises and jumping in older adults with and without knee osteoarthritis on land and in water.Methods
Forty one participants (Healthy n?=?21; Knee osteoarthritis n?=?20; Age 68.5 (4.4) years) completed squats and calf raises at slow, medium and maximal speeds and jumping at maximal speed on land and in waist and chest depth water. Vertical ground reaction force and pain rating was measured in each environment.Results
Force in all exercises was significantly greater on land than in chest depth water (p?<?0.005). Peak force was significantly greater at maximal speed compared to slow speed (p?<?0.001). The pattern of force in squats at slow speed in water was different to on land, with force highest at the start and end of the exercise and decreasing in the central phase. Pain ratings were significantly lower (p?<?0.001) in water compared to on land in squats.Conclusions
Closed kinetic chain exercises offer inherently different loading in an aquatic environment. Body weight squats and calf raises in water could be defined as either neuromotor or low load, high velocity training. Maximal speed exercise in water produces higher relative load compared to slow speed and minimal pain providing an opportunity for clinicians to use greater speed to address power deficits. 相似文献17.
Matthias Steinwachs Nicola Cavalcanti Santhosh Mauuva Venkatesh Reddy Clement Werner Daniel Tschopp Hema N. Choudur 《The Knee》2019,26(1):174-184
Background
CARGEL (Smith & Nephew Inc.), a chitosan-based polymer scaffolding biomaterial, has been used since 2012 for treating articular cartilage lesions. Limited data are available on patient outcomes following CARGEL treatment. This study aimed to describe short-term clinical and radiographic outcomes in a cohort of patients treated with CARGEL and microfracture surgery for articular cartilage defects in the knee.Methods
A retrospective cohort study was conducted of consecutive patients with articular cartilage defects who had undergone microfracture surgery with CARGEL, or in patellar lesions microfracture and CARGEL plus Chondro-Gide (at SportsClinic Zurich). Study outcomes included reoperations, infections, allergic reactions, pain, swelling, range of motion, and tissue quality and quantity. Ethics approval was obtained from the local ethics committee on 05/09/2017 (Basec. Nr: 2017-01441).Results
A total of 91 participants, with 93 treated lesions, consenting to chart review were included. No participants required reoperation due to complications on the index lesion. Fifteen participants had second-look surgery on the index knee for other reasons, allowing for visual confirmation of cartilage repair. No study participants experienced a post-surgical infection or suffered an allergic reaction. No significant changes in range of motion or T2 values were observed from pre-treatment to post-treatment follow-up. However, significant decreases were found in pain (P?<?0.001) and swelling (P?<?0.001), along with significant increases in MOCART II scores (P?<?0.001). Similar results were found in a subgroup of patients with patellar lesions.Conclusions
Patients treated with CARGEL experienced few postoperative complications and reported promising reductions in pain and swelling after treatment.Level of evidence
IV 相似文献18.
Kathryn A. Barth Cort D. Lawton Daniel C. Touhey Ryan S. Selley Daniel D. Li Earvin S. Balderama Gordon W. Nuber Wellington K. Hsu 《The Knee》2019,26(1):142-148
Background
Soccer is one of the most common international sports in which ACL injuries occur, with previous studies reporting high return-to-play rates following ACL reconstruction (ACLR). Return-to-play analysis fails to take into consideration how effective a player remains once returning to competition. The aims of this study are to provide a large-scale international analysis of return-to-play and player performance statistics among professional soccer athletes following ACLR.Methods
Using publicly available sources, professional soccer athletes who have undergone ACLR between the 1996 and 2015 seasons were identified. Player metrics including statistical performance, recovery time, and return-to-play rates were analyzed both before and after reconstruction. Furthermore, player performance statistics during each of three consecutive seasons post-ACLR were compared.Results
A total of 176 athletes who underwent ACLR were included in this study. The return-to-play rate was 93.2% (164 athletes). Cumulative post-surgical statistical analysis of ACLR players demonstrated fewer games/season, minutes/season, minutes/game, goals/season, and more fouls/season following ACLR (p?<?0.04). Analysis of player performance statistics suggests that athletes do not return to their baseline number of games/season and minutes/game until two and three seasons post-ACLR, respectively. At three seasons post-ACLR, athletes are still starting fewer games/season and scoring fewer goals/90?min (p?<?0.04).Conclusion
Return-to-play rate is high following ACLR; however, athletes exhibit poorer statistical performance, especially in the first few seasons upon return. Our data shows that athletes continue to start fewer games/season and score fewer goals/90?min at three seasons post-ACLR. 相似文献19.
20.
Jae S. You Anne R. Wright Ian Hasegawa Brandon Kobayashi Matthew Kawahara Jordan Wang Cass K. Nakasone 《The Knee》2019,26(1):228-239