Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Sep 2024
Clinical and radiological outcome of acute quadriceps tendon repair at 2 - year follow-up.
Though previous studies on surgical quadriceps tendon repair reported good to satisfactory results its impact on knee extensor strength and patellofemoral joint is unknown. The purpose of the study was to assess the clinical and functional outcome by quantifying subjective knee related outcome, isokinetic extensor strength complemented by magnetic resonance imaging (MRI). ⋯ Distal quadriceps tendon repair leads to satisfactory subjective outcome in patients with low to moderate activity levels. Tendon integrity was reliably restored. However, extensor strength deficits remain in more than 40% of patients. Atrophy signs of advanced fatty infiltration were recorded in 15% and patellofemoral cartilage defects in 20% of all patients, indicating that previous assessment tools do not display functional outcome adequately.
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Arch Orthop Trauma Surg · Sep 2024
Predictive and classification capabilities of the timed up and go as a physical performance measure in hip osteoarthritis: a retrospective study of 606 patients.
Hip osteoarthritis (OA) is a common joint pathology that significantly constrains functional capacity. Assessing the impact of hip OA on functionality is crucial for research and clinical practices. The study aimed to assess hip OA patients' functionality using the Timed Up and Go (TUG) test and to evaluate its diagnostic ability to differentiate between different grades of hip OA. We hypothesized that the severity of hip OA would impact the time required to complete the TUG test. ⋯ This study provides evidence that the duration of the TUG test significantly increased with the severity of the disease. TUG can offer real-time data on the management and progression of hip OA. Future studies should explore the correlation between hip OA and the TUG test, as understanding the relationship can influence treatment and patient outcomes.
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Arch Orthop Trauma Surg · Sep 2024
Validation of a computerized model for a new biomechanical concept- the fossa-foveolar mismatch- the answer to lesions of the ligamentous fossa-foveolar complex in the hip?
Hip-preserving surgery in young patients frequently reveals lesions of the ligamentum teres (LT). Histological and clinical evidence supports that those lesions could be source of intraarticular hip pain. It has been hypothesized that LT degeneration could be linked to the abnormal positioning of the fovea outside the lunate surface during various daily motions. We introduce the "fossa-foveolar mismatch" (FFM) by determining the trajectory of the fovea in the fossa during hip motions, enabling a comparison across diverse hip-pathomorphologies. ⋯ The FFM-index showed excellent intraobserver reliability and interobserver reproducibility for all motions. This innovative approach deepens our understanding of biomechanical implications, providing valuable insights for identifying patient populations at risk.
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Arch Orthop Trauma Surg · Sep 2024
The unintentional effect of unicompartmental knee arthroplasty on extraarticular deformity and of high tibial osteotomy on intraarticular deformity for the treatment of anteromedial osteoarthritis.
Unicompartmental Knee Arthroplasty (UKA) and High Tibial Osteotomy (HTO) are two valid options in the treatment of Anteromedial Osteoarthritis (AMOA) of the knee with UKA being mainly performed in cases of Intraarticular deformity (IA) and HTO in cases of Extraarticular deformity (EA). The exact unintentional effect of UKA on EA deformity and HTO on IA deformity is still not well understood. The aim of this study was to assess this unintentional effect of UKA on EA and HTO on IA deformities respectively. ⋯ In addition to intraarticular varus correction, UKA can partly correct the extraarticular varus deformity in AMOA even when resurfacing is exclusively attempted. Additionally, intraarticular deformity can be also partially managed by HTO along with the extraarticular varus correction even without performing overcorrection.
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Arch Orthop Trauma Surg · Sep 2024
No shortening of the patellar tendon during two-stage total knee arthroplasty revision using articulating spacers.
Surgical techniques in two-stage revision total knee arthroplasty (rTKA) include the use of articulating spacers and static spacers. Shortening of the patellar tendon could be a reason for inferior functional outcomes in two-stage septic rTKA . The aim of this study was to determine if articulating spacers also have negative effects on the extensor mechanism in rTKA. ⋯ Septic two-stage revision TKA using an articulating spacer does not lead to patellar tendon shortening in the majority of cases. This study suggests that one reason for the improved range of motion after reimplantation may be the use of articulating spacers compared to static spacers.