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Foot & Ankle International Oct 2021Chronic ankle instability is a common condition that can be treated with lateral ankle ligament repair. These procedures have a reported success rate greater than 85% in... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Chronic ankle instability is a common condition that can be treated with lateral ankle ligament repair. These procedures have a reported success rate greater than 85% in the literature, but little has been reported about the differences in postoperative outcomes between males and females. The purpose of this study was to evaluate sex-specific outcomes following lateral ankle ligament repair.
METHODS
In this systematic review and meta-analysis, we used Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria to search for articles on electronic databases and included studies in which study participants underwent primary lateral ligament repair and sex-specific outcomes were evaluated. Functional postoperative outcomes for males and females were recorded and statistically analyzed.
RESULTS
Out of 2768 studies, 7 (0.25%) met inclusion criteria and were analyzed in this review. These studies included 618 patients (402 males [65%] and 216 females [35%]) who underwent primary lateral ligament repair for ankle instability. Karlsson score ( = .1582) and American Orthopaedic Foot & Ankle Society (AOFAS) score ( = .1586) analyses found no statistically significant difference between males and females. Postoperative success rate-defined as a "good" or "excellent" Karlsson score (>81)-was not found to be significantly different between males and females ( = .9374).
CONCLUSION
There was no difference in postoperative mean Karlsson scores, AOFAS scores, or success rates between males and females who underwent primary lateral ankle ligament repair.
LEVEL OF EVIDENCE
Level IV, therapeutic.
Topics: Ankle; Ankle Injuries; Ankle Joint; Female; Humans; Joint Instability; Lateral Ligament, Ankle; Male
PubMed: 34024152
DOI: 10.1177/10711007211004191 -
Journal of Biomechanics May 2021The introduction of biplane fluoroscopy has created the ability to evaluate in vivo motion, enabling six degree-of-freedom measurement of the tibiotalar and subtalar... (Review)
Review
The introduction of biplane fluoroscopy has created the ability to evaluate in vivo motion, enabling six degree-of-freedom measurement of the tibiotalar and subtalar joints. Although the International Society of Biomechanics defines a standard method of assigning local coordinate systems for the ankle joint complex, standards for the tibiotalar and subtalar joints are lacking. The objective of this systematic review was to summarize and appraise the existing literature that (1) defined coordinate systems for the tibia, talus, and/or calcaneus or (2) assigned kinematic definitions for the tibiotalar and/or subtalar joints. A systematic literature search was developed with search results limited to English Language from 2006 through 2020. Articles were screened by two independent reviewers based on title and abstract. Methodological quality was evaluated using a modified assessment tool. Following screening, 52 articles were identified as having met inclusion criteria. Methodological assessment of these articles varied in quality from 61 to 97. Included articles adopted primary methods for defining coordinate systems that included: (1) anatomical coordinate system (ACS) based on individual bone landmarks and/or geometric shapes, (2) orthogonal principal axes, and (3) interactive closest point (ICP) registration. Common methods for calculating kinematics included: (1) joint coordinate system (JCS) to calculate rotation and translation, (2) Cardan/Euler sequences, and (3) inclination and deviation angles for helical angles. The methods each have strengths and weaknesses. This summarized knowledge should provide the basis for the foot and ankle biomechanics community to create an accepted standard for calculating and reporting tibiotalar and subtalar kinematics.
Topics: Ankle; Ankle Joint; Biomechanical Phenomena; Subtalar Joint; Talus
PubMed: 33744722
DOI: 10.1016/j.jbiomech.2021.110344 -
The Journal of Hand Surgery, European... May 2015Thumb carpometacarpal joint total arthroplasty has been undertaken for many years. The proponents believe the short-term outcomes are better than trapeziectomy and its... (Review)
Review
Thumb carpometacarpal joint total arthroplasty has been undertaken for many years. The proponents believe the short-term outcomes are better than trapeziectomy and its variants, but the longer term complications are often higher. This systematic review of all peer reviewed articles on thumb carpometacarpal joint total arthroplasty for osteoarthritis shows that there are reports of many implants. Some are no longer available. The reported outcomes are very variable: for some there are good long-term outcomes to beyond 10 years ; for others there are unacceptably high early rates of failure. Overall the published evidence does not show that total arthroplasty is better than trapeziectomy and its variants yet there is a higher complication rate and significant extra cost of using an implant. Future research needs to compare total arthroplasty with trapeziectomy to assess short term results where the arthroplasties may be better, long-term outcomes and the healthcare and personal costs so that surgeons and patients can make fully informed choices about the treatment of symptomatic thumb carpometacarpal joint osteoarthritis.
Topics: Arthroplasty, Replacement; Carpometacarpal Joints; Humans; Osteoarthritis; Thumb
PubMed: 25600851
DOI: 10.1177/1753193414563243 -
The Knee Dec 2023In recent years, kinematic alignment (KA) is becoming a valid alternative to mechanical alignment (MA) in total knee arthroplasty (TKA). However, to avoid early... (Review)
Review
BACKGROUND
In recent years, kinematic alignment (KA) is becoming a valid alternative to mechanical alignment (MA) in total knee arthroplasty (TKA). However, to avoid early failures, the restricted kinematic alignment (rKA) approach has been developed to restore native knee kinematics without reproducing extreme knee phenotype. This systematic review aims to evaluate clinical and radiological outcomes between rKA and MA for TKA.
METHODS
A systematic literature search was conducted following PRISMA guidelines on Pubmed, Scopus and Cochrane Library. The following search string was adopted: (((restricted kinematic) AND (mechanical)) AND (alignment)) AND (knee). We included studies that analyzed rKA versus MA in terms of clinical outcomes and complications with a minimum of 6 months of follow up. The following rKA- and MA-related data were evaluated: patient-reported outcome scores (PROMs), radiographic analysis of lower limb alignment, and complications. Criteria from the Methodological Index for Non-Randomized Studies were used to assess the methodological quality of the articles.
RESULTS
This systematic review included seven clinical studies with a total of 892 knees (471 for MA group and 421 for rKA group, respectively). Overall, post-operative PROMs were similar between rKA and MA. Moreover, rKA reached better results regarding Forgotten Joint Score and post-operative patient satisfaction. Finally, no higher complication rate was observed with the rKA approach.
CONCLUSION
The rKA aims to restore native knee kinematics, avoiding extreme deformities. Clinical outcomes are not inferior or even better for rKA compared with MA, without increasing the risk of short-middle-term implant failure. However, there is a high heterogeneity regarding the 'restricted' protocols used.
Topics: Humans; Biomechanical Phenomena; Arthroplasty, Replacement, Knee; Knee Joint; Lower Extremity; Radiography; Osteoarthritis, Knee; Knee Prosthesis
PubMed: 37925804
DOI: 10.1016/j.knee.2023.10.003 -
Acta Orthopaedica Jun 2017Background and purpose - Radiostereometric analysis (RSA) is an accurate method for measurement of early migration of implants. Since a relation has been shown between... (Review)
Review
Background and purpose - Radiostereometric analysis (RSA) is an accurate method for measurement of early migration of implants. Since a relation has been shown between early migration and future loosening of total knee and hip prostheses, RSA plays an important role in the development and evaluation of prostheses. However, there have been few RSA studies of the upper limb, and the value of RSA of the upper limb is not yet clear. We therefore performed a systematic review to investigate the accuracy and precision of RSA of the upper limb. Patients and methods - PRISMA guidelines were followed and the protocol for this review was published online at PROSPERO under registration number CRD42016042014. A systematic search of the literature was performed in the databases Embase, Medline, Cochrane, Web of Science, Scopus, Cinahl, and Google Scholar on April 25, 2015 based on the keywords radiostereometric analysis, shoulder prosthesis, elbow prosthesis, wrist prosthesis, trapeziometacarpal joint prosthesis, humerus, ulna, radius, carpus. Articles concerning RSA for the analysis of early migration of prostheses of the upper limb were included. Quality assessment was performed using the MINORS score, Downs and Black checklist, and the ISO RSA Results - 23 studies were included. Precision values were in the 0.06-0.88 mm and 0.05-10.7° range for the shoulder, the 0.05-0.34 mm and 0.16-0.76° range for the elbow, and the 0.16-1.83 mm and 11-124° range for the TMC joint. Accuracy data from marker- and model-based RSA were not reported in the studies included. Interpretation - RSA is a highly precise method for measurement of early migration of orthopedic implants in the upper limb. However, the precision of rotation measurement is poor in some components. Challenges with RSA in the upper limb include the symmetrical shape of prostheses and the limited size of surrounding bone, leading to over-projection of the markers by the prosthesis. We recommend higher adherence to RSA guidelines and encourage investigators to publish long-term follow-up RSA studies.
Topics: Arthroplasty, Replacement; Elbow Joint; Hand Joints; Humans; Joint Prosthesis; Postoperative Care; Prosthesis Design; Prosthesis Failure; Radiostereometric Analysis; Shoulder Joint; Upper Extremity
PubMed: 28464752
DOI: 10.1080/17453674.2017.1291872 -
Biomedical Engineering Online Aug 2017Quantitative gait analysis can provide a description of joint kinematics and dynamics, and it is recognized as a clinically useful tool for functional assessment,... (Review)
Review
Quantitative gait analysis can provide a description of joint kinematics and dynamics, and it is recognized as a clinically useful tool for functional assessment, diagnosis and intervention planning. Clinically interpretable parameters are estimated from quantitative measures (i.e. ground reaction forces, skin marker trajectories, etc.) through biomechanical modelling. In particular, the estimation of joint moments during motion is grounded on several modelling assumptions: (1) body segmental and joint kinematics is derived from the trajectories of markers and by modelling the human body as a kinematic chain; (2) joint resultant (net) loads are, usually, derived from force plate measurements through a model of segmental dynamics. Therefore, both measurement errors and modelling assumptions can affect the results, to an extent that also depends on the characteristics of the motor task analysed (i.e. gait speed). Errors affecting the trajectories of joint centres, the orientation of joint functional axes, the joint angular velocities, the accuracy of inertial parameters and force measurements (concurring to the definition of the dynamic model), can weigh differently in the estimation of clinically interpretable joint moments. Numerous studies addressed all these methodological aspects separately, but a critical analysis of how these aspects may affect the clinical interpretation of joint dynamics is still missing. This article aims at filling this gap through a systematic review of the literature, conducted on Web of Science, Scopus and PubMed. The final objective is hence to provide clear take-home messages to guide laboratories in the estimation of joint moments for the clinical practice.
Topics: Biomechanical Phenomena; Gait; Humans; Joints; Mechanical Phenomena
PubMed: 28821242
DOI: 10.1186/s12938-017-0396-x -
The Journal of Hand Surgery Jan 2021In the thumb carpometacarpal (CMC) joint osteoarthritis (OA) literature, there is substantial heterogeneity in outcome and outcome measure reporting. This could be...
PURPOSE
In the thumb carpometacarpal (CMC) joint osteoarthritis (OA) literature, there is substantial heterogeneity in outcome and outcome measure reporting. This could be rectified by a standardized core outcome set (COS). This study aimed to identify a comprehensive list of outcomes and outcome measures for thumb CMC joint OA, which represents the first step in developing a COS.
METHODS
A computerized search of MEDLINE, EMBASE, Cochrane, and CINAHL was performed to identify randomized controlled trials, as well as observational studies involving at least 50 participants aged greater than 18 years undergoing surgery for thumb CMC joint OA. Reported outcomes and outcome measures were extracted from these trials and summarized.
RESULTS
This search yielded 3,498 unique articles, 97 of which were used for analysis. A total of 33 unique outcomes and 25 unique outcome measures were identified. The most frequently used outcomes were complications (78), postoperative pain (73), radiologic outcomes (64), and grip strength (63). Within each reported outcome, there was substantial variation in how the outcome was measured. Of the 25 unique outcome measures, 10 were validated. Of the remaining 15, 12 were created ad hoc by the author. The Disabilities of the Arm, Shoulder, and Hand questionnaire was the most commonly reported outcome measure (34%).
CONCLUSIONS
There is a lack of consensus on critical outcomes after surgery for thumb CMC joint OA. A standardized COS created by stakeholder consensus would improve the consistency and therefore the quality of future research.
CLINICAL RELEVANCE
This systematic review of outcomes represents the first step in developing a core outcome set for thumb CMC joint OA.
Topics: Aged; Carpometacarpal Joints; Humans; Osteoarthritis; Outcome Assessment, Health Care; Pain, Postoperative; Thumb
PubMed: 32819777
DOI: 10.1016/j.jhsa.2020.05.024 -
Knee Surgery, Sports Traumatology,... Mar 2016The aim of this systematic review was to apply the anatomic ACL reconstruction scoring checklist (AARSC) and to evaluate the degree to which clinical studies comparing... (Review)
Review
PURPOSE
The aim of this systematic review was to apply the anatomic ACL reconstruction scoring checklist (AARSC) and to evaluate the degree to which clinical studies comparing single-bundle (SB) and double-bundle (DB) ACL reconstructions are anatomic.
METHODS
A systematic electronic search was performed using the databases PubMed (MEDLINE), EMBASE and Cochrane Library. Studies published from January 1995 to January 2014 comparing SB and DB ACL reconstructions with clinical outcome measurements were included. The items from the AARSC were recorded for both the SB and DB groups in each study.
RESULTS
Eight-thousand nine-hundred and ninety-four studies were analysed, 77 were included. Randomized clinical trials (29; 38%) and prospective comparative studies (29; 38%) were the most frequent study type. Most studies were published in 2011 (19; 25%). The most commonly reported items for both SB and DB groups were as follows: graft type (152; 99%), femoral and tibial fixation method (149; 97% respectively), knee flexion angle during graft tensioning (124; 8%) and placement of the tibial tunnel at the ACL insertion site (101; 66%). The highest level of documentation used for ACL tunnel position for both groups was often one dimensional, e.g. drawing, operative notes or o'clock reference. The DB reconstruction was in general more thoroughly reported. The means for the AARSC were 6.9 ± 2.8 for the SB group and 8.3 ± 2.8 for the DB group. Both means were below a proposed required minimum score of 10 for anatomic ACL reconstruction.
CONCLUSIONS
There was substantial underreporting of surgical data for both the SB and DB groups in clinical studies. This underreporting creates difficulties when analysing, comparing and pooling results of scientific studies on this subject.
Topics: Anterior Cruciate Ligament; Anterior Cruciate Ligament Injuries; Anterior Cruciate Ligament Reconstruction; Checklist; Humans; Knee Joint; Transplants
PubMed: 25344803
DOI: 10.1007/s00167-014-3393-7 -
Journal of Strength and Conditioning... Feb 2020Dvir, Z and Müller, S. Multiple-joint isokinetic dynamometry: a critical review. J Strength Cond Res 34(2): 587-601, 2020-Angular isokinetic dynamometry (AID) is widely...
Dvir, Z and Müller, S. Multiple-joint isokinetic dynamometry: a critical review. J Strength Cond Res 34(2): 587-601, 2020-Angular isokinetic dynamometry (AID) is widely regarded as the gold standard for dynamic muscle performance testing. Based on the rotational movement of its actuator, AID targets "single-joint" (knee, shoulder, hip, etc.) configurations namely measurement of muscle potential while it moves the lever arm-limb assembly ostensibly around a single fixed axis. On the other hand, the application of multiple-joint isokinetic dynamometry (MID) is relatively narrow, both in research and in practice. This situation is due, possibly, to the fact that these dynamometers are generally more limited in scope namely to testing/conditioning of combined hip, knee, ankle motion (leg press), combined shoulder, elbow motion, and lifting motion patterns, despite the fact that all 3 are associated with higher functionality. However, with the emerging importance of MID, this critical review takes a fresh look at its various aspects including the terminology and classification of multiple-joint isokinetic dynamometers; the problem of scaling namely the need to adjust the range of motion and linear velocities to subjective anthropometric measures; specific technical and methodological issues that underlie the valid application of these dynamometers; available reference values; and the reproducibility of MID-based test findings. Analysis of these topics indicates that MID may validly and effectively be applied for the assessment and conditioning of specific muscle action patterns. However, there is a clear need for standardization of tests and for conditioning protocols alongside research into the use of this method in various clinical cohorts.
Topics: Adult; Ankle Joint; Elbow Joint; Female; Humans; Joints; Knee Joint; Male; Movement; Muscle Strength Dynamometer; Muscle, Skeletal; Range of Motion, Articular; Reproducibility of Results; Shoulder
PubMed: 30789571
DOI: 10.1519/JSC.0000000000002982 -
World Neurosurgery Mar 2021Facet tropism (FT) refers to the difference in the orientation of facet joints with respect to each other in the sagittal plane. FT leads to unequal biomechanical forces... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Facet tropism (FT) refers to the difference in the orientation of facet joints with respect to each other in the sagittal plane. FT leads to unequal biomechanical forces on facet joint and intervertebral disc during rotation and other physiologic movements. Most of the studies have reported the incidence of FT in the lumbar spine to vary between 40% and 70%, with L4-5 level being the most commonly afflicted level. The objective of this study was to find the association between FT and various lumbar and cervical degenerative disorders.
METHODS
A systematic search of PubMed was performed with the keywords "facet tropism" and "facet asymmetry." Data for meta-analysis were extracted from the studies to obtain pooled impact of FT on lumbar disc herniation (LDH) and lumbar degenerative spondylolisthesis (LDS).
RESULTS
Eighty-two articles were included in the systematic review and 18 studies had the required data to be included in the meta-analysis. The pooled standard mean difference between FT angles in patients with or without LDH was 0.31 with (P = 0.04). The pooled odds ratio for FT in patients with LDH was 3.27 with (P = 0.02). Subgroup analysis showed that there is no significant difference in the L3/4, L4/5, and L5S1 subgroups. The pooled standard mean difference between FT angles in patients with or without LDS was 0.54 (P = 0.009).
CONCLUSIONS
FT is significantly associated with LDH and LDS along with various other lumbar and cervical degenerative diseases.
Topics: Biomechanical Phenomena; Cervical Vertebrae; Humans; Intervertebral Disc; Intervertebral Disc Degeneration; Intervertebral Disc Displacement; Lumbar Vertebrae; Spondylolisthesis; Tropism; Zygapophyseal Joint
PubMed: 33309642
DOI: 10.1016/j.wneu.2020.11.171