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Arthroscopy : the Journal of... Jun 2024
PubMed: 38955317
DOI: 10.1016/j.arthro.2024.06.033 -
Arthroscopy : the Journal of... Jun 2024
PubMed: 38955316
DOI: 10.1016/j.arthro.2024.06.031 -
International Journal of Surgery Case... Jun 2024Meniscal root tears are defined as soft-tissue and/or osseous injuries that rip or avulse within one centimeter of the meniscal insertion to the tibial plateau. These...
INTRODUCTION AND IMPORTANCE
Meniscal root tears are defined as soft-tissue and/or osseous injuries that rip or avulse within one centimeter of the meniscal insertion to the tibial plateau. These injuries impact around 100,000 patients a year and make up 10 % to 21 % of all meniscal tears. Meniscal extrusion frequently happens when there are root rips, and the transmission of circumferential hoop loads is hampered.
CASE PRESENTATION
We present one case of a 28-year-old male who complained of pain and stiffness in his left knee since 2 years after undergoing ACL reconstruction using a hamstring autograft. His examination revealed joint line tenderness on both the medial and lateral sides of the left knee. Further investigations involving X-ray and MRI established the diagnosis of both medial and lateral meniscal root tears, which were surgically managed using the transtibial pullout technique.
DISCUSSION
The biomechanical implications of meniscal root tears, such as loss of hoop forces and increased tibiofemoral contact pressures, underscore the importance of timely diagnosis and management. The literature advocates surgical treatment for managing root tears, as leaving them without surgical intervention can lead to functional outcomes similar to those of total meniscectomy.
CONCLUSION
This case report presents both menisci posterior root tears with an intact ACL graft which is unique in that they commonly tear in conjuction with ACL. These kind of injuries necessitates prompt diagnosis and surgical intervention to protect the knee from early arthritic changes.
PubMed: 38954967
DOI: 10.1016/j.ijscr.2024.109971 -
Clinical Biomechanics (Bristol, Avon) Jun 2024Long-leg frontal radiographs of the lower extremities are used to assess knee osteoarthritis. Given the three-dimensional (3D) nature of alignment changes in...
BACKGROUND
Long-leg frontal radiographs of the lower extremities are used to assess knee osteoarthritis. Given the three-dimensional (3D) nature of alignment changes in osteoarthritis, postural alterations in the femur and tibia extend beyond the coronal plane (in-plane) to include the transverse and sagittal planes (out-of-plane). This study investigates the impact of these out-of-plane factors on in-plane knee alignment parameters observed in frontal radiographs.
METHODS
A total of 97 osteoarthritic knees in women were examined. Using a 3D-to-two-dimensional (2D) image matching technique, we evaluated the 3D postures of the femur and tibia in the standing position as viewed from frontal radiographs in the world coordinate system. Statistical analyses were conducted to explore associations between these 3D postures and 2D alignment parameters obtained from frontal radiographs under identical conditions.
FINDINGS
The femur exhibited a medial inclination of 2.7°, a posterior inclination of 3.9°, and an internal rotation of 4.2°, whereas the tibia showed a lateral inclination of 6.4°, an anterior inclination of 6.7°, and an internal rotation of 6.7°. Both coronal and rotational postures of femur and tibia influenced the hip-knee-ankle angle, mechanical axis percentage, and medial proximal tibial angle. However, only coronal factors of tibia impacted tibial joint line obliquity relative to the floor.
INTERPRETATION
Attention should be paid to the potential impact of the out-of-plane postures of the femur and tibia on parameters assessed in plain frontal radiographs of the lower extremities.
PubMed: 38954887
DOI: 10.1016/j.clinbiomech.2024.106297 -
Journal of Orthopaedic Research :... Jul 2024Total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) are effective surgeries to treat end-stage knee osteoarthritis. Clinicians assume that TKA...
Total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) are effective surgeries to treat end-stage knee osteoarthritis. Clinicians assume that TKA alters knee kinematics while UKA preserves native knee kinematics; however, few studies of in vivo kinematics have evaluated this assumption. This study used biplane radiography to compare side-to-side tibiofemoral kinematics during chair rise, stair ascent, and walking in 16 patients who received either TKA or UKA. We hypothesized that TKA knees would have significant kinematic changes and increased asymmetry with the contralateral knee, while UKA knee kinematics would not change after surgery and preoperative knee symmetry would be maintained. Native bone and implant motion were tracked using a volumetric model-based tracking technique. Six degrees of freedom kinematics were calculated throughout each motion. Kinematics were compared between the operated and contralateral knees pre- and post-surgery using a linear mixed-effects model. TKA knees became less varus with the tibia more medial, posterior, and distal relative to the femur. UKA knees became less varus with the tibia less lateral on average. Postoperative TKA knees were in less varus than UKA knees on average and at low flexion angles, with an internally rotated tibia during chair rise and stair ascent. At high flexion angles, the tibia was more medial and posterior after TKA than UKA. Side-to-side kinematic symmetry worsened after TKA but was maintained or improved after UKA. Greater understanding of kinematic differences between operated and contralateral knees after surgery may help surgeons understand why some patients remain unsatisfied with their new knees.
PubMed: 38956422
DOI: 10.1002/jor.25926 -
Scientific Reports Jul 2024Stegosaurs are a minor but iconic clade of ornithischian dinosaurs, yet due to a poor fossil record, their early evolution is poorly understood. Here, we describe a new...
Stegosaurs are a minor but iconic clade of ornithischian dinosaurs, yet due to a poor fossil record, their early evolution is poorly understood. Here, we describe a new stegosaur, Baiyinosaurus baojiensis, gen. et sp. nov. from the Middle Jurassic Wangjiashan Formation of the Pingchuan District, Baiyin City, Gansu Province, China. The frontal of Baiyinosaurus possesses a unique characteristic among Stegosauria: it is wider than long and contributes to both the medial and anterior margins of the supratemporal fenestra. The character combinations of dorsal vertebrae of Baiyinosaurus are also different to other stegosaurs: its neural arches are not greatly elongated, its parapophyses are well developed, and its neural spines are axially expanded in lateral. The features of the frontal and vertebrae of Baiyinosaurus are reminiscent of basally branching thyreophorans, indicating that Baiyinosaurus is transitional in morphology between early thyreophorans and early-diverging stegosaurs. Systematic analysis shows that Baiyinosaurus is an early-diverging stegosaur.
Topics: Dinosaurs; Animals; China; Fossils; Phylogeny; Spine; Biological Evolution
PubMed: 38956140
DOI: 10.1038/s41598-024-66280-x -
Radiography (London, England : 1995) Jul 2024Radiotherapy is the standard treatment for breast cancer patients after surgery. However, radiotherapy can cause side effects such as dry and moist desquamation of the...
INTRODUCTION
Radiotherapy is the standard treatment for breast cancer patients after surgery. However, radiotherapy can cause side effects such as dry and moist desquamation of the patient's skin. The dose calculation from a treatment planning system (TPS) might also be inaccurate. The purpose of this study is to measure the surface dose on the CIRS thorax phantom by an optically stimulated luminescent dosimeter (OSLD).
METHODS
The characteristics of OSLD were studied in terms of dose linearity, reproducibility, and angulation dependence on the solid water phantom. To determine the surface dose, OSLD (Landauer lnc., USA) was placed on 5 positions at the CIRS phantom (Tissue Simulation and Phantom Technology, USA). The five positions were at the tip, medial, lateral, tip-medial, and tip-lateral. Then, the doses from OSLD and TPS were compared.
RESULTS
The dosimeter's characteristic test was good. The maximum dose at a depth of 15 mm was 514.46 cGy, which was at 100%. The minimum dose at the surface was 174.91 cGy, which was at 34%. The results revealed that the surface dose from TPS was less than the measurement. The percent dose difference was -2.17 ± 6.34, -12.08 ± 3.85, and -48.71 ± 1.29 at the tip, medial, and lateral positions, respectively. The surface dose from TPS at tip-medial and tip-lateral was higher than the measurement, which was 12.56 ± 5.55 and 10.45 ± 1.76 percent dose different, respectively.
CONCLUSION
The percent dose difference is within the acceptable limit, except for the lateral position because of the body curvature. However, OSLD is convenient to assess the radiation dose, and further study is to measure in vivo.
IMPLICATION FOR PRACTICE
The OSL NanoDot dosimeter can be used for dose validation with a constant setup location. The measurement dose is higher than the dose from TPS, except for some tilt angles.
PubMed: 38955646
DOI: 10.1016/j.radi.2024.06.011 -
Dermatologic Surgery : Official... Jul 2024Ingrown toenail is a very common nail disorder, and partial matricectomy by phenolization is considered the most effective treatment technique. However, the contact time...
INTRODUCTION
Ingrown toenail is a very common nail disorder, and partial matricectomy by phenolization is considered the most effective treatment technique. However, the contact time of the phenol with the nail matrix remains debatable.
OBJECTIVE
To evaluate the recurrence rate of ingrown toenail after partial matricectomy by phenol for 45 seconds.
METHODS
A total of 1,460 surgeries were performed, with a photographic record of 802 pictures for a period of 6 months. The presence of any nail spicule or sign of ingrowth during follow-up was considered a recurrence.
RESULTS
A total of 802 surgeries were evaluated, with the most affected nails being the right (49.3%) and left (48%) big toes and most frequently the lateral fold (54.5%). The recurrence rate was 0.75% at 3 months and 1.87% at 6 months, and the medial nail fold had a higher recurrence rate than the lateral nail fold.
CONCLUSION
Forty-five seconds of contact time of 88% phenol with the nail matrix was enough and effective, resulting in low recurrence rates. Prospective studies are needed to better assess postoperative morbidity.
PubMed: 38954750
DOI: 10.1097/DSS.0000000000004265 -
American Journal of Physical Medicine &... Jul 2024Neurogenic thoracic outlet syndrome (nTOS) is a chronic, focal lesion of the lower trunk of the brachial plexus or of the T1 and C8 anterior primary rami, often arising...
Neurogenic thoracic outlet syndrome (nTOS) is a chronic, focal lesion of the lower trunk of the brachial plexus or of the T1 and C8 anterior primary rami, often arising due to distortion of neural structures by a fibrous congenital band extending from a C7 transverse process or cervical rib. Accordingly, patients present with chronic weakness or atrophy of the hand, most prominently of the thenar eminence, which receives most innervation from the T1 root. We present clinical, electrophysiologic, and imaging findings in a case of nTOS presenting in an adult with a history most suggestive of congenital brachial plexus palsy (CBPP), another pathology sharing the mechanism of nerve compression or injury within the supracostoclavicular space. The patient had new right thenar eminence atrophy and a lifelong history of medial forearm sensory deficit and she improved after first rib resection. The convergence of two disorders in the same patient arising in different phases of life illustrates how anatomic or structural variation in this space can predispose to lower brachial plexus injury.
PubMed: 38954650
DOI: 10.1097/PHM.0000000000002572 -
Medical Science Monitor : International... Jul 2024BACKGROUND The Lisfranc ligament is crucial for maintaining the transverse and longitudinal arch of the foot. Owing to the disruption between the medial cuneiform bone...
BACKGROUND The Lisfranc ligament is crucial for maintaining the transverse and longitudinal arch of the foot. Owing to the disruption between the medial cuneiform bone and the base of the second metatarsal bone, the currently preferred fixation method remains controversial. Our fixation technique involves screwing one anchor to the medial and intermediate cuneiform bones and using the anchor to carry the ligament to bind the Lisfranc joint and first and second metatarsal joints altogether for elastic fixation. This study evaluated the clinical and functional outcomes of InternalBrace fixation for Lisfranc injury. MATERIAL AND METHODS This retrospective study included 58 patients who underwent InternalBrace fixation for Lisfranc injury between January 2019 and September 2022 by an experienced surgeon. One-way analysis of variance or t test was used. Preoperative classification was performed according to the Myerson classification with imaging data. Postoperative follow-up was performed based on intraoperative blood loss, fracture healing time, visual analog scale (VAS) score, the American Orthopedic Foot and Ankle Society (AOFAS) score, Tegner score, and complications. RESULTS Surgery was completed in all patients, and follow-up was performed. The patients' ages ranged from 19 to 62 years (average: 34.6±9.4 years). The postoperative follow-up time was 12-24 months (average: 16.9±3.0 months). The average time for fracture healing was 12.8±3.0 (10-24) weeks. The VAS, AOFAS, and Tegner scores significantly improved postoperatively (from 5.33±1.0 (3-7) to 1.24±0.57 (0-2); 28.02±6.70 (18-51) to 91.59±4.76 (82-96); and 2.40±0.67 (1-4) to 6.53±0.54 (6-7), respectively), which was statistically significant (P<0.01), and the good rate of AOFAS was 91.4%. The postoperative complications were traumatic arthritis, incision infection, and temporary dorsal foot numbness, which gradually recovered. No other rejection reactions or Lisfranc fracture/dislocations recurrence occurred during the follow-up period. CONCLUSIONS InternalBrace fixation for Lisfranc injury is beneficial for restoring Lisfranc joint stability and function and allows for early and more aggressive rehabilitation for patients, with fewer surgical complications.
Topics: Humans; Retrospective Studies; Adult; Female; Male; Middle Aged; Fracture Fixation, Internal; Metatarsal Bones; Young Adult; Foot Injuries; Treatment Outcome; Ligaments, Articular
PubMed: 38954596
DOI: 10.12659/MSM.943537