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Journal of Orthopaedic Surgery (Hong... 2023The deltoid ligament is the primary stabilizer of the medial side of the ankle joint. It is a complex structure with an origin at the medial malleolus from where it... (Review)
Review
The deltoid ligament is the primary stabilizer of the medial side of the ankle joint. It is a complex structure with an origin at the medial malleolus from where it spreads fan shaped distally with an insertion into the medial side of the talus, calcaneus and navicular bone. This chapter gives an overview of the anatomy, function, and pathology of the deltoid ligament.The deltoid ligament can become insufficient as a result of an ankle injury or prolonged strain. In the acute setting, deltoid insufficiency often coincides with multi ligament injury the ankle joint; syndesmosis injury, or ankle fractures. Management in the acute phase remains a subject of debate. Some orthopedic surgeons have a tendency towards repair, whereas most trauma surgeons often treat the deltoid nonoperatively. In the chronic setting the ligament complex is often elongated as a result of prolonged strain. It often coexists with a hindfoot valgus, as is the case in planovalgus feet. In such a case a realignment procedure should be combined with the deltoid repair.
Topics: Humans; Fracture Fixation, Internal; Ligaments; Ankle Fractures; Ankle Injuries; Ankle Joint; Ligaments, Articular
PubMed: 37449811
DOI: 10.1177/10225536231182345 -
BMJ Clinical Evidence May 2010Injury of the lateral ligament complex of the ankle joint occurs in about one in 10,000 people a day, accounting for a quarter of all sports injuries. (Review)
Review
INTRODUCTION
Injury of the lateral ligament complex of the ankle joint occurs in about one in 10,000 people a day, accounting for a quarter of all sports injuries.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatment strategies for acute ankle ligament ruptures? We searched: Medline, Embase, The Cochrane Library, and other important databases up to November 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 38 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: cold treatment, diathermy, functional treatment, homeopathic ointment, immobilisation, physiotherapy, surgery, and ultrasound.
Topics: Ankle Injuries; Ankle Joint; Bandages; Humans; Lateral Ligament, Ankle; Ligaments, Articular; Physical Therapy Modalities; Sprains and Strains
PubMed: 21718566
DOI: No ID Found -
Clinics in Sports Medicine Jan 2018This article describes the complex anatomic structures that pass across the lateral aspect of the knee, particularly the iliotibial tract and the underlying... (Review)
Review
This article describes the complex anatomic structures that pass across the lateral aspect of the knee, particularly the iliotibial tract and the underlying anterolateral ligament and capsule. It provides data on their strength and roles in controlling tibiofemoral joint laxity and stability. These findings are discussed in relation to surgery to repair or reconstruct the anatomic structures, or to create tenodeses with similar effect.
Topics: Biomechanical Phenomena; Humans; Joint Instability; Knee Joint; Ligaments, Articular; Rotation; Tendons; Tibia
PubMed: 29173554
DOI: 10.1016/j.csm.2017.07.004 -
Knee Surgery, Sports Traumatology,... Mar 2021The posterior cruciate ligament (PCL) represents an intra-articular structure composed of two distinct bundles. Considering the anterior and posterior meniscofemoral... (Review)
Review
The posterior cruciate ligament (PCL) represents an intra-articular structure composed of two distinct bundles. Considering the anterior and posterior meniscofemoral ligaments, a total of four ligamentous fibre bundles of the posterior knee complex act synergistically to restrain posterior and rotatory tibial loads. Injury mechanisms associated with high-energy trauma and accompanying injury patterns may complicate the diagnostic evaluation and accuracy. Therefore, a thorough and systematic diagnostic workup is necessary to assess the severity of the PCL injury and to initiate an appropriate treatment approach. Since structural damage to the PCL occurs in more than one third of trauma patients experiencing acute knee injury with hemarthrosis, background knowledge for management of PCL injuries is important. In Part 1 of the evidence-based update on management of primary and recurrent PCL injuries, the anatomical, biomechanical, and diagnostic principles are presented. This paper aims to convey the anatomical and biomechanical knowledge needed for accurate diagnosis to facilitate subsequent decision-making in the treatment of PCL injuries.Level of evidence V.
Topics: Adult; Biomechanical Phenomena; Female; Hemarthrosis; Humans; Knee; Knee Injuries; Knee Joint; Ligaments, Articular; Magnetic Resonance Imaging; Male; Posterior Cruciate Ligament; Posterior Cruciate Ligament Reconstruction; Radiography; Recurrence; Rotation; Tibia; Young Adult
PubMed: 33201271
DOI: 10.1007/s00167-020-06357-y -
Knee Surgery, Sports Traumatology,... May 2010Understanding the anatomy of the ankle ligaments is important for correct diagnosis and treatment. Ankle ligament injury is the most frequent cause of acute ankle pain....
Understanding the anatomy of the ankle ligaments is important for correct diagnosis and treatment. Ankle ligament injury is the most frequent cause of acute ankle pain. Chronic ankle pain often finds its cause in laxity of one of the ankle ligaments. In this pictorial essay, the ligaments around the ankle are grouped, depending on their anatomic orientation, and each of the ankle ligaments is discussed in detail.
Topics: Ankle; Ankle Joint; Biomechanical Phenomena; Epiphyses; Humans; Ligaments, Articular; Minimally Invasive Surgical Procedures; Orthopedic Procedures
PubMed: 20309522
DOI: 10.1007/s00167-010-1100-x -
Knee Surgery, Sports Traumatology,... Apr 2017This article reviews the evidence for the roles of the anterolateral soft-tissue structures in rotatory stability of the knee, including their structural properties,... (Review)
Review
This article reviews the evidence for the roles of the anterolateral soft-tissue structures in rotatory stability of the knee, including their structural properties, isometry, and contributions to resisting tibial internal rotation. These data then lead to a biomechanical demonstration that the ilio-tibial band is the most important structure for the restraint of anterolateral rotatory instability. Level of evidence V.
Topics: Anterior Cruciate Ligament; Anterior Cruciate Ligament Injuries; Biomechanical Phenomena; Humans; Joint Deformities, Acquired; Joint Instability; Knee Joint; Ligaments, Articular; Rotation
PubMed: 28299387
DOI: 10.1007/s00167-017-4494-x -
BMC Musculoskeletal Disorders Aug 2016Frozen shoulder is a common yet poorly understood musculoskeletal condition, which for many, is associated with substantial and protracted morbidity. Understanding the... (Review)
Review
BACKGROUND
Frozen shoulder is a common yet poorly understood musculoskeletal condition, which for many, is associated with substantial and protracted morbidity. Understanding the pathology associated with this condition may help to improve management. To date this has not been presented in a systematic fashion. As such, the aim of this review was to summarise the pathological changes associated with this primary frozen shoulder.
DATABASES
Medline, Embase, CINAHL, AMED, BNI and the Cochrane Library, were searched from inception to 2nd May, 2014. To be included participants must not have undergone any prior intervention. Two reviewers independently conducted the; searches, screening, data extraction and assessment of Risk of Bias using the Cochrane Risk of Bias Assessment Tool for non-Randomised Studies of Interventions (ACROBAT-NRSI). Only English language publications reporting findings in humans were included. The findings were summarised in narrative format.
RESULTS
Thirteen observational studies (involving 417 shoulders) were included in the review. Eight studies reported magnetic resonance imaging or arthrography findings and 5 recorded histological findings. When reported mean ages of the participants ranged from 40.0 to 59.8 years. Duration of symptoms ranged from 0 to 30 months. The majority of studies (n = 7) were assessed to be of moderate risk of bias, two studies at high risk and the remaining four were rated as low risk of bias. Study characteristics were poorly reported and there was widespread variety observed between studies in respect of data collection methods and inclusion criteria employed. Pathological changes in the anterior shoulder joint capsule and related structures were commonly reported. Imaging identified pathological changes occurring in the coracohumeral ligament, axillary fold and rotator interval. Obliteration of the subcoracoid fat triangle also appeared to be pathognomonic. Histological studies were inconclusive but suggested that immune, inflammatory and fibrotic changes where associated with primary frozen shoulder.
CONCLUSIONS
This systematic review presents a summary of what is currently known about the tissue pathophysiology of primary frozen shoulder. Further studies that use standardised inclusion and exclusion criteria and investigate changes in naïve tissue at different stages of the condition are required.
Topics: Adult; Arthrography; Bursitis; Humans; Ligaments, Articular; Magnetic Resonance Imaging; Middle Aged; Shoulder Joint; Shoulder Pain
PubMed: 27527912
DOI: 10.1186/s12891-016-1190-9 -
Journal of Biomechanical Engineering Jul 2011The facet joint is a crucial anatomic region of the spine owing to its biomechanical role in facilitating articulation of the vertebrae of the spinal column. It is a... (Review)
Review
The facet joint is a crucial anatomic region of the spine owing to its biomechanical role in facilitating articulation of the vertebrae of the spinal column. It is a diarthrodial joint with opposing articular cartilage surfaces that provide a low friction environment and a ligamentous capsule that encloses the joint space. Together with the disc, the bilateral facet joints transfer loads and guide and constrain motions in the spine due to their geometry and mechanical function. Although a great deal of research has focused on defining the biomechanics of the spine and the form and function of the disc, the facet joint has only recently become the focus of experimental, computational and clinical studies. This mechanical behavior ensures the normal health and function of the spine during physiologic loading but can also lead to its dysfunction when the tissues of the facet joint are altered either by injury, degeneration or as a result of surgical modification of the spine. The anatomical, biomechanical and physiological characteristics of the facet joints in the cervical and lumbar spines have become the focus of increased attention recently with the advent of surgical procedures of the spine, such as disc repair and replacement, which may impact facet responses. Accordingly, this review summarizes the relevant anatomy and biomechanics of the facet joint and the individual tissues that comprise it. In order to better understand the physiological implications of tissue loading in all conditions, a review of mechanotransduction pathways in the cartilage, ligament and bone is also presented ranging from the tissue-level scale to cellular modifications. With this context, experimental studies are summarized as they relate to the most common modifications that alter the biomechanics and health of the spine-injury and degeneration. In addition, many computational and finite element models have been developed that enable more-detailed and specific investigations of the facet joint and its tissues than are provided by experimental approaches and also that expand their utility for the field of biomechanics. These are also reviewed to provide a more complete summary of the current knowledge of facet joint mechanics. Overall, the goal of this review is to present a comprehensive review of the breadth and depth of knowledge regarding the mechanical and adaptive responses of the facet joint and its tissues across a variety of relevant size scales.
Topics: Biomechanical Phenomena; Cartilage, Articular; Cervical Vertebrae; Computer Simulation; Finite Element Analysis; Humans; Intervertebral Disc Displacement; Joint Capsule; Ligaments, Articular; Lumbar Vertebrae; Mechanotransduction, Cellular; Range of Motion, Articular; Spine; Stress, Mechanical; Total Disc Replacement; Zygapophyseal Joint
PubMed: 21823749
DOI: 10.1115/1.4004493 -
Orthopaedics & Traumatology, Surgery &... Feb 2015Injury to the cruciate ligaments of the knee commonly occurs in association with posterolateral instability, which can cause severe functional disability including... (Review)
Review
Injury to the cruciate ligaments of the knee commonly occurs in association with posterolateral instability, which can cause severe functional disability including varus, posterior translation, and external rotational instability. Failure to diagnose and treat an injury of the posterolateral corner in a patient who has a tear of the cruciate ligament can also result in the failure of the reconstructed cruciate ligament. There seems to be a consensus of opinion that injury to the posterolateral corner, whether isolated or combined, is best treated by reconstructing the posterolateral corner along with the coexisting cruciate ligament injury, if combined. Commonly proposed methods of reconstructing the posterolateral corner have focused on the reconstruction of the popliteus, the popliteofibular ligament, and the lateral collateral ligament. The aim of this conference is to describe the posterolateral corner reconstruction technique and to provide an algorithm of treatment.
Topics: Biomechanical Phenomena; Humans; Joint Instability; Knee Injuries; Knee Joint; Lateral Ligament, Ankle; Ligaments, Articular; Muscle, Skeletal; Orthopedic Procedures; Posterior Cruciate Ligament; Plastic Surgery Procedures
PubMed: 25596981
DOI: 10.1016/j.otsr.2014.07.032 -
Australian Family Physician Mar 2017Injury to the tarsometatarsal joint is a relatively rare occurrence that is commonly missed, leading to debilitating outcomes. For this reason, it is considered a red...
BACKGROUND
Injury to the tarsometatarsal joint is a relatively rare occurrence that is commonly missed, leading to debilitating outcomes. For this reason, it is considered a red flag in general practice.
OBJECTIVE
This article reviews the current literature on tarsometatarsal injuries and describes clinical assessment, imaging and management.
DISCUSSION
Lisfranc injuries refer to the displacement of the metatarsals from the tarsus, with special attention placed on the second tarsometa-tarsal joint and Lisfranc ligament. These injuries can occur in numerous circumstances, such as motor vehicle accidents, crush inju-ries and falls. Indirect mechanisms include axial force through the foot or twisting on a plantar flexed foot. Suggestive examination signs include plantar ecchymosis, mid-foot pain and positive findings in the provocative tests described in the article. Weight-bearing radiographs are vital for diagnosis. Correct and prompt management is key to avoiding posttraumatic arthritis, a devastating but common complication of Lisfranc injuries.
Topics: Australia; Clinical Competence; Family Practice; Foot Injuries; Humans; Joint Instability; Ligaments, Articular; Physicians, Primary Care; Tarsal Joints
PubMed: 28260272
DOI: No ID Found