Aims. While residual
We investigated
Aims. The aim of this study was to assess the effect of posterior cruciate ligament (PCL) resection on flexion-extension gaps, mediolateral soft-tissue laxity,
Abstract. Introduction. This study compared biomechanical and functional parameters of a total knee arthroplasty (TKA) implant (Cemented Zimmer Hi-Flex) against healthy older adults to determine whether knee biomechanics was restored in this patient population. Methodology. Patients with a primary TKA and healthy adults >55 years old with no musculoskeletal deficits or arthritis participated. Bilateral knee range of motion (RoM) was assessed with a goniometer, then gait patterns were analysed with a 3D motion-capture system. An arthrometer then quantified anterior-posterior laxity of each knee. Statistical analyses were performed in SPSS (α=0.05; required sample size: n=21 per group). Results. 25 knees were replaced in 21 patients. Nine presented with
Introduction. At Sheffield Children's Hospital, treatment of leg length discrepancy is a common procedure. Historically, this has been done with external fixators. With the development in intramedullary technology, internal nails have become the preferred modality for long bone lengthening in the adolescent population. However, it is important to review whether this technology practically reduces the known challenges seen and if it brings any new issues. Therefore, the aim of this review is to retrospectively evaluate the therapeutic challenges of 16 fit-bone intramedullary femoral lengthening's at Sheffield Children's Hospital between 2021–2022. Materials & Methods. The international classification of function (ICF) framework was used to differentiate outcomes. The patient's therapy notes were retrospectively reviewed for themes around structural, activity and participation limitation. The findings were grouped for analysis and the main themes presented. Results. There were 8 males, mean age 17.4 years (range 17–18) and 8 females, mean age 15.9 years (range 14–18). 5 right and 11 left femurs were lengthened. Underlying pathology varied amongst the 16 patients. All patients went into a hinged knee brace post operatively. Structural limitations included: pain,
Introduction. The objective of this study was to assess the effect of PCL resection on flexion-extension gaps, mediolateral soft tissue laxity,
We reviewed the results of anterior hip release for
Introduction. We propose that Total Hip Replacement with correction of
Total Knee Joint Replacement is mostly commonly performed using a measured resection technique. When the PCL is retained 9mm of bone is resected off the distal femur. If the PCL is excised 11m of bone is resected. Computer assisted total knee joint replacement will guide the surgeon to perform the optimal distal femoral resection to gain neutral alignment and full post operative extension. Three hundred TKJR’s were performed by one surgeon using the De Puy Ci navigation system. A ligament balancing technique is used whereby a neutral tibial resection is performed. A ligament tensor is inserted in extension and flexion. The navigation system then performs an optimization process whereby the distal femoral cut is calculated to give a neutral mechanical axis and 0° of knee extension. Data was collected measuring the distal femoral resection in the PCL retained and resected knees. The distal femoral cut required to achieve full extension for the PCL retaining TKJR ranged from 5 – 15mm. The mean was 11.2mm. The distal femoral cut required to achieve full extension for the PCL sacrificing TKJR ranged from 5 – 15mm. The mean was 10.8mm. There was no difference between the two groups (p=0.07). Both the PCL retaining and sacrificing TKJR distal resections correlated with the preoperative flexion deformity, i.e. patients with a greater
Purpose: Arthrogryposis is a disease of muscular system, which is characterized by fibrous degeneration of muscles that leads to deformed and rigid joints. Aim of this study is to describe the deformities of the lower limbs and their surgical treatment. Material – Methods: Twenty children (12 boys-8 girls) with distal arthrogyposis were treated in our department during the decade 1992–2002. The deformities of lower extremities were referred to hip, knee and foot. Congenital dislocation of hip joint was noticed in 4 patients that were treated by open reduction, while fixed flexion and adduction deformity was appeared in 8 patients that were treated by release of flexors and adductors muscles of hip. The main deformity in knee was
The hip joints are commonly affected in Juvenile Idiopathic Arthritis (JIA) in childhood. Common features are pain, subluxation, femoral anteversion, coxa valga, significant
Introduction. We have previously published limb lengthening using external fixation in pathological bone diseases. We would like to report a case series of femoral lengthening using the PRECICE system in a similar pathological group especially looking at it's feasibility and complications. Materials and Methods. This is a case series of four patients, two patients with osteogenesis imperfecta and two with Ollier's disease, who underwent femoral lengthening via distraction osteogenesis using the PRECICE intramedullary nail system. It was a retrospective study from a prospective database from clinical records and radiographs. Results. The mean age at the time of surgery was 15.5 years, the mean preoperative leg length discrepancy was 30mm, and the mean distraction distance achieved was 28.75mm. Since these patients were of shorter heigh, limb lengthening was considered. All 4 patients had successful insertion of the nail. The outcomes noted from the 4 patients are collated, with several complications occurring including delayed femoral union,
Introduction: Stiffness following total knee arthroplasty is a disabling problem resulting in pain and reduced function. Prevalence is not well defined and although various treatment modalities including manipulation, arthrolysis and revision surgery has been proposed with varying degrees of success for reduced flexion, these Methods: are deemed to be of limited value in
Flexion contractures are a common finding in an end-stage arthritic knee, occurring in up to 60% of patients undergoing total knee arthroplasty.
Flexion contractures are a common finding in an end-stage arthritic knee, occurring in up to 60% of patients undergoing total knee arthroplasty.
Aims. The objectives of this study were to assess the effect of anterior cruciate ligament (ACL) resection on flexion-extension gaps, mediolateral soft tissue laxity, maximum knee extension, and limb alignment during primary total knee arthroplasty (TKA). Methods. This prospective study included 140 patients with symptomatic knee osteoarthritis undergoing primary robotic-arm assisted TKA. All operative procedures were performed by a single surgeon using a standard medial parapatellar approach. Optical motion capture technology with fixed femoral and tibial registration pins was used to assess study outcomes pre- and post-ACL resection with knee extension and 90° knee flexion. This study included 76 males (54.3%) and 64 females (45.7%) with a mean age of 64.1 years (SD 6.8) at time of surgery. Mean preoperative hip-knee-ankle deformity was 6.1° varus (SD 4.6° varus). Results. ACL resection increased the mean extension gap significantly more than the flexion gap in the medial (mean 1.2 mm (SD 1.0) versus mean 0.2 mm (SD 0.7) respectively; p < 0.001) and lateral (mean 1.1 mm (SD 0.9) versus mean 0.2 mm (SD 0.6) respectively; p < 0.001) compartments. The mean gap differences following ACL resection did not create any significant mediolateral soft tissue laxity in extension (gap difference: mean 0.1 mm (SD 2.4); p = 0.89) or flexion (gap difference: mean 0.2 mm (SD 3.1); p = 0.40). ACL resection did not significantly affect maximum knee extension (change in maximum knee extension = mean 0.2° (SD 0.7°); p = 0.23) or
Objective: To emphasize the need to provide a controlled method of intra-operative reduction to correct
Between 1990 and 1996 we performed 20 consecutive ulnohumeral arthroplasties for primary osteoarthritis of the elbow. The outcome was assessed using the Disabilities of Arm, Shoulder and Hand Score (DASH) and the Mayo Elbow Performance Score (MEPS) at a mean follow-up of 75 months (58 to 132). There were excellent or good results in 17 elbows (85%) using the DASH score and in 13 (65%) with the MEPS (correlation coefficient 0.79). The mean