This is a prospective analysis on 30 physically
active individuals with a mean age of 48.9 years (35 to 64) with chronic
insertional tendinopathy of the tendo Achillis. Using a transverse
incision, the tendon was debrided and an osteotomy of the posterosuperior
corner of the calcaneus was performed in all patients. At a minimum
post-operative follow-up of three years, the Victorian Institute
of Sports Assessment scale – Achilles tendon scores were significantly
improved compared to the baseline status. In two patients a superficial
infection of the wound developed which resolved on antibiotics.
There were no other wound complications, no nerve related complications,
and no secondary avulsions of the tendo Achillis. In all, 26 patients
had returned to their pre-injury level of activity and the remaining
four modified their sporting activity. At the last appointment,
the mean pain threshold and the mean post-operative tenderness were
also significantly improved from the baseline (p <
0.001). In patients
with
Aims. Mechanical stimulation is a key factor in the development and healing of tendon-bone
Aims. Periprosthetic fracture and implant loosening are two of the major reasons for revision surgery of cementless implants. Optimal implant fixation with minimal bone damage is challenging in this procedure. This pilot study investigates whether vibratory implant
Introduction. The treatment of posterior malleolar fractures is developing. Mason and Molloy (Foot Ankle Int. 2017 Nov;38(11):1229-1235) identified only 49% of posterior malleolar rotational pilon type fractures had syndesmotic instabilities. This was against general thinking that fixation of such a fragment would stabilize the syndesmosis. Methods. We examined 10 cadaveric lower limbs that had been preserved for dissection at the Human Anatomy and Resource Centre at Liverpool University in a solution of formaldehyde. The lower limbs were carefully dissected to identify the ligamentous structures on the posterior aspect of the ankle. To compare the size to the rotational pilon posterior malleolar fracture (Mason and Molloy 2A and B) we gathered information from our posterior malleolar fracture database. 3D CT imaging was analysed using our department PACS system. Results. The PITFL
INTRODUCTION. The correct placement of pedicle screws is a major part of spine fusion and it requires experienced trained spinal surgeons. In the era of European Working Time Directive (EWTD), surgical trainees have less opportunity to acquire skills. Josh Kauffman (Author of The First 20 Hours) examined the K. Anders-Ericsson study that 10,000 hours is required to be an expert. He suggests you can be good at anything in 20 hours following 5 methods. This study was done to show the use of accelerated learning in trainees to achieve competency and confidence on the
Nearly a quarter of screws cause damage during
Aims. Anatomical atlases document classical safe corridors for the
placement of transosseous fine wires through the calcaneum during
circular frame external fixation. During this process, the posterior
tibial neurovascular bundle (PTNVB) is placed at risk, though this
has not been previously quantified. We describe a cadaveric study
to investigate a safe technique for posterolateral to anteromedial
fine wire
Purpose:. To determine the
Purpose. Current methods for inserting a press fit hemispherical metal-backed acetabular component within the acetabula are uncontrolled, relying on the surgeon to generate the necessary forces required for sufficient introduction. While previous studies have recorded impact forces of 2–3 kN necessary to seat an acetabular cup using visual observation[1], some researchers have observed users imparting as high as 8.9 kN of force[2]. The aim of this study is to quantify the forces required to generate optimal implant primary stability, as well as compare force delivery methods. Method. The experiments were carried out using prepared bone substitute. A high frequency force sensor was rigidly mounted under the substitute to measure impact force and duration. An acetabular cup was inserted using successive reproducible impacts of varying magnitude (2.5 kg falling 17, 34, 43, 51, 68, or 85 mm). Impacts were repeated until the cup was no longer advancing. Each test recorded the number of impacts, maximum impact force, impact duration, and extraction force of the cup after
The exact action of the Peroneus Longus muscle on the foot is not fully understood. It is involved in a number of pathological processes like tendonitis, tenosynovitis, chronic rupture and neurological conditions. It is described as having a consistent
A large number of total hip arthroplasties (THA) are performed each year, of which 60 % use cementless femoral fixation. This means that the implant is press-fitted in the bone by hammer blows. The initial fixation is one of the most important factors for a long lasting fixation [Gheduzzi 2007]. It is not easy to obtain the point of optimal initial fixation, because excessively press-fitting the implant by the hammer blows can cause peak stresses resulting in femoral fracture. In order to reduce these peak stresses during reaming, IMT Integral Medizintechnik (Luzern, Switzerland) designed the Woodpecker, a pneumatic reaming device using a vibrating tool. This study explores the feasibility of using this Woodpecker for implant
Good lag screw holding power in trabecular bone of the femoral head is a requisite to achieve stability in the management of proximal femoral fractures. It has been demonstrated that
Introduction. The exact action of the Peroneus Longus muscle on the foot is not fully understood. It is involved in a number of pathological processes like tendonitis, tenosynovitis, chronic rupture and neurological conditions. It is described as having a consistent
Background:. During the past two decades the medial Patellofemoral ligament has come to the fore as the essential lesion of acute patella dislocation and its reconstruction in cases of chronic instability seems logical. The femoral
Summary Statement. Tendon-bone interface becomes matured with the perforating fiber and the cells striding over the bone area. We suggest that both “perforating fiber” and “cell stride” could play a crucial role in regeneration after rotator cuff repair. Introduction. To obtain a successful outcome after rotator cuff repair, repaired tendon requires to be anchored biologically to the bone. However, it is well known that the histological structure of the repaired tendon-bone
Introduction. Aseptic acetabular component failure rates have been reported to be similar or even slightly higher than femoral component failure. Obtaining proper initial stability by press fitting the cementless acetabular cup into an undersized cavity is crucial to allow for secondary osseous integration. However, finding the
The current decade has seen a marked rise in popularity of minimally invasive hip replacement, done through a variety of surgical approaches. A specific downside to the direct anterior approach includes the significant difficulty getting a “straight shot” down the femoral canal for either straight, nonflexible reaming or broaching as with standard approaches. Improper alignment in the femoral canal can lead to sub-optimal load transfer and thus compromised fixation. The femoral broach and stem
Study design. Literature review of the best available evidence on the accuracy of computer assisted pedicle screw
We have quantitatively documented the
Purpose: To evaluate the