Abstract. Introduction. A spotlight has been placed upon virtual assessment of patients during the coronavirus pandemic. This has been particularly prevalent in the assessment of acute
Most previous studies investigating autograft options (quadriceps, hamstring, bone-patella-tendon-bone) in primary anterior cruciate ligament (ACL) reconstruction are confounded by concomitant
Introduction:. Measurement of ankle brachial pressure index is an easy screening test to perform in patients presenting with an acute
Introduction.
Abstract. Background. Multi-ligament
Traditionally, sports Injuries have been sub-optimally managed through Emergency Departments (ED) in the public health system due to a lack of adequate referral processes. Fractures are ruled out through plain radiographs followed by a reactive process involving patient initiated further follow up and investigation. Consequently, significant soft tissue and chondral injuries can go undiagnosed during periods in which early intervention can significantly affect natural progression. The purpose of this quality improvement project was to assess the efficacy of an innovative Sports Injury Pathway introduced to detect and treat significant soft tissue injuries. A Sports Injury Pathway was introduced at Fiona Stanley Hospital (WA, Australia) in April 2019 as a collaboration between the ED, Physiotherapy and Orthopaedic Departments. ED practitioners were advised to have a low threshold for referral, especially in the presence of a history of a twisting
Knee dislocations are a rare but serious cause of trauma. The aim of this study was to establish current demographics and injury patterns/associations in multi-ligament (MLI)
Introduction. Knee dislocations, vascular injuries and floating
Introduction. Individuals with significant hip and
Meniscal tears are the most common
Meniscal tears are the most common
Reconstruction of the anterior cruciate ligament (ACL) allows to restore stability of the knee, in order to facilitate the return to activity (RTA). Although it is understood that the tendon autograft undergoes a ligamentous transformation postoperatively, knowledge about longitudinal microstructural differences in tissue integrity between types of tendon autografts (ie, hamstring vs. patella) remains limited. Diffusion tensor imaging (DTI) has emerged as an objective biomarker to characterize the ligamentization process of the tendon autograft following surgical reconstruction. One major limitation to its use is the need for a pre-injury baseline MRI to compare recovery of the graft, and inform RTA. Here, we explore the relationship for DTI biomarkers (fractional anisotropy, FA) between knees bilaterally, in healthy participants, with the hypothesis that agreement within a patient's knees may support the use of the contralateral knee as a reference to monitor recovery of the tendon autograft, and inform RTA. Fifteen participants with no previous history of
Ligament reconstruction following multi-ligamentous
Abstract. Background. Fracture dislocation of the knee involves disruption of two or more knee ligaments with associated tibial plateau fracture. If these injuries are not evaluated swiftly, can result in a limb-threatening injury. The aim of this study is to look at the clinical outcomes of a single surgeon case series at a major trauma centre. Methods. Prospectively collected data was analysed for a 5-year period. Primary outcome measures used were International Knee Documented Committee(IKDC) score and
A quick, portable and reliable tool for predicting ACL injury could be an invaluable instrument for athletes, coaches, and clinicians. The gold standard, Vicon motion analysis, despite having a high sensitivity and risk specificity, is not practical for coaches or clinicians to use on a routine basis for assessing athletes. The present study validated the Kinect device to the currently used method of chart review in predicting athletes at high risk. A total of 114 participants were recruited from both the men and women McGill Varsity Sports Program. 69 males and 45 female athletes were evaluated to assess the specificity and sensitivity of the Kinect device in predicting athletes at high risk of injury. Each athlete performed three-drop vertical jumps off of a 31cm box and the data was recorded and risk score was generated. Generation of this data is done by our uniquely programmed software that measures landing angles at different time frames and compares live results to previously known data of injured athletes. A chart review was then performed by a clinician, blinded to these risk scores, to risk stratify the same athletes as high or low risk of ACL injury based on their medical charts. Data reviewed incorporated pre-season physical exams along with documented known risk factors for ACL injury, including previous
Introduction. Patella tendonitis is common amongst sportsmen. No published evidence of this injury in elite professional footballers exists. The aim of this study was to determine the frequency of this injury in the elite professional footballer, along with the impact of such an injury on the amount of time missed and the outcomes of various treatment options. Methods. Data was collected prospectively for injuries suffered by first team players, development squad players and academy squad players over the 2009–10 and 2010–11 English Premier League (EPL) season at one EPL club. Each player's demographics were recorded. The injury was recorded along with the time that the player was absent because of the injury, the treatment that the player received and whether they suffered any recurrence of the injury. Results. 35
Anterior Cruciate Ligament injuries are a common cause of downgrade in Service personnel. The Multidisciplinary Injury Assessment Clinic (MIAC) is a service which patients can be referred to for expert musculoskeletal injury management. MIAC has a Fast Track (FT) referral system in place for imaging, and can subsequently refer isolated ACL injuries to a private provider for reconstruction. We examined this pathway in the South West region which has an overall population at risk of 19775. Over 4 years 173
Background. Kinesiophobia is simply defined as a fear of movement and physical activity. It can be seen in patients as a result of any injury, which results in pain or a fear of injury recurrence. It leads to decreased motion and disuse that may result in a chronic pain syndrome and decreased physical function. High levels of fear-avoidance have been found in subjects with total knee arthroplasty (TKA) and
Introduction. Knee ligament laxity and soft tissue balance are important pre- and intra- operative balancing factors in total knee arthroplasty (TKA). Laxity can be measured pre-operatively from short-leg radiographs using a stress device to apply a reproducible force to the knee, whereas intra-operative laxity is routinely measured using a navigation system in which a variable surgeon-applied force is applied. The relationship between these two methods and TKA outcome however, has not been investigated. This study aims to determine how intra-operative assessments of laxity relate to functional radiographic assessments performed on pre-operatively. We also investigate how laxity relates to short-term patient-reported outcomes. Method. A prospective consecutive study of 60 knees was performed. Eight weeks prior to surgery, patients had a CT scan and functional radiographs captured using a Telos stress device (Metax, Germany). This device applies a force to the knee joint while bracing the hip and ankle causing either a varus or valgus response. 3D bone models were segmented from the CT scan and landmarked to generate patient specific axes and alignments. Individual bone models were registered to the 2D stressed X-rays in flexion and extension. Reference axes identified on the registered 3D bone models were used to measure the coronal plane laxity. These laxity ranges were compared with those measured by a navigation system (OMNINAV, OMNI Life Science, MA) used during surgery, and
Recurrent patellar instability is common in young and active patients. Medial patellofemoral ligament (MPFL) reconstruction with a single bundle hamstring graft is one method of surgical treatment for this problem. This is a retrospective case series of patients who underwent MPFL reconstruction by a single specialist knee surgeon between January 2009 and July 2014. Data was collected prospectively for the purpose of service evaluation. Recorded data included gender, age, length of rehabilitation, complications,