84 research outputs found
Restoring tibiofemoral alignment during ACL reconstruction results in better knee biomechanics
"Published online: 24 October 2017"PURPOSE:
Anterior cruciate ligament (ACL) reconstruction (ACLR) aims to restore normal knee joint function, stability and biomechanics and in the long term avoid joint degeneration. The purpose of this study is to present the anatomic single bundle (SB) ACLR that emphasizes intraoperative correction of tibiofemoral subluxation that occurs after ACL injury. It was hypothesized that this technique leads to optimal outcomes and better restoration of pathological tibiofemoral joint movement that results from ACL deficiency (ACLD).
METHODS:
Thirteen men with unilateral ACLD were prospectively evaluated before and at a mean follow-up of 14.9 (SD = 1.8) months after anatomic SB ACLR with bone patellar tendon bone autograft. The anatomic ACLR replicated the native ACL attachment site anatomy and graft orientation. Emphasis was placed on intraoperative correction of tibiofemoral subluxation by reducing anterior tibial translation (ATT) and internal tibial rotation. Function was measured with IKDC, Lysholm and the Tegner activity scale, ATT was measured with the KT-1000 arthrometer and tibial rotation (TR) kinematics were measured with 3Dmotion analysis during a high-demand pivoting task.
RESULTS:
The results showed significantly higher TR of the ACL-deficient knee when compared to the intact knee prior to surgery (12.2° ± 3.7° and 10.7° ± 2.6° respectively, P = 0.014). Postoperatively, the ACLR knee showed significantly lower TR as compared to the ACL-deficient knee (9.6°±3.1°, P = 0.001) but no difference as compared to the control knee (n.s.). All functional scores were significantly improved and ATT was restored within normal values (P < 0.001).
CONCLUSIONS:
Intraoperative correction of tibiofemoral subluxation that results after ACL injury is an important step during anatomic SB ACLR. The intraoperative correction of tibiofemoral subluxation along with the replication of native ACL anatomy results in restoration of rotational kinematics of ACLD patients to normal levels that are comparable to the control knee. These results indicate that the reestablishment of tibiofemoral alignment during ACLR may be an important step that facilitates normal knee kinematics postoperatively.
LEVEL OF EVIDENCE:
Level II, prospective cohort study.The authors gratefully acknowledge the funding support from the Hellenic Association of Orthopaedic Surgery and
Traumatology (HAOST-EEXOT)info:eu-repo/semantics/publishedVersio
Incidental aneurysms of aorta and basilar artery in patients with coronary artery ectasia. A magnetic resonance angiography study
Objective - Incidental intracranial aneurysms have been revealed in
0.5-1% of adult patients undergoing cerebral angiography, while only
8% of those aneurysms are located in the basilar artery. Those
aneurysms running usually symptomless, may lead to life-threatening
situations due to rupture. Intracranial aneurysms could co-exist with
abdominal aneurysms. Another dilating arterial lesion, coronary artery
ectasia was linked in previous studies with aneurysms of the abdominal
aorta. The aim of the present study is to investigate the coexistence of
coronary artery ectasia with other aneurysms since dilating arterial
lesions seem to share a similar pathogenesis, a thin or absent media of
the arterial wall.
Methods and results - Ten consecutive patients with coronary artery
ectasia after coronary angiography underwent magnetic angiography (MRA)
of the brain, thoracic and abdominal aorta. Three incidental aneurysms
were revealed: one intracranial aneurysm located in the basilar artery,
one extended thoracic/abdominal aneurysm and one abdominal aneurysm.
Embolism was used for the management of the basilar artery aneurysm
while the extended aneurysm of the descending thoracic and abdominal
aorta was surgically repaired in part.
Conclusions - Whether our results are just a coincidence or they
announce a common pathogenesis is a subject of further screening studies
of the population. Nevertheless, a high index of suspicion is expected
for patients with coronary ectasia about the presence of other vascular
defects at different locations, especially when non-typical symptoms are
mentioned
Bilateral adrenal hyperplasia complicated with severe ischemic stroke in a young patient
A young patient suffered from acute right hemiparesis, facial weakness and Broca's aphasia with multiple brain lesions due to severe hypertension. His evaluation for secondary causes of hypertension revealed hyperaldosteronism due to bilateral adrenal hyperplasia. Treatment is based primarily on spironolactone and ACE inhibitors. Two years later he was in an outstanding clinical condition with few remained neurological symptoms and his blood pressure well controlled. © 2008 Published by Elsevier Ireland Ltd
NOSOCOMIAL VS COMMUNITY-ACQUIRED ENTEROCOCCAL ENDOCARDITIS IN GREECE: CURRENT EPIDEMIOLOGICAL TRENDS
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