PATELLOFEMORAL UPDATE

http://www.healio.com/orthopedics

PATELLOFEMORAL UPDATE
	Vincente  Sanchis-Alfonso Anterior knee pain: Remember to look up and be aware of structural anomalies When an orthopedic surgeon sees a patient with anterior knee pain in the office, the surgeon normally only focuses on the knee. If we do this, we are making a big mistake. We must remember to “look up” and evaluate the pelvis and proximal femur as well as psychological factors that modulate the pain. Read more
	Jeffrey T. Sprang Focus on the tubercle transfer: Avoid complications, choose fixation Surgical treatment of patellar instability has many components and successful outcomes have been reported with many different techniques. Each of the surgical procedures relies on bony or soft tissue healing that must take place in order for the technique to be successful. One of the most commonly used surgical techniques is the tibial tubercle osteotomy. Read more
	Cory Edgar Radiographic parallax: Accuracy of lateral radiography determines femoral fixation site for MPFL graft placement Anatomic tunnel placement in medial patellofemoral ligament reconstruction, particularly on the femur, is critical to restoring graft isometry and function. Read more

Relationship between Tibial Bone Defect and Extent of Medial Release in Total Knee Arthroplasty

Indian-Orthopaedic Research-Group‎Indian Orthopaedic Research Group

3 horas · 

Article of the Day: Download full text

Relationship between Tibial Bone Defect and Extent of Medial Release in Total Knee Arthroplasty

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http://www.iorg.co.in/2014/01/5093/

Relationship between Tibial Bone Defect and Extent of Medial Release in Total Knee Arthroplasty...

Relationship between Tibial Bone Defect and Extent of Medial Release in Total Knee Arthroplasty Nam SW, Kwak JH, Kim NK,...

IORG.CO.IN

74y/o male pt presented post falling down with this fracture ...

74y/o male pt presented post falling down with this fracture ... pre and post ORIF shown ... Alahli hospital / Hebron / Palestine (5 fotos)

una publicación de Victor Ravens.

Jone’s Fracture and PseudoJones fracture

http://orthopaedicprinciples.com/2014/05/jones-fracture-and-pseudojones-fracture/?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+orthopaedicprinciples+%28Orthopaedicprinciples.com+%29

Jone’s Fracture and PseudoJones fracture

Posted: 24 May 2014 05:06 AM PDT

Courtesy: Prof Nabile Ebraheim, Chairman, Orthopaedic Surgery, University of Toledo, Ohio, USA

http://youtu.be/0C97dLrkQq8

Jones Fracture,proximal fifth metatarsal - Everything You Need To Know - Dr. Nabil Ebraheim

El doctor Pedro Guillén acerca "El quirófano global" al MIHealth FORUM

 clinicacemtro

Publicado el 22/5/2014

http://www.clinicacemtro.com/index.ph...

El doctor Pedro Guillén, jefe del Servicio de Medicina y Traumatología del Deporte, asistió ayer 21 de mayo a la tercera edición del MIHealth FORUM celebrado en la Fira de Barcelona. Un evento de referencial internacional que reúne a más de 70 expertos nacionales e internacionales del sector sanitario.
En este videoblog, el doctor Guillén nos explica en qué ha consistido su ponencia, englobada en la mesa redonda "Satisfacer las necesidades en la práctica clínica", moderada por John Bringham, Director de Calidad del MD Anderson de la Universidad de Texas.
El doctor Pedro Guillén se convirtió el pasado 21 de junio de 2013 en el primer cirujano en el mundo en retransmitir una cirugía utilizando la tecnología Google Glass.

• Categoría

  Ciencia y tecnología

• Licencia

  Licencia de YouTube estándar

  
  

  http://youtu.be/V1nj9dmqn5E 

  
  

Artroplastia de rodilla

http://blog.pessemdor.com.br/fisioterapia-2/protese-de-joelho/

Pés Sem Dor

13 horas · 

PRÓTESE DE JOELHO

A Artroplastia, popularmente conhecida como cirurgia de prótese de joelho, envolve a substituição de uma articulação danificada, desgastada ou doente por uma artificial (prótese). É uma operação de rotina para dores no joelho causadas por artrite.

Grande parte das pessoas que faz a prótese total de joelho têm mais de 65 anos. Para a maioria, a prótese de joelho dura de 15 a 20 anos, especialmente se o novo joelho for tratado com cuidado e não for submetido a muito esforço.

Conheça mais lendo artigo completo emhttp://blog.pessemdor.com.br/fisioterapia-2/protese-de-joelho/

PRÓTESIS de rodilla artroplastia, popularmente conocido como cirugía de prótesis de rodilla, implica el reemplazo de una articulación dañada, usado por o enferma por una artificial (prótesis). Es una operación de rutina para el dolor de rodilla causado por la artritis.

Mayoría de la gente haciendo prótesis total de rodilla tiene más de 65 años. Para la mayoría, la prótesis de rodilla dura de 15 a 20 años, especialmente si la nueva rodilla se trata con cuidado y no se somete a un gran esfuerzo.

Aprender más leer el artículo completo en http://blog.pessemdor.com.br/fisioterapia-2/protese-de-joelho/ (Traducido por Bing)

IM Nailing of Proximal Tibia fractures

 Courtesy: Prof Nabile Ebraheim, Chairman, Orthopaedic Surgery, University of Toledo, United States

 

Intramedullary Nailing Proximal Tibial Fractures - Everything You Need To Know - Dr. Nabil Ebraheim

http://youtu.be/V_AhdBvF8kE 

 

http://www.healio.com/orthopedics/hip/news/print/orthopedics-today/%7Bc36b5f59-88dc-464e-9e60-ed8be9416b4a%7D/study-collagenthrombin-hemostasis-gel-is-not-warranted-for-routine-tha-procedures

Study: Collagen/thrombin hemostasis gel is not warranted for routine THA procedures

NEW ORLEANS — Investigators of a level 1 study from the Cleveland Clinic discovered no statistical difference in transfusion events or units transfused between cementless total hip arthroplasty patients who underwent the use of a collagen thrombin, fibrinogen and autologous platelet gel for a hemostatic adjuvant compared to a control group using standard hemostatic methods.

“Vitagel, in a healthy patient, used in the setting of a routine cementless total hip, does not seem to make a significant clinical difference in terms of reducing first-time transfusion events,” David M. Joyce, MD, currently with the Orthopaedic Trauma Department of Vanderbilt University in Nashville, said during a presentation at the American Academy of Orthopaedic Surgeons Annual Meeting. “The hemoglobin level was significantly different; however, our transfusion rate was not significantly different between the two groups that were tested.”

The researchers from the Cleveland Clinic compared 60 patients who were given the hemostatic agent, Vitagel (Stryker; Kalamazoo, Mich.), with a control group of 49 patients who received standard hemostasis. All patients underwent cementless total hip arthroplasty between 2010 and 2012. The investigators excluded patients who had deep vein thrombosis (DVT), rheumatic conditions, coagulation abnormalities or low preoperative hemoglobin levels (<8.5 gm/dL). The patients and investigators were blinded to the patients’ allocation to treatment.

The Vitagel was made of microfibular collagen thrombin mixed with the patient’s platelets. “The mechanism forms a hemostatic scaffold and is used as a topical hemostatic agent,” Joyce said. “It is not meant to stop major bleeding vessels, but instead stop some of the small capillaries and raw bleeding surfaces and perioperative oozing that continues after surgery.”

More patients underwent transfusion in the control group (14.3%) compared to the Vitagel group (8.3%), but this difference was not statistically significant. The average amount of transfused units of blood was not significantly different with an average of 2.2 units in the Vitagel group compared to 1.6 units in the control group. Hemoglobin levels were not significantly different at 0 days immediately postoperatively, however at postoperative day 1, day 2 and day 3, hemoglobin levels were statistically significantly higher in the Vitagel group compared to the control group (10 vs. 9.2; 9.6 vs. 9.1; 9.5 vs. 8.7, respectively). There was no difference in SF-12 quality of life and Hip Disability and Osteoarthritis Outcome scores.

“We do not feel this product is clinically warranted for use in all total hips and further study would be needed to justify its use in patients with a higher risk of bleeding such as in revisions,” he said. – by Renee Blisard Buddle

Reference:

Joyce D. Paper #3. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 11-15, 2014; New Orleans.

For more information:

David M. Joyce, MD, can be reached at 3601 The Vanderbilt Clinic, Nashville, TN 37232; email: david.m.joyce@vanderbilt.edu.
Disclosure: Joyce has no relevant financial disclosures.

Arthroscopic Lysis of Adhesions for the Stiff Total Knee: Results After Failed Manipulation

http://www.healio.com/orthopedics/journals/ortho/%7B35f35fcc-b8f1-458c-a78f-97c78f4b2958%7D/arthroscopic-lysis-of-adhesions-for-the-stiff-total-knee-results-after-failed-manipulation

Arthroscopic Lysis of Adhesions for the Stiff Total Knee: Results After Failed Manipulation

Fotios Paul Tjoumakaris, MD; Bradfords Chofield Tucker, MD; Zachary Post, MD; Matthew David Pepe, MD; Fabioo Rozco, MD; Alvin C. Ong, MD

• Orthopedics
• May 2014 - Volume 37 · Issue 5: e482-e487
• DOI: 10.3928/01477447-20140430-60

Abstract

Artrofibrosis después de la artroplastia total de rodilla ( PTR ) es una complicación potencialmente devastadora , lo que resulta en la pérdida de movimiento y la función y el dolor residual. Para los pacientes en los que la terapia física agresiva y la manipulación bajo anestesia fallan, la lisis de adherencias puede ser la única opción para rescatar a la rígida TKA . El propósito de este estudio es dar a conocer los resultados de la lisis de adherencias artroscópica manipulación tras el fracaso de un cadáver , cruzado por sustitución de TKA . Este estudio retrospectivo evaluó a pacientes que habían sido sometidos artroscópico mediante lisis de las adherencias de artrofibrosis después de TKA entre 2007 y 2011. El seguimiento mínimo fue de 12 meses (media, 31 meses ) . Rango total de movimiento promedio de los pacientes en esta serie fue de 62,3 ° . Promedio contractura en flexión preoperatoria fue de 16 ° y flexión media fue de 78,6 ° . Análisis estadístico se realizó mediante el test t de Student. Pre- al aumento postoperatorio en la amplitud de movimiento fue significativa ( P < 0,001 ) ( promedio, 62 ° en el preoperatorio a 98 ° después de la operación ) . Promedio déficit de extensión preoperatorio fue de 16 ° , que se redujo a 4 ° al final del seguimiento . Este valor también se encontró que era estadísticamente significativa (P < 0,0001 ) . Con respecto a la flexión máxima alcanzada , la flexión media preoperatoria fue de 79 ° , que se mejoró a 103 ° en el seguimiento final . Esta mejora en la flexión fue estadísticamente significativa (P < 0,0001 ) . Los pacientes pueden esperar de manera fiable una mejoría después de la lisis de adherencias artroscópica para un fiambre TKA utilizando un abordaje artroscópico estandarizada ; Sin embargo , los pacientes alcanzaron aproximadamente la mitad de la mejora que se obtuvo en el momento de la cirugía .

Arthrofibrosis after total knee arthroplasty (TKA) is a potentially devastating complication, resulting in loss of motion and function and residual pain. For patients in whom aggressive physical therapy and manipulation under anesthesia fail, lysis of adhesions may be the only option to rescue the stiff TKA. The purpose of this study is to report the results of arthroscopic lysis of adhesions after failed manipulation for a stiff, cruciate-substituting TKA. This retrospective study evaluated patients who had undergone arthroscopic lysis of adhesions for arthrofibrosis after TKA between 2007 and 2011. Minimum follow-up was 12 months (average, 31 months). Average total range of motion of patients in this series was 62.3°. Average preoperative flexion contracture was 16° and average flexion was 78.6°. Statistical analysis was performed using Student’s t test. Pre- to postoperative increase in range of motion was significant (P<.001) (average, 62° preoperatively to 98° postoperatively). Average preoperative extension deficit was 16°, which was reduced to 4° at final follow-up. This value was also found to be statistically significant (P<.0001). With regard to ultimate flexion attained, average preoperative flexion was 79°, which was improved to 103° at final follow-up. This improvement in flexion was statistically significant (P<.0001). Patients can reliably expect an improvement after arthroscopic lysis of adhesions for a stiff TKA using a standardized arthroscopic approach; however, patients achieved approximately half of the improvement that was obtained at the time of surgery.

The authors are from Jefferson Medical College, Rothman Institute, Egg Harbor Township, New Jersey.

Drs Tjoumakaris, Post, and Pepe have no relevant financial relationships to disclose. Dr Tucker is a consultant for DePuy Mitek and Knee Creations; is a speaker for DePuy Mitek; and holds stock in Johnson & Johnson. Dr Orozco is a consultant for Stryker. Dr Ong is a consultant for Stryker and Smith & Nephew.

The authors thank Victoria Younger for her contributions to this work in data collection and analysis.

Correspondence should be addressed to: Fotios Paul Tjoumakaris, MD, Jefferson Medical College, Rothman Institute, 2500 English Creek Ave, Bldg 1300, Egg Harbor Township, NJ 08234 ( fotios.tjoumakaris@rothmaninstitute.com).

Received: June 09, 2013

Accepted: November 25, 2013

ACL tear: What to do between diagnosis and surgery / Ruptura del LCA: ¿Qué hacer entre el diagnóstico y la cirugía

Artículo completo en :
http://chrisbutlersportspt.com/2014/04/07/acl-tear-what-to-do-between-diagnosis-and-surgery/

ACL tear: What to do between diagnosis and surgery

Tearing your ACL is usually a traumatic event, most of my ACL patients report knowing they did something serious to their knee.  This will usually land you in the office of an orthopedic specialist within a week of the incident.  Once there is confirmation and diagnosis of an ACL tear it can often take up to 2 months to schedule a surgical date, it may be due to personal schedules, surgeon schedule, choosing a surgeon, or researching graft choices.  This time can be used for pre-op therapy.  As long as you have clearance from your surgeon, here are some ideas to work on during your pre-op time....

Ruptura del LCA: ¿Qué hacer entre el diagnóstico 

y la cirugía

Desgarrarse de ACL es generalmente un evento traumático, la mayoría de mis pacientes de ACL reportan saber que hicieron algo grave para su rodilla. Esto por lo general le aterrizar en el cargo de un especialista en ortopedia dentro de una semana del incidente. Una vez que haya una confirmación y el diagnóstico de una ruptura del LCA a menudo puede tomar hasta 2 meses para programar una fecha de la cirugía, puede ser debido a los horarios personales, horario de cirujano, la elección de un cirujano, o la investigación de opciones de injerto. Este tiempo puede ser utilizado para la terapia pre-operatoria. Como siempre y cuando tenga la autorización de su cirujano, he aquí algunas ideas para trabajar durante su tiempo de pre-op ....

Anterior knee pain: Remember to look up and be aware of structural anomalies

http://www.healio.com/orthopedics/blogs/patellofemoral-update/anterior-knee-pain-remember-to-look-up-and-be-aware-of-structural-anomalies

• 
• Patellofemoral Update focuses on the causes, prevention and treatment of patellofemoral disorders. The blog is sponsored by The Patellofemoral Foundation whose mission is to improve the care of individuals with anterior knee pain through targeted education and research. The Patellofemoral Foundation offers additional online education resources on its website.

Thursday, May 8, 2014

Anterior knee pain: Remember to look up and be aware of structural anomalies

Patellofemoral Update

Unfortunately, when an orthopedic surgeon sees a patient with anterior knee pain in the office, he or she normally only focuses on the knee. If we do this we are making a big mistake.

We must remember to “look up” and evaluate the pelvis and proximal femur as well as psychological factors that modulate the pain to fully understand what is happening and to be able to solve this challenging problem. Moreover, we must be aware of structural anomalies (i.e., chondropathy and patellofemoral (PF) malalignment – patellar tilt and lateral patellar subluxation) given the correlation between structural anomalies and anterior knee pain is low.

Virtual Learning Center: Revision TKA

http://www.healio.com/orthopedics/education-lab/2012/06_june/depuy-master-sessions/activity-cover

Virtual Learning Center: Revision TKA

Sponsored as an educational service by Depuy Synthes Joint Reconstruction

• 

• Virtual Learning Center: Revision TKA

• Surgical techniques, tools, and implants for total knee arthroplasty have drastically changed in recent years. This Virtual Learning Center is a central portal for the latest information on revision TKA. READ MORE »
  Additional Resources

Radiofrecuencia pulsada en la terapia del síndrome de dolor regional complejo

Radiofrecuencia pulsada en la terapia del síndrome de dolor regional complejo

Pulsed Radiofrequency in the Therapy of Complex Regional Pain Syndrome (CRPS) Norina Bergamin, Armin Aeschbach and Haiko Sprott (2014)  JMED Research, Vol. 2014 (2014), Article ID 688314,  DOI: 10.5171/2014.688314 Abstract The application of pulsed radiofrequency to the lumbar sympathetic chain to relief sympatheti-cally maintained pain in the complex therapy of chronic regional pain syndrome (CRPS) is a promising treatment option. Although it is frequently used in clinical practice, there is almost no evidence available.The treatment of 15 patients with lower limb CRPS was prospectively evaluated in a routine clinical setting. Follow-ups were recorded at 6 weeks and 6 months after the intervention. Those patients with a clinically diagnosed CRPS, who experiencing pain relief to sympathetic blocks with local anaesthetics, received percutaneous lumbar sympathicolysis with pulsed radiofrequency. Various pain scores, quality of life, impairment of daily activities and satisfaction were assessed with Numeric Rating Scales. A significant pain relief of 15% at 6 weeks and 13% at 6 months and an improvement in some of the disability scores were achieved. The patients were very satisfied with the procedure at the 6 weeks (7.5 (2.2) p<0.001) and the 6 months follow-up (7.8 (3.2) p<0.001). The improvement in the quality of life was distinct but just missed the significance level. Pulsed radiofrequency applied to the lumbar sympathetic chain in patients with lower limb CRPS and sympathetically maintained pain offers a significant pain relief and an improvement in disability for at least 6 weeks.  Keywords: Pulsed radiofrequency, CRPS, lumbar sympathicolysis.   http://www.ibimapublishing.com/journals/JMED/2014/688314/688314.pdf     Atentamente Anestesiología y Medicina del Dolor www.anestesia-dolor.org