The Knee
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Quadriceps and hamstrings weakness and co-activation are present following total knee arthroplasty (TKA) and may impair functional performance. How surgery and post-operative rehabilitation influence muscle activation during walking early after surgery is unclear. ⋯ Muscle strength, co-activation, and timing differed between patients and controls before and early after surgery. Rehabilitation to improve strength and muscle activation seems imperative to restore proper muscle firing patterns early after surgery.
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Autologous flexor tendons are widely used for anterior cruciate ligament (ACL) reconstruction. Pretension of the graft before fixation has been described as part of the surgical technique, nevertheless there is no consensus on the type and amount to tension needed to increase the stiffness without affecting its biomechanical properties.Our hypothesis is cyclic tension increases flexor tendon stiffness without affecting its ultimate failure at maximum loads (UFML). ⋯ Cyclic loads at 70N result in an increased stiffness of flexor tendons without affecting its ultimate failure at maximum loads. Cyclic loads at higher tensions might cause a deleterious effect on the biomechanical properties of flexor tendon grafts.
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Medial collateral ligament tibial avulsion is rare. Consequently, diagnostic criteria and a treatment regimen for medial collateral ligament tibial side avulsions remain to be established. The purpose of this study is to clarify the clinical features of medial collateral ligament tibial side avulsions. ⋯ Case series, Level IV.
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A recent proposed modification in surgical technique in total knee arthroplasty (TKA) has been the introduction of the "kinematically aligned" TKA, in which the angle and level of the posterior joint line of the femoral component and joint line of the tibial component are aligned to those of the "normal," pre-arthritic knee. The purpose of this study was to establish the relationship of the posterior femoral axis of the "kinematically aligned" total knee arthroplasty (TKA) to the traditional axes used to set femoral component rotation. ⋯ Using a kinematically aligned surgical technique internally rotates the posterior femoral axis relative to the transepicondylar axis, which significantly differs from current alignment instrument targets.