Clinical orthopaedics and related research
-
Clin. Orthop. Relat. Res. · Sep 2014
Is peroneal nerve injury associated with worse function after knee dislocation?
Peroneal nerve palsy is a frequent and potentially disabling complication of multiligament knee dislocation, but little information exists on the degree to which patients recover motor or sensory function after this injury, and whether having this nerve injury--with or without complete recovery--is a predictor of inferior patient-reported outcome scores. ⋯ Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
-
Clin. Orthop. Relat. Res. · Sep 2014
Comparative StudyHow does a novel monoplanar pedicle screw perform biomechanically relative to monoaxial and polyaxial designs?
Minimally invasive spinal fusions frequently require placement of pedicle screws through small incisions with limited visualization. Polyaxial pedicle screws are favored due to the difficulty of rod insertion with fixed monoaxial screws. Recently, a novel monoplanar screw became available that is mobile in the coronal plane to ease rod insertion but fixed in the sagittal plane to eliminate head slippage during flexion loads; however, the strength of this screw has not been established relative to other available screw designs. ⋯ Polyaxial screw heads slip on the screw shank at lower values than monoaxial or monoplanar screws, and this results in angular change between the rod and pedicle screw, which could cause loss of segmental lordosis. The novel monoplanar screw used in this study may combine ease of rod placement with sagittal plane strength.
-
Clin. Orthop. Relat. Res. · Sep 2014
Posterior tibial tendon transfer improves function for foot drop after knee dislocation.
Knee dislocation may be associated with an injury to the common peroneal nerve with a subsequent foot drop. Previous studies have demonstrated good functional results after posterior tibial tendon transfer in patients with foot drop. No studies, to our knowledge, have focused exclusively on knee dislocation as the cause of common peroneal nerve injury leading to foot drop. ⋯ Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.
-
Clin. Orthop. Relat. Res. · Sep 2014
Comparative StudyNo difference in postoperative pain after arthroscopic versus open rotator cuff repair.
Rotator cuff repair is a successful treatment in terms of patient satisfaction and pain relief regardless of the repair method. Although arthroscopic repair is commonly thought to be less painful than open or miniopen repair, studies disagree on this point. ⋯ Level II, therapeutic study. See the Instructions or Authors for a complete description of levels of evidence.
-
Clin. Orthop. Relat. Res. · Sep 2014
Comparative StudyMedial injury in knee dislocations: what are the common injury patterns and surgical outcomes?
When associated with a knee dislocation, management of the medial ligamentous injury is challenging, with little literature available to guide treatment. ⋯ Medial ligament injury is common in knee dislocations. Females who sustain these injuries and patients who have an ultra-low-velocity mechanism should be counseled at the time of injury about the likelihood of inferior outcomes. As ROM deficits are the most commonly encountered complication, postoperative rehabilitation should focus on early ROM exercises as stability and wound healing allow. Future prospective studies are needed to definitively determine whether operative or nonoperative management is appropriate for particular medial ligamentous injury patterns.