Articles: joint-instability-etiology.
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Multiple myeloma (MM) and solitary plasmacytoma of bone (SPB) are two independent subtypes of plasma cell dyscrasias which often occur in spine. However, little is known about the surgical treatment of patients with spinal instability or neurological impairment caused by spinal lesions as the first clinical manifestation. The present study aimed to investigate the surgical outcome of these patients. ⋯ Surgery may be beneficial to patients with spinal instability or neurological impairment caused by spinal lesions as the first clinical manifestation, in which MM patients with postoperative ambulatory ability display better prognosis.
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Review Meta Analysis
Risk factors which predispose first-time traumatic anterior shoulder dislocations to recurrent instability in adults: a systematic review and meta-analysis.
Recurrent instability following a first-time anterior traumatic shoulder dislocation may exceed 26%. We systematically reviewed risk factors which predispose this population to events of recurrence. ⋯ Sex, age at initial dislocation, time from initial dislocation, hyperlaxity and greater tuberosity fractures were key risk factors in at least two good quality cohort studies resulting in strong evidence as concluded in the GRADE criteria. Although bony Bankart lesions, Hill Sachs lesions, occupation, physiotherapy treatment and nerve palsy were risk factors for recurrent instability, the evidence was weak using the GRADE criteria-these findings relied on poorer quality studies or were inconsistent among studies.
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Multiligament knee injuries (MLKIs) can also involve the medial patellofemoral ligament (MPFL), but there is a paucity of information regarding prevalence and relevance of MPFL involvement in this setting. ⋯ MPFL tears occur frequently in patients with MLKI but rarely cause instability. In the majority of cases, MPFL tears do not need to be addressed at the time of surgery.
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The purpose of this study is to explore the diagnostic accuracy of CT measurements in predicting syndesmosis instability of injured ankle, with correlation to operative findings. ⋯ Axial CT measurements of tibiofibular distance were useful predictors for syndesmosis instability in fractured ankles. The aTFD and maxTFD are the most powerful parameters to predict positive operative instability.
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Bone loss in anterior glenohumeral instability occurs on both the glenoid and the humerus; however, existing biomechanical studies have evaluated glenoid and humeral head defects in isolation. Thus, little is known about the combined effect of these bony lesions in a clinically relevant model on glenohumeral stability. ⋯ Bipolar bony lesions of the glenoid and humeral head occur frequently together in clinical practice. Surgeons should be aware that the combined defects and glenoid bone loss of 2 to 4 mm or approximately 8% to 15% of the glenoid could compromise Bankart repair and thus may require surgical strategies in addition to traditional Bankart repair alone to optimize stability.