Essay On Flexion Contracture

Mean follow-up was 117 months. 86% are male. Average age of 26 years at surgery. 35 patients had partial meniscectomy (53% internal, 31% external, 16% bimeniscal). A significant improvement (p<0.001) between pre and postoperative parameters was demonstrated (pre-operative mean IKDC score 47 points; post-operative 94 points). 92% perform moderate demand activities, of which 40% returned to pre-injury activity levels without complaints. An increase in the time between rupture of the ACL and surgery was not associated with higher rates of meniscal lesions, osteoarthritis or lower IKDC scores. There was a correlation between clinical results and associated meniscal or chondral lesions. Clinically 6% had symptoms/signs of anterior instability (Lachman 2 A). Radiologically 25% had an anterior displacement of the tibia with an average distance of 3.9 mm [3.3-7.2]. 10% shown femoral tunnel enlargement (with a average of 1.8 mm) and 60% present with subchondral sclerosis in tibial plates. All patients with symptoms suggesting anterior instability shown anterior displacement of the tibia and sclerosis areas, yet only one has femoral tunnel

Research into the outcomes for successful ACL construction is necessary to ensure the improvement of the surgery, and thus the quality of the knee.[i] In the past, effectiveness of treatment was documented using empiric evaluation. Due to the discrepancies among existing scales, conclusions were often inaccurate, causing limitations in researchers’ abilities to compare treatment effectively.[ii] In addition, to confirm the most successful outcome of treatment, long term follow up studies are vital to analyze the successfulness. To do so, successive exams of patient progress and accuracy of surgery is important for an allowable duration.[iii] The Activities of Daily Living Scale, ADLS, is a reliable patient reported form that assesses the progress concerning the functional limitations of knee impairments.

The fifth article critiqued is the first update of a clinical practice guideline (CPG) authored by the American Academy of Orthopedic Surgeons (AAOS). The purpose of this systematic review is to evaluate the best available evidence associated with nonsurgical treatment of knee OA. To be included in this study, the subjects must be original research treating knee OA with pain, function, and disability status as the primary outcome measures. Studies were excluded based on design and if they were of very limited strength of evidence. The authors searched the databases PubMed, EMBASE, CINAHL, and Cochrane Register of Controlled Trials. The recommendations in this CPG are based upon the evidence found in these studies. When critiquing the articles, the authors analyzed the quality and applicability of the studies using the Grade Evidence Appraisal System and the PRECIS Instrument. The authors made the following recommendations for braces and insoles.

Osteoarthritis, also known as degenerative joint disease, is an endemic condition that affects 20 million people in the United States alone. Osteoarthritis is the most common type of arthritis and is defined as a gradual process of destruction and degeneration or wearing away of the joint cartilage which typically occurs in the older individual age 50 and over (http://emedicine.medscape.com/article/330487-overview#a0101). . Although this diease is well known for its association with the natural aging process, it is also prevalent in athletes. Specifically, osteoarthritis of the knee has been said to be the most commonly affected area as a majpr weight bearing joint and is a growing epidemic in relation to sports injuries in the young adult. http://www.webmd.com/osteoarthritis/guide/ostearthritis-of-the-knee-degenerative-arthritis-of-the-knee. According to, (Vincent), among upper and lower reported extremity sites, the most common region for osteoarthritis to manifest is p’in the medial compartment of the knee. The risk of knee osteoarthritis from knee joint injury is high; approximately 50% of individuals with an ACL or meniscus tear develop knee osteoarthritis [10-15]. A long-term prospective study indicated a relative risk for knee osteoarthritis of approximately 5 for any previous injury of the knee [13]. As cited in, _____, Thelin and colleagues determined that injury of the knee joint was associated with all knee OA in a

54% have been for revision knee arthroplasties. One patient had both a problematic hip and knee replacement. In 43% of the cases there was a recommendation to change the management plan following discussion in the meeting. In several cases, there has been a significant alteration to the treatment plan; including changing the planned procedure from a single stage to a two stage approach, cancelling planned revision surgery to aspirate the affected joint and obtain a microbiological diagnosis prior to revision, and even changing the joint to be operated on. Following discussion, seven cases (4%) have been transferred to NUH for revision surgery. Analysis of the operative plan and the theatre inventories at each hospital revealed that in 59 cases (35%) extra loan kit was likely to be

If nonsurgical treatments like medications and using walking supports are no longer helpful, you may want to consider total knee replacement surgery. Joint replacement surgery is a safe and effective procedure to relieve pain, correct leg deformity, and help you resume normal activities.

The knee has the highest prevalence of OA of all of the joints in the human body. Knee OA regularly causes people to experience troubling pain and/or loss of physical function to varying degrees,5 and often results in total knee arthroplasty8 after years of distress and economic burden to the patient and society.9 During 2005 in Ontario, Canada, knee OA costs for an individual averaged $12,200 annually, including personal expenses as well as lost wages.10 It is estimated that as the world’s population ages and as the obesity epidemic grows, the burden of OA on the healthcare system, and therefore the economy, will continue to increase, barring improvements in knee OA management.8

The condition is most commonly seen in the elderly, overweight/obese individuals, people with a previous history of joint injury or surgery, and smokers.

Study 1 primarily focused on functional and clinical outcomes and knee ROM. Half of the patients in this study undergoing a TKA surgery received an inflated tourniquet, whereas the other half received an un-inflated tourniquet. The primary outcome measurements were Knee Injury and Osteoarthritis Outcome Score (KOOS), a knee specific questionnaire, and knee ROM measurements. KOOS feedback evaluated functional and clinical outcomes, which were expressed as the change in the average score over the period of 12 months for each subscale: pain, symptom, activities of daily living (ADL), sport/recreation, quality of life (QOL). This review will focus on ADL, sports and recreation, and QOL, because these subscales pertain to the knee ROM.

However5, the amount of younger patients receiving the surgery grew between the decades 1990 and 2000. Relieving pain and improving quality of life are the primary goals for the procedure. According to Colby and Kisner’s text book, Therapeutic Exercise,5(778) common indications for the TKA include: severe joint pain when weight bearing, deterioration of articular cartilage secondary to severe arthritis, deformity of the knee, instability or range of motion limitations, and failure of nonoperative management or a previous surgical procedure. The patient chosen for this case study had four out of the five indications for surgery. For the TKA, the patient received an implant of a stryker triathlon, a #4 PCL substituting femur, a number 4 tibial tray, a number 13x3 polyethylene, and a 29mm patella button. In other words, she had a femoral component, tibial component, and patella button implanted into her left knee. General anesthesia and a hemovac drain were used during the surgery. The patient also had a cemented prosthesis, so she was weight bearing as tolerated in the maximum phase of

All patients included in the study were recalled for subjective, objective, and functional evaluation; the study protocol involved the range of motion (ROM), ligamentous stability, Tegner-Lysholm Score, Modified Cincinnati Rating System Questionnaire, Short Form-12 (SF-12) in addition to the plain radiograph, computed tomography (CT), and magnetic resonance imaging (MRI) of the knee. According to international knee documentation committee (IKDC) score, any development of arthrosis was assessed at the final follow-up.

Of note, X-rays of the right knee obtained on this visit showed status post total knee replacement, there is some radiolucency noted on the medial aspect of the tibial component which suggest loosening of this segment. The remaining bone cement interfaces appear stable specifically the lateral tibia, the femoral component and the patellar component. There is good prosthesis alignment with an excellent patellofemoral relationship.

Abstract: Background: Osteoarthritis(OA) is a degenerative joint disease that is becoming a more common issue in today’s society, with knee OA being the most common. This increase in prevalence of knee OA can be attributed to many factors including: obesity, overuse, age and genetics. Since there is an increase in prevalence, there are different methods people choose to treat or relieve symptoms that are associated with knee OA including, pharmaceuticals, braces, physical therapy, and surgery. Surgeries are becoming more common due to the aging population and the increase in obesity rates throughout the country.

The most common indication for total knee replacement is osteoarthritis, or degenerative joint disease. The end stage of osteoarthritis is wearing out of cartilage (smooth, gliding bone ends) resulting in bone-to-bone contact in diseased joints. It is progressive and becomes increasingly painful as the cartilage erodes. Younger people who get knee replacements have damaged their joints by trauma (accidents that destroy joint surfaces), infection, cancer or tumor, and inflammatory conditions such as rheumatoid arthritis.

Background Recurvatum following total knee arthroplasty (TKA) is a spectrum of instability which is the major cause of late failure. TKA in genu recurvatum deformity has received little attention. Decreased distal femoral bone cut to reduce extension gap and increased posterior femoral condylar bone cut to increase flexion gap were proposed to equalize the flexion and extension space. Some surgeons recommended constrain condylar knee or even hinge knee to deal with the recurvatum deformity. A specific protocol which revealed quantity of bone under-resection to manage various degree of recurvatum in TKA has not been reported.