Persistent Knee Monoarthritis as a Lyme Disease Presentation: A Diagnostic Challenge - Case Report.

There are several differential diagnoses for knee monoarthritis. We report a patient with recurrent episodes of knee effusion, in which the non-specific clinical condition implied several diagnostic hypotheses, therapeutic inaccuracies, and a delay in implementing adequate treatment. For more than 2 years, the patient underwent different Orthopedics and Rheumatology visits.

Reconstruction of the interosseous talocalcaneal ligament using allograft for subtalar joint stabilization is effective.

Purpose: The aim of this study was to assess the biomechanical effects of subtalar ligament injury and reconstruction on stability of the subtalar joint in all three spatial planes.

Methods: Fifteen fresh frozen cadaveric legs were used, with transfixed tibiotalar joints to isolate motion to the subtalar joint. An arthrometer fixed to the lateral aspect of the calcaneus measured angular displacement in all three spatial planes on the inversion and eversion stress tests.

Comparison of Direct Repair Versus Anatomic Graft Reconstruction of the Anterior Talofibular Ligament: A Biomechanical Cadaveric Study.

The goal of our study is to compare the stability of the anatomic reconstruction of the anterior talofibular ligament (ATFL) with direct repair of the ATFL, in a cadaver model. We performed the following techniques in 18 cadaveric ankles: the intact ATFL was cut, after which a direct repair using 2 anchors was performed. The repair was sectioned, and anatomic reconstruction was then performed with a tendon autograft.

[Consecutive Ankle Sprain Classification and Injury Systematization (CASCaIS), A New Lateral Ankle Sprain Classification Based on the Pivot Test: A Prospective Cohort Study].

Introduction: The biggest challenge in the treatment of acute ankle sprain is the uncertainty of the prognosis. The traditional classifications have several interpretations and little correlation with prognosis. In this study we propose a new classification for acute ankle sprain only based on clinical criteria.

Influence of the PFNA screw position on the risk of cut-out in an unstable intertrochanteric fracture: a computational analysis.

The position of the lag screw in the femoral head is a key factor to cut-out, the most reported complication in the internal fixation of intertrochanteric fractures. Considering that the best position for the lag screw remains controversial, the aim of this study was to evaluate the influence of different lag screw positions on the risk of cut-out of an unstable intertrochanteric fracture fixed with a Proximal Femoral Nail Anti-Rotation (PFNA) implant. The relationship between cut-out and the tip-apex distance (TAD) or the calcar referenced tip-apex distance (CalTAD) was also investigated.

Medial malleolus malunion with secondary tibiotalar and syndesmotic incongruence - two case reports and ''box resection'' for its treatment.

Introduction: Ankle fractures are among the most common injuries treated by orthopaedic surgeons. Malunion is one of the possible complications, and corrective surgery is often used to avoid long-term disability. However, few studies address medial malleolus malunion and the best revision surgery technique is controversial.

Medial collateral ligament release during knee arthroscopy: key concepts.

Complete access to the posterior medial compartment of the knee may represent a technical challenge during arthroscopy in patients with a tight tibiofemoral joint space.Medial collateral release reduces direct iatrogenic cartilage damage in the medial compartment of the knee through manipulation with instruments.We recommend performing medial collateral release in surgeries that access the posteromedial compartment (e.

Isolated distal pisiform dislocation: Case Report.

Isolated pisiform dislocation is a rare lesion with few cases described in the literature. This type of lesion is typically observed in young males and can be easily overlooked at first assessment. Isolated proximal dislocation is more common due to the action of the flexor carpi ulnaris (FCU) muscle.

Anatomic Arthroscopic Graft Reconstruction of the Interosseous Talocalcaneal Ligament for Subtalar Instability.

Instabilities of the subtalar joint are commonly overlooked or mismanaged, and chronic instability is a debilitating condition leading to premature joint degeneration. Several methods of treatment have been described, mainly screw fixation, arthrodesis, or ligament reconstruction. Most studies describe open methods for ligament reconstruction.

Biomechanical study of autograft anatomic reconstruction in lateral ankle instability.

Introduction: The purpose of this work is perform a biomechanical comparison of anatomic reconstruction of the anterior talofibular ligament (ATFL) with the intact ATFL.

Materials And Methods: We studied 18 fresh cadaveric ankles with intact ATFL. Each specimen was clinically assessed with the anterior drawer (AD) and varus tilt (VT) tests and the angular movement in the three spatial planes (axial, coronal and sagittal) was measured with an arthrometer using a sensor located in the talus.

Contact patterns in the ankle joint after lateral ligamentous injury during internal rotation: A computational study.

Lateral ankle instability, resulting from the inability of ankle ligaments to heal after injury, is believed to cause a change in the articular contact mechanics that may promote cartilage degeneration. Considering that lateral ligaments' insufficiency has been related to rotational instability of the talus, and that few studies have addressed the contact mechanics under this condition, the aim of this work was to evaluate if a purely rotational ankle instability could cause non-physiological changes in contact pressures in the ankle joint cartilages using the finite element method. A finite element model of a healthy ankle joint, including bones, cartilages and nine ligaments, was developed.

Gravity stress tibiotalar laxity evaluation with a biomedical gyroscopes device - cadaver study with progressive sectioning of lateral ankle ligaments.

Purpose: Despite the evidence on the role of gravity stress test to access the instability of other ankle injuries, there is limited literature regarding gravity stress on the lateral ankle ligament's insufficiency. The objective of our study was to objectively measure the tibiotalar angular movement under gravity stress after progressive sectioning of the lateral ankle ligaments.

Methods: We performed sequential sectioning of the anterior talofibular (ATFL), calcaneofibular (CFL), and posterior talofibular ligaments (PTFL) in twelve ankle specimens.

The vascularization of the peroneal tendons: An anatomic study.

Background: Arterial vascularization is intimately related to the peroneal tendon ruptures. Our purpose is to describe the vascular anatomy of peroneal tendons and assess differences in the vascularization patterns between peroneus brevis tendon (PBT) and peroneus longus tendon (PLT).

Methods: Anatomical study of 22 cadaveric lower extremities.

The tibiocalcaneal bundle of the deltoid ligament - Prevalence and variations.

Introduction: A precise understanding of the anatomy of the multiple bundles of the deltoid ankle ligament might have clinical impact. The most relevant deltoid anatomical series report a variable frequency of the tibiocalcaneal ligament, possibly the most important bundle to be reconstructed in medial ankle insufficiency. Our purpose was to access the deltoid's tibiocalcaneal ligament morphology in a large anatomical study as well as to perform a historical literature review on the reasons for its variable prevalence.

Achilles tendon elongation after acute rupture: is it a problem? A systematic review.

Purpose: Rupture of the Achilles tendon (AT) is a common injury. Strength deficits may persist over the long term, possibly owing to elongation of the tendon or inferior mechanical properties. This study aimed to provide a systematic review of the literature on the prevalence and consequences of tendon elongation in patients after acute AT rupture treatment.

Integration and Vascular Ingrowth of a Collagen Meniscal Implant: A Case Report.

Meniscectomy is the most common surgery in orthopaedics. The absence of meniscal tissue might be related to irreversible damage to the articular cartilage. Meniscal replacement is a tissue-engineering technique for post-meniscectomy syndrome.

Irreducible Acute Patellar Dislocation due to a New Anatomical Variant - the Notched Patella.

Irreducible patella dislocations are rare and are usually associated with complex mechanisms. The authors report the clinical case of an irreducible lateral patellar dislocation due to an anatomical variant. The authors assisted a 16-year-old patient who presented with a lateral patella dislocation that was impossible to reduce by closed manipulation, even under general anesthesia.

Rotational Instability after Anterior Talofibular and Calcaneofibular Ligament Section: The Experimental Basis for the Ankle Pivot Test.

The clinical diagnosis of the anterior talofibular ligament (ATFL) rupture is based on the findings from the medical history and the anterior drawer test, a maneuver that allegedly pushes the talus and rearfoot anteriorly, although with great variability in its sensitivity. We consider that an ATFL rupture is best evaluated by a rotational vector (i.e.

Kinematics of the proximal tibiofibular joint is influenced by ligament integrity, knee and ankle mobility: an exploratory cadaver study.

Purpose: The proximal tibiofibular joint (PTFJ) is a rather unknown articulation. There is little understanding of its anatomy, physiology, and functional role. The objectives of this research are to describe the normal kinematics of the PTFJ and its relation to the ankle and knee movements.

Repair with bicortical suspension device restores proximal tibiofibular joint motion.

Purpose: Dislocation of the proximal tibiofibular joint is a complex injury that is often overlooked or misdiagnosed. Surgical treatment is recommended for severe acute or for chronic symptomatic instability but there is still no evidence on the optimal reconstruction technique. The purpose of this study is to analyze the motion of the proximal tibiofibular joint after repair with a bicortical suspension device as compared to its normal kinematics.

Peri-prosthetic bone cysts after total ankle replacement. A systematic review and meta-analysis.

Background: Periprosthetic cystic osteolysis is a well-known complication of total ankle replacement. Several theories have been proposed for its aetiology, based on individual biomechanical, radiological, histopathology and outcome studies.

Methods: Studies that met predefined inclusion/exclusion criteria were analysed to identify literature describing the presence of peri-prosthetic ankle cystic osteolysis.