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Breulmann F, Mehl J, Otto A, Lappen S, Siebenlist S, Rab P. [Treatment of osteochondritis dissecans]. ORTHOPADIE (HEIDELBERG, GERMANY) 2024; 53:69-82. [PMID: 38189958 DOI: 10.1007/s00132-023-04461-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/14/2023] [Indexed: 01/09/2024]
Abstract
Osteochondritis dissecans (OD) is a rare condition with an incidence of 30/100,000. It especially affects male patients aged 10-20 years old. During the staged progression the osteochondral fragments can detach from their base. These can damage the adjacent articular cartilage, which can lead to premature osteoarthritis. Most commonly affected are the knee, ankle and elbow joints. The exact pathogenesis of OD has so far not been clearly confirmed. Several risk factors that can lead to the development of OD are discussed. These include repeated microtrauma and vascularization disorders that can lead to ischemia of the subchondral bone and to a separation of the fragments close to the joint and therefore to the development of free joint bodies. For an adequate clarification patients should undergo a thorough radiological evaluation including X‑ray imaging followed by magnetic resonance imaging (MRI) to assess the integrity of the cartilage-bone formation with determination of the OD stage. The assessment is based on criteria of the International Cartilage Repair Society (ICRS). The instability of the cartilage-bone fragment increases with higher stages. Stages I and II with stable cartilage-bone interconnection can be treated conservatively. For stages III and IV, i.e., instability of the OD fragment or the presence of free fragments, surgical treatment should be performed. Primarily, refixation of a free joint body should be carried out depending on the size and vitality of the fragment. In cases of unsuccessful conservative treatment or fixation, a debridement, if necessary in combination with a bone marrow stimulating procedure, can be employed corresponding to the size of the defect. For larger cartilage defects, an osteochondral graft transplantation should be considered. Overall, OD lesions in stages I and II show a good healing tendency under conservative treatment. In cases of incipient unstable OD, refixation can also lead to good clinical and radiological results.
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Affiliation(s)
- Franziska Breulmann
- Sektion Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, 81675, München, Deutschland
| | - Julian Mehl
- Sektion Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, 81675, München, Deutschland
| | - Alexander Otto
- Sektion Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, 81675, München, Deutschland
| | - Sebastian Lappen
- Sektion Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, 81675, München, Deutschland
| | - Sebastian Siebenlist
- Sektion Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, 81675, München, Deutschland.
| | - Peter Rab
- Sektion Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, 81675, München, Deutschland
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K E, L R, G W, F F, S M, C W, DA B. The use of video consultations to support orthopedic patients' treatment at the interface of a clinic and general practitioners. BMC Musculoskelet Disord 2022; 23:968. [PMID: 36348332 PMCID: PMC9640897 DOI: 10.1186/s12891-022-05909-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 10/25/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction Video consultations have proven to be a powerful support tool for patient–doctor interactions in general, not only during the COVID-19 pandemic. This study analyzed the feasibility and usefulness of orthopedic telemedical consultations (OTCs) for orthopedic patients at the interface of a clinic and general practitioners. Methods The study was carried out at an orthopedic department of a German hospital between April 2020 and October 2020. After written informed consent was obtained, general practitioners (GPs) of a large adjunct health region could present their patients with orthopedic pathologies to specialists at the hospital via OTCs instead of the usual live consultation (LC). The patients, specialists and GPs were evaluated for their OTC experience and attitude (5-point Likert-scale and open questions, 19 to 27 items). Results A total of 89 video consultations took place with 76 patients, 16 GPs and six specialists. The average distance between the GPs/patients and the hospital was 141.9 km. The OTCs were rated as pleasant, and the experience was rated as very satisfying (average Likert-Scale rating, with 5 as strong agreement: specialists = 4.8; GPs = 4.9; patients = 4.7). Following the OTC, a LC was not necessary in 76.4% of cases. Patients with a necessary LC after an OTC showed significantly lower satisfaction with the OTC (p = 0.005). Time savings, the elimination of travel and quick contact with orthopedic consultants were positively highlighted by the participants. A total of 123 recommendations for further treatment were given, such as the initiation of physiotherapy/medication and the use of imaging diagnostics. Different technical and organizational challenges could be identified and addressed. Discussion The vast majority of the participants stated they had a very positive impression. In particular, the potential savings in travel and time as well as straightforward contact with specialists were rated positively. However, limitations in the assessment of initial presentations of complex medical conditions were also highlighted. Further studies on OTCs with a consultative health professional may show other fields of use for this mode of interdisciplinary remote communication. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05909-2.
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Chau MM, Tompkins MA. Osteochondritis Dissecans of the Knee in Young Athletes. Clin Sports Med 2022; 41:579-594. [DOI: 10.1016/j.csm.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Meniscal Ramp Lesions: Anatomy, Epidemiology, Diagnosis, and Treatment. J Am Acad Orthop Surg 2022; 30:255-262. [PMID: 34936583 DOI: 10.5435/jaaos-d-21-00091] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 11/24/2021] [Indexed: 02/01/2023] Open
Abstract
Injuries to the medial meniscus meniscocapsular junction, also known as ramp lesions, are common in the setting of anterior cruciate ligament injuries with a prevalence of 9% to 42%. Anatomically, ramp lesions involve disruption of the posterior meniscocapsular junction and meniscotibial ligaments. Biomechanically, ramp lesions are associated with an increase in anterior tibial translation and internal and external tibial rotation in anterior cruciate ligament-deficient cadaveric knees. Magnetic resonance imaging is useful in evaluating the meniscocapsular junction. Irregularity or increased signal near the posterior meniscocapsular junction and/or signal change indicative of posterior medial tibial plateau edema can suggest these injuries are present before surgical intervention. The current benchmark for diagnosis is arthroscopic visualization of the posterior medial meniscocapsular junction viewed through the intercondylar notch. Once a ramp lesion is identified, stability should be assessed by arthroscopic probing to determine the degree of anterior displacement. Optimal treatment has been debated in the literature, especially for stable ramp lesions, although good outcomes have been shown with and without repair. Repair is warranted for those lesions that are unstable to probing. Unfortunately, only limited literature available to guide clinicians on the optimal rehabilitation for ramp lesions.
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Estel K, Weber G, Richter L, Hofmann M, Ruckdeschel P, Märdian S, Willy C, Back DA. Acceptance of Supportive Illustrations for Preparation of Patients for an Orthopedic Telemedical Consultation. Front Surg 2021; 8:696721. [PMID: 34631777 PMCID: PMC8492955 DOI: 10.3389/fsurg.2021.696721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 08/05/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Telemedical video consultations are a powerful support for patient–doctor interactions. For optimal digital settings, explanatory illustrations may be helpful for patients. This study analyzed patients' the attitude of patients to illustrations preparing for an orthopedic telemedical consultation (OTC). Methods: A leaflet with eight illustrations was designed and their acceptance and estimated necessity was evaluated among patients who had experienced an OTC (EXP-group) and others who had not (NOV-group) with a 12-item-questionnaire. Results: Sixty patients participated (n = 30 each group). All illustrations were evaluated positively. The EXP-group gave significantly higher ratings than the NOV-group for improved understanding by the given keywords of the illustrations (p = 0.046), preference for being informed by illustrations than by merely by a pure text (p = 0.023), better feeling of preparation for an OTC by the illustrations (p = 0.005), and the impression of a simplified process of the OTC by the illustrations (p = 0.012). Discussion: While the illustrations were well-accepted by the participants, significant differences were revealed between the valuation of single aspects by patients, depending on a previous experience with an OTC. Therefore, a leaflet with explanatory illustrations may be helpful in preparing patients for an OTC to support the digital patient–doctor contact.
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Affiliation(s)
- Katharina Estel
- Clinic for Traumatology and Orthopedics, Bundeswehr Hospital Berlin, Berlin, Germany
| | - Gordian Weber
- Clinic for Traumatology and Orthopedics, Bundeswehr Hospital Berlin, Berlin, Germany
| | - Luise Richter
- Clinic for Traumatology and Orthopedics, Bundeswehr Hospital Berlin, Berlin, Germany.,Medical Faculty of the Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Marko Hofmann
- Institute for Computer Engineering Faculty of Computer Science, University of the Bundeswehr Munich, Neubiberg, Germany
| | - Patrick Ruckdeschel
- Institute for Computer Engineering Faculty of Computer Science, University of the Bundeswehr Munich, Neubiberg, Germany
| | - Sven Märdian
- Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Christian Willy
- Clinic for Traumatology and Orthopedics, Bundeswehr Hospital Berlin, Berlin, Germany
| | - David Alexander Back
- Clinic for Traumatology and Orthopedics, Bundeswehr Hospital Berlin, Berlin, Germany.,Dieter Scheffner Center for Medical Education and Educational Research, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Estel K, Weber G, Fellmer F, Richter L, Tsitsilonis S, Willy C, Back DA. The use of online video consultations in the aftercare of orthopedic patients: a prospective case-control study. BMC Musculoskelet Disord 2021; 22:774. [PMID: 34511106 PMCID: PMC8435151 DOI: 10.1186/s12891-021-04653-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 08/11/2021] [Indexed: 11/30/2022] Open
Abstract
Background Video consultations have proven to be an efficient source of support for patient-doctor interactions and have become increasingly used in orthopedics, especially during the COVID-19 pandemic. This study analyzed both patients’ and doctors’ acceptance of an orthopedic telemedical consultation (OTC) and compared the results of OTC examinations to the results of live consultation (LC) to identify discrepancies. Methods The study was carried out in an orthopedic department of a German hospital between 2019 and 2020. After written informed consent was obtained, patients voluntarily presented for follow-up by OTC and LC. The experience with and attitudes toward OTC among both patients and doctors was evaluated (using Likert scale-scored and open questions, 26 to 28 items). The results of the OTC and LC examinations were compared using a 12-item checklist. The data were analyzed by quantitative and qualitative statistics. Results A total of 53 patients were included, each of whom completed an OTC and an LC. The OTC was rated as pleasant, and the experience was rated as very satisfying (average rating on a 5-point Likert scale, with 1 indicating strong agreement: doctors: 1.2; patients: 1.3). Various technical and organizational challenges were identified. Compared to LC, OTC showed no significant differences in patient history or in inspection, palpation, or active range of motion results. Only for the functional or passive joint assessment did LC show significantly higher suitability (p < 0.05) than OTC. Recommendations for further procedures did not differ significantly between OTC and LC. Conclusions Because of the high acceptance and the objective benefits of OTC and the similarity of clinical results with LC, OTC is recommendable for orthopedic follow-up examinations. To better assess joint functionality, meaningful digital alternatives for established examination methods should be further investigated. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04653-3.
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Affiliation(s)
- K Estel
- Department for Traumatology and Orthopedics, Bundeswehr Hospital Berlin, Scharnhorststrasse 13, 10115, Berlin, Germany
| | - G Weber
- Department for Traumatology and Orthopedics, Bundeswehr Hospital Berlin, Scharnhorststrasse 13, 10115, Berlin, Germany
| | - F Fellmer
- Department for Traumatology and Orthopedics, Bundeswehr Hospital Berlin, Scharnhorststrasse 13, 10115, Berlin, Germany
| | - L Richter
- Department for Traumatology and Orthopedics, Bundeswehr Hospital Berlin, Scharnhorststrasse 13, 10115, Berlin, Germany.,Medical Faculty, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - S Tsitsilonis
- Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - C Willy
- Department for Traumatology and Orthopedics, Bundeswehr Hospital Berlin, Scharnhorststrasse 13, 10115, Berlin, Germany
| | - D A Back
- Department for Traumatology and Orthopedics, Bundeswehr Hospital Berlin, Scharnhorststrasse 13, 10115, Berlin, Germany. .,Dieter Scheffner Center for Medical Education and Educational Research, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
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Pinnamaneni S, Lamplot JD, Rodeo SA, Swensen-Buza S, Lawton CD, Dines JS, Young WK, Taylor SA. The Virtual Shoulder Physical Exam. HSS J 2021; 17:59-64. [PMID: 33967643 PMCID: PMC8077973 DOI: 10.1177/1556331620975033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 10/30/2020] [Indexed: 01/25/2023]
Affiliation(s)
| | - Joseph D. Lamplot
- Sports Medicine Division, Department of Orthopedics, Emory University, Atlanta, GA, USA
| | - Scott A. Rodeo
- Sports Medicine Institute, Hospital for Special Surgery, New York City, NY, USA
| | | | - Cort D. Lawton
- Sports Medicine Division, Ortho Illinois, Algonquin, IL, USA
| | - Joshua S. Dines
- Sports Medicine Institute, Hospital for Special Surgery, New York City, NY, USA
| | - Warren K. Young
- Sports Medicine Institute, Hospital for Special Surgery, New York City, NY, USA
| | - Samuel A. Taylor
- Sports Medicine Institute, Hospital for Special Surgery, New York City, NY, USA
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Lamplot JD, Pinnamaneni S, Swensen-Buza S, Lawton CD, Dines JS, Nawabi DH, Young WK, Rodeo SA, Taylor SA. The Knee Examination for Video Telemedicine Encounters. HSS J 2021; 17:80-84. [PMID: 33967647 PMCID: PMC8077991 DOI: 10.1177/1556331620975039] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 10/16/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Joseph D. Lamplot
- Department of Orthopaedic Surgery, Emory University, Atlanta, GA, USA
| | | | | | | | - Joshua S. Dines
- Sports Medicine Institute, Hospital for Special Surgery, New York, NY, USA
| | - Danyal H. Nawabi
- Sports Medicine Institute, Hospital for Special Surgery, New York, NY, USA
| | - Warren K. Young
- Sports Medicine Institute, Hospital for Special Surgery, New York, NY, USA
| | - Scott A. Rodeo
- Sports Medicine Institute, Hospital for Special Surgery, New York, NY, USA
| | - Samuel A. Taylor
- Sports Medicine Institute, Hospital for Special Surgery, New York, NY, USA
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Lawton CD, Swensen-Buza S, Awender JF, Pinnamaneni S, Lamplot JD, Young WK, Rodeo SA, Nawabi DH, Taylor SA, Dines JS. The Elbow Physical Examination for Telemedicine Encounters. HSS J 2021; 17:65-69. [PMID: 33967644 PMCID: PMC8077976 DOI: 10.1177/1556331620975040] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 10/28/2020] [Indexed: 11/15/2022]
Affiliation(s)
- Cort D. Lawton
- Sports Medicine Division, Ortho Illinois, Algonquin, IL, USA
| | | | | | | | - Joseph D. Lamplot
- Department of Orthopedics, Sports Medicine Division, Emory University, Atlanta, GA, USA
| | - Warren K. Young
- Sports Medicine Institute, Hospital for Special Surgery, New York, NY, USA
| | - Scott A. Rodeo
- Sports Medicine Institute, Hospital for Special Surgery, New York, NY, USA
| | - Danyal H. Nawabi
- Sports Medicine Institute, Hospital for Special Surgery, New York, NY, USA
| | - Samuel A. Taylor
- Sports Medicine Institute, Hospital for Special Surgery, New York, NY, USA
| | - Joshua S. Dines
- Sports Medicine Institute, Hospital for Special Surgery, New York, NY, USA
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Okazaki Y, Furumatsu T, Okamoto S, Hiranaka T, Kintaka K, Miyazawa S, Ozaki T. Diagnostic performance of open MRI in the flexed knee position for the detection of medial meniscus ramp lesions. Skeletal Radiol 2020; 49:1781-1788. [PMID: 32488335 DOI: 10.1007/s00256-020-03480-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/17/2020] [Accepted: 05/20/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To identify the diagnostic performance of magnetic resonance imaging (MRI) in the knee-flexed position for the detection of meniscal ramp lesions in patients with anterior cruciate ligament tears. MATERIALS AND METHODS Forty-three patients (mean age 24.5 ± 9.5 years; 21 males, 22 females) with an arthroscopically proven anterior cruciate ligament tear were included in this retrospective study. The presence of the following two important features on MRI was recorded: irregularity of the medial meniscus at the posterior margin, and complete fluid filling between the posterior horn of the medial meniscus and the capsule margin. Findings obtained in arthroscopy served as the reference standard. The diagnostic sensitivity, specificity, and inter-observer agreement were calculated. RESULTS Sixteen ramp lesions were noted on arthroscopy (37.2%). With an irregularity of the medial meniscus at the posterior margin on MRI, the sensitivity and specificity were 87.5 and 59.3% at 10° knee flexion and 93.8 and 85.2% at 90° flexion, respectively. The complete fluid filling sign on MRI showed sensitivity and specificity of 31.3 and 100% at 10° knee flexion and 87.5 and 100% at 90° flexion, respectively. The concordance between the two observers for the two MRI features was very good (k = 0.70-0.88). CONCLUSION MRI with the knee in the flexed position improves the diagnostic performance of the detection of meniscal ramp lesions compared with MRI with the knee in the extended position.
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Affiliation(s)
- Yuki Okazaki
- Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kitaku, Okayama, 700-8558, Japan
| | - Takayuki Furumatsu
- Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kitaku, Okayama, 700-8558, Japan.
| | - Soichiro Okamoto
- Department of Radiology, Okayama University Hospital, 2-5-1 Shikata-cho, Kitaku, Okayama, 700-8558, Japan
| | - Takaaki Hiranaka
- Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kitaku, Okayama, 700-8558, Japan
| | - Keisuke Kintaka
- Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kitaku, Okayama, 700-8558, Japan
| | - Shinichi Miyazawa
- Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kitaku, Okayama, 700-8558, Japan
| | - Toshifumi Ozaki
- Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kitaku, Okayama, 700-8558, Japan
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Lamplot JD, Pinnamaneni S, Swensen-Buza S, Lawton CD, Dines JS, Nawabi DH, Young W, Rodeo SA, Taylor SA. The Virtual Shoulder and Knee Physical Examination. Orthop J Sports Med 2020; 8:2325967120962869. [PMID: 33614791 PMCID: PMC7871077 DOI: 10.1177/2325967120962869] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 09/03/2020] [Indexed: 01/25/2023] Open
Abstract
The COVID-19 crisis has forced a sudden and dramatic shift in the way that clinicians interact with their patients, from outpatient encounters to telehealth visits utilizing a variety of internet-based videoconferencing applications. Although many aspects of pre–COVID-19 outpatient sports medicine care will ultimately resume, it is likely that telehealth will persist because of its practicality and because of patient demand for access to efficient and convenient health care. Physical examination is widely considered a critical obstacle to a thorough evaluation of sports medicine patients during telehealth visits. However, a closer reflection suggests that a majority of the examination maneuvers are possible virtually with limited, if any, modifications. Thus, we provide a comprehensive shoulder and knee physical examination for sports medicine telehealth visits, including (1) verbal instructions in layman’s terms that can be provided to the patient before or read verbatim during the visit, (2) multimedia options (narrated videos and annotated presentations) of the shoulder and knee examination that can be provided to patients via screen-share options, and (3) a corresponding checklist to aid in documentation.
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Affiliation(s)
- Joseph D Lamplot
- Department of Orthopaedics, Emory University, Atlanta, Georgia, USA
| | | | | | | | - Joshua S Dines
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA
| | - Danyal H Nawabi
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA
| | - Warren Young
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA
| | - Scott A Rodeo
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA
| | - Samuel A Taylor
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA
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Sonnery-Cottet B, Serra Cruz R, Vieira TD, Goes RA, Saithna A. Ramp Lesions: An Unrecognized Posteromedial Instability? Clin Sports Med 2020; 39:69-81. [PMID: 31767111 DOI: 10.1016/j.csm.2019.08.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Meniscal ramp lesions occur much more frequently than was previously considered, and particularly so in ACL-injured knees. The historically high rate of missed diagnoses is a result of unfamiliarity with this injury pattern within the orthopedic community, and also the difficulty in diagnosis. A systematic exploration of the posteromedial compartment of the knee is mandatory to reliably identify ramp lesions. Failure to recognize and repair these injuries is associated with persistent anterior and posteromedial instability. Understanding their nature, biomechanics, and epidemiology is essential in allowing orthopedic surgeons to suspect their presence and adequately treat these lesions.
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Affiliation(s)
- Bertrand Sonnery-Cottet
- Centre Orthopédique Santy, FIFA Medical Centre of Excellence, Groupe Ramsay-Générale de Santé, Hôpital Privé Jean Mermoz, 24 Avenue Paul Santy, Lyon 69008, France.
| | - Raphael Serra Cruz
- Instituto Nacional de Traumatologia e Ortopedia, 500 Avendia Brasil, Caju, Rio de Janeiro, 20940-070, Brazil; Hospital São Vicente de Paulo, Rio de Janeiro, Rio de Janeiro, Brazil; Instituto Brasil de Tecnologias da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Thais Dutra Vieira
- Centre Orthopédique Santy, FIFA Medical Centre of Excellence, Groupe Ramsay-Générale de Santé, Hôpital Privé Jean Mermoz, 24 Avenue Paul Santy, Lyon 69008, France
| | - Rodrigo A Goes
- Instituto Nacional de Traumatologia e Ortopedia, 500 Avendia Brasil, Caju, Rio de Janeiro, 20940-070, Brazil
| | - Adnan Saithna
- Sano Orthopedics, 2000 SE Blue Pkwy, Kansas City, MO 64063, USA; Department of Specialty Medicine (Trauma & Orthopedic Surgery), Kansas City University, Kansas City, MO, USA
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HEO JAEHOON, KWON YURI, JEON HYEONGMIN, CHOI EUIBUM, EOM GWANGMOON. DYNAMIC PATTERNS OF CENTER OF PRESSURE DURING WALKING IN DIFFERENT FOOT TYPES. J MECH MED BIOL 2019. [DOI: 10.1142/s0219519419400657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Although the risk of foot injuries during walking increases with the foot deformity, the dynamic mechanism is not clearly understood. This study aims at the investigation of dynamic change of center of pressure (COP) in different foot types. Contrasted by previous studies, this study analyzed COP in each gait phase, i.e., loading response, mid stance, terminal stance, and pre-swing. A total of 19 young males participated in this study and the resting calcaneal stance position (RCSP) angle was measured for the classification into three foot types. All participants performed level walking with shoes on. COP trajectory was normalized by foot width and length. In the loading response and mid stance phases COP of Pes Cavus located most laterally ([Formula: see text]). No difference among foot types existed at terminal stance and pre-swing phases ([Formula: see text]). Foot deformity is known to occur due to the abnormality of musculoskeletal system such as lower extremities muscles, bones, and ligaments. Because the role of musculoskeletal system differs between gait phases, this may have caused phase-dependent COP difference among different foot types.
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Affiliation(s)
- JAE-HOON HEO
- School of Biomedical Engineering, Konkuk University, Chungju 27478, Korea
| | - YURI KWON
- BK21plus Research Institute of Biomedical Engineering, Konkuk University, Chungju 27478, Korea
| | - HYEONG-MIN JEON
- School of Biomedical Engineering, Konkuk University, Chungju 27478, Korea
| | - EUI-BUM CHOI
- School of Biomedical Engineering, Konkuk University, Chungju 27478, Korea
| | - GWANG-MOON EOM
- School of Biomedical Engineering, Konkuk University, Chungju 27478, Korea
- BK21plus Research Institute of Biomedical Engineering, Konkuk University, Chungju 27478, Korea
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Physical Examination of the Knee: Meniscus, Cartilage, and Patellofemoral Conditions. J Am Acad Orthop Surg 2017; 25:e243. [PMID: 28857908 DOI: 10.5435/jaaos-d-17-00331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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