PurposeThe purpose of this study was to determine the prevalence of symptomatic femoroacetabular impingement (FAI) in athletic patients.Materials and MethodsFrom July 2003 to May 2013, 388 patients (422 hips) who underwent arthroscopic surgery for FAI were evaluated demographic characteristics. The patients' age, gender, diagnosis, and type of sports were analyzed using medical records and radiography.ResultsAmong 422 hips in 388 patients, 156 hips were involved with sports. Among the 156 hips, 86, 43, and 27 hips were categorized as cam, pincer, and mixed type, respectively. Types of sports were soccer, baseball and taekwondo which showed 44, 36 and 35 hips, respectively. Also, cases related to sports according to age were 63 hips for twenties and 12 hips for teenagers in which the two showed highest association to FAI. The kinds of sports that showed high association were 28 hips of soccer and 20 cases of martial arts such as taekwondo and judo for twenties and 9 hips of martial arts for teenagers which was the highest.ConclusionFAI usually occurs in young adults and is highly related to sports activity. Most of the FAI type related to sports activity was cam type, and soccer and martial arts such as taekwondo were the most common cause of it.
We diagnosed 10 Galeazzi-equivalent injuries. We report the radiological and clinical results at the end of growth in adolescents, including the results of ulnar lengthening. This study included 10 Galeazzi-equivalent injuries (seven patients requiring open reduction and three requiring closed reduction for ulnar lesions) seen since 2004. The periosteum was entrapped around the fractured physis in five patients and the extensor carpi ulnaris to the periosteum was interposed in two patients. Among the seven patients, ulnar lengthening was performed in only three patients. Ulnar variances at the time of the lengthening were -6, -6, and -5 mm. Gradual lengthening was performed. Radiologic abnormalities, including the ulnar variances, were investigated at the end of growth. In addition, pain scores, the range of wrist motion, and grip strength were evaluated and compared with nonlengthened ulnas. The mean age of the patients at the final follow-up was 19.7 years, and the mean total follow-up period was 6 years. The final ulnar variances were -5, -5, -3, and 0 mm in four patients with nonlengthened ulnas among the seven patients. Three patients with lengthened ulnas showed final neutral variances. In four nonlengthened ulnas, three ulnas bowed to the radial side and two ulnar heads had an inclined and deformed shape. Joint mismatch of the distal radioulnar joint surface was found in one patient with lengthened and one with nonlengthened ulnas. Three patients with nonlengthened ulnas showed decreased range of wrist motions. Comparison of contralateral grip strength indicated a significant difference between patients with or without lengthened ulnas. Long-term follow-up after Galeazzi-equivalent injuries may be essential to check for premature epiphyseal closure, length discrepancies, or joint incongruency. A procedure for a shortened ulna could be needed; however, the appropriate time and degree of lengthening remain to be investigated.
Category: Ankle; Basic Sciences/Biologics Introduction/Purpose: Chronic ankle instability with generalized joint hypermobility (GJH) is considered a relative contraindication for the modified Bröstrom procedure. Most clinicians use the Beighton score to assess GJH. However, the Beighton score itself does not involve investigation of the ankle joint. In our experience, resting, longitudinal ultrasound images of the uninjured, intact ATFL frequently show a loose, wavy pattern in patients with high Beighton scores. We evaluated anterior talofibular ligament (ATFL) status according to Beighton score and the manual anterior drawer test (ADT). It was hypothesized that the value of ultrasound for ATFL would be significantly different between participants with GJH (Beighton score >= 5) and without GJH and show a correlation with participant’s Beighton scores and manual ADT grades. Methods: Forty-four healthy young patients (44 ankles) aged 20 to 40 years and without a history of ankle trauma or disease were included in the study. To assess GJH and ankle instability, Beighton scores and manual ADT grades were evaluated, respectively. For the investigation of ATFL, resting and stress ultrasonography were performed to assess its length, height, and thickness. Ultrasound images were taken in resting position and during maximal plantar-flexion and inversion (Figure: Ultrasound images of the ATFL in (a) the resting position and (b) stress position in a 21-year-old woman with Beighton score of 9. Dotted red line: Length, Yellow line: Height, Green double-headed arrow: Thickness). Beighton scores, manual ADT grades, and ultrasound parameters of participants with and without GJH were compared and the correlation coefficients among Beighton scores, manual ADT grades, and the length, height, and thickness of resting and stress ATFLs were analyzed. Results: The participants were divided into two groups, those without GJH (24 ankles) and with GJH (20 ankles). Mean Beighton scores and manual ADT grades were significantly different between the two groups (P < .05). The mean length, height of resting, stress ATFL and mean difference in height between resting and stress ATFL were significantly different between the two groups (P < .05). The resting and stress ATFL length, height, and difference in height between resting and stress ATFL showed a moderately positive linear relationship with Beighton scores and manual ADT grades (P < .05). Among the ATFL parameters, resting ATFL height showed the strongest relationship with the Beighton score (r = 0.763, P < .001) and ADT grade (r = 0.763, P < .001). Conclusion: The ATFL stress ultrasound parameters showed significant differences between participants with high and low Beighton scores and were correlated with Beighton scores and manual ADT grades. We believe that this ankle joint specific method might provide significant, quantitative parameters for assessing GJH in addition to the Beighton score.
Category: Ankle Arthritis; Basic Sciences/Biologics Introduction/Purpose: Varus ankle osteoarthritis, which is induced by asymmetric joint load in the ankle due to varus malalignment and characterized by a loss of cartilage in the medial talar dome or medial clear space in the ankle mortise, accounts for a large proportion of ankle osteoarthritis osteoarthritis. Realignment surgery, such as supramalleolar osteotomy (SMO) is an effective surgical procedure for treating varus ankle osteoarthritis. In previous study using weightbearing computed tomography (WBCT) by other group, the abnormal internal rotation of the talus was often seen in patients with varus ankle osteoarthritis. We used axial loading three-dimensional computed tomography (AL 3D CT) to evaluate preoperative and postoperative talocrural joints of patients who underwent SMO to treat varus ankle osteoarthritis. Methods: We performed retrospective analyses of 12 patients (14 feet) who underwent SMO and fibular osteotomy. Fibular osteotomy was performed by scarf osteotomy and the center of hinge was fixed with cortical screw. For SMO, distal tibial medial sharp spike of bone produced after the opening wedge osteotomy was resected and used for the autogenous strut bone graft in the osteotomy gap. Tibial-ankle surface angle (TAS), talar tilt angle (TT), Takakura stage, and tibial-lateral surface angle (TLS) was evaluated with weightbearing radiographs before operation and at 2-year follow-up. Talus rotation ration and presence of medial gutter contact was investigated with AL CT before operation and at 6-month follow-up (Figure A-D : preoperative, E-H : postoperative).Clinical outcomes were assessed based on the preoperative and 2-year follow-up American Orthopaedic Foot & Ankle Society (AOFAS) scale, visual analog scale (VAS) for pain, and Foot and Ankle Ability Measure (FAAM). Results: The mean 2-year follow-up TAS, TT, Takakura stage, and TLS were all significantly different relative to preoperative parameters (P < .05). The mean 6-month follow-up talus rotation ratio was significantly restored compared to preoperative value (P = .001). The mean 2-year follow-up clinical outcomes were all significantly improved relative to preoperative measurements (P = .001). The preoperative talus rotation ratio had moderately positive linear relationships with preoperative Takakura stage and preoperative anterior talar translation (P < .05). Among the variables of interest, preoperative anterior talar translation was most strongly related to the preoperative talus rotation ratio (r = 0.655, P < .05). The postoperative talus rotation ratio had moderately positive linear relationships with postoperative Takakura stage and preoperative talar tilt angle (P < .05). Conclusion: In summary, abnormal internal rotation of the talus in mild to moderate varus ankle osteoarthritis, as observed by AL CT, was significantly restored after SMO combined with fibular osteotomy. SMO yielded successful radiological and clinical outcomes. Based on these results, we believe that correction of abnormal internal rotation of the talus is an important prognostic factor in patients with varus ankle osteoarthritis, and we recommend that clinicians investigate such abnormality perioperatively.
Purpose:We report clinical and radiologic outcomes after metacarpal extension osteotomy for mild osteoarthritis of the thumb carpometacarpal joint. Materials and Methods: From 1999 to 2008, 11 patients were diagnosed with mild thumb carpometacarpal arthritis (Eaton stage I, II), and extension osteotomies were performed. Of these, seven patients with at least 6 years follow-up were analyzed retrospectively. Male to female ratio was 2:5, and mean age at time of surgery was 38.9 years old. Symptom onset period was a mean of 11.2 months. Two patients were I, and five patients were II in Eaton stage. Preoperative visual analogue scale (VAS) and disabilities of the arm, shoulder and hand scale (DASH) scores were 3.7 points (3-4 points), and 40.1 points (32-51 points). Radial abduction was 38. . Grip strengths and pinch powers, compared with the normal contralateral side were 82% (64%-90%) and 72% (40%-100%), respectively. Results: The mean follow-up period was 8.5 years, and all patients except one maintained their occupational activity during the followup period. Final VAS and DASH scores were 0.7 points (0-2 points) and 11.7 points (8-16 points), respectively, and were statistically significant. Volar abduction, grip strengths, and pinch power were improved to 45 o (40 o -50 o ), 92.3% (73%-117%), and 94.4% (75%-117%) with statistical significances. In five patients, Eaton stages did not change, and two patients advanced to the next stage (stage I to II in one patient, stage II to III in one patient). Conclusion: Among the various treatment options for mild thumb carpometacarpal arthritis, metacarpal extension osteotomy may be considered as an effective treatment.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.