Purpose Kinematic alignment (KA) and mechanical alignment (MA) position the prosthetic trochlea that guides patellar tracking diferently. The present study determined whether KA or MA more closely restores the groove location and sulcus angle of the prosthetic trochlea to the native trochlea for three femoral component designs. Methods Ten 3D femur-cartilage models were created by combining computer tomographic (CT) and laser scans of native human cadaveric femurs. Three femoral component designs were positioned using KA and MA. Measurements of the prosthetic and native trochlea were made along the arc length of the native trochlear groove. The alignment technique with the smaller absolute diference between prosthetic and native for the medial-lateral and radial locations of the groove and sulcus angle of the trochlea more closely restored the native trochlea. Results For three femoral component designs, KA more closely restored to native the mean medial-lateral location (p = 0.0033 to < 0.0001) and mean radial location (p = 0.0150 to < 0.0001) than MA. For two femoral component designs, KA more closely restored to native the mean sulcus angle (p = 0.0326 to 0.0006) than MA. However, the diferences in the mean sulcus angles between KA and MA were less than 2° for all three designs. Conclusion KA more closely restored the native trochlea, which explains why the reported risk of patellofemoral complications for KA is not higher than MA according to ive randomized clinical trials. Small design modiications of the mediallateral and radial locations and sulcus angle are strategies for restoring the native trochlea. Such modiications might further reduce the risk of patellofemoral complications. Level of evidence II.
The use of suture anchors in lateral ligament stabilization allows for a smaller incision, less surgical dissection, and improved surgical efficiency. It is up to the discretion of the performing surgeon based on preference, ease of use, operative time, and cost profile to choose either of these constructs for anatomic repair of the lateral ligaments of the ankle. The suture repair at the ligament was significantly strong enough such that the majority of ankles failed at the bone interface.
BackgroundMost ice figure skaters train and compete with ongoing issues in the lower extremities, which are often overlooked by the skaters and considered injuries only when they prevent the athletes from skating. Although not severe, these conditions impair the quality of daily training and compromise the skaters’ state of mind and performances.Purpose(1) To determine the point prevalence of the ongoing lower extremity overuse conditions in a population of ice figure skaters of all ages and levels and (2) to identify the risk factors contributing to the development of the most common ongoing conditions.Study DesignCross-sectional study; Level of evidence, 3.MethodsA total of 95 skaters of all ages and skating levels were evaluated in a single examination in the middle of the competitive season. Data collection consisted of a questionnaire, clinical examination, and measurement of the skaters’ characteristics and the equipment used.ResultsRetrocalcaneal bursitis was the most common problem, affecting at least 1 foot in 34% of the skaters evaluated, followed by posterior heel skin calluses and superficial calcaneal bursitis, which affected 29% and 28% of skaters, respectively. The prevalence of the majority of these conditions was 10% to 32% higher in elite skaters than in nonelite skaters. Higher boot–foot length difference was associated with greater risk of superficial calcaneal bursitis in the landing foot of elite skaters, while higher body weight and greater in-skate ankle flexibility were associated with the development of retrocalcaneal bursitis in nonelite skaters. Only 30 skaters (32%) wore the appropriate boot size, while 57 skaters (51%) could not dorsiflex their ankles properly while wearing skates.ConclusionThe heel represents a major area of concern for the high prevalence of calcaneal bursitis and calluses in proximity of the Achilles tendon, suggesting that improvements on the boot heel cup design should take priority. The association of bursitis with higher in-skate ankle flexibility suggests that these conditions may be the results of a process developing when the ankle is bending within the boot. Also, since wearing oversized boots is a major risk factor for the development of subcutaneous bursitis and skin abrasions, boot retailers should be better educated to sell the appropriate boot size to the skaters.
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