Early weight bearing functional rehabilitation reduces the rate of tendo achilles re-rupture: A case control series

Objectives: The aim of the study was to asses the impact of the functional rehabilitation on patella alignment with MRI imaging in patients who underwent the ACL reconstruction. The surgical approach with the use of patellar tendon graft is known to carry the risk of lowering patella height (patella baja), which, in turn, may lead to accelerated cartilage wear in patellofemoral joint. Methods: 30 patients after the anatomical reconstruction of ACL took part in this study (23 male, and 7 female, mean age = 28 ± 10,6 years). During the procedure a patellar tendon graft was used. The Insali-Salvati ratio measured with MRI (images taken pre-procedural, and 9 months after the surgery) was used for the assessment of patellar alignment. The measurements were taken by one radiology specialist on MRI scans in sagittal view in PD sequence. During the examination, patellar joint was in flexion (approx.10 degrees). As the point of reference for patella’s position ISR ratio was in the range of 0.8 - 1.2. All patients were operated on by the same team of surgeons and underwent an unified rehabilitation programme led by a team of selected physiotherapists. The main features of the programme were: an early muscle activation (second day after the procedure); mobilisation of the patella and tissues of the anterior compartment of the knee; weight bearing co-contraction exercises, and the sensomotoric training of the entire kinetic chain of the lower limb. The data recorded was statistically analysed using the Wilcoxon signed-rank test in order to establish parameters’ changes within the study group.. Results: The mean ISR value before the procedure was 0.84 (± 0,1), whereas 9 months after the surgery it was 0.85 (± 0,1). The results’ analysis did not show any statistically significant changes between ISR values. Nine months after the procedure patella baja has not been observed in any of the evaluated patients. Conclusion: The functional rehabilitation programme designed by the CMC team had no negative impact on patella alignment, as no patella baja, which is a common complication after these kinds of surgeries, has been observed. The applied functional rehabilitation programme enabled patients to keep the proper patella alignment, similar to the alignment recorded before the surgery.

Download Full-text

An intact fibula may contribute to allow early weight bearing in surgically treated tibial plateau fractures

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-017-4428-7 ◽

2017 ◽

Vol 26 (3) ◽

pp. 756-761 ◽

Cited By ~ 2

Author(s):

Ion Carrera ◽

Pablo Eduardo Gelber ◽

Gaetan Chary ◽

Mireia Gomez Masdeu ◽

Miguel A. González Ballester ◽

...

Keyword(s):

Tibial Plateau ◽

Weight Bearing ◽

Tibial Plateau Fractures ◽

Early Weight Bearing

Download Full-text

Arthroscopic Versus Open Tennis Elbow Release: 3- to 6-Year Results of a Case-Control Series of 305 Elbows

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2012.12.012 ◽

2013 ◽

Vol 29 (5) ◽

pp. 854-859 ◽

Cited By ~ 55

Author(s):

Eirik Solheim ◽

Janne Hegna ◽

Jannike Øyen

Keyword(s):

Tennis Elbow ◽

Case Control ◽

Control Series

Download Full-text

Effect of Weight-Bearing in Conservative and Operative Management of Fractures of the Base of the Fifth Metatarsal Bone

BioMed Research International ◽

10.1155/2017/1397252 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Jae-Yong Park ◽

Hyong-Nyun Kim ◽

Yoon-Suk Hyun ◽

Jun-Sik Park ◽

Hwan-Jin Kwon ◽

...

Keyword(s):

Bone Resorption ◽

Weight Bearing ◽

Operative Management ◽

Foot And Ankle ◽

Early Weight Bearing ◽

Group A ◽

Vas Scores ◽

American Orthopaedic ◽

Group B ◽

Underlying Diseases

Background. There is no established principle regarding weight-bearing in conservative and operative management of fifth metatarsal base fractures. Methods. We reviewed 86 patients with acute fifth metatarsal base fractures. Conservatively treated late or early weight-bearing patients were assigned to Group A or C, respectively. Operatively treated late or early weight-bearing patients were assigned to Group B or D, respectively. Results were evaluated by clinical union, bone resorption, and the American Orthopaedic Foot and Ankle Society (AOFAS) and Visual Analogue Scale (VAS) scores. Results. All 4 groups had bone union at a mean of 6.9 weeks (range, 5.1–15.0). There were no differences between the groups in the AOFAS and VAS scores. In the early weight-bearing groups, there were fewer cases of bone resorption, and the bone unions periods were earlier. Conclusions. Early weight-bearing may help this patient population. Moreover, conservative treatment could be an option in patients with underlying diseases.

Download Full-text

Distal Tibia Metaphyseal Fractures: Which is Better, Intra-medullary Nailing or Minimally Invasive Plate Osteosynthesis?

Journal of Orthopaedics Trauma and Rehabilitation ◽

10.1016/j.jotr.2017.09.004 ◽

2018 ◽

Vol 24 (1) ◽

pp. 66-71

Author(s):

Kawalkar Abhijit Chandrakant ◽

Badole Chandrashekher Martand

Keyword(s):

Intramedullary Nailing ◽

Weight Bearing ◽

Distal Tibia ◽

Tibial Fractures ◽

Minimally Invasive Plate Osteosynthesis ◽

Early Weight Bearing ◽

Significant Difference ◽

Duration Of Surgery ◽

Tibia Fractures ◽

Distal Tibia Fractures

Introduction Tibia fractures are the most common long bone fractures encountered by the orthopedic surgeons and distal tibia fractures have the second highest incidence of all tibia fractures after the middle third of tibia the distal tibial fractures are unique and are considered as most challenging fractures to treat due to its proximity to the ankle joint and its superficial nature. The objective of this study is to compare two osteosynthesis systems developed for surgical treatment of distal tibia fractures: the intramedullary nailing and the MIPPO technique. Methods The study was conducted between Jan 2011 to Dec 2012. 63 patients with extra-articular distal tibia fracture treated with intramedullary nailing and MIPPO technique were reviewed retrospectively and clinical outcome was evaluated according to American Orthopaedic Foot and Ankle Score. Results 31 patients were treated with intramedullary nail & 32 with MIPPO technique. Fibular fixation was done in cases where fibular fracture was at or below the level of tibial fractures. We found no difference in terms of time for fracture union, mal-union, non-union, duration of surgery and amount of blood loss. But there was significant difference in terms of infection and duration of hospital stay. Also weight bearing was possible much earlier in intramedullary group as compared to the MIPPO group. Conclusion Thus we conclude that intramedullary nailing is better choice of implant in patients with extra- articular distal tibia fractures & helps in early weight bearing and ambulation of patient with fewer complications.

Download Full-text

Ankle Arthrodesis with Cannulated Screw: Case Series

Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya ◽

10.30651/jqm.v4i1.2661 ◽

2020 ◽

Vol 4 (1) ◽

pp. 87

Author(s):

Andre Triadi Desnantyo ◽

Muhammad Zaim Chilmi ◽

Hizbillah Yazid

Keyword(s):

Weight Bearing ◽

Case Series ◽

Ankle Arthrodesis ◽

Cannulated Screw ◽

Average Score ◽

Foot And Ankle ◽

Early Weight Bearing ◽

Sf 36 ◽

Clinical Scoring ◽

Hind Foot

ABSTRACT Ankle osteoarthritis patients are young and lack of available long last treatment. Ankle arthrodesis remains the gold standard and is the procedure of choice for younger patients who are heavy laborers. These case series evaluate and report five patients undergone ankle arthrodesis at RSUD Dr. Soetomo Surabaya on 2012-2016. The data were collected from patient files, radiographs, and a recent physical examination. The outcome has been assessed with SF-36 score and clinical scoring system Ankle-Hind foot American Foot and Ankle Society. Three male patients and two female patients underwent ankle arthrodesis with cannulated screw, caused by neglected severe ankle dislocation. One patient had open dislocation. Based on SF-36 scoring, the five patients had average score 76,7 with highest and lowest score were 95,9 and 56,7. Based on clinical score ankle-hind foot American Ankle and Foot Society, the average score was 68(51 – 88). The scoring result includes general health, physic, emotional, and social. And clinical scoring ankle-hind foot American Foot and Ankle Society evaluation includes pain, function, and alignment. It shows that there was patient that gains an almost perfect result. Patient with the lowest score also had knee osteoarthritis contralateral from the operated ankle. Early weight bearing on ankle arthrodesis with cannulated screw was the major factor caused unsatisfactory result of this patient. Ankle arthrodesis with cannulated screw has satisfactory result eventhough remain complain on one patient. Nevertheless, ankle arthrodesis with cannulated screw still has an important role in the treatment of choice on ankle reconstruction.Keywords : Ankle arthrodesis, cannulated screw, ankle joint fusion

Download Full-text

External skeletal fixation of the tibial shaft fractures

Vojnosanitetski pregled ◽

10.2298/vsp0501011m ◽

2005 ◽

Vol 62 (1) ◽

pp. 11-15 ◽

Cited By ~ 2

Author(s):

Sasa Milenkovic ◽

Milorad Mitkovic ◽

Mile Radenkovic

Keyword(s):

External Fixation ◽

External Fixator ◽

Weight Bearing ◽

Early Mobilization ◽

Tibial Shaft ◽

Closed Fracture ◽

Early Weight Bearing ◽

Shaft Fractures ◽

Pin Tract Infection ◽

Tibial Shaft Fractures

Aim. To present the possibility of a successful use of external skeletal fixation in treating the open and closed tibial shaft fractures with Mitkovic?s external fixator. Methods. External fixation was used in 115 patients with 118 fresh tibial shaft fractures, 82 males (71.3%) and 33 females (28.7%), average age 43.92 years (16?84). Open tibial shaft fractures were present in 37 (31.36%). All the fractures were treated with Mitkovic?s external fixator type M 20. Results. The results of external fixation were excellent or good in 94.07% of the cases, and bad in 5.08%. Pin tract infection appeared in 7 (5.93%) patients. In only 3 cases an external fixator was removed and treatment continued with the functional braces. Nonunion occurred in 6 (5.08%) patients, of which 4 were with open fractures (2 Gustilo type IIIB, 1 Gustilo type IIIA, 1 Gustilo type II) and 2 with the segment fractures. Compartment syndrome was observed in 1 (0.85%) patient with closed fracture. Malunion was found in 2 (1.69%) patients. Conclusion. External fixation of tibial shaft fractures is a simple and effective method to enable the safe healing of fractures, early mobilization of the patients, early weight-bearing, as well as early rehabilitation. Fixation of tibial shaft fractures was unilateral with convergent pins orientation, and there was also a possibility of compression and distraction.

Download Full-text

A study of prospective analysis of unipolar versus bipolar hemiarthroplasty of hip joint in patients with fracture neck of femur

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20211621 ◽

2021 ◽

Vol 7 (3) ◽

pp. 629

Author(s):

Raja X. ◽

Arjun Sarvesh ◽

Karthikeyen M. ◽

A. E. Manoharan

Keyword(s):

Femoral Neck ◽

Weight Bearing ◽

Femoral Neck Fractures ◽

Harris Hip Score ◽

Bipolar Hemiarthroplasty ◽

Neck Of Femur ◽

Early Weight Bearing ◽

Group I ◽

Significant Difference ◽

Group Ii

Background: Femoral neck fractures occur most commonly in elderly females and are a major cause of morbidity and mortality in this age group and require immediate and appropriate management. Aim of the study was to compare the functional outcome of unipolar Austin Moore's prosthesis (AMP) hemiarthroplasty (HA) and bipolar (BHA) HA with femoral neck fractures using Harris hip score system.Methods: The study was conducted on 60 patients aged above 50 years with fractured neck of femur admitted in Vinayaka missions Kirupananda Variyar medical college and hospital from August 2017 to August 2019. Patients with femoral neck fracture were allocated randomly to have 30 cases of AMP.Results: Out of the 60 cases, the patients in the bipolar (nonmodular) HA group II showed better functional outcomes compared to unipolar (AMP) HA group I after six months follow-ups. At 12 months of follow-up, there was no significant difference between group I (AMP) and group II (BHA).Conclusions: Our study demonstrates, hemiarthroplasty of the hip for femoral neck fractures is a good option in elderly patients. The mortality and morbidity are not high, the operative procedure is simple, complications are less disabling, early weight-bearing and functional results are satisfactory and second surgery are less frequently required.

Download Full-text