Department of Orthopaedics and Traumatology, Freiburg University Hospital, Freiburg, Germany.
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for decision-making. A hypertrophic nonunion is stiff, has abundant callus and viable fracture fragments. Therefore, the biology is more than adequate, however, the mechanical instability prevents maturation and consolidation. An oligotrophic nonunion
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University Hospital for Orthopaedics and Trauma Surgery Pius-Hospital, Medical Campus University of Oldenburg, Oldenburg, Germany
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.3%. Joint preparation with convex/concave reamers and joint fixation with a plate with a lag screw shows the lowest non-union rate. Full postoperative weight-bearing in a stiff-soled postoperative shoe is safe and is not associated with non-union vs a more
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Casa di Cura Villa Betania, Rome, Italy
Marrelli Hospital, Crotone, Italy
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The posterior oblique ligament (POL) is the predominant ligamentous structure on the posterior medial corner of the knee joint. A thorough understanding of the anatomy, biomechanics, diagnosis, treatment and rehabilitation of POL injuries will aid orthopaedic surgeons in the management of these injuries.
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The resulting rotational instability, in addition to valgus laxity, may not be tolerated by athletes participating in pivoting sports. The most common mechanism of injury – accounting for 72% of cases – is related to sports activity, particularly football, basketball and skiing. Moreover, three different injury patterns have been reported: those associated with injury to the capsular arm of the semimembranosus (SM), those involving a complete peripheral meniscal detachment and those involving disruption of the SM and peripheral meniscal detachment.
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The hallmark of an injury related to POL lesions is the presence of anteromedial rotatory instability (AMRI), which is defined as ‘external rotation with anterior subluxation of the medial tibial plateau relative to the distal femur’.
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In acute settings, POL lesions can be easily identified using coronal and axial magnetic resonance imaging (MRI) where the medial collateral ligament (MCL) and POL appear as separate structures. However, MRI is not sensitive in chronic cases.
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Surgical treatment of the medial side leads to satisfactory clinical results in a multi-ligamentous reconstruction scenario, but it is known to be associated with secondary stiffness.
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In young patients with high functional demands, return to sports is allowed no earlier than 9–12 months after they have undergone a thorough rehabilitation programme.
Cite this article: EFORT Open Rev 2021;6:364-371. DOI: 10.1302/2058-5241.6.200127
Department of Orthopaedics, Golden Jubilee National Hospital, Clydebank, UK
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Department of Orthopaedics, Golden Jubilee National Hospital, Clydebank, UK
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factors with potential association to instability have been examined such as joint laxity, muscle strength, proprioception, knee joint stiffness, disease severity and gait parameters, finding several significant associations. 2 , 6 - 9 This is of
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loss, choice of implant and level of constraint. During clinical examination, the surgeon must evaluate skin temperature, redness, swelling, deformity both at rest and during weight-bearing, peripheral pulses, range of motion (particularly stiffness 4
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a rise in the incidence of revision TKA. In the current literature, the most common reasons for revision TKA are aseptic loosening, usually as a result of wear, and infection. 2 , 5 - 8 These, together with instability and stiffness, account for
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Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
Faculty of Medicine, University of Geneva, Switzerland
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profession; across papers published over the past 70 years, alternative names put forward or utilized in leading journals have included ‘adhesive capsulitis’, 1 ‘fibrotic capsulitis’, 2 ‘primary idiopathic stiff shoulder’, 3 and ‘contracture of
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headaches, gastrointestinal disturbance, malaise and stiffness of the neck and back, with or without paralysis, may occur. The ratio of unapparent to paralytic infections may be as high as 1000 to 1 in children and 75 to 1 in adults, depending on the viral
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-thickness tear. The risk of stiffness after repair of partial-thickness rotator cuff tears is a concern. Huberty et al 49 evaluated the incidence of post-operative stiffness following arthroscopic rotator cuff repairs. The authors retrospectively studied
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balanced Low standing SS, sagittally imbalanced Fused spine Explanation Physiologic mobility Stiffness Spine-ageing modifications Spine-ageing modifications Spine surgery Risk assessment Very low–low Moderate–high Moderate
