ABSTRACT
We describe the use of the Leeds-Keio ligament to reconstruct a neglected quadriceps tendon rupture following revision knee arthroplasty. The Leeds-Keio ligament has been used in the treatment of patellar tendon ruptures complicating primary knee arthroplasty with good result--but may, as this report shows, also be successfully applied to address deficiencies of the quadriceps tendon in the revision setting, with continued good function for 2 years.
Subject(s)
Arthroplasty, Replacement, Knee , Prostheses and Implants , Tendon Injuries/surgery , Aged, 80 and over , Female , Humans , Polyesters , Reoperation , RuptureABSTRACT
Posttraumatic instability of the distal radioulnar joint (DRUJ), occurring in isolation or in association with fractures of the radius, is well-documented. Few reports have identified simultaneous ipsilateral DRUJ instability and elbow dislocation. The authors of the present study describe a case of persistent radiocapitellar subluxation after closed reduction of an elbow dislocation, secondary to irreducible volar subluxation of the DRUJ.
Subject(s)
Elbow Injuries , Joint Dislocations/surgery , Joint Instability/surgery , Multiple Trauma/surgery , Wrist Injuries/surgery , Accidental Falls , Female , Humans , Joint Dislocations/diagnostic imaging , Joint Dislocations/etiology , Joint Instability/diagnostic imaging , Joint Instability/etiology , Middle Aged , Multiple Trauma/diagnostic imaging , Multiple Trauma/etiology , Radiography , Wrist Injuries/diagnostic imaging , Wrist Injuries/etiologyABSTRACT
In 28 of 1656 total knee arthroplasties (TKAs) (1.7%) performed for osteoarthritis at this institution, the preoperative arc of motion was 60 degrees or less (average 47.5 degrees; range, 20-60 degrees). The outcome of 22 of the 28 TKAs (21 patients) is reported at a mean follow-up of 52.9 months (range, 24-144 months). Eighty-two percent of the cases were managed with standard soft-tissue releases and posterior cruciate-retaining implants and 18% with a cruciate-substituting design. The joint score rose from 28.8 to 82.2 and the Knee Society Score from 24.6 to 77 points. The mean postoperative arc of motion improved by 46 degrees-93.5 degrees. At latest follow-up, 68.2% of knees achieved maximal flexion of 90 degrees or more. Manipulation was performed in 22.7%. Complications were minimal. A functionally useful range of motion is possible after total knee arthroplasty in the majority of stiff osteoarthritic knees, often without the need for posterior cruciate substitution.
