Reconstruction of a Bony Bankart Lesion: Best Fit Based on Radius of Curvature.

Reconstruction of a Bony Bankart Lesion: Best Fit Based on Radius of Curvature.

Am J Sports Med. 2013 Mar 4;
Dehaan A, Munch J, Durkan M, Yoo J, Crawford D

BACKGROUND:The inferior coracoid process has traditionally been considered to be the gold standard for glenoid augmentation after anteroinferior bone loss. Other autograft sites, and more recently, osteochondral allograft sites, have been described as potential donor sources. PURPOSE:Potential autograft and osteochondral allograft sites were compared to identify the graft source that would provide the best fit for glenoid augmentation. STUDY DESIGN:Controlled laboratory study. METHODS:Mose circles, a geometric tool found on a standard goniometer, were used to make radius of curvature measurements of 10 anatomic locations in 17 cadaveric specimens. The bony surface of the glenoid, measured from superior to inferior (G-SI) and from anterior to posterior (G-AP), was used as the standard for comparison. Autograft sites were the inferior coracoid, lateral coracoid, and inner table of the iliac crest. Potential osteochondral allograft sites were the radial head, scaphoid fossa of the distal radius (S-DR), lunate fossa of the distal radius (L-DR), medial tibial plateau, and lateral distal tibia. An acceptable match for autograft sites was based on a paired analysis and defined as a radius of curvature within 5 mm of the G-SI or the G-AP of the same cadaveric specimen. Allograft sites were evaluated using an unpaired analysis in which an ideal fit was defined as a radius of curvature of 25 to 30 mm, based on the interquartile range of the G-SI and G-AP. RESULTS:The median (interquartile range) radii of curvature for the G-SI and G-AP were 30 mm (range, 25-30 mm) and 25 mm (range, 25-25 mm), respectively. The inferior coracoid was within 5 mm of the G-SI 59% of the time and the G-AP 94% of the time; no measurements from the lateral coracoid or iliac crest were within the range of the glenoid radius of curvature. Analysis of the allograft sites demonstrated an acceptable fit for 94% of the distal tibia, 68% of the medial tibial plateau, 12% of the S-DR, and 0% of the L-DR and the radial head specimens. CONCLUSION:An autograft of the inferior coracoid or an osteochondral allograft of the lateral distal tibia provided the best match to re-establish the native radius of curvature of the glenoid. CLINICAL RELEVANCE:To best re-create the native glenohumeral anatomy, surgeons should consider the use of an autograft of the inferior coracoid or an osteochondral allograft of the lateral distal tibia for the reconstruction of osseous glenoid defects. HubMed – rehab


The Effect of Early Whole-Body Vibration Therapy on Neuromuscular Control After Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial.

Am J Sports Med. 2013 Mar 4;
Fu CL, Yung SH, Law KY, Leung KH, Lui PY, Siu HK, Chan KM

BACKGROUND:Despite rehabilitation training, deficiency in knee joint position sense, muscular performance, postural control, and functional ability is common after anterior cruciate ligament reconstruction (ACLR). Whole-body vibration therapy (WBVT), which is initiated from 3 months postoperatively, has proven benefits. However, the effect of earlier WBVT is unknown. PURPOSE:To investigate the effect of early WBVT on neuromuscular control after ACLR. STUDY DESIGN:Randomized controlled trial; Level of evidence, 1. METHODS:A total of 48 patients with unilateral complete isolated ACL tears were recruited. Single-bundle hamstring ACLR was performed in all patients. After surgery, they were randomly assigned to either the reference or treatment group. Reference group patients received conventional ACL rehabilitation, while treatment group patients received 8 weeks of WBVT in addition to conventional rehabilitation, starting from 1 month postoperatively. Joint position sense, postural control, and knee isokinetic performance were assessed before surgery and at 1, 3, and 6 months postoperatively using the Biodex dynamometer, Biodex Stability System, and Cybex NORM, respectively. Knee range of motion (ROM), stability (manual testing and KT-1000 arthrometer), and functional ability (single-legged hop test, triple hop test, shuttle run test, and carioca test) were also examined. Two-way repeated-measures analysis of variance and the Mann-Whitney U test were used for statistical analysis. RESULTS:There was no complication throughout the rehabilitation. All patients achieved full knee ROM and stable knee joints at 6 months after surgery. The WBVT group demonstrated significantly better postural control, muscle performance, single-legged hop, and shuttle run (P < .05) than the reference group, but there was no significant difference in knee joint position sense, triple hop, carioca, ROM, and stability (P > .05). CONCLUSION:Early WBVT started from 1 month postoperatively was an effective training method without compromising knee ROM and stability. It improved postural control, isokinetic performance, single-legged hop, and shuttle run but not knee joint position sense, triple hop, and carioca. HubMed – rehab


The missing tracheoesophageal puncture prosthesis: Evaluation and management.

Ear Nose Throat J. 2013 Feb; 92(2): E14-6
Leuin SC, Deschler DG

Placement of a tracheoesophageal puncture prosthesis in the post-laryngectomy patient has significantly improved voice rehabilitation in this population. Rarely, the prosthesis may become dislodged, necessitating medical evaluation. We present the case of a 61-year-old man who presented to our Emergency Department with a missing prosthesis. We describe the evaluation and management of this patient and review the relevant literature. We conclude with the following algorithm: When a patient presents with a missing prosthesis, evaluation of the tracheobronchial tree must be performed. Once the pulmonary system is cleared, the prosthesis can be presumed in the gastrointestinal tract and allowed to pass. A new prosthesis or catheter should be placed in the tract to prevent aspiration. HubMed – rehab


[Hospitalization and dementia: what was new in 2012? : Literature review.]

Z Gerontol Geriatr. 2013 Mar 6;
Hofmann W

The present work provides a review of literature published in 2012 that were found in a PubMed search with the terms “hospitalization and dementia. Further information was obtained from personal contacts. The rate of publications was ten times higher in 2012 as in previous years. Frequency of dementia, hospital admission, acute coronary syndrome, femoral neck fracture, stroke, complications during hospital stay, outcomes after hospitalization, prediction, rehabilitation, and training are the common topics. HubMed – rehab


Wheelchair Skill Performance of Manual Wheelchair Users With Spinal Cord Injury.

Top Spinal Cord Inj Rehabil. 2012; 18(2): 138-139
Oyster ML, Smith IJ, Kirby RL, Cooper TA, Groah SL, Pedersen JP, Boninger ML

HubMed – rehab