MyMedR

Anatomy of the lateral retinaculum of the knee

Merican AM, Amis AA

J Bone Joint Surg Br, 2008 Apr;90(4):527-34.

PMID: 18378934 DOI: 10.1302/0301-620X.90B4.20085

Anatomical descriptions of the lateral retinaculum have been published, but the attachments, name or even existence of its tissue bands and layers are ill-defined. We have examined 35 specimens of the knee. The deep fascia is the most superficial layer and the joint capsule is the deepest. The intermediate layer is the most substantial and consists of derivatives of the iliotibial band and the quadriceps aponeurosis. The longitudinal fibres of the iliotibial band merge with those of the quadriceps aponeurosis adjacent to the patella. These longitudinal fibres are reinforced by superficial arciform fibres and on the deep aspect by transverse fibres of the iliotibial band. The latter are dense and provide attachment of the iliotibial band to the patella and the tendon of vastus lateralis obliquus. Our study identifies two important new findings which are a constant connection of the deep fascia to the quadriceps tendon superior and lateral to the patella, and, a connection of the deeper transverse fibres to the tendon of vastus lateralis obliquus.

Matched MeSH terms: Joint Instability/etiology

Fulltext Iatrogenic instability of the lumbar spine

Sivananthan KS

Med J Malaysia, 2001 Jun;56 Suppl C:1-2.

PMID: 11814241

Matched MeSH terms: Joint Instability/etiology*

Fulltext Median occipital condyle associated with atlantoaxial instability and myelopathy: a case report

Fadzil F

Med J Malaysia, 2011 Oct;66(4):365-6.

PMID: 22299561 MyJurnal

A Median Occipital Condyle is a rare occurrence. We have not found any clinical studies in the literature and myelopathy due to a median condyle has been reported once before. Myelopathy due to anomalies of the craniovertebral junction is rare in neurosurgical practice. We describe a case of a 72-year-old man presenting with progressive myelopathy related to a median occipital condyle located at the anterior foramen magnum region.

Matched MeSH terms: Joint Instability/etiology*

Displaced medial epicondyle fractures of the humerus: surgical treatment and results. A report of 139 cases

Louahem DM, Bourelle S, Buscayret F, Mazeau P, Kelly P, Dimeglio A, et al.

Arch Orthop Trauma Surg, 2010 May;130(5):649-55.

PMID: 19960347 DOI: 10.1007/s00402-009-1009-3

Elbow instability is a common feature after medial epicondyle fractures, displaced or not, even in the absence of dislocation. Undisplaced or minimally displaced fractures often have an underestimated degree of instability secondary to unrecognised capsuloligamentous and muscular injuries. The purpose of this retrospective study was to analyze and to assess objectively the results of the surgical treatment of these acute injuries.

Matched MeSH terms: Joint Instability/etiology

Fulltext Progressive supra-axial cervical instability in Down syndrome: a case report emphasising the role of extended short-segment fusion

Tan GH, Tan KK, Afian MS, Liew WF, Mohamad AR

Med J Malaysia, 2005 Jul;60 Suppl C:111-3.

PMID: 16381295

We report a case of upper cervical instability associated with Down syndrome to highlight its potential progression to inflict cord compression and the rationale for surgical decompression and extended short segment occipito-axial fusion.

Matched MeSH terms: Joint Instability/etiology*

Fulltext A modified Blatt dorsal capsulodesis in the treatment of dynamic scapholunate instability

Azura L, Ahmad TS, Kamarul T

Med J Malaysia, 2006 Dec;61 Suppl B:51-4.

PMID: 17600993

We report a case of scapholunate dissociation which was initially missed and presented late. A modification of Blatt dorsal capsulodesis performed using dorsal intercarpal ligament (DICL) and extra tunnel appears not only to add to dorsal stability but also address the volar problem as well. This modification may be a better alternative to the current technique of using a single flap.

Matched MeSH terms: Joint Instability/etiology

Effect of the Timing of Anterior Cruciate Ligament Reconstruction on Clinical and Stability Outcomes: A Systematic Review and Meta-analysis

Lee YS, Lee OS, Lee SH, Hui TS

Arthroscopy, 2018 02;34(2):592-602.

PMID: 28974333 DOI: 10.1016/j.arthro.2017.07.023

PURPOSE: The purpose of this systematic review and meta-analysis was to evaluate the effect of the timing of anterior cruciate ligament (ACL) reconstruction on clinical and stability outcomes by analyzing high-quality studies that assessed timing as a primary objective.

METHODS: The MEDLINE, EMBASE, and Cochrane database were systematically searched. The inclusion criteria were as follows: (1) English articles, (2) noncomparative study or relevant study reporting clinical and/or stability results, and (3) timing of the ACL reconstruction as a primary objective. Study type, level of evidence, randomization method, exclusion criteria, number of cases, age, sex, timing of ACL reconstruction, follow-up, clinical outcomes, stability outcomes, and other relevant findings were recorded. Statistical analysis of the Lysholm scores and KT-1000 arthrometer measurements after early and delayed ACL reconstruction was performed using R version 3.3.1.

RESULTS: Seven articles were included in the final analysis. There were 6 randomized controlled trials and 1 Level II study. Pooled analysis was performed using only Level I studies. All studies assessed the timing of ACL reconstruction as a primary objective. The definition of early ranged broadly from 9 days to 5 months and delayed ranged from 10 weeks to >24 months, and there was an overlap of the time intervals between some studies. The standard timing of the delayed reconstruction was around 10 weeks from injury in the pooled analysis. After pooling of data, clinical result was not statistically different between groups (I2: 47%, moderate level of heterogeneity). No statistically significant difference was observed in the KT-1000 arthrometer measurements between groups (I2: 76.2%, high level of heterogeneity) either.

CONCLUSION: This systematic review and meta-analysis performed using currently available high-quality literature provides relatively strong evidence that early ACL reconstruction results in good clinical and stability outcomes. Early ACL reconstruction results in comparable clinical and stability outcomes compared with delayed ACL reconstruction.

LEVEL OF EVIDENCE: Level II, a systematic review and meta-analysis of Level I and II studies.

Matched MeSH terms: Joint Instability/etiology

Fulltext Chronic posterolateral rotatory instability of the knee

Yong CK

Med J Malaysia, 2006 Dec;61 Suppl B:27-31.

PMID: 17605179

Posterolateral corner (PLC) laxity of the knee results in rotatory instability, in association with posterior cruciate ligament (PCL) laxity led to a grossly unstable knee. This is a series of eight patients with chronic PLC and PCL laxity treated with arthroscopic quadriceps tendon PCL reconstruction and extraarticular hamstring PLC reconstruction. Seven cases had high tibial osteotomy to address associated genu varus deformity. With prospective pre- and post-operative assessments, there was a significant improvement in the 2000 International Knee Documentation Committee (IKDC) subjective assessment and knee examination, Lysholm-Gillquist and Tegner activity scores, as well as KT-1000 arthrometry measurement after one year in all knees. Surgical treatment of PLC laxity must address coexisting problems of the PCL and mechanical alignment for a successful outcome.

Matched MeSH terms: Joint Instability/etiology*

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