(see also: AKA Prosthesis, Amputations in the Diabetic Patient Discussion average AK amputee walks 43% slower and expends 89% more kcal/min than the normal person; if proximal circulation is adequate, a longer anterior muscle flap may be left and the combination myodesis- myoplasty technique is used; ability to ambulate with a prosthesis depends heavily … Read more
Discussion it is important that knee joint is extended throughout stance phase; this means that the components are assembled so that a straight line extended fromthe "trochanter" will pass anterior to the knee and through the ankle; friction is adjusted to help control the amount of knee flexion and to help decelerate the shank; mechanical … Read more
Discussion classic disease results from deficiency of factor VIII clotting activity; hemophilia A is not caused by an absolute deficiency of factor VIII, but from an abnormal molecule making up part of the VIII clotting factor; hemophilic arthropathy: pathologic changes (coag pathway / coag labs); inheritance pattern: sex-linked recessive; affected male will have normal sons … Read more
(see also: osteoarthritis of the knee) Discussion hyaluronic acid is a glycosaminoglycan found in synovial fluid & cartilage; complex sugar (not a protein) ancient molecule, highly conserved- identical function acts as lubricant and shock absorber; acts as barrier permitting metabolites to pass thru it by diffusion but resists penetration by bacteria and other infectious agents; … Read more
(see also: Chondral Injuries: Nourishment) Discussion articular cartilage is avascular & is prevented from mounting a vascular response when there is isolated cartilage injury; absence of vessels w/ in cartilage imposes limitations on healing potential; indeed, some traumatic defects in cartilage apparently never heal; chondrocytes in articular cartilage are capable of cell division & are … Read more
Discussion » orthopaedic infection menu general orders and treatment differential diagnosis » (also consider Brucella melitensis, Borrelia burgdorferi and Treponema pallidum) Painful knee–an unusual cause secondary to pseudomonas septic arthritis of the hip. Septic until proven otherwise: approach to and treatment of the septic joint in adult patients. Indicators for detection of septic arthritis in … Read more
(see also: Spondyloarthropathies) Discussion psoriasis affects 1-2 % of U.S. population & typically presents w/ well-defined erythematous scaly plaques; only a minority of pts with psoriasis develop arthritis; when arthritis develops, it most often is an asymmetrical oligoarthritis, which at times may be quite destructive; some patients may develop spondylitis (usually will have HLA-B27 antigen); … Read more
Discussion indicated for symptomatic soft tissue impingement, synovitis: specific lesions amenable to arthroscopic debridement include: osteochondral lesions; meniscoid lesion in anterolateral gutter; mass of fibrocartilagenous tissue arising from the tibio-fibular joint will protrude into the joint; patients will note anterolateral ankle pain, popping, and giving way; anterior impingement snydrome of the ankle thickening of antero-inferior … Read more
Discussion acute arthritis caused by CPPD crystal-induced inflammation; almost as common as gout & may perfectly mimic gout during acute flare; pseudogout attacks occurring before age 50 are uncommon; see: pseudogout occurence after joint replacement references: A histological study of calcium pyrophosphate dihydrate crystal-deposition disease. Clinical features of pseudogout attack. A survey of 50 cases. … Read more
Discussion OA is defined as a chronic irreversible degenerative disease of articular cartilage predisposing conditions pathology and histology clinical features laboratory aspects Osteoarthritis of the Knee » Hip Osteoarthritis clinical features pain on wt-bearing felt in the groin, buttock, or medial thigh; trendelenburg gait will decrease mechanical stress on joint and thereby lessen pain (see … Read more