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Peter J Millett - One of the best experts on this subject based on the ideXlab platform.

  • scapulothoracic bursitis and snapping scapula syndrome a critical review of current evidence
    American Journal of Sports Medicine, 2015
    Co-Authors: Ryan J Warth, Ulrich J Spiegl, Peter J Millett
    Abstract:

    Background:Symptomatic scapulothoracic disorders, such as painful scapular Crepitus and/or bursitis, are uncommon; however, they can produce significant pain and disability in many patients.Purpose:To review the current knowledge pertaining to snapping scapula syndrome and to identify areas of further research that may be helpful to improve clinical outcomes and patient satisfaction.Study Design:Systematic review.Methods:We performed a preliminary search of the PubMed and Embase databases using the search terms “snapping scapula,” “scapulothoracic bursitis,” “partial scapulectomy,” and “superomedial angle resection” in September 2013. All nonreview articles related to the topic of snapping scapula syndrome were included.Results:The search identified a total of 167 unique articles, 81 of which were relevant to the topic of snapping scapula syndrome. There were 36 case series of fewer than 10 patients, 16 technique papers, 11 imaging studies, 9 anatomic studies, and 9 level IV outcomes studies. The level of...

  • snapping scapula syndrome diagnosis and management
    Journal of The American Academy of Orthopaedic Surgeons, 2013
    Co-Authors: Trevor R Gaskill, Peter J Millett
    Abstract:

    AbstractScapulothoracic bursitis and snapping scapula syndrome are rare diagnoses that contribute to considerable morbidity in some patients. These conditions represent a spectrum of disorders characterized by pain with or without mechanical Crepitus. They are commonly identified in young, active pa

Richard J Hawkins - One of the best experts on this subject based on the ideXlab platform.

  • relationships between objective assessment of ligament stability and subjective assessment of symptoms and function after anterior cruciate ligament reconstruction
    American Journal of Sports Medicine, 2004
    Co-Authors: Mininder S Kocher, Richard J Steadman, Karen K Briggs, William I Sterett, Richard J Hawkins
    Abstract:

    BackgroundRelationships between objective assessment of ligament stability and subjective assessment of symptoms and function after anterior cruciate ligament reconstruction have not been established.HypothesisRelationships exist between objective and subjective assessments after anterior cruciate ligament reconstruction.Study DesignCase series.MethodsPatients (N = 202) undergoing anterior cruciate ligament reconstruction with 2-year minimum follow-up were studied. Objective variables of ligament stability at follow-up included instrumented laxity, Lachman examination, and pivot-shift examination. Subjective variables of symptoms at follow-up included pain, swelling, giving way, locking, Crepitus, stiffness, and limping. Subjective function at follow-up included walking, squatting, stair climbing, running, cutting, jumping, twisting, activity limitation, sports level, activities of daily living level, work level, knee function, sports participation, Lysholm score, and satisfaction withoutcome.ResultsInstr...

  • symptomatic scapulothoracic Crepitus and bursitis
    Journal of The American Academy of Orthopaedic Surgeons, 1998
    Co-Authors: Joh E Kuh, Kevi D Planche, Richard J Hawkins
    Abstract:

    Scapulothoracic Crepitus and scapulothoracic bursitis are related painful disorders of the scapulothoracic articulation. Scapulothoracic Crepitus is the production of a grinding or snapping noise with scapulothoracic motion, which may be accompanied by pain. Scapulothoracic bursitis manifests as pain and swelling of the bursae of the scapulothoracic articulation. Scapulothoracic bursitis is always seen in patients with symptomatic scapulothoracic Crepitus, but may exist as an isolated entity. Symptomatic scapulothoracic Crepitus may be due to pathologic changes in the bone or soft tissue between the scapula and the chest wall or may be due to changes in congruence of the scapulothoracic articulation, as seen in scoliosis and thoracic kyphosis. Treatment of patients with symptomatic scapulothoracic Crepitus begins with nonoperative methods, including postural and scapular strengthening exercises and the application of local modalities. When soft-tissue lesions are the cause of scapulothoracic Crepitus, conservative treatment is highly effective. When symptomatic scapulothoracic Crepitus is due to osseous lesions, or when conservative treatment has failed, surgical options are available. Partial scapulectomies have produced satisfactory outcomes in selected patients. Recently, open and arthroscopic scapulothoracic bursectomies have been performed with some success and are being used more frequently.

Douglas A Dennis - One of the best experts on this subject based on the ideXlab platform.

  • femoral implant design modification decreases the incidence of patellar Crepitus in total knee arthroplasty
    Journal of Arthroplasty, 2017
    Co-Authors: Rya J Marti, David Clinto Mcnabb, Jaso M Jennings, Tyle S Watters, Daniel L Levy, Douglas A Dennis
    Abstract:

    Abstract Background Patellar Crepitus is a complication most commonly seen in patients implanted with a posterior-stabilized total knee arthroplasty (TKA). Recently, design changes in the patellofemoral geometry and the intercondylar box ratio have been optimized in newer TKA designs. A comparative study was performed to analyze the incidence of patellar Crepitus between a historical vs modern TKA design. Methods A retrospective review of all patients at our institution that underwent a primary TKA with either a PFC Sigma or Attune posterior-stabilized TKA (DePuy, Inc, Warsaw, IN), with a minimum of 1-year follow-up duration was performed. A total of 1165 participants implanted with the PFC Sigma and 728 with the Attune design were analyzed. Patellar Crepitus incidence, functional scores, and range of motion were recorded at each follow-up appointment. Statistical analyses were performed between the 2 groups to determine if there were differences in clinical outcomes. Results The incidence of Crepitus in participants implanted with the Attune was 0.55% vs 6.26% in the PFC Sigma cohort ( P P Conclusion The Attune posterior-stabilized TKA demonstrated substantially less patellofemoral Crepitus incidence than the historical control. We hypothesize that these findings are related to femoral component changes including a thinner and narrower anterior flange and a reduced femoral intercondylar box ratio.

  • implant design and effects on patellofemoral Crepitus
    Journal of Knee Surgery, 2017
    Co-Authors: David Clinto Mcnabb, Douglas A Dennis, Jaso M Jennings, Ia K Daines, Pete J Laz, Raymond H Kim
    Abstract:

    Background Patellofemoral Crepitus is a known complication of posterior stabilized (PS) total knee arthroplasty (TKA). This study compared the incidence of patellofemoral Crepitus between two femoral components designs. Materials and Methods Between January 2005 and August 2010, 1,120 patients with complete 2-year follow-up had a PS TKA with two different prosthetic designs (group A, 553 patients; group B, 567 patients). Records were reviewed to identify the incidence of total, symptomatic, and operative patellofemoral Crepitus. Results No statistical differences were observed in the incidence of total patellofemoral Crepitus (group A 14.1%, group B 14.5%; p = 0.932) or symptomatic patellofemoral Crepitus (group A 5.6%, group B 4.2%; p = 0.334). The incidence of operative Crepitus was greater in group A (3.3%) than in group B (1.3%; p = 0.026). Analysis of mobile versus fixed bearing designs showed a higher incidence of total patellofemoral Crepitus in mobile bearing TKA (16.04 vs. 4.93%; p = 0.006) within group B only. Conclusion Femoral component design with a smoother intercondylar box transition zone resulted in a lower incidence of operative patellofemoral Crepitus. No statistical differences were noted regarding the incidence of total and symptomatic patellofemoral Crepitus. Mobile bearing TKA exhibited greater total Crepitus within group B. Level of Evidence Level III.

  • patellofemoral Crepitus after total knee arthroplasty etiology and preventive measures
    Clinics in Orthopedic Surgery, 2014
    Co-Authors: David N Conrad, Douglas A Dennis
    Abstract:

    Patellofemoral Crepitus and clunk syndrome are infrequent, yet troublesome complications of total knee arthroplasty with a reported incidence of 0%-18%. They are primarily associated with implantation of posterior cruciate substituting designs. These entities are the result of peripatellar fibrosynovial hyperplasia at the junction of the superior pole of the patella and the distal quadriceps tendon which becomes entrapped within the superior aspect of the intercondylar box of the femoral component during knee flexion. When the knee extends, a crepitant sensation occurs as the fibrosynovial tissue exits the intercondylar box. Numerous etiologies have been proposed such as femoral component designs with a high intercondylar box ratio, previous knee surgery, reduced patellar tendon length, thinner patellar components, reduced patella-patellar component composite thickness, and smaller femoral components. Preventative measures include choice of femoral components with a reduced intercondylar box ratio, use of thicker patellar components, avoidance of over-resection of the patella, and debridement of the fibrosynovial tissue at the time of knee arthroplasty. Most patients with Crepitus are unaware of the problem or have minimal symptoms so that no treatment is required. If significant disability is incurred, symptoms can be eliminated in a high percentage of patients with arthroscopic debridement of the fibrosynovial hyperplasia.

  • the john insall award control matched evaluation of painful patellar Crepitus after total knee arthroplasty
    Clinical Orthopaedics and Related Research, 2011
    Co-Authors: Douglas A Dennis, Raymond H Kim, Derek R Johnso, Ya D Springe, Thomas K Fehring, Adrija Sharma
    Abstract:

    Background Patellar Crepitus (PC) is reported in up to 14% of subjects implanted with cruciate-substituting total knee arthroplasty (TKA). Numerous etiologies of PC have been proposed.

  • control matched evaluation of painful patellar Crepitus after total knee arthroplasty
    2011
    Co-Authors: Douglas A Dennis, Raymond H Kim, Derek R Johnso, Ya D Springe, Thomas K Fehring
    Abstract:

    Background Patellar Crepitus (PC) is reported in up to 14% of subjects implanted with cruciate-substituting total knee arthroplasty (TKA). Numerous etiologies of PC have been proposed. Questions/purposes We determined when painful PC typically occurs postoperatively and compared patients undergoing primary TKA who developed painful PC requiring subsequent surgery with a matched group without this complication to identify clinical, radiographic, and surgical variables associated with this complication. Methods From the databases of two institutions (greater than 4000 TKAs), we identified 60 patients who required surgery for painful PC from 2002 to 2008. This group was then compared with an identified control group of 60 TKA subjects without PC who were matched for the key variables of age, gender, and body mass index to determine clinical, radiographic, and surgical factors associated with the development of PC. Results The mean time to presentation of PC was 10.9 months. The incidence of PC correlated with a greater number of previous knee surgeries, decreased patellar component size, decreased composite patellar thickness, shorter preoperative and postoperative patellar tendon length, increased posterior femoral condylar offset, use of smaller femoral components and thicker tibial polyethylene inserts, and placement of the femoral component in a flexed posture. Conclusions Many of the factors associated with an increased incidence of postoperative PC such as shortened patellar tendon length, use of smaller patellar components, decreased patellar composite thickness, and increased posterior femoral condylar offset may all increase quadriceps tendon contact forces against the superior aspect of the intercondylar box, increasing the risk of fibrosynovial proliferation and entrapment within the intercondylar region of the femoral component. Based on these findings, the authors recommend use of larger patellar components when possible, avoid oversection of the patella or increasing posterior The Rocky Mountain Musculoskeletal Research Laboratory has received funding for clerical support in preparation of this manuscript. No authors have received any financial support directly related to the preparation of this manuscript, although one or more of the authors (DAD, TKF) serve as consultants to the manufacturing company (Depuy, Inc) of the implant studied in this review. The current analysis has received approval from the Institutional Review Boards of the participating institutions. This work was performed at Colorado Joint Replacement, Denver, CO, USA, and OrthoCarolina, Charlotte, NC, USA.

Trevor R Gaskill - One of the best experts on this subject based on the ideXlab platform.

  • snapping scapula syndrome diagnosis and management
    Journal of The American Academy of Orthopaedic Surgeons, 2013
    Co-Authors: Trevor R Gaskill, Peter J Millett
    Abstract:

    AbstractScapulothoracic bursitis and snapping scapula syndrome are rare diagnoses that contribute to considerable morbidity in some patients. These conditions represent a spectrum of disorders characterized by pain with or without mechanical Crepitus. They are commonly identified in young, active pa

Hiroyuki Kato - One of the best experts on this subject based on the ideXlab platform.

  • risk assessment of tendon attrition following treatment of distal radius fractures with volar locking plates using audible Crepitus and placement of the plate a prospective clinical cohort study
    Journal of Hand Surgery (European Volume), 2015
    Co-Authors: Hiroshi Yamazaki, Shigeharu Uchiyama, Masatoshi Komatsu, Shu Hashimoto, Hiroyuki Kato
    Abstract:

    Purpose To identify risk factors for tendon attrition after volar locking plate fixation of distal radius fractures. Methods We prospectively assessed attrition of the flexor pollicis longus tendon at volar plate removal in 127 hands in 126 patients. We also evaluated preoperative lateral wrist radiographs, sonographs, and Crepitus with flexor pollicis longus tendon motion and compared the demographic and radiographic characteristics of patients with and without tendon attrition. Multivariate logistic regression analysis was employed to identify the factors independently associated with tendon attrition. Results We found 12 cases of tendon attrition (10%) and 1 that presented with tendon rupture in our cohort. Crepitus was recognized in 14 patients (11%): 6 cases (50%) were among the 12 hands in 12 patients with tendon attrition whereas 8 (7%) were detected in the remaining 114 hands in 113 patients. Logistic regression examination revealed that audible Crepitus and volar placement of the plate in lateral radiographs were independent predictors of tendon attrition. Conclusions Crepitus and volar placement of hardware in lateral radiographs were independent risk factors for flexor tendon attrition after volar plating for distal radius fracture. These results may facilitate surgical decisions regarding early plate removal to prevent possible tendon rupture. Type of study/level of evidence Diagnostic II.