An anterior force applied to the tibia during the dial test in a combined PCL-PLC-injured knee increased the overall amount of observed tibial external rotation during the dial test. The anterior force reduced the posterior tibial subluxation associated with PCL injury, which is analogous to what is observed when the dial test is performed with the patient in the prone position. Reducing the tibia with either an anterior force when the patient is supine or performing the dial test with the patient in the prone position increases the ability of an examiner to detect a concomitant PLC injury in the setting of a PCL-deficient knee.
Our results indicate that pediatric patients with ALL should be screened for transfusional iron load and the amount of erythrocyte transfusions seems to be a more reliable indication than serum ferritin levels to detect cardiac iron loading in these patients.
We constructed a crouching machine to study the motion of the knee joint, in which a motor was used to wind the quadriceps tendon so as to move the knee from high flexion to extension and back into flexion, while springs simulated hamstrings forces. Seven human cadaveric knees were tested intact and then after anterior cruciate ligament (ACL) resection. Motions of the femur, tibia, and patella were recorded by an optical tracking system. We then inserted plastic models representing commonly used total condylar and posterior stabilized knee replacement designs. Femoral motion was described by successive positions of the transverse axis of the femur projected onto the tibial surface. In the knee replacements, motions were similar to that of an ACL-deficient knee. We then tested two new designs with features intended to prevent anterior paradoxical sliding and to promote a medial pivot motion with femoral rollback primarily on the lateral side. The motion path more closely followed that of the normal intact knee. We concluded that motion guiding features in a total knee replacement could reproduce a normal neutral path that might result in functional improvements for the patient. ß
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