Objectives: To assess the relationship between dynamic knee motion in female athletes during landing after jumping and lower limb clinical physical measurements, considered risk factors for anterior cruciate ligament (ACL) injury. We proposed that (1) knee valgus and flexion angles during landing are correlated with clinical physical measurements; (2) combining these measurements enables prediction of the knee valgus and flexion angles during landing. Methods: Sixty-one female collegiate basketball athletes performed a continuous jump test; the peak knee valgus and flexion angles were measured. The Q-angle, the ranges of motion (ROMs) of hip internal rotation (IR) and external rotation (ER), as well as ankle dorsiflexion (DF), navicular drop, leg-heel alignment, and balance ability as assessed by the Star Excursion Balance Test (SEBT) were measured. Stepwise linear regression analyses were used to assess whether these factors can predict the peak knee valgus or flexion angle. Results: Increased ROM of hip IR and navicular drop predicted 7.9% of the peak knee valgus angle variance. Increased ROMs of ankle DF and hip IR, navicular drop, and anterior balance predicted 29.0% of the peak knee flexion angle variance. The knee valgus and flexion angles during the continuous jump test were slightly correlated with clinical physical measurements. Conclusions: Proximal and distal joint alignment and balance ability influence knee motion during landing. The relationship between knee motion during landing and these factors is weak; therefore, lower limb movement during landing is almost independent of clinical physical measurements, and knee movement should be evaluated by itself.
Pyogenic spondylitis is a challenging condition that requires early and accurate diagnosis for appropriate treatment. Most cases can be treated non-surgically or with minimally invasive surgical procedures; however, a combination of anterior debridement/bone grafting and posterior fixation is necessary for severe cases. We encountered a case of lumbar pyogenic spondylitis treated with anterior debridement and autogenous bone grafting after percutaneous endoscopic discectomy drainage (PEDD) with percutaneous pedicle screw (PPS) fixation. The continuous pus oozing from the PEDD drainage tube wound was characteristic in this case, and the pus was considered to be caused by secondary infection/microbial substitution. The discharge immediately stopped and healed after anterior debridement and autogenous bone grafting. Escherichia coli was first detected as the causative bacterium, and Corynebacterium amycolatum and Corynebacterium striatum were detected as the cause of secondary infection/microbial substitution. The possibility of secondary infection/microbial substitution should be considered when the clinical course worsens.
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A 70-year-old healthy woman came to our hospital with right index finger pain and swelling after an injury incurred due to a commercial dishwasher. X-ray of the hand showed osteolysis around the distal interphalangeal joint. A further examination revealed Pseudomonas aeruginosa in the unexposed pus, so the patient was treated with a total of 10 weeks of cefepime, followed by levofloxacin and debridement twice. While this may have been a case of bacterial replacement, we should still consider P. aeruginosa infection in healthy adults when faced with an episode of waterborne injury.
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