INTRODUCTION: Lateral epicondylosis is a common cause of lateral elbow pain, however, some patients fail conservative management. One reason, many pathologies have similar presentations. There are no valid and reliabl...INTRODUCTION: Lateral epicondylosis is a common cause of lateral elbow pain, however, some patients fail conservative management. One reason, many pathologies have similar presentations. There are no valid and reliable clinical tests to differentiate between tendopathy and arthropathy. This single case design looks at the utilization of the humeroradial joint (HRJ) distraction test to diagnose HRJ chondropathy. CASE SUMMARY: 38-year-old male recreational athlete with persistent lateral elbow pain, impaired motion, crepitus and locking. Disability of the Arm Shoulder Hand Questionnaire (DASH): 13.33/100. DASH Sport Module, 68.75/100. Differential Diagnosis: Chondropathy of the HRJ with loose body, based on history of elbow pain and locking, non-capsular pattern of limitation of motion and a positive HRJ distraction test. Intervention: loose body manipulation improved pain free range of motion with continued remarkable HRJ distraction test;referral to orthopedic surgeon. Plain radiographs and CT demonstrated a loose body and marked cartilage thinning within the HRJ. Arthroscopic removal of the loose body and plica resection was performed. Surgical exploration confirmed Grade 3 cartilage lesions within the radial head without involvement of the extensor muscle group. Post-operative physical therapy focused on restoration of accessory joint motion and education on return to functional and recreational activity. OUTCOMES: Full range and normal joint accessory motion, DASH score and DASH Sport Module score reduced to 8.33 and 25, 12-weeks post-operative. CONCLUSION: Arthroscopic exploratory surgery is recommended for chronic lateral elbow pain resistant to conservative management;however, patients who present with pain in the absence of a positive clinical examination and radiographic findings benefit least from arthroscopic evaluation. No clinical test(s) have been validated in the literature to diagnose HRJ lesions. This report is the first to propose the use of a new clinical test for HRJ lesion, with confirmation using imaging and arthroscopy. Level 4 Case Report.展开更多
In the previous arthroscopic studies, the ratio of presence and type of plica was somewhat different. We arthroscopically investigated and classified suprapatellar plica and medial synovial plica in a Japanese populat...In the previous arthroscopic studies, the ratio of presence and type of plica was somewhat different. We arthroscopically investigated and classified suprapatellar plica and medial synovial plica in a Japanese population. Subjects and Methods: The anatomy of suprapatellar plica and medial synovial plica was studied arthroscopically in 130 knees. Original diagnosis of patients included in this study were 53 meniscal injuries, 51 ACL injuries, 17 osteoarthritis, 5 popliteal cysts, 3 osteochondritis dissecans, and 1 synovial osteochodromatosis. Results: The suprapatellar plica was present 73.8% and classified into 6 types which were arch type, medial type, lateral type, perforated type, pillar type and complete type. The medial synovial plica was present 62.3% and classified into 4 types which were narrow type, medium type, broad type and perforated type. No relationship between age and the pattern of the suprapatellar plica or medial synovial plica could be found. There was no trend to be correlation between the type of suprapatellar plica and medial synovial plica. Conclusion: We classified suprapatellar plica by only location and shape of plica and medial synovial plica by the size of plica.展开更多
We report herein a rare case of lateral parapatellar synovial plica that developed simultaneously in both knees. A 15-year-old competitive soccer player visited our institution with a six-month history of anterolatera...We report herein a rare case of lateral parapatellar synovial plica that developed simultaneously in both knees. A 15-year-old competitive soccer player visited our institution with a six-month history of anterolateral pain and catching sensation in both knee joints. On physical examination, he complained of tenderness along the joint line of bilateral patellofemoral joint (PFJ). Visible and palpable popping was observed at the lateral margin of each patella during active knee motion. Magnetic resonance imaging showed obvious synovial soft nodules in the lateral side of the PFJ. On arthroscopy, a yellowish, thick, tongue-shaped tissue extending transversely from the lateral parapatellar synovium was identified in both knees, and parts of this tissue showed avascular hypertrophy. Arthroscopic findings of both knees are almost symmetrical in anatomical location, but no similar in size. After arthroscopic excision, the patient became asymptomatic. At 24-month follow up, he demonstrated full knee function, without evidence of local recurrence.展开更多
Untethered and self-transformable miniature robots are capable of performing reconfigurable deformation and on-demand locomotion,which aid the traversal toward various lumens,and bring revolutionary changes for target...Untethered and self-transformable miniature robots are capable of performing reconfigurable deformation and on-demand locomotion,which aid the traversal toward various lumens,and bring revolutionary changes for targeted delivery in gastrointestinal(GI)tract.However,the viscous non-Newtonian liquid environment and plicae gastricae obstacles severely hamper high-precision actuation and payload delivery.Here,we developed a low-friction soft robot by assembly of densely arranged cone structures and grafting of hydrophobic monolayers.The magnetic orientation encoded robot can move in multiple modes,with a substantially reduced drag,terrain adaptability,and improved motion velocity across the non-Newtonian liquids.Notably,the robot stiffness can be reversibly controlled with magnetically induced hardening,enabling on-site scratching and destruction of antibiotic-ineradicable polymeric matrix in biofilms with a low-frequency magnetic field.Furthermore,the magnetocaloric effect can be utilized to eradicate the bacteria by magnetocaloric effect under high-frequency alternating field.To verify the potential applications inside the body,the clinical imaging-guided actuation platforms were developed for vision-based control and delivery of the robots.The developed low-friction robots and clinical imaging-guided actuation platforms show their high potential to perform bacterial infection therapy in various lumens inside the body.展开更多
INTRODUCTIONKnee osteoarthritis （KOA） has many risk factors,such as overweight,old age,and female gender,[1,2] and patients with KOA are generally asked to lose weight as well as have moderate exercise.[3-5] However...INTRODUCTIONKnee osteoarthritis （KOA） has many risk factors,such as overweight,old age,and female gender,[1,2] and patients with KOA are generally asked to lose weight as well as have moderate exercise.[3-5] However,up to now,it is still unclear what causes the pathological conversion from nondisease to disease.And there still remains many KOA features that without proper explanation.For example,why KOA is more common in black and Chinese people than in white people？[6] Except for the racial and ethnic differences,the former seems to eat less and do more manual labor than the latter.Furthermore,since mechanical malalignment is believed to be the most potent factor in KOA progression,[7] why some pathological changes （such as worn articular cartilage,osteophytes,bony sclerosis and cysts） happened at the edge of the bone,which are supposed to be seldom influenced by the load？ And patellofemoral joint compartments,most commonly affected by KOA is an unload-bearing joint.[6,8] There may exist some factor that act on the cartilage surface and cause these changes.展开更多
Background The medial plica may be caused by direct trauma or joint degeneration, which also could be iatrogenic. There have been few reports in the literature discussing incidence of the medial plica caused by an ope...Background The medial plica may be caused by direct trauma or joint degeneration, which also could be iatrogenic. There have been few reports in the literature discussing incidence of the medial plica caused by an operation on the knee joint, specifically after the reconstruction of anterior cruciate ligament （ACL）. In this study, we aimed to evaluate and analyze the relationship between the incidence of the medial plica and reconstruction of the ACL. Methods A retrospective case series study was conducted to review the findings of 1085 patients between 2003 and 2007, who underwent second-look arthroscopy after reconstruction of the ACL （between 2002 and 2006）. The correlation of the incidence of medial plica with the stability of the knee joint, the time from onset of injury to reconstruction surgery, the associated injuries, and the rate of progress during postoperative rehabilitation were analyzed. Results We found that 722 patients had the structure of a medial plica. The incidence after reconstruction of the anterior cruciate ligament （66.5%） was significantly higher than usually reported. All these medial plica had avascular fibrotic and thickened edges. An excision of pathologic medial plica and fat pad synovial fringes were done. The incidences were significantly different between the two groups with their reconstruction operation time, from onset of injury to surgery （less than one month or over 2 years）, and the progress rate of postoperative rehabilitation （knee flexion could not be over 90~ in four weeks）. The incidence was not different between the groups with knee stable conditions. Conclusions Medial plica is more common in patients after reconstruction of ACL. More associated injuries and more rehabilitation difficulties can increase the medial plica incidence.展开更多
文摘INTRODUCTION: Lateral epicondylosis is a common cause of lateral elbow pain, however, some patients fail conservative management. One reason, many pathologies have similar presentations. There are no valid and reliable clinical tests to differentiate between tendopathy and arthropathy. This single case design looks at the utilization of the humeroradial joint (HRJ) distraction test to diagnose HRJ chondropathy. CASE SUMMARY: 38-year-old male recreational athlete with persistent lateral elbow pain, impaired motion, crepitus and locking. Disability of the Arm Shoulder Hand Questionnaire (DASH): 13.33/100. DASH Sport Module, 68.75/100. Differential Diagnosis: Chondropathy of the HRJ with loose body, based on history of elbow pain and locking, non-capsular pattern of limitation of motion and a positive HRJ distraction test. Intervention: loose body manipulation improved pain free range of motion with continued remarkable HRJ distraction test;referral to orthopedic surgeon. Plain radiographs and CT demonstrated a loose body and marked cartilage thinning within the HRJ. Arthroscopic removal of the loose body and plica resection was performed. Surgical exploration confirmed Grade 3 cartilage lesions within the radial head without involvement of the extensor muscle group. Post-operative physical therapy focused on restoration of accessory joint motion and education on return to functional and recreational activity. OUTCOMES: Full range and normal joint accessory motion, DASH score and DASH Sport Module score reduced to 8.33 and 25, 12-weeks post-operative. CONCLUSION: Arthroscopic exploratory surgery is recommended for chronic lateral elbow pain resistant to conservative management;however, patients who present with pain in the absence of a positive clinical examination and radiographic findings benefit least from arthroscopic evaluation. No clinical test(s) have been validated in the literature to diagnose HRJ lesions. This report is the first to propose the use of a new clinical test for HRJ lesion, with confirmation using imaging and arthroscopy. Level 4 Case Report.
文摘In the previous arthroscopic studies, the ratio of presence and type of plica was somewhat different. We arthroscopically investigated and classified suprapatellar plica and medial synovial plica in a Japanese population. Subjects and Methods: The anatomy of suprapatellar plica and medial synovial plica was studied arthroscopically in 130 knees. Original diagnosis of patients included in this study were 53 meniscal injuries, 51 ACL injuries, 17 osteoarthritis, 5 popliteal cysts, 3 osteochondritis dissecans, and 1 synovial osteochodromatosis. Results: The suprapatellar plica was present 73.8% and classified into 6 types which were arch type, medial type, lateral type, perforated type, pillar type and complete type. The medial synovial plica was present 62.3% and classified into 4 types which were narrow type, medium type, broad type and perforated type. No relationship between age and the pattern of the suprapatellar plica or medial synovial plica could be found. There was no trend to be correlation between the type of suprapatellar plica and medial synovial plica. Conclusion: We classified suprapatellar plica by only location and shape of plica and medial synovial plica by the size of plica.
文摘We report herein a rare case of lateral parapatellar synovial plica that developed simultaneously in both knees. A 15-year-old competitive soccer player visited our institution with a six-month history of anterolateral pain and catching sensation in both knee joints. On physical examination, he complained of tenderness along the joint line of bilateral patellofemoral joint (PFJ). Visible and palpable popping was observed at the lateral margin of each patella during active knee motion. Magnetic resonance imaging showed obvious synovial soft nodules in the lateral side of the PFJ. On arthroscopy, a yellowish, thick, tongue-shaped tissue extending transversely from the lateral parapatellar synovium was identified in both knees, and parts of this tissue showed avascular hypertrophy. Arthroscopic findings of both knees are almost symmetrical in anatomical location, but no similar in size. After arthroscopic excision, the patient became asymptomatic. At 24-month follow up, he demonstrated full knee function, without evidence of local recurrence.
基金supported by the National Natural Science Foundation of China(22102104 and U22A2064)the General Research Fund(project no.14203123)+7 种基金National Key Research and Development Project(grant no.2023YFB4705300)the Shenzhen Science and Technology Program(JCYJ20220531103409021 and JCYJ20220818101611025)the Guangdong Basic and Applied Basic Research Foundation(2021A1515010672 and 2022B1515120010)the Research Impact Fund(project no.R4015-21)Research Fellow Scheme(project no.RFS2122-4S03)the EU-Hong Kong Research and Innovation Cooperation Co-funding Mechanism(project no.E-CUHK401/20)from the Research Grants Council(RGC)of Hong Kongthe support from the SIATCUHK Joint Laboratory of Robotics and Intelligent Systems and the Multi-Scale Medical Robotics Center(MRC),InnoHK,at the Hong Kong Science ParkGuangdong University Students Science and Technology Innovation Cultivation Special Fund Project with project no.pdjh2022b0446.
文摘Untethered and self-transformable miniature robots are capable of performing reconfigurable deformation and on-demand locomotion,which aid the traversal toward various lumens,and bring revolutionary changes for targeted delivery in gastrointestinal(GI)tract.However,the viscous non-Newtonian liquid environment and plicae gastricae obstacles severely hamper high-precision actuation and payload delivery.Here,we developed a low-friction soft robot by assembly of densely arranged cone structures and grafting of hydrophobic monolayers.The magnetic orientation encoded robot can move in multiple modes,with a substantially reduced drag,terrain adaptability,and improved motion velocity across the non-Newtonian liquids.Notably,the robot stiffness can be reversibly controlled with magnetically induced hardening,enabling on-site scratching and destruction of antibiotic-ineradicable polymeric matrix in biofilms with a low-frequency magnetic field.Furthermore,the magnetocaloric effect can be utilized to eradicate the bacteria by magnetocaloric effect under high-frequency alternating field.To verify the potential applications inside the body,the clinical imaging-guided actuation platforms were developed for vision-based control and delivery of the robots.The developed low-friction robots and clinical imaging-guided actuation platforms show their high potential to perform bacterial infection therapy in various lumens inside the body.
文摘INTRODUCTIONKnee osteoarthritis （KOA） has many risk factors,such as overweight,old age,and female gender,[1,2] and patients with KOA are generally asked to lose weight as well as have moderate exercise.[3-5] However,up to now,it is still unclear what causes the pathological conversion from nondisease to disease.And there still remains many KOA features that without proper explanation.For example,why KOA is more common in black and Chinese people than in white people？[6] Except for the racial and ethnic differences,the former seems to eat less and do more manual labor than the latter.Furthermore,since mechanical malalignment is believed to be the most potent factor in KOA progression,[7] why some pathological changes （such as worn articular cartilage,osteophytes,bony sclerosis and cysts） happened at the edge of the bone,which are supposed to be seldom influenced by the load？ And patellofemoral joint compartments,most commonly affected by KOA is an unload-bearing joint.[6,8] There may exist some factor that act on the cartilage surface and cause these changes.
文摘Background The medial plica may be caused by direct trauma or joint degeneration, which also could be iatrogenic. There have been few reports in the literature discussing incidence of the medial plica caused by an operation on the knee joint, specifically after the reconstruction of anterior cruciate ligament （ACL）. In this study, we aimed to evaluate and analyze the relationship between the incidence of the medial plica and reconstruction of the ACL. Methods A retrospective case series study was conducted to review the findings of 1085 patients between 2003 and 2007, who underwent second-look arthroscopy after reconstruction of the ACL （between 2002 and 2006）. The correlation of the incidence of medial plica with the stability of the knee joint, the time from onset of injury to reconstruction surgery, the associated injuries, and the rate of progress during postoperative rehabilitation were analyzed. Results We found that 722 patients had the structure of a medial plica. The incidence after reconstruction of the anterior cruciate ligament （66.5%） was significantly higher than usually reported. All these medial plica had avascular fibrotic and thickened edges. An excision of pathologic medial plica and fat pad synovial fringes were done. The incidences were significantly different between the two groups with their reconstruction operation time, from onset of injury to surgery （less than one month or over 2 years）, and the progress rate of postoperative rehabilitation （knee flexion could not be over 90~ in four weeks）. The incidence was not different between the groups with knee stable conditions. Conclusions Medial plica is more common in patients after reconstruction of ACL. More associated injuries and more rehabilitation difficulties can increase the medial plica incidence.
