Journal articles: 'Patellar tendon bearing'

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Demirbüken, İlkşan, Seher Özyürek, and Salih Angın. "The immediate effect of patellar tendon strap on weight-bearing asymmetry during squatting in patients with unilateral knee osteoarthritis: A pilot study." Prosthetics and Orthotics International 40, no. 6 (July 10, 2016): 682–88. http://dx.doi.org/10.1177/0309364615612251.

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Background: Knee osteoarthritis has commonly been associated with a symptom of pain resulting in an inter-limb weight-bearing asymmetry during functional tasks. Patellar tendon strap is one of the non-pharmacologic interventions to alleviate knee pain. Objectives: To investigate the immediate effect of a patellar tendon strap on weight-bearing asymmetry during squatting in people with unilateral knee osteoarthritis. Study design: Cross-sectional study. Methods: Ten patients with unilateral knee osteoarthritis and 10 healthy subjects were included in the study. Weight-bearing asymmetry of patients was assessed using a weight-bearing squat test during squatting at 30° and 60° both with and without patellar tendon strap. Pain intensity was assessed during squatting in unstrapped and strapped conditions with Visual Analog Scale. Results: The decrease in weight-bearing asymmetry values immediately after wearing patellar tendon strap during 30° ( p = 0.006) and 60° ( p = 0.011) of squatting tests was significantly higher in knee osteoarthritis patients than in healthy subjects. Reported pain intensity was similar in unstrapped and strapped conditions ( p = 0.066). Conclusion: The results of this study showed improved inter-limb weight-bearing symmetry during squatting. Further research with larger sample sizes investigating the effect of patellar tendon strap on weight-bearing asymmetry during functional activities in people with knee osteoarthritis is warranted. Clinical relevance Patellar tendon straps (easily fit and cheap unlike knee braces) had more improvements in inter-limb weight-bearing symmetry during squatting in people with knee osteoarthritis compared to healthy subjects. This study is a new insight for future studies to investigate clinical benefits of wearing patellar tendon straps in this population.

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Alimerzaloo, Farnaz, Reza V. Kashani, Hassan Saeedi, Marjan Farzi, and Nader Fallahian. "Patellar tendon bearing brace: Combined effect of heel clearance and ankle status on foot plantar pressure." Prosthetics and Orthotics International 38, no. 1 (May 20, 2013): 34–38. http://dx.doi.org/10.1177/0309364613486916.

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Background: Heel clearance and ankle status (free or locked) are of major determinants affecting peak plantar pressures and contact area in patellar tendon bearing brace and have been separately studied by many researchers. This study investigated the combined effect of ankle status and heel clearance on contact area and peak plantar pressure in different areas of foot (hindfoot, midfoot, and forefoot). Study design: Before–after repeated measurement trial. Methods: Nine healthy male volunteers walked 8 m with normal shoe and four conditions of patellar tendon bearing brace wear. Repeated-measure analysis of variance test was used to compare contact area and plantar pressure changes in three areas of the foot. Results: Application of patellar tendon bearing brace significantly reduced overall plantar pressure and contact area ( p < 0.01). Although both contact area and plantar pressure significantly decreased in hindfoot and midfoot, plantar pressure increased in forefoot area ( p < 0.05). Conclusions: Application of the patellar tendon bearing brace can reduce the overall peak plantar pressure in the foot but increases focal plantar pressure in forefoot. Excessive lifting of the heel seems to minimize the contact area, thus increase focal pressure in forefoot. Overall, plantar pressure seems to be more effectively off-loaded by combining maximum heel clearance and restriction of the ankle joint. Clinical relevance Although effective parameters of patellar tendon bearing brace have been separately addressed in previous studies, no study was found that investigated the combined effect of ankle status and heel clearance. This study investigates the combined effect of these parameters and provides detailed information on clinical application of the patellar tendon bearing brace.

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Tanaka, Hiroyuki, Hisashi Hoshiko, Takeshi Goto, Akio Inoue, and Ryo Sakai. "The Load Bearing Function of Patellar Tendon Bearing Brace." Orthopedics & Traumatology 45, no. 1 (1996): 235–37. http://dx.doi.org/10.5035/nishiseisai.45.235.

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Sunil, T. M. "Efficacy of the Patellar Tendon-Bearing Cast." Journal of Bone and Joint Surgery-American Volume 82, no. 10 (October 2000): 1511–12. http://dx.doi.org/10.2106/00004623-200010000-00025.

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Bhave, Anil, and John E. Herzenberg. "Efficacy of the Patellar Tendon-Bearing Cast." Journal of Bone and Joint Surgery-American Volume 82, no. 10 (October 2000): 1512. http://dx.doi.org/10.2106/00004623-200010000-00026.

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Shahar, R., R. Joseph, J. Milgram, and A. Shipov. "Successful management of bilateral patellar tendon rupture in a dog." Veterinary and Comparative Orthopaedics and Traumatology 21, no. 02 (2008): 181–84. http://dx.doi.org/10.3415/vcot-07-05-0053.

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SummaryA seven-year-old, 41 kg, intact, cross breed dog, was presented with a history of bilateral hind limb lameness after falling from a height of 1 m. Clinical and radiographic findings were consistent with bilateral patellar tendon rupture. Surgical repair was performed bilaterally. The tendons were sutured primarily, and an internal splint of nylon leader was added. Good apposition of the severed tendon ends had been achieved intraoperatively; however, post operative radiographs showed supra-trochlear displacement of both patellae. The casts used to immobilize the stifle joints slipped distally and three days post operatively the tendon repair had broken down, bilaterally. Revision surgery was undertaken and the tendons were re-sutured. Nylon leader was placed through holes that had been drilled in the patellae and tibiae. The stifle joints were immobilized with type I external skeletal fixators (ESFs). Both freeform polymethylmethacrylate (PMMA) connecting bars were found to be broken at the level of the stifle joints two days later, without any disruption of the primary tendon repair. Each connecting bar was replaced with two connecting bars of PMMA reinforced with 3 mm steel wire. The dog was fully weight-bearing with a reduced range of motion in flexion immediately after removal of the ESFs at six weeks and was still sound 18 months post-operatively. Primary tendon repair in combination with adequate immobilization allowed for an excellent outcome in a complicated bilateral pathology.

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Liao, Chi-Yang, and Chun-Li Lin. "Arthrodesis with Retrograde Intramedullary Nail for Recurrent Infected Total Knee Arthroplasty with Patellar Tendon Rupture: A Case Report and Literature Review." Orthopaedic Journal of Sports Medicine 8, no. 5_suppl5 (May 1, 2020): 2325967120S0005. http://dx.doi.org/10.1177/2325967120s00050.

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Patellar tendon rupture after total knee arthroplasty is a rare, but often catastrophic complication. In addition, infection is also a dreaded complication after total knee arthroplasty. We report an 84-year-old female that has late infected total knee arthroplasty with patellar tendon rupture treated with resection arthroplasty and then subsequent arthrodesis with retrograde intramedullary nail. Case Presentation: The 84-year-old female underwent left total knee arthroplasty 2 years ago and revision arthroplasty last year after trauma. She presented to the emergency department with painful disability of left knee. The septic arthritis of left knee was confirmed by bacterial culture through arthrocentesis which yielded methicillinsensitive staphylococcus aureus. Patellar tendon rupture was also noted by loss of extension mechanism and patella alta in plain films. Despite attempts on open debridement and parenteral antibiotics, the infection did not settle. Resection arthroplasty with vancomycin- impregnated cement spacer implantation was performed following by 4-week parenteral antibiotics therapy. The ESR and CRP level of serum improved gradually. Arthrodesis of left knee with retrograde locking intramedullary femoral nail through single incision of the knee was performed. Protected weight bearing was allowed in one week after arthrodesis. The patient discharged 2 weeks later without recurrent infection, but leg length discrepancy about 2cm was noted. Discussion: Patellar tendon rupture after total knee arthroplasty is a rare but disabling complication whose management is often difficult. It was reported that incidence of patellar tendon rupture in literature varies between 0.3- 12.4% for primary total knee arthroplasty and between 1-15% for revision total knee arthroplasty. Contributing factors are excessive dissection and knee manipulation, and trauma. In the literature, various different operative techniques and rehabilitation programs have been described indicating the lack of a golden standard treatment protocol. However, in patients with a total knee arthroplasty, the results have been discouraging. Reconstruction of the patellar tendon can be utilized semitendinosus-gracilis graft with an interference screw and a staple fixation in treating acute ruptures, whereas allografts and synthetic mesh are indicated for chronic cases. Nevertheless, treatment outcomes for ruptured patellar tendon are not good. Gold standard treatment of infected total knee arthroplasty was resection arthroplasty with antibiotic-impregnated bone cement spacer and parenteral antibiotics therapy and then second stage revision total knee arthroplasty until the infection is eradicated. The patella tendon repair and second revision arthroplasty were not suggested by Jake et al. Patellar tendon rupture is best treated with primary repair, but infected prosthetic knee with patellar tendon rupture seemed to be more difficult to manage. Arthrodesis but not revision arthroplasty may be the best choice after infection control to improve the patient’s level of function.

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Boot, D. A., and N. J. Young. "A new directly moulded patellar-tendon-bearing socket." Prosthetics and Orthotics International 9, no. 2 (August 1985): 112–14. http://dx.doi.org/10.3109/03093648509164717.

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Silicone rubbers and casting tapes individually have previously been used in the manufacture of sockets (Swanson, 1972; Sweitzer, 1973; Ruder, 1977; Graves, 1980; Aqualite, 1982). The authors believe that the present combination of these materials to manufacture a directly moulded socket with a complete silicone rubber lining of variable thickness has not previously been described.

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Vailas, A. C., D. M. Deluna, L. L. Lewis, S. L. Curwin, R. R. Roy, and E. K. Alford. "Adaptation of bone and tendon to prolonged hindlimb suspension in rats." Journal of Applied Physiology 65, no. 1 (July 1, 1988): 373–76. http://dx.doi.org/10.1152/jappl.1988.65.1.373.

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The rat hindlimb suspension model was used to ascertain the importance of ground reaction forces in maintaining bone and tendon homeostasis. Young female Sprague-Dawley rats were randomly assigned to either a suspended or a nonsuspended group. After 28 days, femur bones and patellar tendons were obtained for morphological and biochemical analyses. Prolonged suspension induced a significant change in the geometric configuration of the femur middiaphysis by increasing the minimum diameter (12%) without any significant alterations in cortical area, density, mineral, and collagen concentrations. Femur wet weight, length, DNA, and uronic acid concentrations of suspended animals were not significantly different from bones of nonsuspended rats. However, the collagen and proteoglycan concentrations in patellar tendons of suspended rats were 28% lower than the concentrations of matrix proteins in tissues obtained from nonsuspended animals. These data suggest that elimination of ground reaction forces induces alterations in tendon composition and femur diaphyseal shape by changing regional rates in bone remodeling and localized tendon strain. Therefore it appears that ground reaction forces are an important factor in the maintenance of cortical bone and patellar tendon homeostasis during weight-bearing conditions.

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Straszewski, Dariusz, Marcin Plenzler, Joanna Szczepaniak, Robert Śmigielski, Beata Ciszkowska-Łysoń, Marcin Popieluch, and Szymon Kopko. "MRI Evaluation of Patella Alignment Before and After Anatomical Reconstruction of ACL Undergoing Unified Rehabilitation Programme Introduced by CMC Physical Therapy Team." Orthopaedic Journal of Sports Medicine 2, no. 11_suppl3 (November 1, 2014): 2325967114S0014. http://dx.doi.org/10.1177/2325967114s00148.

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Objectives: The aim of the study was to asses the impact of the functional rehabilitation on patella alignment with MRI imaging in patients who underwent the ACL reconstruction. The surgical approach with the use of patellar tendon graft is known to carry the risk of lowering patella height (patella baja), which, in turn, may lead to accelerated cartilage wear in patellofemoral joint. Methods: 30 patients after the anatomical reconstruction of ACL took part in this study (23 male, and 7 female, mean age = 28 ± 10,6 years). During the procedure a patellar tendon graft was used. The Insali-Salvati ratio measured with MRI (images taken pre-procedural, and 9 months after the surgery) was used for the assessment of patellar alignment. The measurements were taken by one radiology specialist on MRI scans in sagittal view in PD sequence. During the examination, patellar joint was in flexion (approx.10 degrees). As the point of reference for patella’s position ISR ratio was in the range of 0.8 - 1.2. All patients were operated on by the same team of surgeons and underwent an unified rehabilitation programme led by a team of selected physiotherapists. The main features of the programme were: an early muscle activation (second day after the procedure); mobilisation of the patella and tissues of the anterior compartment of the knee; weight bearing co-contraction exercises, and the sensomotoric training of the entire kinetic chain of the lower limb. The data recorded was statistically analysed using the Wilcoxon signed-rank test in order to establish parameters’ changes within the study group.. Results: The mean ISR value before the procedure was 0.84 (± 0,1), whereas 9 months after the surgery it was 0.85 (± 0,1). The results’ analysis did not show any statistically significant changes between ISR values. Nine months after the procedure patella baja has not been observed in any of the evaluated patients. Conclusion: The functional rehabilitation programme designed by the CMC team had no negative impact on patella alignment, as no patella baja, which is a common complication after these kinds of surgeries, has been observed. The applied functional rehabilitation programme enabled patients to keep the proper patella alignment, similar to the alignment recorded before the surgery.

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Gholizadeh, Hossein, Noor Azuan Abu Osman, Arezoo Eshraghi, Nooranida Arifin, and Tze Yang Chung. "A comparison of pressure distributions between two types of sockets in a bulbous stump." Prosthetics and Orthotics International 40, no. 4 (January 12, 2015): 509–16. http://dx.doi.org/10.1177/0309364614564022.

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Background:This article describes a total surface bearing prosthetic socket for a patient (25-year-old female) with a bulbous stump.Case Description and Methods:The subject had unstable excessive soft tissue at the distal end of the residuum. After 2 years of prosthetic use, she experienced several problems, including pain in the residual limb and knee joint. Pressure distribution was evaluated during ambulation. We also designed a total surface bearing socket with Velcro as suspension system to distribute the load evenly on the residual limb, and to facilitate donning procedure.Findings and Outcomes:The main site of weight bearing in the old prosthesis (patellar tendon bearing) was anterior proximal region of the residual limb, especially the patellar tendon. The pressure was almost 10 times higher than the distal region during level walking. Pressures were distributed more evenly with the total surface bearing socket design, and the donning was much easier.Conclusion:Pressure distribution within the socket could be affected by socket design and suspension system. Using the total surface bearing socket and Velcro as suspension system might facilitate donning of prosthesis and reduce traction at the end of residual limb during the swing phase of gait.Clinical relevanceProper socket design and suspension system based on the amputees’ need can facilitate rehabilitation process and lead to the amputee’s satisfaction. The pressure is distributed more uniformly over the residual limb by the total surface bearing socket compared to the patellar tendon bearing socket for lower limb amputees with unusual stump shape.

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Kim, W. D., D. Lim, and K. S. Hong. "An evaluation of the effectiveness of the patellar tendon bar in the trans-tibial patellar-tendon-bearing prosthesis socket." Prosthetics and Orthotics International 27, no. 1 (April 2003): 23–35. http://dx.doi.org/10.3109/03093640309167974.

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The aim of this study is to determine the relationship between varying depths of the patellar tendon bar in trans-tibial prosthesis sockets and the pressures exerted by other regions within the socket, such as the tibial crest, medial and lateral tibial condyles, lateral femoral condyle and the distal tibial end. Five (5) patients selected from a population of trans-tibial amputees in Singapore. Patellar-tendon-bearing (PTB) sockets were made for them. Polypropylene spacers 2mm thick were used to simulate the increasing depths of the patellar tendon bar. P-Scan pressure transducers were inserted into the sockets to measure the pressures exerted by the socket and the data collected were analysed statistically to see if there was a relationship between varying PTB depths and pressures exerted from selected parts of the socket.

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SASAGAWA, Kazuhiko, Toshiaki HARA, Takashi ISHII, Yoshio KOGA, Kikuo KANAYA, and Yoshinori TAMURA. "Estimation of the Load-Bearing Functions of the Patellar-Tendon-Bearing Orthosis." Transactions of the Japan Society of Mechanical Engineers Series A 58, no. 551 (1992): 1148–53. http://dx.doi.org/10.1299/kikaia.58.1148.

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Richman, Mark, Andrew Kieffer, Rachel Moss, and Daniel Dexeus. "Patella Fracture Identified Using Point-of-care Ultrasound." Prague Medical Report 122, no. 4 (2021): 308–12. http://dx.doi.org/10.14712/23362936.2021.29.

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A 49-year-old female fell from standing. Her right knee extended into the air. She had acute right knee pain preventing weight-bearing. Her knee was most comfortable fully-extended. She could not flex it due to pain, nor extend it against resistance. Tenderness and a horizontal defect were noted over the anterior knee. Bedside ultrasound demonstrated a horizontally-fractured patella (confirmed on X-ray) with intact femoral and patellar tendons. She was put in a knee immobilizer and underwent surgery, with return to full function and activities. Ultrasound can identify patella fractures and help with early evaluation, management, and specialty referral, as well as ordering more-focused imaging. In one study, POCUS (point-of-care ultrasound) for patella fracture had 95% sensitivity, 63% specificity, 86% positive predictive value, and 83% negative predictive value. The dynamic nature of ultrasound allows a ruptured patella (87% sensitivity) or quadriceps tendon (100% sensitivity) to be excluded with high certainty.

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Dembour, T., H. Gallois Bride, J. L. Chancrin, and F. Arnault. "Rupture of the quadriceps tendon." Veterinary and Comparative Orthopaedics and Traumatology 22, no. 01 (2009): 74–80. http://dx.doi.org/10.3415/vcot-07-10-0096.

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SummaryA five-month-old, male, 16 kg, mixed breed dog was presented for an acute non-weight bearing lameness of the right hind limb. A subtotal avulsion of the quadriceps tendon at its patellar insertion was diagnosed through radiography and ultrasonography. Two nylon sutures secured with a stainless steel crimp were placed in a locking loop pattern in the quadriceps tendon and through a transverse 2.7 mm drill-hole in the patella. No external coaptation was used postoperatively. A full functional recovery was observed, and was followed for one year postoperatively. Quadriceps tendon rupture has not been described in the veterinary literature to our knowledge; in humans, quadriceps tendon rupture is a well known entity, often due to systemic disease resulting in weakening of the tendinous structures. In the case presented herein, the dog’s history, young age and location, without underlying biochemical abnormalities, led us to believe that the observed lesion was of traumatic origin. The surgical treatment performed was based on that performed in humans and also that which has been investigated experimentally in the dog.

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Fujimura, Kenjiro, Koji Sakuraba, Satoshi Kamura, Kiyoshi Miyazaki, Nobuo Kobara, Kazumasa Terada, and Hisaaki Miyahara. "Reconstruction of Acute Patellar Tendon Rupture after Patellectomy." Case Reports in Orthopedics 2018 (2018): 1–5. http://dx.doi.org/10.1155/2018/7549476.

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Acute rupture of the knee extensor mechanism after patellectomy is extremely rare. We present the case of a patient with acute patellar tendon rupture who had undergone patellectomy 53 years before. Twelve days after the injury, the ruptured patellar tendon was repaired with end-to-end suture. Postoperatively, we splinted the knee for 6 weeks but permitted the patient to walk without limiting weight bearing at 1 week postoperatively. At one-year follow-up, the patient is able to move his knee almost full range of motion and the Lysholm knee score is 81. The patient is satisfied with the outcome. This is the first report to treat acute rupture of the patellar tendon in a patient who had undergone patellectomy. Although careful rehabilitation is required, end-to-end suture might be an adequate surgical procedure for acute rupture of the knee extensor mechanism after patellectomy.

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ROWLEY, DAVID I. "The effect of the patellar tendon-bearing cast on loading." Journal of Bone and Joint Surgery. British volume 82-B, no. 6 (August 2000): 930. http://dx.doi.org/10.1302/0301-620x.82b6.0820930.

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Ahmad, S., M. K. Mam, and T. S. Sethi. "Patellar tendon bearing plaster casts in fractures of the tibia." International Orthopaedics 13, no. 4 (November 1989): 247–51. http://dx.doi.org/10.1007/bf00268506.

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Convery, P., A. W. P. Buis, R. Wilkie, S. Sockalingam, A. Blair, and B. McHugh. "Measurement of the consistency of patellar-tendon-bearing cast rectification." Prosthetics and Orthotics International 27, no. 3 (December 2003): 207–13. http://dx.doi.org/10.1080/03093640308726683.

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The quality of fit of a trans-tibial patellar-tendon-bearing (PTB) socket may be influenced by consistency in casting, rectification or alignment. This paper quantifies, for the first time, the variations in the rectified casts between two experienced prosthetists and the variation between the rectified casts of each individual prosthetist. Prosthetists A and B observed the hand casting of a typical trans-tibial amputee. Each prosthetist was supplied with 5 previously measured duplicated plaster models. The two prosthetists rectified the supplied plaster models based on their own interpretation of basic rectification guidelines. Both prosthetists operated in isolation. The re-measured rectified plaster model data was compared with the unrectified data. The extent of rectification at each of 1800 locations per plaster model was calculated. In zones of major rectification, the mean difference between prosthetists was quantified as 2mm and the standard deviation (SD) about that mean was ±1mm for each prosthetist. The co-ordinates of the apex of the fibular head for the 10 modified casts indicated that the maximum variation was in the axial direction with a SD of 4.3mm for prosthetist A and a SD of 2.8mm for prosthetist B. The lengths of the 5 plaster models rectified by prosthetist A indicated a SD of 0.2mm whereas the lengths of the 5 plaster models rectified by prosthetist B indicated a SD of 2.9mm.

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Tanaka, H., K. Nagata, T. Goto, H. Hoshiko, and A. Inoue. "The effect of the patellar tendon-bearing cast on loading." Journal of Bone and Joint Surgery. British volume 82-B, no. 2 (March 2000): 228–32. http://dx.doi.org/10.1302/0301-620x.82b2.0820228.

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Alam, MR, WJ Gordon, SY Heo, KC Lee, NS Kim, MS Kim, and HB Lee. "Augmentation of ruptured tendon using fresh frozen Achilles tendon allograft in two dogs: a case report." Veterinární Medicína 58, No. 1 (February 22, 2013): 50–55. http://dx.doi.org/10.17221/6656-vetmed.

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This article describes two cases of augmentation of ruptured tendon with fresh frozen Achilles tendon allograft (FFATA) in dogs. Case 1 was a two-year-old crossbreed dog (29 kg) that presented with an open wound on the right forelimb and with complete rupture of the flexor carpi ulnaris and superficial digital flexor tendons. Case 2 was a four-year-old crossbreed dog (4 kg) with partial ruptures of the patellar tendon and detachment of the tibial tuberosity in the right hind limb. In both cases, the ends of the ruptured tendon were sutured and apposed after debridement. To minimize suture failure, FFATA (cut to sufficient size) was placed across the primary suture with tension and sutured to the host tendon. In addition, Case 2 received a Krackow suture through a transverse bone tunnel made in the tibia to fix the patellar tendon along with the tibial tuberosity in situ. The surgical areas healed without any evidence of exaggerated inflammatory response or clinical signs consistent with rejection of the allograft. Both the dogs had normal ambulation and weight bearing on the affected limb 12 weeks postoperatively. No postoperative complications were observed during a one-year follow up period except for slight contracture of the carpus and digits of the affected limb in Case 1. Thus, ruptured tendons can be successfully repaired using suture and augmentation with FFCTA. Augmentation with FFATA may provide additional stability, which counters tension on the primary repair and reduces the chance of gap formation or suture failure in case of reconstruction of the damaged tendon in dogs.  

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Goh, J. C. H., P. V. S. Lee, and S. Y. Chong. "Static and dynamic pressure profiles of a patellar-tendon-bearing (PTB) socket." Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine 217, no. 2 (February 1, 2003): 121–26. http://dx.doi.org/10.1243/09544110360579330.

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The purpose of this study was to evaluate the pressure distribution at the stump/socket interface in amputees wearing the patellar-tendon-bearing socket. A specially built strain gauged type pressure transducer was used for measuring this pressure distribution in four unilateral transtibial amputees. Pressure and gait parameters were measured simultaneously while they were standing and walking. Pressure profiles were compiled at 10, 25 and 50 per cent of gait cycle and compared with the pressure profiles predicted by Radcliffe in 1961. The subject's anterior-posterior pressure profiles were different from each other. However, at toe-off, each subject exhibited an increase in pressure at the patellar tendon. Their medial-lateral pressure profiles were similar: exhibiting high pressure at the medial proximal and lateral distal regions except for one subject who exhibited high pressure at the lateral proximal region instead. The subjects' pressure profiles did not resemble Radcliffe's anticipated pressure profiles. This was because ground reaction force was not the only factor affecting the resulting pressure profiles.

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Goh, James Cho Hong, Peter Vee Sin Lee, and Sook Yee Chong. "Comparative study between patellar-tendon-bearing and pressure cast prosthetic sockets." Journal of Rehabilitation Research and Development 41, no. 3b (2004): 491. http://dx.doi.org/10.1682/jrrd.2004.03.0491.

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Nunley, Ryan M., Donna Wright, Jordan B. Renner, Bing Yu, and William E. Garrett. "Gender Comparison of Patellar Tendon Tibial Shaft Angle with Weight Bearing." Research in Sports Medicine 11, no. 3 (July 2003): 173–85. http://dx.doi.org/10.1080/15438620390231193.

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Kobayashi, Koichi, Makoto Sakamoto, Ali Hosseini, Harry E. Rubash, and Guoan Li. "In-vivo patellar tendon kinematics during weight-bearing deep knee flexion." Journal of Orthopaedic Research 30, no. 10 (April 10, 2012): 1596–603. http://dx.doi.org/10.1002/jor.22126.

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Wilson, S. F., and W. E. Fisher. "Seated-popliteal weight bearing prosthesis for a bilateral amputee." Prosthetics and Orthotics International 22, no. 1 (April 1998): 68–70. http://dx.doi.org/10.3109/03093649809164458.

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Bilateral lower limb amputees suffer from a lack of stability when seated without prostheses due to lack of ground reaction forces through the stumps. In patients for whom ambulation is not a realistic goal, the seated-popliteal weight bearing prosthesis provides a solution for stability when seated in a wheelchair, without the problem of tibial pressure experienced with patellar-tendon-bearing prostheses.

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Khan, Mohammad Shahnewaz Hossain, Rezaul Karim, SM Eqbal, Abdullah Masum, and ASM Kowser. "Stress Fracture Tibia among Military Recruits Management by Patellar Tendon Bearing Cast." Journal of Armed Forces Medical College, Bangladesh 15, no. 2 (December 20, 2020): 196–99. http://dx.doi.org/10.3329/jafmc.v15i2.50834.

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Introduction: Lower limb overuse injuries are common features of military training. Female recruits have significantly higher incidence of fracture than male recruits. In addition to the cost and time of rehabilitation, injury leads to disillusionment among recruits. Conventionally stress fracture tibia is treated with long leg posterior cast for 6-8 weeks but little is known about the length of time required for rehabilitation and to return to pre-injury level. Objectives: To see the outcome of management of stress fracture tibia among military recruits treated with Patellar Tendon Bearing (PTB) cast for 8 weeks and to find out the rehabilitation time to return to pre-injury level. Materials and Methods: This prospective study was conducted in Combined Military Hospital, Bogura, Bangladesh, from January 2015 to December 2016. Out of 2600 recruits 74 (male 60 females 14) were diagnosed as case of stress fracture tibia during the period. They were treated by PTB cast for 08 weeks and their treatment and rehabilitation to pre-injury level (follow-up) were recorded prospectively. Results: Total 85 patients were clinically suspected to have stress fracture tibia, out of them 74(87.06%) patients were finally diagnosed as case of stress fracture. Of these 74 patients 44(59.46%) were diagnosed by initial x-ray and 30(40.54%) were diagnosed by MRI scan. Prevalence of stress fracture in male was 2.45% and in female recruits 9.33%, overall prevalence was 2.85%.About 56(75.67%) patients developed stress fracture in 0-8 weeks of training, mean rehabilitation time to return to pre-injury level was 15.51 weeks, there was no recurrence of stress fracture and all the patients completed 12 months training, none of them was relegated or withdrawn from training on medical ground. Conclusion:Patellar tendon bearing cast is an effective, technically simple method for treating stress fracture of tibia in military recruits with excellent outcome. This method not only treats the fracture but also prevents depressive disorders. JAFMC Bangladesh. Vol 15, No 2 (December) 2019: 196-199

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Stefanyshyn, D. J., J. R. Engsberg, K. G. Tedford, and J. A. Harder. "A pilot study to test the influence of specific prosthetic features in preventing trans-tibial amputees from walking like able-bodied subjects." Prosthetics and Orthotics International 18, no. 3 (December 1994): 180–90. http://dx.doi.org/10.3109/03093649409164403.

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The purpose of this pilot investigation was to develop a method to test the influence of specific prosthetic features in preventing trans-tibial amputees from walking like able-bodied subjects. An able-bodied subject was fitted with a patellar-tendon-bearing orthosis incorporating several features of an amputee's prosthesis. Kinetic, kinematic and metabolic data were collected as features were systematically removed from the orthosis. While wearing the orthosis the gait of the able-bodied subject closely simulated trans-tibial amputee gait kinematically, kinetically and metabolically. Although it was obvious that the various prosthetic features influenced the kinetics and kinematics of gait, they were difficult to quantify with only a single subject. However, the two features which appeared to have the largest influence in preventing trans-tibial amputees from walking like able-bodied subjects were patellar tendon loading and a solid ankle.

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Milankov, Miroslav, Vaso Kecojevic, Srdjan Ninkovic, and Djordje Gajdobranski. "Patella fracture following anterior cruciate ligament reconstruction: A case report." Medical review 56, no. 11-12 (2003): 574–77. http://dx.doi.org/10.2298/mpns0312574m.

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Introduction The most frequent procedure in treatment of acute or chronic anterior cruciate ligament (ACL) rupture is the so called bone-tendon-bone reconstruction. A transverse dislocated patella fracture is a rare complication of this procedure with an incidence of 0.23%-2.3%. In a five year period, (1998-2002), 407 arthroscopic reconstructions of the anterior cruciate ligaments were done at our Clinic, and there was only one case of patella fracture. Case report An 18-year-old female patient, a handball player, suffered an acute rupture of anterior cruciate ligament of the left knee, so arthroscopic bone-tendon-bone reconstruction of the anterior cruciate ligament was performed. After adequate skin incision, a bone graft was taken from the patella and upper part of trapezoid tibia, which was 25 mm long, 10 mm wide and 5 mm thick, together with a part of patellar ligament. After the remains of the anterior cruciate ligament had been arthroscopically removed, tunnels were made in tibia and femur and a graft was inserted and fixed with two metal interference screws. Knee stability was tested, and drainage was put in the knee joint. The wound was closed by layers. The quadriceps exercises and passive knee movements started immediately. Full range of movements was accomplished six weeks later when the patient started to walk with full weight-bearing on her operated leg. Three weeks later, (nine weeks after the operation), the patient has accidentally lost her balance and fell. A transverse, dislocated fracture of the left patella was diagnosed and osteosynthesis of the fractured patella with two Kirschner wires and a metallic loop was performed. Postoperatively, full range of movement was allowed. Six months later, the patient felt no pain, there was no swelling, full range of knee movement was achieved, while the Lachman Test was identical in both knees and the pivot shift test was negative. Discussion Fracture of patella after ACL reconstruction is due to several reasons: size and shape of the graft, technique of its taking, disturbed patellar blood supply, incomplete filling of patella defect after graft taking, and inappropriate postoperative rehabilitation. If a patellar fracture occurs after anterior cruciate ligament reconstruction, the best treatment is firm osteosynthesis, which enables bone healing and immediate continuation of the previously resumed rehabilitation program. However, this complication prolongs the rehabilitation period and slows down return to sports.

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Quesada, Peter, and Harry B. Skinner. "Analysis of a below-knee patellar tendon-bearing prosthesis: A finite element study." Journal of Rehabilitation Research and Development 28, no. 3 (1991): 1. http://dx.doi.org/10.1682/jrrd.1991.07.0001.

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DeFrate, Louis E., Kyung Wook Nha, Ramprasad Papannagari, Jeremy M. Moses, Thomas J. Gill, and Guoan Li. "The biomechanical function of the patellar tendon during in-vivo weight-bearing flexion." Journal of Biomechanics 40, no. 8 (January 2007): 1716–22. http://dx.doi.org/10.1016/j.jbiomech.2006.08.009.

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ABU OSMAN, N. A., S. S. WONG, and Z. OMAR. "AN APPROACH FOR THE CORRELATION OF EMG SIGNALS AND THE RECTIFICATION OF PTB SOCKETS." Journal of Mechanics in Medicine and Biology 02, no. 01 (March 2002): 9–17. http://dx.doi.org/10.1142/s0219519402000150.

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Prosthesis is often used to restore the appearance and functional mobility to individuals following limb amputatio n. The purpose of this study is to investigate the correlation between the electromyogram (EMG) signals with the rectification of patellar tendon bearing (PTB) socket. Six PTB sockets are manufactured with different compression depths at the patellar tendon region. Experiments for the subject are carried out to obtain the EMG signals using EMG telemetry system. From this study, it is found that there exists some kinds of pattern as the depths of PTB rectification is changed. As the PTB rectification depth is increased, the EMG activity rises generally yet in an N pattern for the quadriceps group for both left and right legs of the amputee. The results of this case study will lead to an appropriate range of rectification depths for prosthetists in the manufacturing of PTB sockets, and perhaps the identification of the most suitable depth for optimum transtibial amputee ambulation.

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Yiğiter, K., G. Şener, and K. Bayar. "Comparison of the effects of patellar tendon bearing and total surface bearing sockets on prosthetic fitting and rehabilitation." Prosthetics and Orthotics International 26, no. 3 (December 2002): 206–12. http://dx.doi.org/10.1080/03093640208726649.

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Patellar tendon bearing (PTB) and total surface bearing (TSB) sockets have been used respectively in the prosthetic treatment of 20 trans-tibial amputees to investigate the effectiveness of both sockets on prosthetic fitting and rehabilitation. Data analysis showed that prostheses with TSB sockets were lighter than the prostheses with PTB sockets and better suspension was obtained from TSB prosthetic socket (p<0.05). It was also found that weight acceptance on the amputated side advanced to a more normal value with TSB prostheses (p<0.05). There was a statistically significant difference between the two socket types in walking and in other ambulation activities except sitting and standing up from a chair, in favour of the TSB socket (p<0.05). Consequently, due to the outcome of this study it can be said that TSB prosthetic sockets can be used effectively in the rehabilitation of trans-tibial amputees.

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Dandu, Navya, Nicholas A. Trasolini, Steven F. DeFroda, Tai Holland, and Adam B. Yanke. "Revision Quadriceps Tendon Repair With Bone-Achilles Allograft Augmentation." Video Journal of Sports Medicine 1, no. 6 (November 2021): 263502542110326. http://dx.doi.org/10.1177/26350254211032680.

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Background: Surgical repair of chronic quadriceps tendon ruptures can be daunting, especially after failure of a prior repair. In this setting, tissue quality is usually poor, necessitating graft augmentation. In this video, we describe our technique for Achilles tendon allograft augmentation for revision quadriceps tendon repair. Indications: Failed quadriceps tendon repair defined as ongoing extensor mechanism deficit including patella baja, functional deficit, or palpable quadriceps defect with confirmed retear on advanced imaging. Technique Description: Patient is placed in the supine position, and a midline incision is extended to the tibial tubercle. Full thickness medial and lateral flaps are raised, nonviable scar tissue is excised, and suprapatellar adhesions are released to ensure full mobilization of the viable remnant quadriceps. A plane is then developed deep to the patellar tendon paratenon from proximal to distal. A reamer is used to prepare a socket just medial to the tibial tubercle. The calcaneal bone block of the Achilles allograft is fashioned to match the recipient site on the tibia with a sagittal saw. The graft is shuttled deep to the paratenon, and the bone plug is fixed to the tibia with an interference screw. Suture from the patellar anchors is then used to place 2 running Krackow stitches spanning the remnant quadriceps tendon proximally. The remnant tissue is subsequently reduced and tied with an anchor pull-through technique. The soft tissue component of the Achilles graft is laid over the repair and oversewn with free nonabsorbable suture. Patient is placed in a brace locked in extension for 6 weeks and allowed to be weight bearing as tolerated. Results: Long-term patient-reported outcomes of Achilles allograft reconstruction for revision extensor mechanism repairs are limited. Two studies of 17 reconstructions each reported this to be a reliable and durable option at a mean follow-up of 65 and 52 months, respectively. Discussion/Conclusion: Revision surgery for extensor mechanism deficits can be a challenging procedure. Our preference is to perform augmentation with Achilles allograft with bone plug fixation on the tibial side. This allows for augmentation of the entire extensor mechanism, as well as bone-to-bone healing on the tibial side.

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Pretz, R., C. Brown, W. Hughes, and E. Altschuler. "Maximizing functional mobility in an electrical burn patient using a patellar tendon bearing orthosis." Journal of Rehabilitation Medicine 48, no. 7 (2016): 636–38. http://dx.doi.org/10.2340/16501977-2114.

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Guse, Steven T., and Franklin G. Alvine. "Treatment of Diabetic Foot Ulcers and Charcot Neuroarthropathy Using the Patellar Tendon-Bearing Brace." Foot & Ankle International 18, no. 10 (October 1997): 675–77. http://dx.doi.org/10.1177/107110079701801015.

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Tsur, Atzmon. "Easy Technique for Radiographic Evaluation of Stump-socket Fit in Below-knee Amputees." Ortopedia Traumatologia Rehabilitacja 21, no. 1 (February 28, 2019): 57–63. http://dx.doi.org/10.5604/01.3001.0013.1428.

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Background. The alignment of a prosthesis affects the way load is transferred to the stump through the socket; this is critically important for its comfort and function. The aim of the study was to assess the value of radiopaque materials in evaluation of stump-socket fit in people with below-knee amputation. Material and methods. Thirty-two amputees (skin breakdown group) had cutaneous lesions in the stump, and another 26 amputees (control group) had no lesion in the stump after training with their prosthesis. Metallic markers were attached to weight-bearing points in the internal socket. X-rays were taken in the antero-posterior and lateral projections. Results. In the antero-posterior view, the weight-bearing points of the stump did not correspond to the metallic markers placed over the patellar tendon and the tibial tuberosity points in the socket in 78.1% of the 32 amputees in the skin breakdown group. This malalignment was present in 42.3% of the 26 amputees in the control group (Pearson Chi-Square, p<0.007). In the lateral view, in 65.6% of the 32, the weight-bearing points of the stump did not correspond to the metallic markers placed over the patellar tendon and the tibial tuberosity points in the socket. This malalignment was noted in 23.1% of the 26 patients in the other group (Pearson Chi-Square, p<0.002). Conclusions. Conventional X-ray films of the stump in the socket under weight-bearing conditions are of considerable value in determining fit and alignment. Adequate visualization of the stump-socket fitting interface can provide valuable information for the physician, the physiotherapist and the prosthetist in below-knee amputees.

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Ito, Ko, Yasuhiro Go, Shoji Tatsumoto, Chika Usui, Yosuke Mizuno, Eiji Ikami, Yuta Isozaki, et al. "Gene expression profiling of the masticatory muscle tendons and Achilles tendons under tensile strain in the Japanese macaque Macaca fuscata." PLOS ONE 18, no. 1 (January 19, 2023): e0280649. http://dx.doi.org/10.1371/journal.pone.0280649.

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Both Achilles and masticatory muscle tendons are large load-bearing structures, and excessive mechanical loading leads to hypertrophic changes in these tendons. In the maxillofacial region, hyperplasia of the masticatory muscle tendons and aponeurosis affect muscle extensibility resulting in limited mouth opening. Although gene expression profiles of Achilles and patellar tendons under mechanical strain are well investigated in rodents, the gene expression profile of the masticatory muscle tendons remains unexplored. Herein, we examined the gene expression pattern of masticatory muscle tendons and compared it with that of Achilles tendons under tensile strain conditions in the Japanese macaque Macaca fuscata. Primary tenocytes isolated from the masticatory muscle tendons (temporal tendon and masseter aponeurosis) and Achilles tendons were mechanically loaded using the tensile force and gene expression was analyzed using the next-generation sequencing. In tendons exposed to tensile strain, we identified 1076 differentially expressed genes with a false discovery rate (FDR) < 10−10. To identify genes that are differentially expressed in temporal tendon and masseter aponeurosis, an FDR of < 10−10 was used, whereas the FDR for Achilles tendons was set at > 0.05. Results showed that 147 genes are differentially expressed between temporal tendons and masseter aponeurosis, out of which, 125 human orthologs were identified using the Ensemble database. Eight of these orthologs were related to tendons and among them the expression of the glycoprotein nmb and sphingosine kinase 1 was increased in temporal tendons and masseter aponeurosis following exposure to tensile strain. Moreover, the expression of tubulin beta 3 class III, which promotes cell cycle progression, and septin 9, which promotes cytoskeletal rearrangements, were decreased in stretched Achilles tendon cells and their expression was increased in stretched masseter aponeurosis and temporal tendon cells. In conclusion, cyclic strain differentially affects gene expression in Achilles tendons and tendons of the masticatory muscles.

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Convery, P., and A. W. P. Buis. "Conventional patellar-tendon-bearing (PTB) socket/stump interface dynamic pressure distributions recorded during the prosthetic stance phase of gait of a transtibial amputee." Prosthetics and Orthotics International 22, no. 3 (December 1998): 193–98. http://dx.doi.org/10.3109/03093649809164484.

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Force sensing resistors (FSR) have been used to measure dynamic stump/socket interface pressures during the gait of a trans-tibial amputee. A total of 350 pressure sensor cells were attached to the inner wall of a patellar-tendon-bearing (PTB) socket. Data was sampled at 150 Hz during the approximate 0.8 seconds of prosthetic stance of gait. A total of 42,000 pressures were recorded during a single prosthetic stance. This paper describes the distribution of the pressure patterns monitored during the prosthetic stance phase of gait.

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Khaira, H. S., T. Coddington, A. Drew, P. N. Roberts, and C. H. E. Imray. "Patellar tendon bearing orthosis — Application as adjunctive treatment in healing of lower-limb tissue loss." European Journal of Vascular and Endovascular Surgery 16, no. 6 (December 1998): 485–88. http://dx.doi.org/10.1016/s1078-5884(98)80238-4.

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Ishii, Yoshinori, Hideo Noguchi, Junko Sato, Shota Watanuki, and Shin-ichi Toyabe. "Patellar tendon length during knee flexion of meniscal-bearing and rotating total knee arthroplasty implants." Knee Surgery, Sports Traumatology, Arthroscopy 25, no. 12 (August 12, 2016): 3773–78. http://dx.doi.org/10.1007/s00167-016-4279-7.

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Saltzman, Charles L., Kenneth A. Johnson, Ronald H. Goldstein, and Richard E. Donnelly. "The Patellar Tendon-Bearing Brace as Treatment for Neurotrophic Arthropathy: A Dynamic Force Monitoring Study." Foot & Ankle 13, no. 1 (January 1992): 14–21. http://dx.doi.org/10.1177/107110079201300103.

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The effects of shoe wear, custom-made inserts, patellar tendon-bearing (PTB) braces, and extra-padded PTB braces on load transmission to neuroarthropathic (Charcot) feet of six diabetic patients were assessed. A PTB brace with a free ankle and an extradepth shoe without external modifications was used. Four distinct anatomical regions were evaluated by an in-shoe technique measuring vertical force. The mean peak force transmitted to the entire foot was higher in the affected than in the unaffected extremity barefoot and shod. The mean peak forces under the midfoot were higher for the affected than for the unaffected extremity for all tested circumstances. In the affected foot, use of the standard PTB brace reduced mean peak force to the entire foot by 15%. Adding extra padding to the brace decreased the mean peak force 32%. The effect of padding on vertical load transmission was greatest for patients who had worn the brace the longest. For the patients who had worn it longer than average, the addition of padding decreased the mean peak force to the entire foot by 19%, to the hindfoot by 37%, and to the midfoot by 20%. Clinical Relevance: In this preliminary study, we found that a properly fitted PTB brace can reduce load transmission to the Charcot foot. Specifically, load transmission was reduced to the hindfoot, but not to the midfoot or forefoot. Based on these results, we cannot recommend its use to reduce vertical force transmission to the Charcot midfoot or forefoot. Long-term PTB brace use, especially in the limited weightbearing patient, should be regularly adjusted to ensure adequate brace fit.

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Özçakar, Levent, Erkam Kömürcü, İsmaİl Safaz, Ahmet Salİm Göktepe, and Kamİl YazicioĞLU. "Evaluation of the Patellar Tendon in Transtibial Amputees: A Preliminary Sonographic Study." Prosthetics and Orthotics International 33, no. 4 (December 2009): 324–28. http://dx.doi.org/10.3109/03093640903171010.

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This study aimed to provide sonographic imaging of the patellar tendon (PT) – one of the main weight bearing structures for prosthetic use – in transtibial amputees. Thirteen males, who had been under follow-up for unilateral traumatic transtibial amputations, were enrolled. After physical examination of the limb, pain was evaluated by visual analogue scale and Leeds Assessment of Neuropathic Symptoms and Signs. Sonographic evaluations were performed by using a linear array probe (Aloka UST-5524-7.5 MHz) on both sides. Measurements pertaining to the contralateral limbs were taken as controls. In three subjects (23.1%), two with a silicone liner and one with a pelite liner, cortical irregularities were detected at the tibial insertion of the PT on the amputated sides. PTs were found to be thicker on the amputated sides when compared with those of the contralateral sides ( p = 0.03), and this increase in thickness correlated with disease duration ( r = 0.67, p = 0.01). Overall, our preliminary results imply that after transtibial amputation, PTs of the amputated sides tend to become thicker by time. These findings need to be complemented with future studies. In this regard, sonography seems to be promising for imaging the soft tissue problems of the stump.

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Deroche, Etienne, Pieter Erasmus, and Cecilia Roberts. "MPFL Reconstruction With a Double-Loop Gracilis: The Concept of “Favorable Anisometry”." Video Journal of Sports Medicine 2, no. 6 (November 2022): 263502542211280. http://dx.doi.org/10.1177/26350254221128039.

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Background: Medial patellofemoral ligament (MPFL) reconstruction has shown very good results in patella dislocation and patient satisfaction. However, correct positioning and tensioning of the graft can be difficult to achieve and can lead to complications. Indications: Medial patellofemoral ligament reconstruction is always indicated for recurrent patellar instability with dislocation in extension, with or without other procedures that aim to correct predisposing factors of instability. Technique Description: An arthroscopic examination is first done to assess chondral lesions. The gracilis tendon is detached from the tibia and prepared to pass through 3-mm drill holes. The medial edge of the patella is exposed, and two 3-mm drill holes are made. Dissection is performed with a scissors between the second and third layers toward the medial epicondyle, where a small skin incision is made. A guidewire is placed just anterior and distal to the adductor tubercle. A suture is used to test the isometry of the femoral drill hole. If correct tension or “favorable anisometry” is achieved, a 5-mm bone anchor is placed. The graft is looped and pulled into the femoral hole with sliding sutures. The 2 free ends of the graft are pulled through the patellar drill holes and looped back onto themselves. The graft is tensioned with the knee in maximum extension while pulling the patella proximally with a bone hook as hard as possible in the direction of the femoral shaft. The principle is that with maximum quads contraction, the tension in the patella tendon should be more than in the reconstructed MPFL. Results: Immediate full range of motion, intensive isomeric quads contraction exercises, and full weight-bearing with crutches for 2 to 4 weeks are recommended. Sport can be resumed after 3 months, but it usually takes 6 months to play at the same level as before. Discussion/Conclusion: The technique of “favorable anisometry” of the MPFL has shown a very low rate of recurrence of patella dislocation. Complications are rare and extensor lag is very uncommon, thanks to the specificity of tensioning the graft. The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

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Sreekala, V. K. "A Rare Indication for Amputation." Indian Journal of Physical Medicine and Rehabilitation 27, no. 3 (2016): 90–92. http://dx.doi.org/10.5005/ijopmr-27-3-90.

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Abstract A forty-two years old housewife came to the outpatient department. She met with a very bad road traffic accident in childhood resulting in a crush injury of left lower limb and a degloving injury on the right lower limb. She had undergone transtibial amputation on the left and skin grafting on the right lower limbs. The scar has been transformed into a large keloid. Now she is ambulant with patellar tendon bearing prosthesis on the left side and a rocky hard, heavy, insensate right lower limb with a grotesque appearance. She requests amputation and prosthetic fitting on the right side.

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Memmel, Clemens, Werner Krutsch, Dominik Szymski, Christian Pfeifer, Leopold Henssler, Borys Frankewycz, Peter Angele, Volker Alt, and Matthias Koch. "Current Standards of Early Rehabilitation after Anterior Cruciate Ligament Reconstruction in German Speaking Countries—Differentiation Based on Tendon Graft and Concomitant Injuries." International Journal of Environmental Research and Public Health 19, no. 7 (March 29, 2022): 4060. http://dx.doi.org/10.3390/ijerph19074060.

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Background: Although anterior cruciate ligament reconstruction (ACLR) is a well-established procedure and is standardly performed by orthopedic surgeons all over the world, there does not seem to be a standard protocol for early rehabilitation. The purpose of this study was to give answers to the following questions: (i) Does (a) the use of a specific tendon graft, and (b) potentially additional therapy of concomitant pathologies influence surgeons’ choice of a distinct postoperative rehabilitation protocol after ACLR? (ii) To what extent do these rehabilitation recommendations differ? Methods: Retrospective analysis of currently used early rehabilitation protocols after ACLR in German-speaking countries (GER, AUT and SUI) was conducted. Rehabilitation criteria included weight bearing, range of motion (ROM), the utilization of braces, continuous passive/active motion therapy (CPM/CAM), rehabilitation training and sport-specific training. Tendon grafts were differentiated as hamstring (HAM) and bone–patellar tendon–bone grafts (BTB). Concomitant pathologies included meniscus injuries (+M) and unhappy triad injuries (+UTI). Results: Most of the surveyed protocols were differentiated according to the used tendon graft or additional therapy of concomitant injuries (ACLR-differentiated, n = 147 vs. ACLR without graft differentiation, n = 58). When comparing ACLR-HAM and ACLR-BTB, significant differences were found regarding weight bearing (p = 0.01), ROM (p = 0.05) and the utilization of braces (p = 0.03). Regarding ACLR+M, an overall significant decelerated rehabilitation could be detected. After ACLR+UTI-therapy, a significant delayed start to full weight bearing (p = 0.002) and ROM (p < 0.001) was found. Conclusions: Most orthopedic surgeons from German-speaking countries differentiate early rehabilitation after ACLR according to the tendon graft used and therapy of concomitant pathologies. No consensus about early rehabilitation after ACLR is available. However, tendencies for an accelerated rehabilitation after ACLR-BTB and a more restrained rehabilitation of multiple injured knees were detected.

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Zhang, Ming, and Winson C. C. Lee. "Quantifying the Regional Load-Bearing Ability of Trans-Tibial Stumps." Prosthetics and Orthotics International 30, no. 1 (April 2006): 25–34. http://dx.doi.org/10.1080/03093640500468074.

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This paper reports findings of experiments aiming to (1) compare the load tolerant ability over different regions of stumps of lower limb amputees, (2) study the effect of walking on the load tolerant ability, and (3) examine the distal-end weight-bearing ability supported by different interface materials. The method was to apply increasing load to the stump up to the pain level through a force transducer or a digital scale, considering the effect of regional difference, walking, and interface materials. The results show that the patellar tendon and the distal end of the fibula were the best and worst load-tolerant region, respectively. Walking with prostheses tended to increase the load-tolerant ability, which is thought to be due to the massage-like effect of the socket. Different interface materials did not significantly alter the distal-end weight-bearing ability. However, there was a great difference in the distal-end weight-bearing ability among different subjects.

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Raja, R., H. Ravindranath Rai, J. N. Sridharamurthy, B. Madhouraj, R. Balaji, Vijayalakshmi Raja, and Somasundaram . "To Compare the Effect of Vertical Ground Reaction force in Conventional below Knee Prosthesis Versus Modular below Knee Prosthesis on Unilateral Transtibial Amputee Patients." International Journal of Medical and Dental Sciences 6, no. 1 (January 1, 2017): 1398. http://dx.doi.org/10.18311/ijmds/2017/18797.

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Background: Proper prescription of prosthetic device and potential rehabilitation increases the quality of life for subjects with amputations.Objective: To compare the effect of vertical ground reaction force (Fz) on unilateral Transtibial amputees those who are using conventional and modular patellar tendon bearing (PTB) prosthesis with stump exercises.Material and Methodology: A sample of 120 persons with below knee amputees who were trained to wear prosthesis were studied with an comparative follow up study design with purposive sampling technique. The 120 adult amputee patients were divided in to two groups having 60 samples in each group, group A patients were given conventional patellar tendon bearing (PTB) prosthesis with intensive stump exercises and group B patients were given modular PTB prosthesis with intensive stump exercises respectively. Data analyzed statistically.Results: The unilateral transtibial amputees who trained with modular prosthesis along with stump exercises group patients Fz-force in newton were increased as compared to the unilateral transtibial amputees who were trained with conventional PTB prosthesis along with stump exercises. There was no significant difference seen in both the groups while giving stump exercises alone.Conclusion: The unilateral transtibial amputees who were trained with modular PTB prosthesis along with stump exercises group patient's Fz-force in newton (VGRF) has increased drastically compared with conventional PTB prosthesis.

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Tzeng, Ming-Ji, Lai-Hsing Hsu, and Shih-Hsin Chang. "DEVELOPMENT AND EVALUATION OF A CAD/3DP PROCESS FOR TRANSTIBIAL SOCKET FABRICATION." Biomedical Engineering: Applications, Basis and Communications 27, no. 05 (October 2015): 1550044. http://dx.doi.org/10.4015/s1016237215500441.

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This paper describes a multidisciplinary project that applied the concept of reverse engineering using computer-aided design (CAD) tools to develop a three-dimensional printing (3DP)-based prosthetic socket for transtibial amputees by combining the concepts of patellar tendon-bearing (PTB) socket design principle and total surface-bearing (TSB) socket casting method. Using contemporary tools such as a handheld 3D scanner and an entry-level 3DP machine, together with an in-house prosthetic socket design system and a stump forming device, allowed us to fabricate prosthetic sockets with a consistent quality, and to shorten the learning process time-frame to fabricate them. The results of a case study of two participants demonstrated that the proposed CAD/3DP process of fabrication of transtibial sockets can be easily applied by an unskilled prosthetist to fabricate a socket with the required quality at the first fitting.

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Coombes, A. G. A., R. B. Lawrence, and R. M. Davies. "The use of bicomponent fabrics for bonding polypropylene sockets in prostheses." Prosthetics and Orthotics International 9, no. 3 (December 1985): 145–53. http://dx.doi.org/10.3109/03093648509164727.

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A technique has been established for bonding polypropylene sockets to the structural components of prostheses based on the use of bicomponent knitted fabrics which adhere to the surface of polypropylene sockets during thermoforming. The strength of adhesion of fabric bonded polypropylene with polyester resin based microballoon for instance is increased by more than 10 times relative to uncoated polypropylene. This procedure has been approved by the United Kingdom Department of Health for incorporating polypropylene sockets in conventional, laminated plastic patellar tendon bearing (PTB) prostheses. The bonding technique described should find general application for bonding polypropylene during the manufacture of both prosthetic and orthotic devices.

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Journal articles on the topic 'Patellar tendon bearing'

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