Brian D. Fox, Lawrence W. Judge, D. Clark Dickin, Henry Wang*
Biomechanics Laboratory, School of Kinesiology, Ball State University. Muncie, IN, USA
Load carriage is a common activity used in daily tasks for many occupations, so understanding its injury mechanisms, as well as the biomechanical modifications made to gait and posture during load carriage, could reduce injury risk during this activity. The purpose of this review was to compile the most recent literature regarding biomechanical adaptations to load carriage, including its effects on musculoskeletal injury, kinematic, spatiotemporal, and kinetic adaptations, and insights about the future of load carriage research. Researchers found a high degree of injury in personnel who participate in heavy load carriage activities as a part of their job, with lower back and lower extremity injuries being the most common. An observation of several studies that measured kinematic, spatiotemporal, and kinetic adaptations suggest that there may be a threshold in which typical gait kinematics must change to account for the additional load. Not adapting proper mechanisms to deal with increased load carriage forces may lead to lower extremity injury. Future studies should observe how persons untrained in load carriage respond to these loads, and how controlling for variables like speed and cadence affect gait adaptations.
DOI: 10.29245/2767-5130/2020/1.1104 View / Download PdfEric D Haunschild, Ron Gilat, Michael C Fu, Brian J Cole*
Midwest Orthopaedics at Rush, Chicago IL, USA
Meniscus injuries are a common presentation to orthopedic clinics, with hundreds of thousands of meniscectomies and meniscus repairs being performed every year1. As the consequence of osteoarthritis progression has been found to be associated with functional meniscal deficiency, a significant increase in repair surgeries have occurred in recent years2. However, in symptomatic patients with irreparable tears, partial meniscectomy remains the standard of care. Meniscectomy is not harmless and can result in increased contact stress, predisposing the patient to early-onset osteoarthritis1.
In a select group of patients with persistent unicompartmental pain and symptomatic meniscus deficiency, meniscal allograft transplantation (MAT) has emerged as an acceptable surgical procedure aiming to restore function and improve pain. In many patients, MAT can result in long-term improvement, with a recent systematic review demonstrating favorable graft survival and functional outcomes at a minimum ten years after surgery3. These favorable outcomes demonstrate lasting symptomatic improvement and, though unproven at this time, may decrease the progression of osteoarthritis in the knee. The purpose of this article is to review five key points on the indications, pre-operative considerations and surgical preparation, surgical technique, and common concomitant procedures of MAT.
DOI: 10.29245/2767-5130/2020/1.1101 View / Download Pdf