Emmanuel J Favaloro, Sandya Arunachalam, Kent Chapman, Leonardo Pasalic
OBJECTIVES: Our objective was to maintain low interlaboratory variation and bias in international normalized ratio (INR) results following a network change in instrumentation and reagents, using a process of ongoing standardization and harmonization. METHODS: Network-wide standardization to new common instrument and reagent platforms followed by network-wide application of a simple novel process of verification of international sensitive index and mean normal prothrombin time values for each new lot of prothrombin time (PT) reagent that does not require use of World Health Organization reference thromboplastin or INR calibration/certified plasma...
July 18, 2024: American Journal of Clinical Pathology
Stefano Nuccio, Carina M Germer, Andrea Casolo, Riccardo Borzuola, Luciana Labanca, Jacopo E Rocchi, Pier Paolo Mariani, Francesco Felici, Dario Farina, Deborah Falla, Andrea Macaluso, Paola Sbriccoli, Alessandro Del Vecchio
This cross-sectional study aims to elucidate the neural mechanisms underlying the control of knee extension forces in individuals with anterior cruciate ligament reconstructions (ACLR). Eleven soccer players with ACLR and nine control players performed unilateral isometric knee extensions at 10% and 30% of their maximum voluntary force (MVF). Simultaneous recordings of high-density surface electromyography (HDEMG) and force output were conducted for each lower limb, and HDEMG data from the vastus lateralis (VL) and vastus medialis (VM) muscles were decomposed into individual motor unit spike trains...
July 18, 2024: Journal of Applied Physiology
Satoshi Yamakawa, Freddie H Fu, Volker Musahl, Richard E Debski
A bone bruise is generated by a bony collision that could occur when the ACL is injured, and its pattern supposedly depends on the injury mechanism and level of skeletal maturity. The objective of this study was to determine the effect of material properties and knee position on the bone bruise pattern in skeletally mature and immature subjects using finite element analysis. Finite element models were created from an MR image in the sagittal plane of a skeletally mature and immature male subject. The femur and tibia were collided at 2 m/s to simulate the impact and determine the maximum principal stress...
July 18, 2024: Journal of Biomechanical Engineering
Chen Bocheng, Ye Ziyan, Wu Jiaxin, Guoxiang Wang, Yu Tiancheng
This study investigated the effects of plyometric training on lower-limb muscle strength and knee biomechanical characteristics during the landing phase. Twenty-four male subjects were recruited for this study with a randomised controlled design. They were randomly divided into a plyometric training group and a traditional training group and underwent training for 16 weeks. Each subject was evaluated every 8 weeks for knee and hip isokinetic muscle strength as well as knee kinematics and kinetics during landing...
July 18, 2024: European Journal of Sport Science
Felix Eckstein, Nicholas M Brisson, Susanne Maschek, Anna Wisser, Francis Berenbaum, Georg N Duda, Wolfgang Wirth
BACKGROUND: Magnetic resonance imaging (MRI) cartilage transverse relaxation time (T2) reflects cartilage composition, mechanical properties, and early osteoarthritis (OA). T2 analysis requires cartilage segmentation. In this study, we clinically validate fully automated T2 analysis at 1.5 Tesla (T) in anterior cruciate ligament (ACL)-injured and healthy knees. METHODS: We studied 71 participants: 20 ACL-injured patients with, and 22 without dynamic knee instability, 13 with surgical reconstruction, and 16 healthy controls...
July 1, 2024: Quantitative Imaging in Medicine and Surgery
Torsten Grønbech Nielsen, Ulrik Dalgas, Martin Lind
PURPOSE: The majority of anterior cruciate ligament reconstruction (ACLr) patients wish to return to sport. Clinical evaluations after ACLr often do not include physical testing, making it difficult to determine the patient's readiness to return to sport. Thus, it would be helpful to identify easily assessable factors associated with physical function in ACLr patients that could inform planning of patients' return to sport. This study sought to evaluate the associations between physical test performance in ACLr patients and known ACL injury risk factors, knee laxity and patient-reported outcomes at 1-year follow-up...
July 2024: Journal of Experimental Orthopaedics
Qiao Lin, Jiwen Wu, Shijun Qiu
BACKGROUND: This meta-analysis assessed the efficacy of dual-energy computed tomography (DECT) in the diagnosis of anterior cruciate ligament (ACL) injuries. METHODS: The literature search was performed up to December 8, 2023, and included a comprehensive examination of several databases: PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP. Diagnostic metrics sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and a summary receiver operating characteristic (SROC) were determined using a bivariate model analysis...
July 18, 2024: BMC Musculoskeletal Disorders
Izzet Bingol, Saygin Kamaci, Ibrahim Kaya, Ali Aykut Fidanci, Mustafa Okan Ayvali, Naim Ata, M Mahir Ulgu, Suayip Birinci, Ozgur Ahmet Atay, Alper Kaya
BACKGROUND: Concomitant knee injuries, such as meniscal tears, are observed in up to 80% of cases and can have a detrimental impact on outcomes following anterior cruciate ligament reconstruction (ACLR). Over recent decades, there has been a growing recognition of the importance of preserving meniscal tissue. Consequently, the prevalence of meniscal-preserving procedures has been on the rise. PURPOSE: The objective of this study was to examine the prevalence of concurrent meniscal procedures, assess the success rate, and identify factors associated with the failure of meniscal repair in patients undergoing ACLR...
July 17, 2024: BMC Musculoskeletal Disorders
Suha Hamshari, Sondos Hamadneh, Mukaram Ghneem, Raghad Khalaf, Sara Daqqa, Rola Abu Alwafa, Mahfouz Ktaifan
INTRODUCTION: Physicians working in primary health care (PHC) centers are the first contact for patients and expected to deal with emergencies. Emergency care training in PHC settings has been neglected globally, especially in low to middle income countries. Adequate preparation becomes especially important during periods of conflict. The study objectives are to identify the barriers facing PHC physicians when dealing with emergency cases in the northern region of Palestine during the current conflict...
July 17, 2024: BMC Prim Care
Jingxin Li, Jie Yang, Zhaoguang Xu, Weican Wang
PURPOSE: This prospective study aimed to compare the postoperative evaluation of the quadrant method measuring four points and Bernard method in femoral tunnel position evaluation on 3-Dimensional (3D) reconstructed computed tomography (CT) following the arthroscopic single-bundle anterior cruciate ligament (ACL) reconstruction. METHODS: Thirty-eight patients with ACL tears that were reconstructed using single-bundle ACL reconstruction between May 2021 and March 2023 were included in this study...
July 18, 2024: BMC Musculoskeletal Disorders
Mohamed A Khalefa, Randeep S Aujla, Nadim Aslam, Tarek Boutefnouchet, Peter D'Alessandro, Peter B MacDonald, Shahbaz S Malik
BACKGROUND: The autograft of choice for anterior cruciate ligament reconstruction (ACLR) remains debateable. Recently there has been increased popularity of soft tissue quadriceps tendon (s-QT) autograft due to less donor site morbidity, reduced anterior knee pain and comparable re-operation and complication rates. The aim of this review was to analyse functional outcomes of primary ACLR using s-QT in adult population without the bone plug and to report its complication profile against other autografts...
July 16, 2024: Orthopaedics & Traumatology, Surgery & Research: OTSR
Ayato Miyamoto, Atsuo Nakamae, Kazuhiro Tsukisaka, Masataka Deie, Eisaku Fujimoto, Yoshinori Soda, Ryo Shimizu, Nobuo Adachi
The purpose of this study was to investigate factors that influence clinical outcomes after ACL reconstruction in patients age 40 and older. We studied 264 patients aged 40 or older and 154 patients aged 20 or younger who underwent ACL reconstruction at several surgical centers. Logistic regression analysis was conducted to identify factors that influenced the KOOS scores at 1 year post ACL reconstruction. In the older patient group, cartilage damage in the patellofemoral compartment at surgery was a significant risk factor for poor postoperative KOOS subscores (pain, ADL, sports, and QOL)...
July 17, 2024: Journal of Knee Surgery
Matthew Quinn, Nicholas Lemme, Patrick Morrissey, Paul Fadale, Brett D Owens
» The rate of primary anterior cruciate ligament reconstruction (ACLR) failure in at-risk populations remains unacceptably high and necessitates thorough evaluation of native alignment and concomitant injuries.» Posterior tibial slope of >12° is a substantial risk factor of ACLR failure and should be corrected through anterior closing wedge osteotomy.» Varus malalignment of >5° exacerbates stress on the ACL graft, increases ACLR failure risks, and should be considered for correction through high tibial osteotomy at the time of revision ACLR...
July 1, 2024: JBJS Reviews
Varun Ravi, Mahad Rehman, Shuda Xia, Avneesh Chhabra, Flavio Duarte Silva
OBJECTIVE: To compare radiographic measurements of lateral tibial slope (LTS), medial TS (MTS), and coronal TS (CTS) in MRI-defined intact, injured, and mucoid-degenerated native ACL knees and determine inter-reader reliability. MATERIALS AND METHODS: Patient records from 2 years at tertiary care hospitals were reviewed for individuals aged 18-100 undergoing 3-Tesla knee MRI and radiographs. Two randomly selected cohorts, control, and pathologic ACLs on MRI with 86 patients each, were age, gender, and BMI-matched...
July 17, 2024: Skeletal Radiology
Takuya Sengoku, Junsuke Nakase, Yushin Mizuno, Yoshihiro Ishida, Yusuke Yanatori, Naoki Takemoto, Satoru Demura
PURPOSE: This study aimed to identify factors influencing persistent muscle weakness in knee flexor strength after anterior cruciate ligament (ACL) reconstruction using the hamstring tendon and establish a clear cut-off value at 3 months postoperatively for the limb symmetry index (LSI) to exceed 90% at 6 months postoperatively. METHODS: One hundred forty-eight patients undergoing ACL reconstruction were included and categorised into two groups based on knee flexor strength at 6 months postoperatively: patients with LSI of 90% or greater (achieved group: n = 114) and patients with LSI less than 85% (nonachieved group: n = 34)...
July 17, 2024: Knee Surgery, Sports Traumatology, Arthroscopy
Fuji Ren, Jiang Wu, Dong Zhao, Rui Wang, Jingmin Huang
OBJECTIVE: To investigate whether different degrees of primary varus knee affect joint function and stability in patients undergoing anterior cruciate ligament (ACL) reconstruction. METHODS: A clinical data of 160 patients with primary varus knee, who were admitted between January 2020 and December 2021 and met the selection criteria, was retrospectively analyzed. All patients underwent primary ACL reconstruction using autologous single-bundle hamstring tendon. Patients were divided into three groups based on the hip-knee-ankle angle (HKA): group A (64 patients with HKA 0°-3°), group B (55 patients with HKA 3°-6°), and group C (41 patients with HKA 6°-9°)...
July 15, 2024: Chinese Journal of Reparative and Reconstructive Surgery
McKenzie S White, Lucia M Mancini, Luke Stoneback, Riann M Palmieri-Smith, Lindsey K Lepley
Following anterior cruciate ligament reconstruction (ACLR), patients exhibit abnormal walking mechanics and quadriceps dysfunction. Quadriceps dysfunction has been largely attributed to muscle atrophy and weakness. While important, these factors do not capture intrinsic properties of muscle that govern its ability to generate force and withstand load. While fascicle abnormalities after ACLR have been documented in early stages of recovery (<12 mo), long-term effects of ACLR on fascicle mechanics remain unexplored...
July 16, 2024: Journal of Applied Biomechanics
Mansour M Aldhilan, Abdullah H Alshahrani, Ismail H Almogbil
Anterior cruciate ligament and meniscus tears are common among sports injuries. There are different techniques for addressing anterior cruciate ligament and meniscus tears, with distinct indications, advantages, and disadvantages. We present the case of a 23-year-old male who underwent right anterior cruciate ligament reconstruction and posterior horn medial meniscus repair using an all-inside technique via superficial medial collateral ligament (sMCL) pie-crusting. Clinical examination and radiological investigations a few months later identified calcifications on the medial side of the right knee...
July 2024: Journal of Surgical Case Reports
Eduard M Cernat, Andrei Neagu, Cezar Betianu, Drago-Eugen Georgescu, Adrian Barbilian, Loredana Sabina Cornelia
Background: The intercondylar notch (ICN) is an important element of knee morphometry, in close relation to the anterior cruciate ligament (ACL). To find the average are of the anterior notch in each ICN specific shape (A-, W-, or U-shape). Methods: Magnetic resonance imaging (MRI) scans were independently analyzed by two experts, one orthopedic surgeon and one imaging physician. In all cases, the following measurements were done according to the existing definitions: ICN type, aICN area. Results: 65 cases (A-35...
June 2024: Chirurgia
Andreas K Lindner, Maria Cristina Moreno-Del Castillo, Mia Wintel, Gabriela Equihua Martinez, Joachim Richter, Florian Kurth, Frieder Pfäfflin, Thomas Zoller, Maximilian Gertler, Susanne Georgi, Michael Nürnberg, Claudia Hülso, Julian Bernhard, Sarah Konopelska Kotsias, Antonio Seigerschmidt, Welmoed van Loon, Frank Mockenhaupt, Beate Kampmann, Gundel Harms
BACKGROUND: American Cutaneous Leishmaniasis (ACL) shows variable response to therapy, but data on species-specific treatment efficacy is scarce. We describe the clinical characteristics and outcome of patients with ACL imported to a tertiary centre in Germany and determine whether species-specific therapy according to the 2014 "LeishMan" group recommendations is associated with cure. METHODS: A retrospective chart review was conducted at the Charité Institute of International Health in Berlin...
July 15, 2024: PLoS Neglected Tropical Diseases
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