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Acl And Knee

Jiaxin Jin, Liping Yu, Min Wei, Yi Shang, Xin Wang
BACKGROUND: Anterior cruciate ligament (ACL) injury is a common ligament injury to the knee joint, and often lead to limited function, osteoarthritis after knee trauma, secondary damage to meniscus and cartilage, and impaired quality of life. ACL reconstruction is the gold standard surgical treatment for ACL injury, and ligament fixation after reconstruction is the key factor of ACL reconstruction success. However, the optimal fixation device for ACL reconstruction remains unclear. This study aims to evaluate the efficacy and safety of different fixation devices and to find the best fixation device for ACL reconstruction...
March 2019: Medicine (Baltimore)
Nath Adulkasem, Sattaya Rojanasthien, Nattapol Siripocaratana, Sakkadech Limmahakhun
Unicompartmental knee arthroplasty (UKA) in anterior cruciate ligament deficiency (ACLD) has been debated for decades after the development of highly cross-linked polyethylene. This study aims to evaluate the effect of posterior tibial slope on restoring adequate knee stability and flexion after UKA in patients with ACLD. A total of 15 fresh cadaveric knees were divided into three groups: intact ACL, partial ACLD, and complete ACLD. Fixed-bearing UKAs including 3-D-printed tibial inserts with the slopes ranging from 3° to 12° were performed using computer-assisted navigation...
May 2019: Journal of Orthopaedic Surgery
Yuki Kato, Joverienne Chavez, Shin Yamada, Soichi Hattori, Shuzo Takazawa, Hiroshi Ohuchi
Purpose: : This study aimed to investigate anterior knee symptoms in patients who underwent anterior cruciate ligament (ACL) reconstruction using bone-patellar tendon-bone (BPTB) graft followed by implantation of a beta-tricalcium phosphate (β-TCP) block as a bone void filler. Materials and Methods: : We retrospectively reviewed 84 cases of synthetic bone grafting using a β-TCP block for the patellar bone defect in ACL reconstruction with a BPTB autograft. Computed tomography of the operated knee was performed immediately after the surgery to evaluate whether the grafted β-TCP block protruded forward from the anterior surface of the patella...
March 18, 2019: Knee Surgery & related Research
Nicolas Bouguennec, Philippe Colombet, Nicolas Graveleau, Stephane Jambou
Allergy to metal, especially to titanium, is a poorly known subject in orthopedic surgery and is mostly found after arthroplasty. Here, we describe an original case of titanium allergy that developed after an anterior cruciate ligament (ACL) reconstruction of the left knee in a patient with a history of severe atopic dermatitis. Three years after the surgery, he returned to the clinic with the femoral cortical button in his hand; he removed the device from the wound when the skin spontaneously opened at the lateral part of the thigh...
March 18, 2019: Knee Surgery & related Research
Vikram Arun Mhaskar, Jitendra Mahehswari, Manjeet Sansanwal
Anterior cruciate ligament (ACL) femoral avulsions are a rare entity mainly seen in children. We describe a unique case of a bony ACL avulsion with a medial collateral ligament (MCL) and lateral meniscus (LM) tear in a 37-year-old patient who sustained a two-wheeler accident. The ACL femoral avulsion was fixed arthroscopically using a Knee Scorpion and a FiberTape fixed over a suture disc on the lateral cortex. The MCL was repaired with an internal brace using a FiberTape and two SwiveLocks and the torn LM was repaired using all-inside sutures...
March 18, 2019: Knee Surgery & related Research
Jan-Hendrik Naendrup, Jason P Zlotnicki, Conor I Murphy, Neel K Patel, Richard E Debski, Volker Musahl
BACKGROUND: Grading of the pivot shift test varies significantly depending on the examiner's technique. Thus, the purpose of this study was to determine the influence of knee starting position and the magnitude of motion during the reduction event on the magnitude of the pivot shift test. METHODS: Twenty-five clinical providers each performed a total of twenty pivot shift tests on one of two fresh-frozen cadaveric full lower extremity specimens with different grades of rotatory knee laxity...
March 19, 2019: Journal of Experimental Orthopaedics
Panagiotis Kouloumentas, Efstratios Kavroudakis, Efstathios Charalampidis, Dimitris Kavroudakis, Georgios K Triantafyllopoulos
PURPOSE: To compare the "all-inside technique" for anterior cruciate ligament (ACL) reconstruction using a short, quadrupled semitendinosus tendon (ST4) autograft and suspensory cortical fixation on both the femoral and tibial side vs the "conventional technique" using a semitendinosus/gracilis (ST/G) autograft fixed with a suspensory device on the femoral side and with an interference screw on the tibial side, in terms of clinical and functional outcomes. METHODS: A total of 90 patients were enrolled, randomised into two groups, and prospectively followed...
March 19, 2019: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Stephan G Bodkin, Brian C Werner, Lindsay V Slater, Joseph M Hart
PURPOSE: The purpose was to calculate the incidence of osteoarthritis in individuals following Anterior Cruciate Ligament Reconstruction (ACLR) in a large, national database and to examine the risk factors associated with OA development. METHODS: A commercially available insurance database was queried to identify new diagnoses of knee OA in patients with ACLR. The cumulative incidence of knee OA diagnoses in patients after ACLR was calculated and stratified by time from reconstruction...
March 18, 2019: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Andrew Gage, Melissa A Kluczynski, Leslie J Bisson, John M Marzo
Background: Arthrofibrosis commonly occurs after an acute anterior cruciate ligament (ACL) injury and following ACL reconstruction and can lead to poor outcomes. Preoperative stiffness has been shown to be associated with postoperative stiffness; however, few studies have examined predictors of preoperative delay in obtaining full knee extension. Purpose: To examine demographic and injury factors as predictors of time required to achieve full knee extension preoperatively in patients with an acute ACL injury...
March 2019: Orthopaedic Journal of Sports Medicine
Burak Gunaydin, Ali Turgut, Abdulkadir Sari, Cagatay Tekin, Bekir Eray Kilinc, Ibrahim Kusak, Gulcan Gucer Sahin, Onder Kalenderer, Yavuz Selim Kabukcuoglu
BACKGROUND: Studies have shown that the anterolateral ligament contributes to knee stability. This study aims to compare the results of postoperative physical examinations, knee joint stability tests, and functional assessment tests of patients with intact anterolateral (AL) ligaments and patients with ruptured anterolateral (AL) ligaments. MATERIAL AND METHOD: This study consisted of 101 patients, with at least a 12-month follow-up period, who underwent an anterior cruciate ligament reconstruction between 2010 and 2016, and whose AL ligaments were evaluated by the radiologist with the preoperative and postoperative magnetic resonance images (MRI)...
March 15, 2019: International Journal of Surgery
Tetsuro Ushio, Ken Okazaki, Kanji Osaki, Yukihisa Takayama, Koji Sagiyama, Hideki Mizu-Uchi, Satoshi Hamai, Yukio Akasaki, Hiroshi Honda, Yasuharu Nakashima
PURPOSE: Magnetic resonance imaging with T1ρ mapping is used to quantify the amount of glycosaminoglycan in articular cartilage, which reflects early degenerative changes. The purposes of this study were to evaluate early degenerative changes in knees after anterior cruciate ligament (ACL) reconstruction by comparing T1ρ values before and 2 years after surgery and investigate whether surgical factors and clinical outcomes are related to differences in T1ρ values. METHODS: Fifty patients who underwent unilateral primary ACL reconstruction were evaluated using T1ρ mapping before and 2 years after surgery...
March 16, 2019: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Thorkell Snaebjörnsson, Eleonor Svantesson, David Sundemo, Olof Westin, Mikael Sansone, Lars Engebretsen, Eric Hamrin-Senorski
PURPOSE: To analyse patient-related risk factors for 2-year ACL revision after primary reconstruction. The hypothesis was that younger athletes would have a higher incidence of an early ACL revision. METHODS: This prospective cohort study was based on data from the Norwegian and Swedish National Knee Ligament Registries and included patients who underwent primary ACL reconstruction from 2004 to 2014. The primary end-point was the 2-year incidence of ACL revision...
March 16, 2019: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Cesar Praz, Vikram Kishor Kandhari, Adnan Saithna, Bertrand Sonnery-Cottet
Anterior cruciate ligament (ACL) rupture in the immediate build-up to a major international competition can preclude an athletes' participation due to the prolonged period of rehabilitation that is typically required after ACL reconstruction. ACL repair is an alternative strategy that has been postulated to confer the advantage of rapid rehabilitation and earlier return to sport. A 33-year-old professional alpine skier sustained a right knee ACL rupture in September 2017. The athlete indicated that she wanted to participate in the 2018 Olympics...
March 15, 2019: BMJ Case Reports
Alberto Grassi, Cecilia Signorelli, Francisco Urrizola, Luca Macchiarola, Federico Raggi, Massimiliano Mosca, Kristian Samuelsson, Stefano Zaffagnini
PURPOSE: To compare knee anatomical parameters of patients with failed anterior cruciate ligament reconstruction (ACL-R) with those of a control group of sex-matched patients with successful ACL-R. METHODS: Forty-three patients (34 male, 9 female) who experienced graft failure after ACL-R were enrolled in the failed group. These patients were matched to a control group of 43 patients who underwent primary ACL-R with a minimum follow-up of 24 months. On magnetic resonance imaging, the following parameters were evaluated: transepicondylar distance, lateral and medial femoral condyle widths, tibial plateau width, notch width index, and the ratio of width and height of the femoral notch, ratio between the height and depth of the lateral and medial femoral condyle, lateral and medial posterior tibial slopes, and anterior subluxation of the lateral and medial tibial plateau...
March 13, 2019: Arthroscopy: the Journal of Arthroscopic & related Surgery
Robert W Westermann, Kurt P Spindler, Laura J Huston
PURPOSE: To evaluate differences in repair and nonoperatively managed grade III medial collateral ligament (MCL) injuries during anterior cruciate ligament (ACL) reconstruction. METHODS: Patients enrolled in a multicenter prospective longitudinal group who underwent unilateral primary ACL reconstruction between 2002 and 2008 were evaluated. Patients with concomitant grade III MCL injuries treated either operatively or nonoperatively were identified. Concurrent injuries, subsequent surgeries, surgical chronicity, and MCL tear location were analyzed...
March 13, 2019: Arthroscopy: the Journal of Arthroscopic & related Surgery
Ralph Akoto, Malte Albers, Maurice Balke, Bertil Bouillon, Jürgen Höher
BACKGROUND: The objective of the study was to compare the results of a primary anterior cruciate ligament reconstruction (ACLR) using the press-fit fixation technique for a quadriceps tendon (QT) graft to a standard quadrupled hamstring (HT) graft with interference screw fixation. METHODS: A retrospective cohort study with a 12-month follow up provided data for 92 patients. Exclusion criteria were accompanying ligament injuries and contralateral ACL injury. Patients who suffered a graft failure, which was defined as a side-to-side difference of > 3 mm, or infection were rated 'D' according to the IKDC and excluded from further evaluation...
March 14, 2019: BMC Musculoskeletal Disorders
Byung Kag Kim, Tae Won Kim, Chul Ho Hwang, Hong Ki Park, Kyung Hoon Hwang, Jae Ang Sim, Yong Seuk Lee, Beom Koo Lee
Purpose: This study was to evaluate changes of the mechanical loading pattern after anatomic anterior cruciate ligament (ACL) reconstruction by analyzing uptake patterns using combined single-photon emission computerized tomography and conventional computerized tomography (SPECT/CT). Materials and Methods: On SPECT/CT, high signal intensity of the articular surface which shows biological activity and mean increase of mechanical loading was compared with that of the tibiofemoral shaft as a comparative signal...
March 1, 2019: Knee Surgery & related Research
Brian M Capogna, Benjamin S Kester, Kartik Shenoy, Laith Jazrawi, Eric J Strauss, Michael J Alaia
BACKGROUND: Despite advances in technology, graft rupture rates reported in the literature following anterior cruciate ligament (ACL) surgery range from 1.8% to 18%. Recent anatomical studies have identified a lateral structure, the anterolateral ligament (ALL), as a potential source of residual pivoting following ACL reconstruction. The purpose of this report is to review the history surrounding the ALL and recent anatomic studies, identify its biomechanical and clinical implications, and develop a practical approach to utilizing it during ACL reconstruction...
March 2019: Bulletin of the Hospital for Joint Diseases
Peter D Chang, Tony T Wong, Michael J Rasiej
Deep learning for MRI detection of sports injuries poses unique challenges. To address these difficulties, this study examines the feasibility and incremental benefit of several customized network architectures in evaluation of complete anterior cruciate ligament (ACL) tears. Two hundred sixty patients, ages 18-40, were identified in a retrospective review of knee MRIs obtained from September 2013 to March 2016. Half of the cases demonstrated a complete ACL tear (624 slices), the other half a normal ACL (3520 slices)...
March 11, 2019: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
Freddie H Fu, Stephen J Rabuck, Robin V West, Scott Tashman, James J Irrgang
Background: The quadriceps tendon is a versatile graft option, and the clinical implications of a quadriceps tendon harvest need to be further defined. Purpose: To review surgical considerations for the safe harvest of a quadriceps tendon autograft for anterior cruciate ligament (ACL) reconstruction, with a focus on the risk of patellar fractures. Study Design: Case series; Level of evidence, 4. Methods: A series of 57 patients underwent ACL reconstruction with a quadriceps tendon autograft with a patellar bone block from March 2011 to December 2012 at a single institution...
March 2019: Orthopaedic Journal of Sports Medicine
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