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Clinics in Sports Medicine

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https://www.readbyqxmd.com/read/27871666/management-of-the-anterior-cruciate-ligament-deficient-knee
#1
EDITORIAL
Darren L Johnson
No abstract text is available yet for this article.
January 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27871665/anterior-cruciate-ligament
#2
EDITORIAL
Mark D Miller
No abstract text is available yet for this article.
January 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27871664/gross-arthroscopic-and-radiographic-anatomies-of-the-anterior-cruciate-ligament-foundations-for-anterior-cruciate-ligament-surgery
#3
REVIEW
Sebastián Irarrázaval, Marcio Albers, Tom Chao, Freddie H Fu
The anterior cruciate ligament (ACL) is one of the more studied structures in the knee joint. It is not a tubular structure, but is much narrower in its midsubstance and broader at its ends, producing an hourglass shape. The ACL is composed of 2 functional bundles, the anteromedial and posterolateral bundles, that are named for their location of insertion on the anterior surface of the tibial plateau. Although the relative contribution in terms of total cross-sectional area of the ACL has been noted to be equal in regards to each bundle, dynamically these bundles demonstrate different properties for knee function...
January 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27871663/surgical-management-and-treatment-of-the-anterior-cruciate-ligament-medial-collateral-ligament-injured-knee
#4
REVIEW
Kevin M Dale, James R Bailey, Claude T Moorman
The medial collateral ligament (MCL) is the most commonly injured ligament of the knee. The anterior cruciate ligament (ACL) is the most commonly injured ligament in conjunction with the MCL. Most MCL injuries can be treated nonoperatively, whereas the ACL often requires reconstruction. A good physical examination is essential for diagnosis, whereas radiographs and MRI of the knee confirm diagnosis and help guide treatment planning. Preoperative physical therapy should be completed before surgical management to allow for return of knee range of motion and an attempt at MCL healing...
January 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27871662/indications-for-two-incision-outside-in-anterior-cruciate-ligament-reconstruction
#5
REVIEW
Barton R Branam, Christopher J Utz
Anterior cruciate ligament (ACL) reconstruction is a commonly performed procedure. Drilling the femoral tunnel independent of the tibial tunnel has become popular as surgeons strive to create tunnels in the anatomic locations of the femoral and tibial attachments of the native ligament. The 2-incision technique effectively and reproducibly accomplishes this goal. The 2-incision technique for ACL reconstruction is a valuable tool in the skillset of the reconstructive knee surgeon. Indications for the 2-incision surgery are reviewed in detail...
January 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27871661/single-bundle-anatomic-anterior-cruciate-ligament-reconstruction-surgical-technique-pearls-and-pitfalls
#6
REVIEW
Chaitu S Malempati, Adam V Metzler, Darren L Johnson
Anterior cruciate ligament (ACL) ruptures are some of the most common sports-related injuries. Treatment of these injuries with ACL reconstruction has evolved over the last several decades. Anatomic single-bundle ACL reconstruction offers an accurate and reproducible method to reproduce native knee anatomy, restore knee kinematics, and ultimately restore function and decrease long-term degenerative effects. The importance of adequate arthroscopic visualization and a thorough understanding of the native anatomic ACL landmarks are discussed in this article...
January 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27871660/management-of-the-anterior-cruciate-ligament-injured-knee-in-the-skeletally-immature-athlete
#7
REVIEW
Christian N Anderson, Allen F Anderson
Intrasubstance tears of the anterior cruciate ligament (ACL) are being diagnosed with increasing frequency in the skeletally immature. Management options include nonoperative/ early surgical, or delayed surgical reconstruction. Nonoperative/delayed reconstruction results in worse functional outcomes than early reconstruction. Physicians are faced with a treatment dilemma; clinical and basic science studies have demonstrated risk of limb-length discrepancy and angular deformity with ACL reconstruction. Vertical drill tunnels decrease physeal damage and minimize growth deformity; however, this technique results in nonanatomic ACL graft placement...
January 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27871659/graft-selection-in-anterior-cruciate-ligament-surgery-who-gets-what-and-why
#8
REVIEW
Kyle R Duchman, T Sean Lynch, Kurt P Spindler
Anterior cruciate ligament (ACL) injuries are common and affect a young, active patient population. Despite much research, ACL reconstruction graft choice remains a topic of debate. Based on the best available evidence, autograft seems to be superior to allograft for ACL reconstruction in young, active patients. Future high-level studies are required in order to better define the role of allograft in ACL reconstruction. As graft choice is often influenced by surgeon preference, it is important that surgeons understand the current literature as well as the goals of their patients...
January 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27871658/rehabilitation-principles-of-the-anterior-cruciate-ligament-reconstructed-knee-twelve-steps-for-successful-progression-and-return-to-play
#9
REVIEW
Kevin E Wilk, Christopher A Arrigo
The rehabilitation process begins immediately after injury to the anterior cruciate ligament (ACL). The goal of preoperative rehabilitation is to prepare the patient for surgery. Current rehabilitation programs focus on strengthening exercises and proprioceptive and neuromuscular control drills to provide a neurologic stimulus. It is also important to address preexisting factors, especially for the female athlete, that may predispose to future injury, such as hip and hamstring weakness. Our goal in the rehabilitation program is to restore full, unrestricted function and to assist the patient to return to 100% of the preinjury level while achieving excellent long-term outcomes...
January 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27871657/surgical-pearls-in-revision-anterior-cruciate-ligament-surgery-when-must-i-stage
#10
REVIEW
Dustin L Richter, Brian C Werner, Mark D Miller
Failed anterior cruciate ligament (ACL) reconstruction is a challenging clinical entity and revision ACL reconstruction is a technically challenging procedure. This article reviews the etiology of ACL failures, the need for appropriate examination and imaging studies, and discusses the technical considerations to allow for a successful revision reconstruction. Furthermore, we elaborate on the decision-making process of when a 2-stage revision is preferred to a single-stage revision.
January 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27871656/etiologic-factors-that-lead-to-failure-after-primary-anterior-cruciate-ligament-surgery
#11
REVIEW
James D Wylie, Lucas S Marchand, Robert T Burks
Anterior cruciate ligament (ACL) reconstruction is common in the active young population. Failure of ACL reconstruction can be due to continued or recurrent instability, stiffness, or patient-reported failure in the setting of seemingly successful surgical reconstruction, such as pain that limits activity. Multiple preoperative, intraoperative, and postoperative variables can be optimized to give the greatest likelihood of success. Some of these include timing of surgery, identification, and treatment of associated ligamentous, meniscal and chondral injuries, tunnel placement, graft choice, fixation, tensioning, and postoperative rehabilitation...
January 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27871655/surgical-indications-and-technique-for-anterior-cruciate-ligament-reconstruction-combined-with-lateral-extra-articular-tenodesis-or-anterolateral-ligament-reconstruction
#12
REVIEW
Bart Vundelinckx, Benjamin Herman, Alan Getgood, Robert Litchfield
After anterior cruciate ligament (ACL) rupture, anteroposterior and rotational laxity in the knee causes instability, functional symptoms, and damage to other intra-articular structures. Surgical reconstruction aims to restore the stability in the knee, and to improve function and ability to participate in sports. It also protects cartilage and menisci from secondary injuries. Because of persistent rotational instability after ACL reconstruction, combined intra-articular and extra-articular procedures are more commonly performed...
January 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27871654/surgical-management-and-treatment-of-the-anterior-cruciate-ligament-deficient-knee-with-malalignment
#13
REVIEW
Matthew D Crawford, Lee H Diehl, Annunziato Amendola
Varus malalignment and an increased tibial slope can result in instability in an anterior cruciate ligament (ACL)-deficient knee. Malalignment can also be a cause of recurrent instability following ACL reconstruction. Varus malalignment can contribute to loosening or failure of primary ACL reconstruction and contribute to progressive medial compartment arthritis. High tibial osteotomies performed in conjunction with ACL reconstruction can improve alignment, restore anterior knee stability, and help reduce the advancement of arthritis...
January 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27871653/surgical-management-and-treatment-of-the-anterior-cruciate-ligament-posterolateral-corner-injured-knee
#14
REVIEW
Nicholas I Kennedy, Christopher M LaPrade, Robert F LaPrade
Posterolateral knee injuries occur more commonly than in the past. These injuries most commonly occur concurrent with cruciate ligament tears. The main stabilizers of the posterolateral knee are the fibular collateral ligament, the popliteus tendon, and the popliteofibular ligament. These static stabilizers function to prevent increased varus, external rotation, and coupled posterolateral rotation of the knee. The most important clinical tests to diagnose posterolateral knee injuries are the varus stress test, posterolateral drawer, and dial tests...
January 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27871652/epidemiology-and-diagnosis-of-anterior-cruciate-ligament-injuries
#15
REVIEW
Christopher C Kaeding, Benjamin Léger-St-Jean, Robert A Magnussen
Anterior cruciate ligament (ACL) injuries are increasingly common in the United States. This may be related to the increase in high school sports participation, particularly in female athletes. A significant proportion of these injuries are caused by noncontact mechanisms. The incidence of these noncontact injuries may be significantly reduced by enrolling young athletes in jump-training programs. The diagnosis of ACL injuries involves a focused history and physical examination, which can provide a high index of suspicion...
January 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27543410/return-to-play-following-musculoskeletal-injury
#16
EDITORIAL
Brett D Owens
No abstract text is available yet for this article.
October 2016: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27543409/foreword
#17
EDITORIAL
Mark D Miller
No abstract text is available yet for this article.
October 2016: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27543408/return-to-play-following-ankle-sprain-and-lateral-ligament-reconstruction
#18
REVIEW
Scott B Shawen, Theodora Dworak, Robert B Anderson
Ankle sprains are the most common musculoskeletal injury occurring during athletics. Proper initial treatment with supportive pain control, limited immobilization, early return to weight bearing and range of motion, and directed physical therapy are essential for preventing recurrent injury. Reconstruction of the lateral ligaments is indicated for patients with continued instability and dysfunction despite physical therapy. Return to athletic activity should be reserved for athletes who have regained strength, proprioception, and range of motion of the injured ankle...
October 2016: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27543407/return-to-play-after-medial-collateral-ligament-injury
#19
REVIEW
Christopher Kim, Patrick M Chasse, Dean C Taylor
Medial collateral ligament injuries are common in the athletic population. Partial injuries are treated nonoperatively with excellent outcomes. Complete ruptures may be treated nonoperatively, although some will require surgery. A comprehensive rehabilitation program is critical to outcome, but a standardized program for all injuries does not exist. Most of the literature regarding nonoperative and postoperative rehabilitation include observational reports and case studies. Level I studies comparing rehabilitation protocols have not been published...
October 2016: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27543406/return-to-play-following-meniscus-surgery
#20
REVIEW
Alaina M Brelin, John-Paul H Rue
Meniscus tears are commonly encountered in the athletic population and can result in significant loss of playing time. Current treatment methods for acute tears consist of meniscectomy and meniscal repair, whereas meniscal allograft transplant is reserved as a salvage procedure for symptomatic meniscectomized patients who desire a more functional knee. This review describes the postoperative rehabilitation protocol for each procedure and evaluates the outcomes in existing literature as it pertains to the athlete...
October 2016: Clinics in Sports Medicine
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