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Outcome of ACLR

Robert Westermann, Chris A Anthony, Kyle R Duchman, Yubo Gao, Andrew J Pugely, Carolyn M Hettrich, Ned Amendola, Brian R Wolf
Infection following anterior cruciate ligament reconstruction (ACLR) is rare. Previous authors have concluded that diabetes, tobacco use, and previous knee surgery may influence infection rates following ACLR. The purpose of this study was to identify a cohort of patients undergoing ACLR and define (1) the incidence of infection after ACLR from a large multicenter database and (2) the risk factors for infection after ACLR. We identified patients undergoing elective ACLRs in the American College of Surgeons National Surgical Quality Improvement Program database between 2007 and 2013...
October 25, 2016: Journal of Knee Surgery
Benedict U Nwachukwu, Pramod B Voleti, Brenda Chang, Patricia Berkanish, Gregory T Mahony, Riley J Williams, David W Altchek, Answorth A Allen
PURPOSE: To investigate differences between sport types for patient-reported outcome after anterior cruciate ligament reconstruction (ACLR). METHODS: Included patients were enrolled as part of a prospective institutional ACL registry. Inclusion criteria were preoperative self-identification as a competitive athlete, maximum score on the preoperative Marx Activity Scale, and minimum 2-year follow-up. Demographic, intraoperative, and outcome data were extracted from the registry...
October 20, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Jeong-Ku Ha, Dhong-Won Lee, Jin-Goo Kim
BACKGROUND: Numerous studies have elucidated the functional anatomy and biomechanics of the anterior cruciate ligament (ACL), as a result, double-bundle (DB) ACL reconstruction has received much attention and has become a popular choice because it gives better rotational stability. Many other studies, however, found no differences with respect to stability, and/or other clinical outcomes between the DB and single-bundle (SB) techniques. There is still not enough evidence as to whether the anatomical DB anterior cruciate ligament reconstruction (ACLR) is superior to anatomical SB reconstruction...
September 2016: Indian Journal of Orthopaedics
Jason Beng Teck Lim, Bryan Loh, Hwei Chi Chong, Andrew Hwee Chye Tan
BACKGROUND: Patients with a history of previous knee surgeries, such as anterior cruciate ligament reconstruction (ACLR) and high tibial osteotomy (HTO), often have a higher likelihood of requiring a subsequent total knee arthroplasty (TKA). However, there is relatively limited data, especially in the Asian population, on how previous knee surgery could affect the clinical outcomes of TKA. Therefore, this study aims to evaluate the impact of previous knee surgeries on the clinical outcomes of future TKA...
August 2016: Annals of Translational Medicine
Peter Faunø, Lone Rømer, Torsten Nielsen, Martin Lind
BACKGROUND: Anterior cruciate ligament reconstruction (ACLR) in skeletally immature patients can result in growth plate injury, which can cause growth disturbances. PURPOSE: To evaluate radiological tibial and femoral length and axis growth disturbances as well as clinical outcomes in skeletally immature ACLR patients treated with a transphyseal drilling technique. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A total of 39 pediatric patients with ACL injury and open physes at time of surgery, as diagnosed clinically and with magnetic resonance imaging (MRI), were treated using transphyseal ACLR using hamstring graft...
September 2016: Orthopaedic Journal of Sports Medicine
Robert W Westermann, Thomas Sean Lynch, Kurt P Spindler
Since 2015, the Multicenter Orthopedic Outcomes Network (MOON) has addressed several factors associated with patient outcome after anterior cruciate ligament (ACL) injury. These factors include predictors of high grade knee laxity, the impact of meniscus treatment on joint space narrowing after surgery, graft selection, treating diabetic patients, predictors of clinically significant pain, and outcomes of patients where meniscus tears were left in situ without treatment. The presence of meniscus tears and generalized laxity predict a lax examination under anesthesia prior to surgery...
October 2016: Journal of Knee Surgery
Ana Tichonova, Inesa Rimdeikienė, Daiva Petruševičienė, Eglė Lendraitienė
BACKGROUND AND OBJECTIVE: Psychological responses to the initial injury and rehabilitation might be an important additional determinant of functional level outcomes after knee surgery. The objectives of this study were (1) to measure pain catastrophizing and kinesiophobia levels and (2) determine their association with self-reported subjective knee function during rehabilitation, following anterior cruciate ligament reconstruction (ACLR) and meniscectomy. MATERIALS AND METHODS: The study involved 41 participants...
2016: Medicina
Adam Meierbachtol, Eric Rohman, Eric Paur, John Bottoms, Marc Tompkins
BACKGROUND: In patients who have undergone anterior cruciate ligament reconstruction (ACLR), the effect of neuromuscular re-education (NMR) programs on standard hop tests outcomes, including limb symmetry indices (LSIs), is unknown. HYPOTHESIS: Both legs will show improvement in hop test-measured units after neuromuscular training, but the involved leg will show relatively greater improvement leading to improved limb symmetry. Patients younger than 18 years will show more improvement than patients who are older...
September 12, 2016: Sports Health
Adrian Kurz, Nathan Evaniew, Marco Yeung, Kristian Samuelsson, Devin Peterson, Olufemi R Ayeni
PURPOSE: This systematic review examined the methodological credibility and quality of reporting of all meta-analyses which have compared bone-patellar tendon-bone (BPTB) versus hamstring tendon (HT) for anterior cruciate ligament (ACL) reconstruction (ACLR). METHODS: EMBASE, MEDLINE, and The Cochrane Library were systematically searched, and two reviewers independently assessed eligibility, credibility according to the Users' Guide to medical literature, and completeness of reporting according to the preferred reporting items for systematic review and meta-analyses (PRISMA) checklist...
August 20, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Thomas L Sanders, Ayoosh Pareek, Timothy E Hewett, Bruce A Levy, Diane L Dahm, Michael J Stuart, Aaron J Krych
PURPOSE: Graft failure following anterior cruciate ligament reconstruction (ACLR) is a devastating injury among patients returning to activity. The goals of this study were to define the long-term rate of graft failure after ACLR in the general population and evaluate factors associated with graft failure. METHODS: This long-term observational study included a population-based incidence cohort of patients who underwent primary ACLR after diagnosis with new-onset, isolated ACL tears between 1990 and 2010...
August 13, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Matteo Guzzini, Daniele Mazza, Mattia Fabbri, Riccardo Lanzetti, Andrea Redler, Carlo Iorio, Edoardo Monaco, Andrea Ferretti
PURPOSE: The growing popularity of elite soccer among female participants has led to increased incidents of anterior cruciate ligament (ACL) ruptures. Many authors underline a positive glide after ACL reconstruction (ACLR), especially in women. In fact, an isolated intra-articular ACLR may be inadequate to control rotational instability after a combined injury of the ACL and the peripheral structures of the knee. Extra-articular procedures are sometimes used in primary cases displaying excessive antero-lateral rotatory instability...
October 2016: International Orthopaedics
Endre Soreide, Lars-Petter Granan, Geir A Hjorthaug, Birgitte Espehaug, Sigbjørn Dimmen, Lars Nordsletten
BACKGROUND: The administration of nonsteroidal anti-inflammatory drugs (NSAIDs) to patients undergoing anterior cruciate ligament reconstruction (ACLR) is controversial because it may impair tissue healing and clinical outcomes. PURPOSE: To assess the effect of NSAID administration on patients undergoing ACLR. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Included patients were aged >15 years and were registered in the Norwegian Knee Ligament Registry from 2008 until 2013 after the primary ACLR...
August 5, 2016: American Journal of Sports Medicine
Shaoqi Tian, Bin Wang, Lun Liu, Yuanhe Wang, Chengzhi Ha, Qicai Li, Xu Yang, Kang Sun
BACKGROUND: Most studies on grafts for anterior cruciate ligament (ACL) reconstruction (ACLR) have been of autografts or nonirradiated allografts with a single-bundle (SB) technique. Outcome reports evaluating anatomic double-bundle (DB) ACLR with a hamstring tendon autograft versus irradiated allograft are rare. PURPOSE: To compare the clinical outcomes of arthroscopic anatomic DB ACLR with a hamstring tendon autograft versus irradiated allograft. STUDY DESIGN: Randomized controlled trial; Level of evidence, 2...
October 2016: American Journal of Sports Medicine
Dariusz Witoński, Rafał Kęska, Rafał Cyranowski, Przemysław T Paradowski
INTRODUCTION: Several studies have suggested that anterior cruciate ligament reconstruction (ACLR) without wound drainage has no impact on long-term follow-up. AIM: To investigate a prospective patient series as measured by the patient-administered disease-specific questionnaire Knee injury and Osteoarthritis Outcome Score (KOOS). MATERIAL AND METHODS: The study included 101 consecutive patients (71 men and 30 women) with a mean age of 30 years (SD 10, range: 15-62 years), who had undergone primary single incision arthroscopic bone-patellar tendon-bone autograft (BPTB) ACLR without wound drainage...
2016: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
David A Novikov, Stephanie J Swensen, John A Buza Iii, Ramesh H Gidumal, Eric J Strauss
OBJECTIVE: Anterior cruciate ligament reconstruction (ACLR) depends on proper healing of the graft or bone plug at the cellular level. The effect of cigarette smoke on ACLR was not commonly reported until recently. The primary purpose of this review was to determine if smoking has a negative effect on subjective or objective outcome scores after ACLR. The secondary purpose was to identify any increased risk of complications, infection, ACL re-tear, or revision procedures. METHODS: A systematic literature review of the MEDLINE, SCOPUS and PubMed databases was performed to identify all studies that compared outcomes of ACLR surgery between smokers and nonsmokers...
July 25, 2016: Physician and Sportsmedicine
Mark Ci-En Chan, Justin Wen-Jie Wee, Mui-Hong Lim
OBJECTIVE: The efficacy of kinesiology taping in arthroscopic knee surgery has not been reported. The objective of this study is to investigate the efficacy of kinesiology taping in the early postoperative phase after anterior cruciate ligament reconstruction (ACLR). We hypothesized that kinesiology taping reduces knee pain and swelling and improves knee range of movement and functional outcome. DESIGN: Randomized controlled study. SETTING: Primary Institutional Hospital...
July 15, 2016: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Mathew J Failla, David S Logerstedt, Hege Grindem, Michael J Axe, May Arna Risberg, Lars Engebretsen, Laura J Huston, Kurt P Spindler, Lynn Snyder-Mackler
BACKGROUND: Rehabilitation before anterior cruciate ligament (ACL) reconstruction (ACLR) is effective at improving postoperative outcomes at least in the short term. Less is known about the effects of preoperative rehabilitation on functional outcomes and return-to-sport (RTS) rates 2 years after reconstruction. PURPOSE/HYPOTHESIS: The purpose of this study was to compare functional outcomes 2 years after ACLR in a cohort that underwent additional preoperative rehabilitation, including progressive strengthening and neuromuscular training after impairments were resolved, compared with a nonexperimental cohort...
October 2016: American Journal of Sports Medicine
Melissa M Allen, Ayoosh Pareek, Aaron J Krych, Timothy Hewett, Bruce A Levy, Michael J Stuart, Diane L Dahm
BACKGROUND: Female soccer players have a well-known risk for anterior cruciate ligament (ACL) injury, but few studies have reported on second ACL injuries in this population. PURPOSE: To (1) report the rates of subsequent ACL injury (ipsilateral graft rupture or contralateral tear) in competitive female soccer players, (2) compare these rates with those of other female athletes of similar competitive level, (3) determine risk factors for second ACL injury, and (4) report clinical outcome scores in this population...
June 3, 2016: American Journal of Sports Medicine
Yang Zhang, Caiqi Xu, Shiqui Dong, Peng Shen, Wei Su, Jinzhong Zhao
PURPOSE: To provide an up-to-date assessment of the difference between anatomic double-bundle anterior cruciate ligament (ACL) reconstruction (DB-ACLR) and anatomic single-bundle ACL reconstruction (SB-ACLR). We hypothesized that anatomic SB-ACLR using independent femoral drilling technique would be able to achieve kinematic stability as with anatomic DB-ACLR. METHODS: A comprehensive Internet search was performed to identify all therapeutic trials of anatomic DB-ACLR versus anatomic SB-ACLR...
September 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
S R Filbay, I N Ackerman, T G Russell, K M Crossley
Many individuals experience long-term quality of life (QOL) impairment following anterior cruciate ligament reconstruction (ACLR). Factors contributing to poor QOL and psychological health >5 years after ACLR remain unclear. This study aimed to describe QOL and psychological health outcomes in people with knee difficulties (pain, symptoms, or functional limitations) 5-20 years following ACLR and identify factors explaining variability in these outcomes. Participants with knee difficulties 5-20 years following ACLR completed a battery of validated patient-reported outcomes [including the Knee injury and Osteoarthritis Outcome Score (KOOS), ACL-QOL, and the Assessment of QOL (AQoL-8D) instrument]...
May 11, 2016: Scandinavian Journal of Medicine & Science in Sports
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