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Outcome of ACLR

Brian R Waterman, William Arroyo, Eric J Cotter, Michael A Zacchilli, E'Stephan J Garcia, Brett D Owens
Background: There remains a debate over whether to retain the index anterior cruciate ligament (ACL) graft in the setting of septic arthritis. Purpose: To evaluate and compare clinical outcomes for the treatment of septic arthritis after ACL reconstruction (ACLR) in those with and without early graft retention. Study Design: Case series; Level of evidence, 4. Methods: The Military Health System was queried for all ACLR procedures performed between 2007 and 2013...
March 2018: Orthopaedic Journal of Sports Medicine
Britt Elin Øiestad, Inger Holm, May Arna Risberg
OBJECTIVES: To examine the associations between return to pivoting sport following ACL reconstruction (ACLR) and knee osteoarthritis (OA), and self-reported knee symptoms, function and quality of life after 15 years. METHODS: Study sample included 258 participants with ACLR 15 years previously. Return to pivoting sport (handball, soccer and basketball) data were collected by interviews, and symptomatic OA was defined as Kellgren and Lawrence grade ≥2 plus almost daily knee pain in the last month...
March 17, 2018: British Journal of Sports Medicine
Eric J Cotter, Charles P Hannon, Philip Locker, Annabelle Davey, Kevin C Wang, Nikhil N Verma, Brian J Cole
Background: Patient-reported outcome (PRO) surveys have become increasingly important in both improving patient care and assessing outcomes. Purpose/Hypothesis: The purpose of this study was to evaluate which variables are associated with compliance with completing PRO surveys in patients who have undergone anterior cruciate ligament reconstruction (ACLR). The authors hypothesized that older patient age and longer time since ACLR would be associated with lower completion rates of PRO surveys preoperatively and at postoperative time points...
March 2018: Orthopaedic Journal of Sports Medicine
Darren de Sa, Ajaykumar Shanmugaraj, Melissa Weidman, Devin C Peterson, Nicole Simunovic, Volker Musahl, Olufemi R Ayeni
The all-inside technique (AIT) for anterior cruciate ligament reconstruction (ACLR) is gaining popularity as a more anatomic, less invasive, technique with the potential for more rapid recovery. This systematic review aims to critically assess components of the technique, its safety profile, outcomes, and complications. PUBMED, EMBASE, and MEDLINE were searched for studies discussing primary ACLR using the AIT. Article screening, quality assessment, and data abstraction were completed in duplicate, and a minimal clinically important difference (MCID) was used to frame the descriptive results in a clinically significant context...
February 8, 2018: Journal of Knee Surgery
Hope C Davis, Jeffery T Spang, Richard F Loeser, Staffan Larsson, Veronica Ulici, J Troy Blackburn, R Alexander Creighton, Ganesh M Kamath, Joanne M Jordan, Stephen W Marshall, Brian Pietrosimone
BACKGROUND: To determine the association between time from injury to ACL reconstruction (TimeInjury-ACLR ) and biochemical markers of cartilage metabolism and inflammation six months following ACL reconstruction (ACLR). METHODS: Individuals with a unilateral ACL injury were enrolled at initial presentation in the orthopedic clinic; blood was collected six months following ACLR. Enzyme-linked immunosorbent assays were used to analyze the ratio of serum concentrations of type-II collagen breakdown (C2C) to synthesis (CPII), plasma matrix metalloproteinase-3 (MMP-3), interleukin-6 (IL-6), and serum aggrecan neoepitope (ARGS)...
March 7, 2018: Knee
Ciaran Thrush, Tabitha J Porter, Brian M Devitt
PURPOSE: Anterior cruciate ligament (ACL) rupture commonly occurs in conjunction with articular cartilage injury. However, there is no consensus on the most appropriate rehabilitation which should be carried out for ACL reconstruction (ACLR) and the surgical management of articular cartilage lesions of the knee. The purpose of this study was to systematically review the literature to investigate the recommended rehabilitation protocol for patients undergoing ACLR with concomitant articular cartilage injury with a view to develop guidelines on the most appropriate treatment...
March 6, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Julie P Burland, Jenny Toonstra, Jennifer L Werner, Carl G Mattacola, Dana M Howell, Jennifer S Howard
CONTEXT:   Return-to-sport criteria after anterior cruciate ligament (ACL) injury are often based on "satisfactory" functional and patient-reported outcomes. However, an individual's decision to return to sport is likely multifactorial; psychological and physical readiness to return may not be synonymous. OBJECTIVE:   To determine the psychosocial factors that influence the decision to return to sport in athletes 1 year post-ACL reconstruction (ACLR)...
March 5, 2018: Journal of Athletic Training
Berkcan Akpinar, Eric Thorhauer, James J Irrgang, Scott Tashman, Freddie H Fu, William J Anderst
BACKGROUND: Limited in vivo kinematic information exists on managing meniscal injury during anterior cruciate ligament reconstruction (ACLR). HYPOTHESIS: Isolated anatomic ACLR restores knee kinematics, whereas ACLR in the presence of medial meniscal injury is associated with altered long-term knee kinematics. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: From March 2011 to December 2012, 49 of 57 participants in a clinical trial underwent anatomic ACLR with successful kinematic testing at 24 months after ACLR...
March 1, 2018: American Journal of Sports Medicine
Robert G Willson, Regina O Kostyun, Matthew D Milewski, Carl W Nissen
Background: Reconstruction of the anterior cruciate ligament (ACL) in the skeletally immature patient is frequently performed in hopes of preventing new or additional chondral damage and meniscal injuries. Patients within a few years of skeletal maturity are more at risk for ACL injuries than prepubescent patients, about whom several physeal-sparing techniques have been described. Reconstruction techniques in the former higher risk group need to be better understood. Purpose: To review a series of adolescent patients with ACL injuries surgically treated with the hybrid physeal-sparing technique...
February 2018: Orthopaedic Journal of Sports Medicine
A A Williams, M R Titchenal, T P Andriacchi, C R Chu
OBJECTIVE: Quantitative magnetic resonance imaging (MRI) ultrashort echo time (UTE) T2* is sensitive to cartilage deep tissue matrix changes after anterior cruciate ligament reconstruction (ACLR). This study was performed to determine whether UTE-T2* profile analysis is a useful clinical metric for assessing cartilage matrix degeneration. This work tests the hypotheses that UTE-T2* depthwise rates of change (profile slopes) correlate with clinical outcome metrics of walking mechanics and patient reported outcomes (PRO) in patients 2 years after ACLR...
February 7, 2018: Osteoarthritis and Cartilage
Zhen-Yu Jia, Jin Cui, Wei Wang, Chen-Chen Xue, Tian-Ze Liu, Xuan Huang, Wei-Dong Xu
PURPOSE: The aim of this study is to obtain a translation and adaptation of the anterior cruciate ligament-return to sport after injury (ACL-RSI) into simplified Chinese and validate the simplified Chinese version. METHODS: Translation and adaptation were performed according to the guidelines of the American Academy of Orthopaedic Surgeons Outcome Committee. A total of 122 patients who were diagnosed with an ACL injury and underwent primary arthroscopic anterior cruciate ligament reconstruction (ACLR) between 2015 and 2016 were included in this study...
February 5, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Alexander E Weber, William Zuke, Erik N Mayer, Brian Forsythe, Alan Getgood, Nikhil N Verma, Bernard R Bach, Asheesh Bedi, Brian J Cole
BACKGROUND: There has been an increasing interest in lateral-based soft tissue reconstructive techniques as augments to anterior cruciate ligament reconstruction (ACLR). The objective of these procedures is to minimize anterolateral rotational instability of the knee after surgery. Despite the relatively rapid increase in surgical application of these techniques, many clinical questions remain. PURPOSE: To provide a comprehensive update on the current state of these lateral-based augmentation procedures by reviewing the origins of the surgical techniques, the biomechanical data to support their use, and the clinical results to date...
February 1, 2018: American Journal of Sports Medicine
Ivan J Antosh, Jeanne C Patzkowski, Adam W Racusin, James K Aden, Scott M Waterman
Background: Return to play and risk factors for functional limitations have been widely reported among athletes following anterior cruciate ligament reconstruction (ACLR) but has not been well studied in the military population. Methods: We conducted a retrospective review of all active duty service members who underwent primary ACLR at our institution between 2005 and 2010. The primary endpoints evaluated included Medical Evaluation Board (MEB) and activity limitations as noted by permanent profile (PP) following surgery...
January 1, 2018: Military Medicine
Brendan R Southam, Angelo J Colosimo, Brian Grawe
Primary anterior cruciate ligament (ACL) reconstructions (ACLRs) are being performed with increasing frequency. While many of these will have successful outcomes, failures will occur in a subset of patients who will require revision ACLRs. As such, the number of revision procedures will continue to rise as well. While many reviews have focused on factors that commonly contribute to failure of primary ACLR, including graft choice, patient factors, early return to sport, and technical errors, this review focused on several factors that have received less attention in the literature...
January 2018: Orthopaedic Journal of Sports Medicine
Mikko Laakso, Jussi Kosola, Pekka Niemi, Keijo Mäkelä, Juha Ranne, Sakari Orava, Lasse Lempainen
Background: Semitendinosus (ST) is widely used autograft in anterior cruciate ligament reconstructions (ACLR). Although tendon harvesting is a common procedure, some patients exhibit pain, cramping and dysfunctional at posterior thigh after the ACLR. The formation of the newly regenerated neotendon could be compromised by a new injury or too rapid rehabilitation. We present this clinical entity and the developed surgical technique and share our experience in treatment of these patients...
July 2017: Muscles, Ligaments and Tendons Journal
John W Belk, Matthew J Kraeutler, Trevor J Carver, Eric C McCarty
PURPOSE: The primary purpose of this study was to systematically review high-quality studies in the literature to compare the postoperative radiographic incidence of knee osteoarthritis (OA) after anterior cruciate ligament reconstruction (ACLR) with bone-patellar tendon-bone (BPTB) versus hamstring tendon (HT) autograft. The secondary purpose of this study was to compare other symptoms of postoperative knee OA between these 2 groups through patient-reported outcome scores and knee range of motion...
January 20, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Darby A Houck, Matthew J Kraeutler, John W Belk, Eric C McCarty, Jonathan T Bravman
PURPOSE: The purpose of this systematic review is to evaluate the current literature in an effort to assess specific clinical outcomes following meniscal scaffold implantation using the two available scaffolds: Collagen Meniscal Implant (CMI) and the Actifit polyurethane meniscal scaffold. METHODS: A systematic review was performed by searching PubMed, Embase, and Cochrane Library to find studies evaluating clinical outcomes of patients undergoing meniscal scaffold implantation...
January 16, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Mark V Paterno, Bin Huang, Staci Thomas, Timothy E Hewett, Laura C Schmitt
Background: Biomechanical predictors of a second anterior cruciate ligament (ACL) injury after ACL reconstruction (ACLR) and return to sport (RTS) have been identified; however, these measures may not be feasible in a standard clinical environment. Purpose/Hypothesis: The purpose of this study was to evaluate whether standard clinical measures predicted the risk of second ACL injuries. The hypothesis tested was that a combination of strength, function, and patient-reported measures at the time of RTS would predict the risk of second ACL injuries with high sensitivity and specificity...
December 2017: Orthopaedic Journal of Sports Medicine
Heather Menzer, Lindsay V Slater, David Diduch, Mark Miller, Grant Norte, John Goetschius, Joseph M Hart
Background: Many clinicians release patients to return to activity after anterior cruciate ligament reconstruction (ACLR) based on time from surgery despite deficits in muscle strength and function. It is unclear whether symmetry or unilateral performance is the best predictor of subjective outcomes after ACLR. Purpose: To determine physical performance predictors of patient-reported outcomes after reconstruction. Study Design: Cross-sectional study; Level of evidence, 3...
December 2017: Orthopaedic Journal of Sports Medicine
Seyed M Kazemi, Mohammad R Abbasian, Ali A Esmailijah, Ali Zafari, Zahra Salehi Shahrbabaki, Amir H Keshavarz, Nina Esmaeilijah, Farshad Safdari
Background: It has been shown that the proper placement of ACL graft during the ACL reconstruction surgery significantly improves the clinical outcomes. This study investigated whether a change in the femoral tunnel position in both axial and coronal planes can significantly alter the postoperative functional and clinical outcomes of the patients. Methods: This comparative, retrospective, single-center study was performed on 44 patients undergone single-bundle anterior cruciate ligament reconstruction (ACLR)...
November 2017: Archives of Bone and Joint Surgery
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