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CRUCIATE RECONSTRUCTION

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https://www.readbyqxmd.com/read/29216706/-intraarticular-lesions-associated-with-tibial-fixation-during-anterior-cruciate-ligament-reconstruction
#1
A Almazán-Díaz, L Sierra-Suárez, F Cruz-López, F J Pérez-Jiménez, C Ibarra-Ponce de León, I Alba-Sánchez
Anterior cruciate ligament reconstruction is a demanding procedure; complications may arise at any of its stages. This is the report of three cases in which the tibial fixation devices (IntraFix and Bio-IntraFix) led to intraarticular lesions. The complications were detected in one of the cases while the patient was still in the operating room and in the remaining two during the follow-up. All the patients had a stable knee, but all of them sustained chondral lesions resulting from the inadequate placement of the implants used for tibial fixation...
May 2017: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/29209793/degenerative-changes-after-posterior-cruciate-ligament-reconstruction-are-irrespective-of-posterior-knee-stability-mri-based-long-term-results
#2
Clemens Gwinner, Andreas Weiler, Timm Denecke, Julian M M Rogasch, Heide Boeth, Tobias M Jung
INTRODUCTION: Posterior cruciate ligament reconstruction (PCLR) is advocated to prevent an early onset of osteoarthritis. We hypothesized that posterior instability after PCLR correlates with degenerative changes. MATERIALS AND METHODS: MRIs of 42 (12 female/30 male; 39 ± 9 years) patients were enrolled with a minimum 5-year follow-up (FFU) after PCLR. In addition, 25 contralateral and 15 follow-up MRIs (12 months after baseline) were performed. Degenerative changes were graded using WORMS...
December 6, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29209517/clinical-course-and-recommendations-for-patients-after-anterior-cruciate-ligament-injury-and-subsequent-reconstruction-a-narrative-review
#3
Alli Gokeler, Bart Dingenen, Caroline Mouton, Romain Seil
Almost all athletes who have suffered an anterior cruciate ligament (ACL) injury expect a full return to sports at the same pre-injury level after ACL reconstruction (ACLR). Detailed patient information on the reasonable outcomes of the surgery may be essential to improve patient satisfaction.Pre-operative rehabilitation before ACLR should be considered as an addition to the standard of care to maximise functional outcomes after ACLR.We propose an optimised criterion-based rehabilitation programme within a biopsychosocial framework...
October 2017: EFORT Open Reviews
https://www.readbyqxmd.com/read/29208010/prediction-of-progression-of-damage-to-articular-cartilage-2%C3%A2-years-after-anterior-cruciate-ligament-reconstruction-use-of-aggrecan-and-type-ii-collagen-biomarkers-in-a-retrospective-observational-study
#4
Yasumori Sobue, Toshihisa Kojima, Kazutoshi Kurokouchi, Shigeo Takahashi, Hiroaki Yoshida, Robin Poole, Naoki Ishiguro
BACKGROUND: We aimed to determine whether synovial fluid (SF) biomarkers can predict the progression of articular cartilage damage as determined by arthroscopic evaluation during and after anterior cruciate ligament (ACL) reconstruction. METHODS: Arthroscopic assessment of articular cartilage damage was performed twice in 62 patients, first during ACL reconstruction and then approximately 2 years later during implant removal for ligament fixation. SF levels of the collagenase-generated cleavage neoepitope of type II collagen (C2C) and proteoglycan glycosaminoglycans keratan sulfate (KS), chondroitin-4-sulfate (Δdi-C4S), and chondroitin-6-sulfate (Δdi-C6S) were measured at ACL reconstruction...
December 6, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/29205225/using-the-discrete-wavelet-transform-in-assessing-the-effectiveness-of-rehabilitation-in-patients-after-acl-reconstruction
#5
Adam Czaplicki, Wiesława Kuniszyk-Jóźkowiak, Janusz Jaszczuk, Marta Jarocka, Jacek Walawski
PURPOSE: The purpose of the current study was to assess the effectiveness of rehabilitation in patients after anterior cruciate ligament reconstruction (ACLR) using a wavelet analysis of the torque-time curve patterns of the extensors of the affected knee. The analysis aimed at the quantitative evaluation of irregularities in these torque-time patterns. METHODS: The study involved a group of 22 men who had had ACL reconstruction. The torque-time characteristics were recorded 3, 6 and 12 months after the surgery by an isokinetic dynamometer...
2017: Acta of Bioengineering and Biomechanics
https://www.readbyqxmd.com/read/29204489/the-cyclops-lesion-after-bicruciate-retaining-total-knee-replacement
#6
Mark A Klaassen, Jerry L Aikins
The cyclops lesion is a localized anterior arthrofibrosis most commonly seen following anterior cruciate ligament reconstruction. The lesion forms at the anterior cruciate ligament insertion creating a painful extension block between femoral intercondylar notch and tibial plateau. We present 2 cases (3 knees) in which cyclops lesions appeared atypically following bicruciate-retaining total knee replacement. Two lesions occurred in a single patient following bilateral knee replacement. One lesion occurred in an active sportswoman...
December 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/29203380/periarticular-injection-versus-femoral-nerve-block-for-pain-relief-after-anterior-cruciate-ligament-reconstruction-a-randomized-controlled-trial
#7
Kenji Kurosaka, Sachiyuki Tsukada, Hiroshi Nakayama, Tomoya Iseki, Ryo Kanto, Ryo Sugama, Shinichi Yoshiya
PURPOSE: To compare the effectiveness and safety of periarticular injection (PI) with those of femoral nerve block (FNB) after anterior cruciate ligament (ACL) reconstruction. METHODS: A total of 129 patients scheduled for ACL reconstruction were randomly assigned to receive PI or FNB. Other perioperative interventions were identical for all patients. The primary outcome was the postoperative pain score 24 hours after surgery, which was measured using a 100-mm visual analog scale (VAS)...
December 1, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29201926/factors-associated-with-physician-loss-in-anterior-cruciate-ligament-reconstruction-malpractice-lawsuits
#8
Steven L Bokshan, Roy Ruttiman, Adam E M Eltorai, J Mason DePasse, Alan H Daniels, Brett D Owens
Background: Anterior cruciate ligament (ACL) reconstruction is among the most common orthopaedic procedures, with its incidence doubling over the past decade. To date, no studies have analyzed litigation after ACL reconstruction. Purpose: To characterize the causes of malpractice litigation after ACL reconstruction. Study Design: Cross-sectional study. Methods: A retrospective review of malpractice lawsuits after ACL reconstruction was performed using VerdictSearch, a large legal claims database encompassing nearly 180,000 legal cases, from February 1988 to May 2015...
November 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29201924/flexion-gap-in-the-isolated-posterior-cruciate-ligament-injured-knee-affects-symptom-relief-after-conservative-treatment-a-case-control-study
#9
Yasukazu Yonetani, Yoshio Matsui, Yoshinari Tanaka, Shuji Horibe
Background: The posterior cruciate ligament (PCL) is a primary stabilizer of the knee in the posterior direction. However, PCL deficiency presents a clinical paradox because the outcome of PCL deficiency ranges from total disability to uninterrupted participation in competitive athletics. Purpose: To investigate whether posterior laxity (PL) and the flexion gap (FG) influence the results of the conservative treatment of isolated PCL injuries. Study Design: Case-control study; Level of evidence, 3...
November 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29201308/a-rare-case-of-intra-articular-displacement-of-endobutton-following-anterior-cruciate-ligament-reconstruction
#10
Sean Wl Ho, Keng Thiam Lee
The EndoButton is a commonly used device for femoral fixation of anterior cruciate ligament grafts. Complications from its usage remain rare. Incorrect femoral tunnel placement may increase the risk of intra-articular displacement of the EndoButton. We present a case of anterior femoral tunnel placement resulting in intra-articular displacement of the EndoButton after failure. A 24-year-old man presented to us after failure of anterior cruciate ligament reconstruction performed 3 years prior. Radiographs revealed an intra-articular displacement of the EndoButton...
December 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/29201295/a-comparative-study-of-clinical-outcomes-and-second-look-arthroscopic-findings-between-remnant-preserving-tibialis-tendon-allograft-and-hamstring-tendon-autograft-in-anterior-cruciate-ligament-reconstruction-matched-pair-design
#11
You Keun Kim, Jong Hyun Ahn, Jae Doo Yoo
Background: This study aimed to compare stability, functional outcome, and second-look arthroscopic findings after anterior cruciate ligament reconstruction between remnant-preserving tibialis tendon allograft and remnant-sacrificing hamstring tendon autograft. Methods: We matched two groups (remnant-preserving tibialis tendon allograft group and hamstring tendon autograft group) in terms of demographic characteristics, associated injury, and knee characteristics...
December 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/29200071/evidence-basis-for-regional-anesthesia-in-ambulatory-anterior-cruciate-ligament-reconstruction-part-iii-local-instillation-analgesia-a-systematic-review-and-meta-analysis
#12
Eric M Yung, Richard Brull, Eric Albrecht, Girish P Joshi, Faraj W Abdallah
BACKGROUND: Local infiltration analgesia offers effective postoperative analgesia after knee arthroplasty, but the role of its counterpart, local instillation analgesia (LIA), in anterior cruciate ligament reconstruction (ACLR) is unclear. This systematic review and meta-analysis evaluates the analgesic benefits of LIA for outpatient ACLR. METHODS: We sought randomized controlled trials investigating the analgesic effects of LIA versus control in adults having outpatient ACLR and receiving multimodal analgesia (excluding nerve blocks, which are examined in parts I and II of this project)...
November 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29199191/an-animal-model-of-reconstruction-of-single-femoral-tunnel-with-single-bone-bi-quadruple-acl-and-internal-fixation
#13
T Gong, X-T Su, Q Xia, J-G Wang
We introduced several variables in an animal model of anterior cruciate ligament (ACL) reconstruction to determine the best parameters for surgery in humans. We divided 130 LYD pigs into two groups depending on whether the femoral tunnel goes through the medial tibial tunnel or through the medial fossa of the knee joint. Each subgroup was further divided. Four weeks after surgery the knee specimens were examined for passive flexion and extension test. No group showed a creep effect. In the biomechanical tests, we recorded maximal strength, maximum load, and stiffness parameters...
December 1, 2017: Journal of Musculoskeletal & Neuronal Interactions
https://www.readbyqxmd.com/read/29198590/clinical-outcomes-of-single-anteromedial-bundle-biologic-augmentation-sambba-technique-for-anterior-cruciate-ligament-reconstruction-with-consideration-of-tibial-remnant-size
#14
Hervé Ouanezar, William G Blakeney, Levi Reina Fernandes, Amrut Borade, Charles Latrobe, Eduardo Frois Temponi, Bertrand Sonnery-Cottet
PURPOSE: The primary aim of this study was to evaluate the functional outcomes, knee stability, complications, and reoperations associated with anatomic anterior cruciate ligament (ACL) reconstruction using the single anteromedial bundle biological augmentation (SAMBBA) technique in a consecutive series of 128 patients with a minimum follow-up of 24 months. A secondary aim was to compare larger preserved ACL remnants with smaller preserved remnants. METHODS: Patients who underwent primary anatomic ACL reconstruction using the SAMBBA technique from July 2013 to October 2014 were analyzed...
November 30, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29198357/editorial-commentary-hamstring-autograft-with-preserved-insertions-versus-free-hamstring-autograft-in-knee-anterior-cruciate-ligament-reconstruction-clinically-the-same-but-statistically-different
#15
EDITORIAL
Mark P Cote
There is considerable debate over the ideal graft for anterior cruciate ligament (ACL) reconstruction in athletes. The use of a hamstring autograft with preserved insertions is an approach to ACL reconstruction that may lead to earlier healing and less morbidity in comparison to a free hamstring autograft. When compared in a randomized trial, statistically significant but clinically irrelevant differences in clinical outcome and instrumented laxity were observed. These contradictory findings highlight the importance of examining the results from many vantage points and further demonstrate the misleading conclusions that may result from reliance on P values...
December 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29198356/editorial-commentary-the-acrid-bioscrew-in-anterior-cruciate-ligament-reconstruction-of-the-knee
#16
EDITORIAL
Leo A Pinczewski, Lucy J Salmon
Bioresorbable screws have been widely adopted for graft fixation in knee anterior cruciate ligament (ACL) reconstruction on the promise of screw resorbtion and replacement by bone. When considering the value of bioresorbable screws, it is imperative to understand that the "A" in PGA and PLA, the base ingredient of all bioscrews, is for Acid. All resorb by a process of hydrolysis; the speed and extent of resorbtion is determined by both the acidity of the screw and the environment in which it is placed. Regrettably, the promise of reliable, predictable screw resorbtion and replacement by bone remains elusive, despite the addition of "osteoconductive" materials...
December 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29198355/editorial-commentary-knee-lateral-collateral-ligament-injury-is-more-common-than-we-thought
#17
EDITORIAL
Russell F Warren
Detection of a knee lateral collateral ligament (LCL) tear, in combination with an anterior cruciate ligament tear, may be facilitated by the heel height test, which seems a modification of Hughston's external rotation recurvatum test for posterolateral rotatory instability. The radiographic and arthroscopic stress tests are also valuable. We have found that varus stress will increase varus opening by 1° to 4° for isolated LCL tears and 5° to 9° for combined (LCL) popliteus injury; an arthroscopic stress evaluation will note a normal opening of 5 to 6 mm increasing to 9 to 10 mm in combined LCL popliteus injury...
December 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29193888/associations-between-slower-walking-speed-and-t1%C3%AF-magnetic-resonance-imaging-of-femoral-cartilage-following-anterior-cruciate-ligament-reconstruction
#18
Steven Pfeiffer, Matthew S Harkey, Laura E Stanley, J Troy Blackburn, Darin A Padua, Jeffrey T Spang, Stephen W Marshall, Joanne M Jordan, Randy Schmitz, Daniel Nissman, Brian Pietrosimone
To determine if walking speed collected at 6 and 12 months following anterior cruciate ligament reconstruction (ACLR) associates with inter-limb differences in proteoglycan density, measured via T1ρ magnetic resonance imaging (MRI), in tibiofemoral articular cartilage 12 months following ACLR METHODS: Twenty-one individuals with a unilateral patellar-tendon autograft ACLR (10 females, 11 males, 23.9±2.7 years, 23.9±2.7 BMI) were recruited for participation in this study. Walking speed was collected using 3-dimensional motion capture at 6 and 12 months following ACLR...
November 28, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/29191469/role-of-anterolateral-reconstruction-in-patients-undergoing-anterior-cruciate-ligament-reconstruction
#19
REVIEW
C Lutz
There is renewed interest in anterolateral reconstruction (ALR) for patients undergoing anterior cruciate ligament (ACL) reconstruction. This is the result of isolated ACL reconstruction and double-bundle reconstruction providing inadequate control over the pivot shift, and recent anatomical and biomechanical studies on the anterolateral ligament (ALL) and its role in the knee's rotational stability.From a technical point of view, ALR can be performed either as a continuity of the intra-articular ACL reconstruction or an independent procedure...
November 27, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29189882/the-transportal-technique-shows-better-clinical-results-than-the-transtibial-techniques-for-single-bundle-anterior-cruciate-ligament-reconstruction
#20
Kyung-Han Ro, Hyun-Jung Kim, Dae-Hee Lee
PURPOSE: Although anatomical and independent drilling techniques, such as transportal (TP) technique, have become more popular in anterior cruciate ligament (ACL) reconstruction, the TP technique has not been shown to yield superior clinical or functional outcomes compared to the transtibial (TT) technique. The aim of the current meta-analysis was to compare clinical outcomes of the TP and TT techniques, as determined by patient-reported outcome scores and knee joint laxity tests. It was hypothesized that the TP and TT techniques of ACL reconstruction would yield similar patient-reported functional outcomes and similar results on knee joint laxity tests...
November 30, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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