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Anterolateral And Knee

Liangjun Jiang, Qiang Zheng, Zhijun Pan
BACKGROUND: Our hospital has recently used the extended anterolateral approach in posterolateral tibial plateau fracture. We compared the clinical effects of this method in Schatzker type II or type V/VI fractures with posterolateral tibial plateau fracture based on our patients. METHODS: The patients from January 2013 to December 2015 were summarized, and some of them were assisted with arthroscopy. According to Schatzker classification, patients with Schatzker type II fracture were divided into group A; patients with Schatzker type V/VI fracture were divided into group B...
November 28, 2018: Journal of Orthopaedic Surgery and Research
M Wurm, E Herbst, P Forkel, A B Imhoff, M Herbort
OBJECTIVE: Treatment of persistent anterolateral knee instability. INDICATIONS: Subjective/objective (rotational) instability of the knee after anatomic anterior cruciate ligament (ACL) reconstruction. ACL re-rupture including special demands (e.g., high-performance athletes, hyperlaxity) RELATIVE CONTRAINDICATIONS: Osteoarthritis, additional instability of the knee, which should be treated independently; non-anatomic ACL reconstruction with persisting instability should be treated first with anatomic ACL reconstruction...
November 26, 2018: Operative Orthopädie und Traumatologie
Carlos M Barrera, Azael Arizpe, Ross Wodicka, Bryson P Lesniak, Michael G Baraga, Lee Kaplan, Jean Jose
Maintaining anterolateral rotational stability of the knee requires a complex set of structures, most notably the anterior cruciate ligament. However, lateral knee structures such as the anterolateral ligament (ALL) also play an important role. There has been controversy over the role the ALL plays in an ACL deficient knee to maintain rotational stability. In this study, we examined ACL deficient knees with and without intact ALLs, for rotatory laxity using a pivot shift examination. This was graded using International Knee Document Committee (IKDC) criteria...
October 2018: Journal of Clinical Orthopaedics and Trauma
M C Liebensteiner, B Henninger, C Kittl, R Attal, J M Giesinger, C Kranewitter
PURPOSE: To assess the visibility of both the anterolateral ligament (ALL) and the deep structures of the iliotibial tract (ITT) by means of MRI in paediatric patients. To determine reproducibility for such measurements. METHODS: Knee MRI data from patients aged <18a without lesions of the capsule or ligaments, fractures, bone edemas, foreign material or motion artifacts were analyzed by two musculoskeletal radiologists separately and twice. The visibility of the different parts of the ALL was determined (femoral, meniscal, tibial parts)...
October 29, 2018: Injury
Timothy A Burkhart, Manoj Matthew, W Scott McGuffin, Alexandra Blokker, David Holdsworth, Ryan M Degen, Alan Getgood
BACKGROUND: Previous research demonstrated that the attachment of the anterolateral ligament (ALL) to the lateral meniscus is stiffer and stronger in its tibial attachment than its femoral attachment. How this relates to anterolateral knee stability and lateral meniscal function is unknown. HYPOTHESIS/PURPOSE: The hypothesis was that the ALL acts as a peripheral anchor to the lateral meniscus, aiding in anterolateral rotatory stability, and that the inframeniscal fibers of the ALL will provide greater anterolateral rotatory stability because of their greater tensile properties...
December 2018: American Journal of Sports Medicine
Willem A Kernkamp, Axel J T Jens, Nathan H Varady, Ewoud R A van Arkel, Rob G H H Nelissen, Peter D Asnis, Robert F LaPrade, Samuel K Van de Velde, Guoan Li
PURPOSE: To elucidate the effects of various tibial and femoral attachment locations on the theoretical length changes and isometry of PCL grafts in healthy knees during in vivo weightbearing motion. METHODS: The intact knees of 14 patients were imaged using a combined magnetic resonance and dual fluoroscopic imaging technique while the patient performed a quasi-static lunge (0°-120° of flexion). The theoretical end-to-end distances of the 3-dimensional wrapping paths between 165 femoral attachments, including the anatomic anterolateral bundle (ALB), central attachment and posteromedial bundle (PMB) of the PCL, connected to an anterolateral, central, and posteromedial tibial attachment were simulated and measured...
October 26, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Matt Daggett, Clark Stephenson, John Dobson, Amy Whitaker, Andrea Redler, Edoardo Monaco, Barth Wright, Adnan Saithna, Bertrand Sonnery-Cottet
Background: The structure and function of the anterolateral aspect of the knee have been significantly debated, with renewed interest in this topic since the description of the anterolateral ligament (ALL). Purpose: To define and describe the distinct structures of the lateral knee and to correlate the macroscopic and histologic anatomic features. Study Design: Descriptive laboratory study. Methods: Twelve fresh-frozen human cadavers were used for anatomic analysis...
October 2018: Orthopaedic Journal of Sports Medicine
Mustafa Akkaya, Nurdan Cay, Safa Gursoy, Mehmet Emin Simsek, Mesut Tahta, Metin Doğan, Murat Bozkurt
AIM: Magnetic resonance imaging (MRI) is generally the preferred method for assessing lesions of the knee cartilage and subchondral bone. There have been a few cartilage imaging studies using real-time elastosonography (RTE), which has increased in importance and range of use in recent years. The aim of this cadaveric study was to assess the efficacy of a new diagnostic method combining USG and RTE and also to perform intra-articular examinations together with arthroscopy. METHODS: A total of 12 fresh unpaired human knees were examined...
October 15, 2018: Clinical Anatomy
Jin Wook Choi, Jun Ho Lee, Minjong Ki, Myung Jong Kim, Sehrin Kang, Juhyung Lee, Jun-Rae Lee, Young-Jin Han, Ji-Seon Son
Background: The intraarticular (IA) injection has become popular for the management of the osteoarthritic knee without an effusion. The success rate of IA injection would be better if it was able to be visually confirmed. We hypothesized that an anterolateral approach, which targets the synovial membrane of the lateral condyle using ultrasound, would provide an equivalent alternative to the anterolateral approach, targeting the synovial membrane of the medial condyle for IA injection of the knee...
October 2018: Korean Journal of Pain
Bertrand Sonnery-Cottet, Cesar Praz, Nikolaus Rosenstiel, William G Blakeney, Herve Ouanezar, Vikram Kandhari, Thais Dutra Vieira, Adnan Saithna
BACKGROUND: Ramp lesions are characterized by disruption of the peripheral meniscocapsular attachments of the posterior horn of the medial meniscus. Ramp repair performed at the time of anterior cruciate ligament reconstruction (ACLR) has been shown to improve knee biomechanics. PURPOSE: The primary objectives of this study were to evaluate the incidence of and risk factors for ramp lesions among a large series of patients undergoing ACLR. Secondary objectives were to determine the reoperation rate for failure of ramp repair, defined by subsequent reoperations for partial medial meniscectomy...
November 2018: American Journal of Sports Medicine
Kristof Smeets, J Bellemans, G Lamers, B Valgaeren, L Bruckers, E Gielen, J Vandevenne, F Vandenabeele, J Truijen
PURPOSE: To assess the risk of femoral tunnel convergence in combined anterior cruciate ligament (ACL) and anterolateral ligament (ALL) reconstructions. The hypothesis was that a more proximal and anterior orientation of the ALL femoral tunnel should reduce the risk of convergence with the ACL femoral tunnel. METHODS: 15 fresh-frozen cadaver knees were examined. An anatomic ACL femoral tunnel was drilled arthroscopically in each specimen and ALL tunnels were made in two directions: (1) 0° coronal angulation and 20° axial angulation, (2) 30° coronal angulation and 30° axial angulation...
October 8, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Mikhail Bekarev, Abraham M Goch, David S Geller, Evan S Garfein
Wound coverage in the supra-patellar area presents a significant challenge for orthopaedic and reconstructive surgeons due to the need for preservation of knee joint function but the paucity of regional soft tissue flaps available. While many orthopaedic and reconstructive surgeons make use of the rotational gastrocnemius flap for coverage of peri-patellar defects, this flap has certain limitations. The goal of this study was to report a single-centre experience with the use of the distally based anterolateral thigh flap (ALT) and review the current literature on the use of the ALT for peri-patellar defects...
October 1, 2018: Strategies in Trauma and Limb Reconstruction
Andrea Ferretti, Edoardo Monaco, Antonio Ponzo, Matthew Dagget, Matteo Guzzini, Daniele Mazza, Andrea Redler, Fabio Conteduca
AIM OF THE STUDY: To describe the surgical findings of the anterolateral complex in patients with the "unhappy triad" lesion of the knee. METHOD: One hundred and twenty-five consecutive patients presenting with acute anterior cruciate ligament (ACL) tears were selected for this study. Only cases, evaluated with a valgus stress test under fluoroscopy, with a medial opening more than 5 mm of the medial collateral ligament (MCL) were included in the study (11 patients)...
October 1, 2018: International Orthopaedics
Xiang Yao, Yong Xu, Jishan Yuan, Bin Lv, Xingli Fu, Lei Wang, Shengquan Yang, Sheng Meng
PURPOSE: The existing classification systems of tibial plateau fracture (TPF) are suboptimal for clinical use and academic communication. A more comprehensive and universal classification system with the capability to analyze all patterns of TPF is urgently required to guide the clinical practice. This study aimed to analyze the incidence and fracture characteristics of TPF using a computed tomography-based "four-column and nine-segment" classification. METHODS: According to the differentiated morphological characteristics, tibial plateau and proximal fibula were divided into four columns, which were subdivided into nine segments...
September 20, 2018: Injury
Tyler Marshall, Sameer R Oak, Naveen Subhas, Joshua Polster, Carl Winalski, Kurt P Spindler
Background: The anterolateral ligament (ALL) has been described as an extracapsular stabilizer of knee rotational stability. Investigators have shown a renewed interest in the ALL and further evaluated its anatomy and biomechanical role as a knee stabilizer. The appearance of the ALL on magnetic resonance imaging (MRI) remains inconsistent across the literature. Purpose: The aims of this study were 2-fold. The first objective was to further investigate the appearance of the uninjured ALL on MRI and provide data regarding interrater agreement in identifying the ligament...
September 2018: Orthopaedic Journal of Sports Medicine
Devendra K Chouhan, Mandeep Singh Dhillon, K Puneeth, Vivek Ponnusamy, Rajendra Kanaujia, Mahesh Prakash
Posterior column fractures of the tibial plateau have been considered problem injury as many authors reported poor outcome. Commonly used surgical approaches have limitations in addressing complex fractures involving the posterior column, leading to malreduction and subsequent leading to chronic posteroinferior subluxation, arthritis and chronic pain. There is thus a need for a surgical approach, which can provide adequate exposure to both quadrant of posterior column, in addition to allowing sufficient space for fracture manipulation and implant placement...
September 10, 2018: Injury
Brian Forsythe, Avinesh Agarwalla, Drew A Lansdown, Richard Puzzitiello, Nikhil N Verma, Brian J Cole, Bernard R Bach, Nozomu Inoue
PURPOSE: Concomitant anterolateral ligament (ALL) injury is often observed in patients with an anterior cruciate ligament injury leading some to recommend concurrent ALL reconstruction. In ligament reconstruction, it is imperative to restore desirable ligament length changes to prevent stress on the graft. The purpose of this investigation is to identify the optimal femoral and tibial locations for fixation in ALL reconstruction. METHODS: 3D computerized tomography (CT) knee models were obtained from six fresh-frozen, unpaired, cadaveric human knees at 0°, 10°, 20°, 30°, 40°, 90°, 110°, and 125°of knee flexion...
September 27, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Adnan Saithna, Mathieu Thaunat, Jean Romain Delaloye, Hervé Ouanezar, Jean Marie Fayard, Bertrand Sonnery-Cottet
Background: Clinical results of combined anterior cruciate ligament (ACL) and anterolateral ligament (ALL) reconstruction have demonstrated a significant reduction in ACL graft rupture rates and improved rates of return to sports compared with isolated ACL reconstruction1 . This finding is supported by laboratory studies that have demonstrated that combined ACL reconstruction and lateral extra-articular tenodesis procedures protect the ACL graft by load-sharing with it and by more reliably restoring normal knee kinematics compared with isolated ACL reconstruction...
March 28, 2018: JBJS essential surgical techniques
Karl Grob, Helen Gilbey, Mirjana Manestar, Timothy Ackland, Markus S Kuster
Background: The anatomy of the articularis genus muscle has prompted speculation that it elevates the suprapatellar bursa during extension of the knee joint. However, its architectural parameters indicate that this muscle is not capable of generating enough force to fulfill this function. The purpose of the present study was to investigate the anatomy of the articularis genus, with special emphasis on its relationship with the adjacent vastus intermedius and vastus medialis muscles. Methods: The articularis genus muscle was investigated in 18 human cadaveric lower limbs with use of macrodissection techniques...
December 28, 2017: JB & JS open access
Tahsin Gürpınar, Barış Polat, Ayşe Esin Polat, İlhan Nahit Mutlu, Tolga Tüzüner
BACKGROUND: The aim of the present study was to evaluate the clinical role of anterolateral ligament (ALL) rupture and its impact on rotational stability by comparing the clinical results and rotational stability between reconstructed anterior cruciate ligament (ACL) with intact ALL knees and reconstructed ACL with ALL injured knees. METHODS: A total of 69 patients who had undergone surgery for ACL reconstruction and had received a minimum of two years of follow-up were included...
September 12, 2018: Knee
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