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Anterolateral And Knee

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...
October 11, 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
Yoonah Song, Jae-Hyuk Yang, Won Rak Choi, Jin Kyu Lee
The purpose of this study was to determine and compare the prevalence of anterolateral ligament abnormality and associated injuries among patients with complete and partial anterior cruciate ligament tears. In addition, the prevalence of associated injuries with anterolateral ligament abnormality was further analyzed. Of the 158 patients diagnosed with acute anterior cruciate ligament tear, 82 patients were diagnosed with acute complete anterior cruciate ligament confirmed by magnetic resonance imaging (MRI) and arthroscopic procedures (Group C), and 74 patients were diagnosed with acute partial anterior cruciate ligament tears confirmed by MRI (Group P)...
September 6, 2018: Journal of Knee Surgery
Alan Getgood
Significant focus has recently been placed on the contribution of the anterolateral ligament (ALL) to controlling anterolateral rotatory laxity of the anterior cruciate ligament (ACL) injured knee. Many recent studies have investigated the use of magnetic resonance imaging and ultrasound on determining the degree of ALL injury and whether this is correlated to high-grade rotatory laxity. Unfortunately, most studies lack a reference standard, and as such it is challenging to determine whether it truly is the ALL that is injured or if the capsule-osseous layer and deep iliotibial band are involved...
September 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Andrea Ferretti
The role of the anterolateral ligament as a secondary restraint to the anterior cruciate ligament in controlling tibial internal rotation and pivot shift is greatly debated today because biomechanical studies lead to conflicting results. However, extra-articular reconstructions used along with intra-articular reconstructions seem to be able to improve knee stability and reduce the rate of failure, especially when a graft other than bone-patellar tendon-bone is used as an anterior cruciate ligament substitute...
September 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Frank R Noyes, Lauren E Huser, John West, Darin Jurgensmeier, James Walsh, Martin S Levy
PURPOSE: To determine the effect of 2 extra-articular reconstructions on pivot-shift rotational stability and tibial internal rotation as a basis for clinical recommendations. METHODS: A robotic simulator tested 15 cadaver knees. Group 1 (anterior cruciate ligament [ACL] cut) underwent ACL bone-patellar tendon-bone reconstruction followed by sectioning the anterolateral structures and an extra-articular, manual-tension iliotibial band (ITB) tenodesis. Group 2 (ACL intact) tested the rotational stabilizing effect of a low-tension ITB tenodesis before and after sectioning the anterolateral ligament/ITB structures...
September 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Iñaki Mediavilla, Mikel Aramberri, Giovanni Tiso, Jorge A Murillo-González
A double-bundle anterior cruciate ligament (ACL) reconstruction associated with an anterolateral ligament (ALL) reconstructions is performed. The semitendinosus and gracilis are harvested. At knee maximum flexion, the anteromedial (AM) femoral tunnel is performed in the AM footprint area. Through the anterolateral portal, the tip of the outside-in femoral guide is placed in the posterolateral footprint area. The guide sleeve is pushed onto the lateral femoral cortex at the ALL attachment. At 110° knee flexion, the posterolateral-ALL tunnel is performed...
August 2018: Arthroscopy Techniques
Colin M Robbins, Colin P Murphy, Blake T Daney, Anthony Sanchez, Matthew T Provencher
In recent years there has been increased attention on preserving the menisci because they perform vital roles in maintaining knee joint homeostasis. The anterolateral (AL) meniscal root is particularly vulnerable during anterior cruciate ligament reconstruction. When the AL root is iatrogenically injured, it is imperative that it is repaired in a timely fashion to prevent early-onset osteoarthritis. In this article we outline our knotless suture anchor repair for AL root tears.
August 2018: Arthroscopy Techniques
Łukasz Olewnik, Bartosz Gonera, Konrad Kurtys, Michał Podgórski, Michał Polguj, Marcin Sibiński, Mirosław Topol
INTRODUCTION: The anterolateral ligament (ALL) is a potential stabilizer of the knee and cooperates with the anterior cruciate ligament (ACL). It originates on the lateral epicondyle of the femur, to which it is mainly posterior and proximal; insertion is posterior to Gerdy's tubercle. Its anatomical characteristics vary. Recent publications have focused on morphological variations concerning mainly the femoral and tibial attachments, and on morphometric measurements. Histological and cystochemical examinations have also been performed...
August 25, 2018: Clinical Anatomy
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