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Acl And Knee

Eric Hamrin Senorski, Eleonor Svantesson, Kurt P Spindler, Eduard Alentorn-Geli, David Sundemo, Olaf Westin, Jon Karlsson, Kristian Samuelsson
BACKGROUND: Factors relating to the patient and anterior cruciate ligament (ACL) reconstruction may help to identify prognostic factors of long-term outcome after reconstruction. PURPOSE: To determine 10-year risk factors for inferior knee function after ACL reconstruction. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: Prospectively collected data from the Swedish National Knee Ligament Register were extracted for patients who underwent ACL reconstruction between January 2005 and December 2006...
August 13, 2018: American Journal of Sports Medicine
Moon Jong Chang, Jin Hwa Jeong, Chong Bum Chang, Young Jun Kim, Bo-Kyung Seo, Min Kyu Song, Taehoon Kang, Seung-Baik Kang
BACKGROUND: Some patients with recurrent symptomatic instability after primary anterior cruciate ligament (ACL) reconstruction have an extension deficiency (ED). This study 1) compared preoperative clinical conditions between the ED and non-ED groups undergoing revision ACL reconstruction, 2) documented clinical and arthroscopic findings in ACL-reconstructed patients with re-instability and ED, and 3) determined whether the ED could be resolved and whether the clinical results of revision surgery differed between the ED and non-ED groups METHODS: This study included 58 patients who underwent revision ACL reconstruction...
August 13, 2018: Scandinavian Journal of Medicine & Science in Sports
Bruno Pombo, Ana Cristina Ferreira, Pedro Marques
The posterior cruciate ligament index (PCL index) has been reported as a diagnostic and prognostic marker for anterior cruciate ligament (ACL) reconstruction. The clinical relevance of PCL index on the reconstruction of ACL with hamstring tendon autograft has not been described in the literature. The objective of this study is to evaluate the importance of the PCL index as a marker of anatomic reconstruction and of functional improvement of patients undergoing ACL reconstruction with HT autograft. Twenty-four patients were submitted to ACL reconstruction with HT autograft...
August 12, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Sannasi Rajasekar, Ajay Kumar, Jignesh Patel, Muthukrishnan Ramprasad, Asir John Samuel
BACKGROUND: Deficiency in hip girdle neuromuscular control can cause exaggerated Dynamic Knee Valgus (DKV) which afflicts the knee joint and lead to knee injuries especially ACL injury in sports. Though Kinesio taping (KT) is known to improve function, stability and proprioception, the evidence is inconclusive on its effectiveness in athletes. We hypothesized that kinesio taping could enhance neuromuscular control of the hip girdle there by causing a reduction in DKV. AIM/OBJECTIVE: To determine whether KT on Gluteus medius can correct exaggerated dynamic knee valgus and improves hip abductor strength when compared to sham KT...
July 2018: Journal of Bodywork and Movement Therapies
Kenneth Pihl, Aleksandra Turkiewicz, Martin Englund, L Stefan Lohmander, Uffe Jørgensen, Nis Nissen, Jeppe Schjerning, Jonas B Thorlund
OBJECTIVES: We explored associations between specific meniscal pathologies and other concurrent structural knee pathologies with presence of self-reported mechanical symptoms in patients undergoing meniscal surgery. DESIGN: Cross-sectional study. METHODS: We included patients undergoing surgery for a meniscal tear from Knee Arthroscopy Cohort Southern Denmark (KACS). Pre-surgery, patients completed online questionnaires including self-reported presence of mechanical symptoms...
July 31, 2018: Journal of Science and Medicine in Sport
Willem A Kernkamp, Nathan H Varady, Jing-Sheng Li, Peter D Asnis, Ewoud R A van Arkel, Rob G H H Nelissen, Samuel K Van de Velde, Guoan Li
PURPOSE: To evaluate the effect of ACL deficiency on the in vivo changes in end-to-end distances and to determine appropriate graft fixation angles for commonly used tunnel positions in contemporary ACL reconstruction techniques. METHODS: Twenty-one patients with unilateral ACL-deficient and intact contralateral knees were included. Each knee was studied using a combined magnetic resonance and dual fluoroscopic imaging technique while the patients performed a dynamic step-up motion (~50° of flexion to extension)...
August 7, 2018: Knee
Malou E Slichter, Nienke Wolterbeek, K Gie Auw Yang, Jacco A C Zijl, Tom M Piscaer
BACKGROUND: Rotational instability of the knee may persist after anterior cruciate ligament (ACL) reconstruction, which may be due to insufficiency of anterolateral stabilizing structures. However, no reliable diagnostic tool or physical examination test is available for identifying patients with anterolateral rotatory instability (ALRI). As shown in cadaveric studies, static internal rotation of the knee is increased in higher flexion angles of the knee after severing the anterolateral structures...
August 9, 2018: Journal of Experimental Orthopaedics
Avinesh Agarwalla, Richard Puzzitiello, Grant H Garcia, Brian Forsythe
Anterior cruciate ligament (ACL) reconstruction with a bone-patellar tendon-bone autograft yields good clinical outcomes. Despite appropriate clinical outcomes, the most common complaint after reconstruction with a bone-patellar tendon-bone autograft is anterior knee pain at the donor graft sites. Synthetic bone grafts, such as beta-tricalcium phosphate (β-TCP), have been previously used to fill the bony defect in fractures as well as removal of bony tumors, and have shown positive utility in improving anterior knee pain after ACL reconstruction...
July 2018: Arthroscopy Techniques
E Archer Danielle, Reza Mafi, Pouya Mafi, Wasim Khan
BACKGROUND: Knee joint trauma may result in damage of the intra-articular ligaments, with rupture of the anterior cruciate ligament (ACL) a common and troublesome injury due to poor capabilities for spontaneous regeneration. Autograft and allograft surgical reconstructions are the mainstay of treatment, but have associated risks of failure, therefore tissue-engineering techniques aiming to regenerate the native ACL are being researched as a potential alternative treatment. OBJECTIVES: This article aims to review the current evidence produced by ex vivo and in vivo studies investigating biomaterial scaffolding and mesenchymal stem cell (MSC) techniques in orthopaedic tissue engineering of ACL injuries...
August 8, 2018: Current Stem Cell Research & Therapy
Brett A Bousquet, Luke O'Brien, Steve Singleton, Michael Beggs
The anterior cruciate ligament (ACL) is the most commonly reconstructed ligament of the knee. Most often, the goal of surgical reconstruction is to recreate stability within the knee and prevent joint degeneration. To date, clinical studies have not demonstrated the ability of various reconstruction techniques in establishing complete knee stability when comparing rates of osteoarthritis. Rates of osteoarthritis commonly resemble those of knees which have not be reconstructed and in this light, may not demonstrate a successful outcome...
April 2018: International Journal of Sports Physical Therapy
Heather Myers, Zachary Christopherson, Robert J Butler
Background: ACL injuries are common among sports populations and achieving adequate lower extremity strength is important prior to return to play. Access to isokinetic testing equipment that measures lower extremity strength is limited. Screening tools that measure functional criteria are accessible to clinicians, however the tools' relationship to strength constructs have not been investigated in an ACL reconstructed (ACLR) population. Purpose: The primary objective was to determine if relationships exist between isokinetic peak knee extension torque (PKET), peak knee flexion torque (PKFT), hamstring to quadriceps (HQ) ratios, and YBT-LQ performance following ACLR...
April 2018: International Journal of Sports Physical Therapy
Stefano Zaffagnini, Alberto Grassi, Iacopo Romandini, Maurilio Marcacci, Giuseppe Filardo
PURPOSE: Aim of this study is to document if combined meniscal allograft transplantation (MAT) and ACL reconstruction can improve knee function, reduce pain and allow patients with meniscal defect and ACL lesion to resume sport activities. METHODS: Fifty MAT, arthroscopically performed without bone plugs and combined with one-stage primary or revision ACL reconstruction, with or without high tibial osteotomy (HTO), were included. Patients (aged 38.2 ± 10.6 years, 87% males) were evaluated at a mean follow-up of 5 years with Lysholm, Tegner and VAS scores...
August 6, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Jie Xu, Xin Zhou, Xiaoguang Guo, Guoyou Wang, Shijie Fu, Lei Zhang
BACKGROUND Anterior cruciate ligament (ACL) injury can cause knee proprioception degeneration, on which the electroacupuncture (EA) treatment has a definite effect. However, it is still not clear whether conducting EA intervention on the injured side can promote bilateral proprioception recovery. MATERIAL AND METHODS We randomly selected 6 of 9 normal cynomolgus monkeys to develop unilateral ACL injury models via arthroscopy. All knees were divided into 5 groups: the normal control (NC) group, injured side of blank model (ISBM) group, contralateral side of blank model (CSBM) group, injured side of EA (ISE) group, and contralateral side of EA (CSE) group...
August 7, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
A Ristaniemi, L Stenroth, S Mikkonen, R K Korhonen
The knee ligaments and patellar tendon function in concert with each other and other joint tissues, and are adapted to their specific physiological function via geometry and material properties. However, it is not well known how the viscoelastic and quasi-static material properties compare between the ligaments. The purpose of this study was to characterize and compare these material properties between the knee ligaments and patellar tendon. Dumbbell-shaped tensile test samples were cut from bovine knee ligaments (ACL, LCL, MCL, PCL) and patellar tendon (PT) and subjected to tensile testing (n = 10 per ligament type)...
July 29, 2018: Journal of Biomechanics
Derek N Pamukoff, Melissa M Montgomery, Skylar C Holmes, Tyler J Moffit, Steven A Garcia, Michael N Vakula
BACKGROUND: Individuals with anterior cruciate ligament reconstruction (ACLR) are at greater risk for knee osteoarthritis, which may be in part due to altered gait biomechanics. Articular cartilage thickness is typically imaged using magnetic resonance imaging, which is costly and lacks portability. Ultrasonography may provide an alternative imaging method for articular cartilage. It is unclear if ultrasonographic measurements of cartilage thickness are associated with gait biomechanics in individuals with ACLR...
July 24, 2018: Gait & Posture
Frank W Roemer, Martin Englund, Aleksandra Turkiewicz, André Struglics, Ali Guermazi, L Stefan Lohmander, Staffan Larsson, Richard Frobell
OBJECTIVE: To determine the role of inflammatory biomarkers at 2 years after anterior cruciate ligament (ACL) injury for predicting radiographic and magnetic resonance imaging (MRI)-defined knee osteoarthritis (OA) 5 years post injury. Secondary aim was to estimate the concordance of inflammatory biomarkers assessed by MRI and synovial fluid. METHODS: We studied 113 patients with acute ACL injury. 1.5 Tesla knee MRIs were read for Hoffa- and effusion-synovitis. Biomarkers of inflammation included IL-6, IL-8, IL-10, TNF-α and IFN-ɣ in serum and synovial fluid, and IL-12p70 in serum...
August 6, 2018: Arthritis & Rheumatology
Andrés Valentí, Jesús Payo-Ollero, María Pérez-Mozas, José María Lamo-Espinosa, Juan Ramón Valentí
BACKGROUND: There are no well-established guidelines for safe driving after injury or surgical treatment. The purpose of this study was to assess the aptitude to regain driving skills and brake reaction abilities after anterior cruciate ligament (ACL) surgery. METHODS: This study compared the driving abilities and skills at four to six weeks after surgery of 31 patients who underwent ACL reconstruction with hamstring autograft with 31 healthy volunteers. Multiple variables, including pedestrian impact, car crash, red traffic light violations, visual reaction time, and other driving abilities were measured with a validated driving simulator...
August 2, 2018: Knee
Freddie H Fu, Kanto Nagai
The anterior cruciate ligament (ACL) is a dynamic structure composed of distinct bundles that function synergistically to facilitate normal knee kinematics in concert with bony morphology. Characterized by individual uniqueness, the ACL is inherently subject to both anatomic and morphological variations as well as physiologic aging. No locus on the lateral wall of the intercondylar notch is truly isometric through full range of motion, suggesting the ACL is a dynamic structure. Future studies should explore dynamic ACL behavior in vivo...
August 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Brian Forsythe, Drew Lansdown, William A Zuke, Nikhil N Verma, Brian J Cole, Bernard R Bach, Nozomu Inoue
PURPOSE: The purpose of this study was to (1) map the length changes of the medial wall of the lateral femoral condyle (MWLFC) with respect to various points about the tibial anterior cruciate ligament (ACL) footprint to determine the area that demonstrates the least amount of length change through full range of motion and (2) to identify a range of flexion that would be favorable for graft tensioning. METHODS: Six fresh-frozen cadaveric knees were obtained from screened individuals with no prior history of arthritis, cancer, surgery, or any ligamentous knee injury...
August 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Cale A Jacobs, Michael R Peabody, Christian Lattermann, Jose F Vega, Laura J Huston, Kurt P Spindler, Annunziato Amendola, Jack T Andrish, Robert H Brophy, Warren R Dunn, David C Flanigan, Morgan H Jones, Christopher C Kaeding, Robert G Marx, Matthew J Matava, Eric C McCarty, Richard D Parker, Emily K Reinke, Michelle L Wolcott, Brian R Wolf, Rick W Wright, Armando F Vidal
BACKGROUND: The Knee injury and Osteoarthritis Outcome Score (KOOS) has demonstrated inferior psychometric properties when compared with the International Knee Documentation Committee (IKDC) subjective knee form when assessing outcomes after anterior cruciate ligament (ACL) reconstruction. The KOOS, Joint Replacement (KOOS, JR) is a validated short-form instrument to assess patient-reported outcomes (PROs) after knee arthroplasty, and the purpose of this study was to determine if augmenting the KOOS, JR with additional KOOS items would allow for the creation of a short-form KOOS-based global knee score for patients undergoing ACL reconstruction, with psychometric properties similar to those of the IKDC...
August 3, 2018: American Journal of Sports Medicine
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