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https://www.readbyqxmd.com/read/28507781/isolated-posterior-cruciate-ligament-tears-an-update-of-management
#1
REVIEW
Alfonso Vaquero-Picado, E Carlos Rodríguez-Merchán
Isolated posterior cruciate ligament (PCL) tears are much less frequent than anterior cruciate ligament (ACL) tears.Abrupt posterior tibial translation (such as dashboard impact), falls in hyperflexion and direct hyperextension trauma are the most frequent mechanisms of production.The anterolateral bundle represents two-thirds of PCL mass and is reconstructed in single-bundle techniques.The PCL has an intrinsic capability for healing. This is the reason why, nowadays, the majority of isolated PCL tears are managed non-operatively, with rehabilitation and bracing...
April 2017: EFORT Open Rev
https://www.readbyqxmd.com/read/28461919/anterior-cruciate-ligament-reconstruction-principles-of-treatment
#2
REVIEW
Nikolaos K Paschos, Stephen M Howell
Anterior cruciate ligament (ACL) reconstruction is one of the most common procedures in sports medicine. Several areas of controversy exist in ACL tear management which have engaged surgeons and researchers in debates towards identifying an ideal approach for these patients.This instructional review discusses the principles of ACL reconstruction in an attempt to provide guidelines and initiate a critical thinking approach on the most common areas of controversy regarding ACL reconstruction.Using high-level evidence from the literature, as presented in randomised controlled trials, systematic reviews, and meta-analyses, operative versus conservative treatment, timing of surgery, and rehabilitation are discussed...
November 2016: EFORT Open Rev
https://www.readbyqxmd.com/read/28458784/evaluating-the-functional-results-and-complications-of-autograft-vs-allograft-use-for-reconstruction-of-the-anterior-cruciate-ligament-a-systematic-review
#3
REVIEW
Ojas Pujji, Nikita Keswani, Naomi Collier, Marion Black, Lucy Doos
The aim of our review is to identify the reconstruction technique that has a superior functional outcome and decreased number of complications for the anterior cruciate ligament (ACL). We have divided our review into 2 sections. Our primary question evaluates the functional results and complications of autografts compared to allografts for ACL reconstruction. Our subsidiary question evaluates the functional results and complications of bone-patellar tendon-bone (BPTB) autografts compared to hamstring tendon autografts...
February 20, 2017: Orthopedic Reviews
https://www.readbyqxmd.com/read/28426251/current-concepts-of-the-anterolateral-ligament-of-the-knee-anatomy-biomechanics-and-reconstruction
#4
Matthew J Kraeutler, K Linnea Welton, Jorge Chahla, Robert F LaPrade, Eric C McCarty
In 1879, Paul Segond described an avulsion fracture (now known as a Segond fracture) at the anterolateral proximal tibia with the presence of a fibrous band at the location of this fracture. Although references to this ligament were occasionally made in the anatomy literature after Segond's discovery, it was not until 2012 that Vincent et al named this ligament what we know it as today, the anterolateral ligament (ALL) of the knee. The ALL originates near the lateral epicondyle of the distal femur and inserts on the proximal tibia near Gerdy's tubercle...
April 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28383764/risk-factors-for-radiographic-joint-space-narrowing-and-patient-reported-outcomes-of-post-traumatic-osteoarthritis-after-acl-reconstruction-data-from-the-moon-cohort
#5
Morgan H Jones, Kurt P Spindler
The Multicenter Orthopaedic Outcomes Network (MOON) is an NIH-funded prospective, longitudinal cohort of over 3,500 patients who have undergone anterior cruciate ligament reconstruction (ACLR) by 14 sports medicine surgeons at 7 academic medical centers. Patient reported outcome questionnaires (PRO's) are completed at baseline and multiple timepoints after surgery, and a nested cohort of patients return for radiographs to assess the development of joint space changes. We review the risk factors for worse patient reported outcomes, the predictors of clinically significant symptoms of post-traumatic osteoarthritis (PTOA), and the factors associated with more radiographic joint space narrowing...
April 6, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28373946/anteromedial-portal-anterior-cruciate-ligament-reconstruction-with-tibialis-anterior-allograft
#6
Steven Shamah, Daniel Kaplan, Eric J Strauss, Brian Singh
In an effort to better restore normal joint function and kinematics, recent emphasis has been placed on surgical techniques that provide a more anatomic reconstruction of the anterior cruciate ligament (ACL). With femoral tunnel placement shown to play a vital role in the biomechanics, stability, and clinical outcomes after ACL reconstruction, approaches that better approximate the ACL's native femoral origin have been adopted. The independent anteromedial portal technique is thought to better position the femoral tunnel within the native ACL footprint and leave the graft more posteroinferior on the wall of the lateral femoral condyle than the more traditional transtibial approach...
February 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28373945/technique-for-arthroscopic-assisted-primary-anterior-cruciate-ligament-reconstruction-using-doubled-tibialis-anterior-tendon
#7
Michael Rose, Dennis Crawford
Advances in surgical technique and our knowledge of anterior cruciate ligament (ACL) anatomy have resulted in a marked increase in options for ACL reconstruction. Currently, patient age and activity level, surgeon preference and experience, and cost are factors influencing the type of reconstruction recommended to address knee instability. We present a simplified transtibial method of ACL reconstruction using a single-bundle, doubled tibialis anterior allograft. This method uses fixation with a suspensory device on the femur and a bio-composite interference screw on the tibia...
February 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28353048/what-factors-influence-the-biomechanical-properties-of-allograft-tissue-for-acl-reconstruction-a-systematic-review
#8
Drew A Lansdown, Andrew J Riff, Molly Meadows, Adam B Yanke, Bernard R Bach
BACKGROUND: Allograft tissue is used in 22% to 42% of anterior cruciate ligament (ACL) reconstructions. Clinical outcomes have been inconsistent with allograft tissue, with some series reporting no differences in outcomes and others reporting increased risk of failure. There are numerous variations in processing and preparation that may influence the eventual performance of allograft tissue in ACL reconstruction. We sought to perform a systematic review to summarize the factors that affect the biomechanical properties of allograft tissue for use in ACL reconstruction...
March 28, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28350237/hierarchically-structured-electrospun-scaffolds-with-chemically-conjugated-growth-factor-for-ligament-tissue-engineering
#9
Hannah M Pauly, Binulal N Sathy, Dinorath Olvera, Helen O McCarthy, Daniel J Kelly, Ketul C Popat, Nicholas J Dunne, Tammy Lynn Haut Donahue
The anterior cruciate ligament (ACL) of the knee is vital for proper joint function and is commonly ruptured during sports injuries or car accidents. Due to a lack of intrinsic healing capacity and drawbacks with allografts and autografts, there is a need for a tissue-engineered ACL replacement. Our group has previously used aligned sheets of electrospun polycaprolactone nanofibers to develop solid cylindrical bundles of longitudinally aligned nanofibers. We have shown that these nanofiber bundles support cell proliferation and elongation and the hierarchical structure and material properties are similar to the native human ACL...
March 27, 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/28298067/incidence-of-second-anterior-cruciate-ligament-tears-1990-2000-and-associated-factors-by-geographic-locale
#10
Nathan D Schilaty, Nathaniel A Bates, Thomas L Sanders, Aaron J Krych, Michael J Stuart, Timothy E Hewett
BACKGROUND: Second anterior cruciate ligament (ACL) tears after reconstruction occur at a reported rate of 20% to 30%. This high frequency indicates that there may be factors that predispose an athlete to graft failure and ACL tears of the contralateral knee. PURPOSE: To determine the incidence of second ACL injuries in a geographic population-based cohort over a 10-year observation period. STUDY DESIGN: Descriptive epidemiological study. METHODS: International Classification of Diseases, 9th Revision (ICD-9) codes relevant to the diagnosis of an ACL tear and the procedure code for ACL reconstruction were searched across the Rochester Epidemiology Project, a multidisciplinary county database, between the years of 1990 and 2000...
March 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28298052/allograft-augmentation-of-hamstring-autograft-for-younger-patients-undergoing-anterior-cruciate-ligament-reconstruction
#11
Cale A Jacobs, Jeremy M Burnham, Eric Makhni, Chaitu S Malempati, Eric Swart, Darren L Johnson
BACKGROUND: Younger patients and those with smaller hamstring autograft diameters have been shown to be at significantly greater risk of graft failure after anterior cruciate ligament (ACL) reconstruction. To date, there is no information in the literature about the clinical success and/or cost-effectiveness of increasing graft diameter by augmenting with semitendinosus allograft tissue for younger patients. HYPOTHESIS: Hybrid hamstring grafts are a cost-effective treatment option because of a reduced rate of graft failure...
March 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28275205/a-comparative-study-of-effect-of-autograft-compared-with-allograft-anterior-cruciate-ligament-reconstruction-on-expressions-of-loxs-and-mmps
#12
Wei-Ming Wang, Xiao-Jun Ma, Shi-Bo Huang, Liu-Bao Ren, Yu-Peng Liu
The present study aimed to compare the effect of autograft or allograft anterior cruciate ligament (ACL) reconstruction on the expressions of lipoxygenases (LOXs) and matrix metalloproteinases (MMPs) in a New Zealand white rabbit model. New Zealand white rabbits were divided randomly into control, sham, autograft and allograft groups. At the 4th and 8th week after operation, biomechanical testing was performed to measure the primary length, cross-sectional area, maximum tensile load and stiffness of ACL, and HE staining was used to observe cell morphology and fibre alignment of ACL...
April 30, 2017: Bioscience Reports
https://www.readbyqxmd.com/read/28244929/can-a-novel-low-cost-simulation-model-be-used-to-teach-anterior-cruciate-ligament-graft-preparation
#13
Christopher M Brusalis, John Todd R Lawrence, Sheena C Ranade, Joy C Kerr, Nicholas Pulos, Lawrence Wells, Theodore J Ganley
BACKGROUND: This study evaluated an anterior cruciate ligament (ACL) graft preparation simulation learning model for use by orthopaedic surgery trainees. METHODS: A simulation model for ACL graft preparation was constructed using shoelace as graft material and a wooden graft preparation board that matched the dimensions of existing products. A 12-minute instructional video targeted at novice learners was created to accompany the simulation model. A prospective randomized controlled trial was conducted on orthopaedic surgery residents divided into 2 groups with equal distributions of postgraduate year (PGY) status...
June 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28224072/concomitant-arthroscopic-meniscal-allograft-transplantation-and-anterior-cruciate-ligament-reconstruction
#14
Bryan M Saltzman, Justin W Griffin, Nathan Wetters, Maximilian A Meyer, Brian J Cole, Adam B Yanke
In recent decades, arthroscopic meniscal allograft transplantation (MAT) has been refined as a robust option for the treatment of evolving unicompartmental tibiofemoral arthrosis in the setting of meniscal deficiency. It is imperative that the MAT be performed in a knee with anatomic stability and alignment to reduce aberrant biomechanical forces experienced by the allograft tissue to maintain its durability. Thus, in an anterior cruciate ligament (ACL)-deficient knee, ACL reconstruction (ACLR) must be performed to restore the stable knee environment for the MAT to succeed...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28224069/allograft-anterior-cruciate-ligament-reconstruction-utilizing-internal-brace-augmentation
#15
Patrick A Smith, Jordan A Bley
Anterior cruciate ligament (ACL) tears are among the most common sports-related injuries. Although studies have reported reliable outcomes with allograft tissue, several studies have shown a higher failure rate in younger patients. Although ACL graft augmentation has been met with varying levels of success, internal bracing of an allograft represents a promising area in ACL reconstruction. The purpose of this article is to detail allograft preparation involving a collagen-coated, ultrahigh-molecular-weight polyethylene/polyester suture tape as an internal brace augmentation for ACL reconstruction using the all-inside ACL GraftLink Technique (Arthrex, Naples, FL)...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28211291/a-biomechanical-analysis-of-tibial-acl-reconstruction-with-graft-length-mismatch
#16
Evan B Gaines, Diana Lau, Qais Naziri, Westley Hayes, Julio J Jauregui, Bhaveen H Kapadia, William P Urban, Bashir A Zikria
INTRODUCTION: The incidence of graft length mismatch (GLM) during anterior cruciate ligament (ACL) reconstruction is reported to be up to 13%, with a rate of 20% when using bone-patellar tendon-bone (BPTB) allografts. Multiple techniques have been described to accommodate for the longer BPTB graft. As no study has compared the biomechanical properties of these methods (with cyclic loading), we evaluated the strength of four different surgical techniques used to accommodate for GLM during ACL reconstruction...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28195744/-proprietary-processed-allografts
#17
Troy A Roberson, Jeffrey T Abildgaard, Douglas J Wyland, Paul C Siffri, Stephen P Geary, Richard J Hawkins, John M Tokish
BACKGROUND: The processing of allograft tissues in anterior cruciate ligament (ACL) reconstruction continues to be controversial. While high-dose irradiation of grafts has received scrutiny for high failure rates, lower dose irradiation and "proprietary-based" nonirradiated sterilization techniques have become increasingly popular, with little in the literature to evaluate their outcomes. Recent studies have suggested that the specifics of allograft processing techniques may be a risk factor for higher failure rates...
February 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28178094/reconstruction-of-symptomatic-congenital-anterior-cruciate-ligament-insufficiency
#18
Brant C Sachleben, Adam Y Nasreddine, Jeffrey J Nepple, Frances A Tepolt, James R Kasser, Mininder S Kocher
BACKGROUND: Hypoplasia or congenital absence of the anterior cruciate ligament (ACL) is a rare disorder occurring in ∼1 in every 6000 births. Although some patients with hypoplasia or agenesis of the ACL may not complain of instability, others desire to participate in more demanding activities that require the stability of a competent ACL. There are limited reports of surgical treatment of this patient population. The purpose of this study was to report ACL reconstruction in a case series of patients with symptomatic congenital ACL deficiency...
February 7, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28159425/magnetic-resonance-imaging-evaluation-of-physeal-violation-in-adolescents-after-transphyseal-anterior-cruciate-ligament-reconstruction
#19
Joon-Ho Wang, Kang-Min Son, Dae-Hee Lee
PURPOSE: To quantify and compare the amount and location of physis violation of the distal femur and proximal tibia after transphyseal anterior cruciate ligament (ACL) reconstruction in skeletally immature patients. METHODS: This study included 19 patients with open physes of the distal femur and proximal tibia who underwent ACL reconstruction with tibialis anterior allografts. Physeal tunnel volume and location on the growth plate, as well as obliquity to the growth plate, were measured by 3-dimensional postoperative magnetic resonance imaging of the distal femur and proximal tibia...
January 31, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28024306/a-canine-arthroscopic-anterior-cruciate-ligament-reconstruction-model-for-study-of-synthetic-augmentation-of-tendon-allografts
#20
James L Cook, Pat Smith, James P Stannard, Ferris Pfeiffer, Keiichi Kuroki, Chantelle C Bozynski, Cristi Cook
Novel graft types, fixation methods, and means for augmenting anterior cruciate ligament (ACL) reconstructions require preclinical validation prior to safe and effective clinical application. The objective of this study was to describe and validate a translational canine model for all-inside arthroscopic complete ACL reconstruction using a quadriceps tendon allograft with internal brace (QTIB). With institutional approval, adult research hounds underwent complete transection of the native ACL followed by all-inside ACL reconstruction using the novel QTIB construct with suspensory fixation (n = 10)...
December 26, 2016: Journal of Knee Surgery
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