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Mark E Cinque, Jorge Chahla, Gilbert Moatshe, Nicholas N DePhillipo, Nicholas I Kennedy, Jonathan A Godin, Robert F LaPrade
BACKGROUND: Until recently, anterior cruciate ligament (ACL) tears in older patients were treated conservatively; however, these patients often experienced significant pain and instability. PURPOSE/HYPOTHESIS: The purpose of this study was to compare the patient-reported outcomes, patient satisfaction, and failure rates of primary ACL reconstruction between a younger (age 20-30 years) and older (age 50-75 years) patient cohort. It was hypothesized that patients in the older cohort could achieve comparable clinical outcomes and retear rates following ACL reconstruction with a bone-tendon-bone autograft or allograft compared with the younger patients...
October 2017: Orthopaedic Journal of Sports Medicine
#2
S Zaffagnini, A Grassi, G M Marcheggiani Muccioli, T R Di Sarsina, L Macchiarola, M Mosca, M P Neri, M Marcacci
BACKGROUND: Return to sport after revision ACL reconstruction is a controversial topic, several studies reported the results of different techniques and graft in sportsman, presenting an incredibly wide range of return to the same pre-injury activity level, from 0% to 100%. The purpose of this study was to evaluate the clinical outcomes and return to sport rate in young athletes after non anatomic double-bundle revision ACL reconstruction with Achilles allograft. HYPOTHESIS: the present revision technique was effective in terms of stability, return to sport and functional outcomes MATERIAL AND METHODS: All the athletes undergone Revision ACL reconstruction with non-irradiated Achilles tendon allograft with a non-anatomical double-bundle technique were included in the study...
October 12, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
#3
Ji Hyun Ahn, Ho Won Kang, Kug Jin Choi
PURPOSE: To identify the risk factors predicting unsatisfactory postoperative clinical outcomes after double-bundle (DB) anterior cruciate ligament (ACL) reconstruction using multivariate logistic regression. METHODS: Inclusion criteria were consecutive DB ACL reconstructions from January 2006 to September 2012 with a minimum 3-year follow-up. Exclusion criteria included (1) a delay to surgery from initial injury of more than 4 years (210 weeks); (2) contralateral knee pathology; (3) the lack of postoperative 3-dimensional computed tomography; (4) single-bundle ACL reconstruction; (5) revision ACL reconstruction; (6) meniscus allograft transplantation after total or subtotal meniscectomy; (7) multiple ligament surgeries...
September 8, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
#4
Andrew J Riff, Timothy J Luchetti, Alexander E Weber, Jaskarndip Chahal, Bernard R Bach
BACKGROUND: During the preoperative discussion prior to anterior cruciate ligament reconstruction (ACLR), patients are often interested in data regarding rates of revision reconstruction, reoperation, concomitant pathologic changes, and future contralateral ACL injury. PURPOSE: To analyze a single surgeon's experience with primary and revision ACLR over a 30-year interval, focusing on incidence and risk factors for revision and reoperation. STUDY DESIGN: Case series; Level of evidence, 4...
August 2017: Orthopaedic Journal of Sports Medicine
#5
Rui Yang, Haiquan Deng, Jingyi Hou, Yi Ouyang, Zhong Chen, Bin Song, Yunfeng Zhou, Weiquan Tan, Weiping Li, Huiyong Shen
This study compared knee stability and alterations in the composition of synovial fluid among patients who underwent arthroscopic anterior cruciate ligament (ACL) reconstruction with either a hamstring autograft or a hamstring allograft. This prospective cohort study enrolled 175 patients. Of these patients, 90 underwent hamstring tendon autograft ACL reconstruction. The remaining patients (n=85) underwent hamstring tendon allograft ACL reconstruction. All of the patients had a minimum of 1 year of follow-up (mean, 2...
September 1, 2017: Orthopedics
#6
Rohith Mohan, Kate E Webster, Nick R Johnson, Michael J Stuart, Timothy E Hewett, Aaron J Krych
PURPOSE: The purpose of this meta-analysis was to determine overall objective graft failure rate, failure rate by graft type (allograft vs autograft reconstruction), instrumented laxity, and patient outcome scores following revision anterior cruciate ligament (ACL) reconstruction. Outcomes of interest were collected for all studies meeting the study inclusion criteria, but lower-level studies (level III/IV) were not pooled for quantitative synthesis due to high levels of heterogeneity in these study populations...
August 30, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
#7
Brent R Davis, Jason Chen, Maria C S Inacio, Rebecca Love, Heather A Prentice, Gregory B Maletis
BACKGROUND: A goal of anterior cruciate ligament (ACL) reconstruction is to provide a meniscal protective effect for the knee. PURPOSE: (1) To evaluate whether there was a different likelihood of subsequent meniscal surgery in the ACL-reconstructed knee or in the normal contralateral knee and (2) to compare the risk factors associated with subsequent meniscal surgery in the ACL-reconstructed knee and contralateral knee. STUDY DESIGN: Cohort study; Level of evidence, 3...
August 1, 2017: American Journal of Sports Medicine
#8
Nathan D Schilaty, Christopher Nagelli, Nathaniel A Bates, Thomas L Sanders, Aaron J Krych, Michael J Stuart, Timothy E Hewett
BACKGROUND: The reported rate of second anterior cruciate ligament (ACL) injuries (20%-30%), including graft failure and contralateral ACL tears, after ACL reconstruction (ACLR) or nonoperative therapy indicates that multiple factors may predispose patients to subsequent ACL injuries. PURPOSE: To determine the incidence of second ACL injuries in a population-based cohort over a 10-year observation period (2001-2010) and to identify factors that contribute to the risk of second injuries...
August 2017: Orthopaedic Journal of Sports Medicine
#9
Michael Rose, Dennis Crawford
BACKGROUND: Allograft healing (ligamentization) after reconstruction of the anterior cruciate ligament (ACL) is dependent on multiple factors, including tissue processing, host biologic environment, and biomechanical stressors. Magnetic resonance imaging (MRI) can be used to assess graft maturation after ACL reconstruction. HYPOTHESIS: A significant difference will exist in the MRI analysis between 2 distinct allograft constructs. Specifically, the MRI signal-to-noise quotient (SNQ) value will be smaller in quadrupled hamstring tendon (HT) allografts compared with doubled tibialis anterior (TA) allografts due to the difference in graft geometry (surface area-to-volume ratio)...
August 2017: Orthopaedic Journal of Sports Medicine
#10
J Sklenský, P Vališ, M Repko, M Rouchal, M Maršálek, D Hrůzová
PURPOSE OF THE STUDY A retrospective evaluation of the success rate of revision ACL reconstruction performed using BTB allograft in terms of the life expectancy of the procedure up to and over five years from surgery. MATERIAL AND METHODS Over a ten-year period, from 2003 to 2013, we performed 47 revision ACL reconstruction surgeries. The majority of the primary ACL reconstructions using BTB autografts were not performed at our site. The group observed included 16 women (34%) and 31 men (66%). The women were aged between 25 and 48 years, the median age being 32...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
#11
Dean Wang, Claire D Eliasberg, Tim Wang, Ryan R Fader, Francesca R Coxe, Mollyann D Pais, Riley J Williams
PURPOSE: To compare failure rates and clinical outcomes of osteochondral allograft transplantation (OCA) in anterior cruciate ligament (ACL)-intact versus ACL-reconstructed knees at midterm follow-up. METHODS: After a priori power analysis, a prospective registry of patients treated with OCA for focal chondral lesions ≥2 cm(2) in size with minimum 2-year follow-up was used to match ACL-reconstructed knees with ACL-intact knees by age, sex, and primary chondral defect location...
August 8, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
#12
Anchal Bansal, Joseph D Lamplot, James T Vandenberg, Robert H Brophy
BACKGROUND: An infection after anterior cruciate ligament (ACL) reconstruction is a relatively rare but challenging complication. There are no meta-analyses comparing the incidence of infections after ACL reconstruction with the various available graft choices. PURPOSE: To compare the incidence of infections after ACL reconstruction with bone-patellar tendon-bone (BPTB) autografts compared with hamstring autografts, with a secondary aim of comparing the incidence of infections after reconstruction with autografts compared with allografts...
July 1, 2017: American Journal of Sports Medicine
#13
Benedict U Nwachukwu, Brenda Chang, Pramod B Voleti, Patricia Berkanish, Matthew R Cohn, David W Altchek, Answorth A Allen, Riley J Williams
BACKGROUND: There is increased interest in understanding the preoperative determinants of postoperative outcomes. Return to play (RTP) and the patient-reported minimal clinically important difference (MCID) are useful measures of postoperative outcomes after anterior cruciate ligament reconstruction (ACLR). PURPOSE: To define the MCID after ACLR and to investigate the role of preoperative outcome scores for predicting the MCID and RTP after ACLR. STUDY DESIGN: Case-control study; Level of evidence, 3...
October 2017: American Journal of Sports Medicine
#14
Moira McCarthy, Katherine Mallett, Matthew Abola, Sherrie Vassallo, Joseph Nguyen
BACKGROUND: Anterior cruciate ligament (ACL) injuries are among the most common knee injuries. Patient outcomes, rate of subsequent operations, and rate of subsequent ACL reconstruction following primary ACL reconstruction need to be evaluated. QUESTIONS/PURPOSES: This study was designed to answer the following questions: (1) What is the return to surgery (OR) rate following primary ACL reconstruction and (2) what is the revision ACL reconstruction rate? METHODS: Data was drawn from the Hospital for Special Surgery (HSS) ACL Registry...
July 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
#15
Keun Churl Chun, Sung Hyun Lee, Jeong Woo Kim, Eun Jung Jin, Kwang Mee Kim, Churl Hong Chun
BACKGROUND: Attempts have been made to validate the significance of remnant preservation with anterior cruciate ligament (ACL) reconstruction using immunohistochemical and immunocytochemical techniques. The purpose of this study was to examine the expression of mechanoreceptors in the remnant tissue of ACL reconstruction performed with the remnant-preserving technique. METHODS: Tissue samples were obtained from 10 patients who underwent ACL reconstruction with the remnant-preserving technique...
June 14, 2017: Journal of Orthopaedic Surgery and Research
#16
Christopher M Larson, Asheesh Bedi, Mark E Dietrich, Jennifer C Swaringen, Corey A Wulf, David M Rowley, M Russell Giveans
PURPOSE: To determine whether generalized hypermobility and contralateral knee hyperextension affect failure rates and patient-related outcomes after anterior cruciate ligament reconstruction (ACLR). METHODS: A total of 226 consecutive patients presenting with acute ACL tears were prospectively evaluated for generalized hypermobility by a modified Beighton criteria. Minimum 2-year follow-up was achieved for 183 knees (81%). Patients underwent ACLR with either bone-patellar-tendon (BPTB) autograft (n = 46), quadrupled hamstring (HT) autograft (n = 85), or allograft tissue (n = 52)...
June 6, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
#17
Matthew Lacey, Joseph Lamplot, Kempland C Walley, Joseph P DeAngelis, Arun J Ramappa
AIM: To describe an approach to anterior cruciate ligament (ACL) reconstruction using autologous hamstring by drilling via the anteromedial portal in the presence of an intramedullary (IM) femoral nail. METHODS: Once preoperative imagining has characterized the proposed location of the femoral tunnel preparations are made to remove all of the hardware (locking bolts and IM nail). A diagnostic arthroscopy is performed in the usual fashion addressing all intra-articular pathology...
May 18, 2017: World Journal of Orthopedics
#18
REVIEW
A Grassi, M Nitri, S G Moulton, G M Marcheggiani Muccioli, A Bondi, M Romagnoli, S Zaffagnini
AIMS: Our aim was to perform a meta-analysis of the outcomes of revision anterior cruciate ligament (ACL) reconstruction, comparing the use of different types of graft. MATERIALS AND METHODS: A search was performed of Medline and Pubmed using the terms "Anterior Cruciate Ligament" and "ACL" combined with "revision", "re-operation" and "failure". Only studies that reported the outcome at a minimum follow-up of two years were included. Two authors reviewed the papers, and outcomes were subdivided into autograft and allograft...
June 2017: Bone & Joint Journal
#19
David Y Ding, Alan L Zhang, Christina R Allen, Allen F Anderson, Daniel E Cooper, Thomas M DeBerardino, Warren R Dunn, Amanda K Haas, Laura J Huston, Brett Brick A Lantz, Barton Mann, Kurt P Spindler, Michael J Stuart, Rick W Wright, John P Albright, Annunziato Ned Amendola, Jack T Andrish, Christopher C Annunziata, Robert A Arciero, Bernard R Bach, Champ L Baker, Arthur R Bartolozzi, Keith M Baumgarten, Jeffery R Bechler, Jeffrey H Berg, Geoffrey A Bernas, Stephen F Brockmeier, Robert H Brophy, Charles A Bush-Joseph, J Brad Butler, John D Campbell, James L Carey, James E Carpenter, Brian J Cole, Jonathan M Cooper, Charles L Cox, R Alexander Creighton, Diane L Dahm, Tal S David, David C Flanigan, Robert W Frederick, Theodore J Ganley, Elizabeth A Garofoli, Charles J Gatt, Steven R Gecha, James Robert Giffin, Sharon L Hame, Jo A Hannafin, Christopher D Harner, Norman Lindsay Harris, Keith S Hechtman, Elliott B Hershman, Rudolf G Hoellrich, Timothy M Hosea, David C Johnson, Timothy S Johnson, Morgan H Jones, Christopher C Kaeding, Ganesh V Kamath, Thomas E Klootwyk, Bruce A Levy, C Benjamin Ma, G Peter Maiers, Robert G Marx, Matthew J Matava, Gregory M Mathien, David R McAllister, Eric C McCarty, Robert G McCormack, Bruce S Miller, Carl W Nissen, Daniel F O'Neill, Brett D Owens, Richard D Parker, Mark L Purnell, Arun J Ramappa, Michael A Rauh, Arthur C Rettig, Jon K Sekiya, Kevin G Shea, Orrin H Sherman, James R Slauterbeck, Matthew V Smith, Jeffrey T Spang, Steven J Svoboda, Timothy N Taft, Joachim J Tenuta, Edwin M Tingstad, Armando F Vidal, Darius G Viskontas, Richard A White, James S Williams, Michelle L Wolcott, Brian R Wolf, James J York
BACKGROUND: While revision anterior cruciate ligament reconstruction (ACLR) can be performed to restore knee stability and improve patient activity levels, outcomes after this surgery are reported to be inferior to those after primary ACLR. Further reoperations after revision ACLR can have an even more profound effect on patient satisfaction and outcomes. However, there is a current lack of information regarding the rate and risk factors for subsequent surgery after revision ACLR. PURPOSE: To report the rate of reoperations, procedures performed, and risk factors for a reoperation 2 years after revision ACLR...
July 2017: American Journal of Sports Medicine
#20
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 reviews
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