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Posterior ligament reconstruction

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https://www.readbyqxmd.com/read/27909681/double-bundle-all-inside-posterior-cruciate-ligament-reconstruction-a-technique-using-2%C3%A2-separate-autologous-grafts
#1
Roy A G Hoogeslag, Bart W Oudelaar, Rianne Huis In't Veld, Reinoud W Brouwer
In a double-bundle posterior cruciate ligament reconstruction, several surgical techniques are available. Compared with other techniques, the advantages of the all-inside technique and cortical suspension devices with variable loop length are that shorter grafts can be used, tendons can be quadrupled, and a double-bundle posterior cruciate ligament reconstruction can be performed with autologous grafts. Furthermore, the all-inside technique provides independent outside-in socket reaming and is soft tissue, cortex, and bone sparing because no full diameter tunnels but sockets are created with a small diameter guide pin, which can transform into a retrograde drill...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27904222/functional-and-computed-tomography-correlation-of-femoral-and-tibial-tunnels-in-single-bundle-anterior-cruciate-ligament-reconstruction-use-of-accessory-anteromedial-portal
#2
Naveen Joseph Mathai, Rajkumar S Amaravathi, K V Pavan, Padmanabhan Sekaran, Gaurav Sharma, Belliappa Codanda
BACKGROUND: An accessory anteromedial portal (AAMP) has been shown to be effective in placing an anatomically ideal femoral tunnel. It is well known that this is due to the independent femoral drilling which is possible with the AAMP. However very little is known regarding the significance of this reconstruction technique in influencing the functional outcomes of anatomic anterior cruciate ligament reconstruction (ACLR). This study documents the influence of tibial and femoral tunnel positions on functional outcomes of anatomic ACLR using the AAMP...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27899355/the-anatomic-centers-of-the-femoral-and-tibial-insertions-of-the-anterior-cruciate-ligament-a-systematic-review-of-imaging-and-cadaveric-studies-reporting-normal-center-locations
#3
Anagha P Parkar, Miraude E A P M Adriaensen, Søren Vindfeld, Eirik Solheim
BACKGROUND: The anterior cruciate ligament (ACL) is regularly reconstructed if knee joint function is impaired. Anatomic graft tunnel placement, often assessed with varying measurement methods, in the femur and tibia is considered important for an optimal clinical outcome. A consensus on the exact location of the femoral and tibial footprint centers is lacking. PURPOSE: To systematically review the literature regarding anatomic centers of the femoral and tibial ACL footprints and assess the mean, median, and percentiles of normal centers...
November 29, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27898453/resolution-of-rectal-prolapse-by-vaginal-reconstruction
#4
Hemikaa Devakumar, Neeraja Chandrasekaran, Alexandriah Alas, Laura Martin, G Willy Davila, Eric Hurtado
BACKGROUND: Rectal prolapse is a disorder of the pelvic floor in which the layers of the rectal mucosa protrude outward through the anus. Surgical repair is the mainstay of treatment. Options include intra-abdominal procedures such as rectopexy and perineal procedures such as the Delorme and Altemeier perineal rectosigmoidectomy. Rectal and vaginal prolapse can often coexist. However, to our knowledge, there are no reported cases of rectal prolapse resolved by the repair of a compressive enterocele abutting the anterior rectal wall through a vaginal approach alone...
November 28, 2016: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/27896678/no-clinically-important-difference-in-knee-scores-or-instability-between-transtibial-and-inlay-techniques-for-pcl-reconstruction-a-systematic-review
#5
REVIEW
Young-Soo Shin, Hyun-Jung Kim, Dae-Hee Lee
BACKGROUND: It is unclear whether the biomechanical superiority of the inlay technique over the transtibial technique, arising from avoidance of the killer turn at the graft-tunnel margin of the proximal tibia during posterior cruciate ligament (PCL) reconstruction, leads to better knee scores or greater knee stability. QUESTIONS/PURPOSES: This systematic review was designed to compare Tegner and Lysholm scores, and posterior residual laxity of the knee, between single-bundle PCL reconstruction using transtibial and inlay techniques...
November 28, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27881382/early-changes-in-knee-center-of-rotation-during-walking-after-anterior-cruciate-ligament-reconstruction-correlate-with-later-changes-in-patient-reported-outcomes
#6
Matthew R Titchenal, Constance R Chu, Jennifer C Erhart-Hledik, Thomas P Andriacchi
BACKGROUND: Altered knee kinematics after anterior cruciate ligament injury and reconstruction (ACLR) have been implicated in the development of posttraumatic osteoarthritis (PTOA), leading to poor long-term clinical outcomes. PURPOSE: This study was conducted to determine (1) whether the average knee center of rotation (KCOR), a multidimensional metric of knee kinematics, of the ACL-reconstructed knee during walking differs from that of the uninjured contralateral knee; (2) whether KCOR changes between 2 and 4 years after surgery; and (3) whether early KCOR changes predict patient-reported outcomes 8 years after ACLR...
November 23, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27880849/loading-patterns-of-the-posterior-cruciate-ligament-in-the-healthy-knee-a-systematic-review
#7
S H Hosseini Nasab, Renate List, Katja Oberhofer, Sandro F Fucentese, Jess G Snedeker, William R Taylor
BACKGROUND: The posterior cruciate ligament (PCL) is the strongest ligament of the knee, serving as one of the major passive stabilizers of the tibio-femoral joint. However, despite a number of experimental and modelling approaches to understand the kinematics and kinetics of the ligament, the normal loading conditions of the PCL and its functional bundles are still controversially discussed. OBJECTIVES: This study aimed to generate science-based evidence for understanding the functional loading of the PCL, including the anterolateral and posteromedial bundles, in the healthy knee joint through systematic review and statistical analysis of the literature...
2016: PloS One
https://www.readbyqxmd.com/read/27872126/multiple-ligament-reconstruction-femoral-tunnels-intertunnel-relationships-and-guidelines-to-avoid-convergence
#8
Gilbert Moatshe, Alex W Brady, Erik L Slette, Jorge Chahla, Travis Lee Turnbull, Lars Engebretsen, Robert F LaPrade
BACKGROUND: Knee dislocations often require multiple concurrent ligament reconstructions, which involve creating several tunnels in the distal femur. Therefore, the risk of tunnel convergence is increased because of the limited bone volume within the distal aspect of the femur. PURPOSE: To assess the risk of tunnel convergence and determine the optimal reconstruction tunnel orientations for multiple ligament reconstructions in the femur. STUDY DESIGN: Descriptive laboratory study...
November 21, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27868076/synovial-c-shaped-tibial-footprint-of-the-anterior-cruciate-ligament
#9
César Janovsky, Camila Cohen Kaleka, Maria Teresa Seixas Alves, Mario Ferretti, Moises Cohen
BACKGROUND: Although numerous anatomic studies about the anterior cruciate ligament (ACL) structure and attachments have been performed, these studies have not reached consensus on the ACL footprint. PURPOSE: To investigate the existing controversy regarding the morphology of the tibial ACL insertion (footprint) and confirm histologically that the tibial ACL footprint is not completely filled with ligament tissue. STUDY DESIGN: Descriptive laboratory study...
November 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/27855670/influence-of-disruption-of-the-acromioclavicular-and-coracoclavicular-ligaments-on-glenohumeral-motion-a-kinematic-evaluation
#10
Kempland C Walley, Babak Haghpanah, Andreas Hingsammer, Ethan R Harlow, Ashkan Vaziri, Joseph P DeAngelis, Ara Nazarian, Arun J Ramappa
BACKGROUND: Changes to the integrity of the acromioclavicular (AC) joint impact scapulothoracic and clavicular kinematics. AC ligaments provide anterior-posterior stability, while the coracoclavicular (CC) ligaments provide superior-inferior stability and a restraint to scapular internal rotation. The purpose of this cadaveric study was to describe the effect of sequential AC and CC sectioning on glenohumeral (GH) kinematics during abduction (ABD) of the arm. We hypothesized that complete AC ligament insult would result in altered GH translation in the anterior-posterior plane during abduction, while subsequent sectioning of both CC ligaments would result in an increasing inferior shift in GH translation...
November 17, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27855310/between-leg-differences-in-challenging-single-limb-balance-performance-one-year-following-anterior-cruciate-ligament-reconstruction
#11
Anna L Hatton, Kay M Crossley, Ross A Clark, Timothy S Whitehead, Hayden G Morris, Adam G Culvenor
Following anterior cruciate ligament (ACL) rupture, reconstructive surgery (ALCR) is often performed to mechanically stabilise the knee, however functional deficits often persist long after surgery. Impaired single-limb standing balance has been observed in the ACLR limb compared to healthy individuals. However, it remains inconclusive as to whether these same balance deficits exist between the injured and contralateral uninjured limbs, during challenging balance tasks, and at a time when patients are permitted to return to sport...
November 11, 2016: Gait & Posture
https://www.readbyqxmd.com/read/27847839/anatomical-individualized-acl-reconstruction
#12
REVIEW
Amir Ata Rahnemai-Azar, Soheil Sabzevari, Sebastián Irarrázaval, Tom Chao, Freddie H Fu
The anterior cruciate ligament (ACL) is composed of two bundles, which work together to provide both antero-posterior and rotatory stability of the knee. Understanding the anatomy and function of the ACL plays a key role in management of patients with ACL injury. Anatomic ACL reconstruction aims to restore the function of the native ACL. Femoral and tibial tunnels should be placed in their anatomical location accounting for both the native ACL insertion site and bony landmarks. One main component of anatomical individualized ACL reconstruction is customizing the treatment according to each patient's individual characteristics, considering preoperative and intraoperative evaluation of the native ACL and knee bony anatomy...
October 2016: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/27843343/the-danish-knee-ligament-reconstruction-registry
#13
REVIEW
Lene Rahr-Wagner, Martin Lind
The Danish Knee Ligament Reconstruction Registry was established in 2005 as a web-based nationwide clinical database with the purpose of improving the monitoring and quality of both primary and revision knee ligament reconstructions in Denmark. All primary and revision anterior and posterior cruciate ligament reconstructions as well as collateral ligament and multiligament reconstructions are recorded. Main variables include sex, age, cause of injury, objective ligament instability, and surgical data, such as affected ligament, graft- and implant choice, operation technique among other things...
2016: Clinical Epidemiology
https://www.readbyqxmd.com/read/27842571/medial-patellofemoral-ligament-reconstruction-using-a-bone-groove-and-a-suture-anchor-at-patellar-a-safe-and-firm-fixation-technique-and-3-year-follow-up-study
#14
Hong-De Wang, Jiang-Tao Dong, Shi-Jun Gao
BACKGROUND: Graft fixation is critical to the restoration of the medial patella of femoral ligament function and long-term success. Numerous fixations at the patella have been described, while the complications including patellar fractures, violation of the posterior patella and delay of tendon-to-bone healing remain significant challenges. Here, we describe a safe and firm fixation at the patellar for medial patellofemoral ligament (MPFL) reconstruction and explore the safety angle of drilling the suture anchor at different morphology of the patellar...
November 14, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27828983/sacrotuberous-ligament-healing-following-surgical-division-during-transgluteal-pudendal-nerve-decompression-a-3-tesla-mr-neurography-study
#15
Jan Fritz, Benjamin Fritz, A Lee Dellon
Pelvic pain due to chronic pudendal nerve (PN) compression, when treated surgically, is approached with a transgluteal division of the sacrotuberous ligament (STL). Controversy exists as to whether the STL heals spontaneously or requires grafting. Therefore, the aim of this study was to determine how surgically divided and unrepaired STL heal. A retrospective evaluation of 10 patients who had high spatial resolution 3-Tesla magnetic resonance imaging (3T MRI) exams of the pelvis was done using an IRB-approved protocol...
2016: PloS One
https://www.readbyqxmd.com/read/27824492/evolution-of-intrameniscal-signal-intensity-alterations-detected-on-mri-over-24-months-in-patients-with-traumatic-anterior-cruciate-ligament-tear
#16
Julio Brandao Guimaraes, Luca Facchetti, Benedikt J Schwaiger, Alexandra S Gersing, Sharmila Majumdar, Benjamin C Ma, Xiaojuan Li, Thomas M Link
OBJECTIVE: The objective of our study was to assess the prevalence and evolution of intrameniscal signal-intensity alteration in subjects with an anterior cruciate ligament (ACL) tear over 24 months and compare clinical outcome and changes of cartilage between subjects with and those without this meniscal abnormality. MATERIALS AND METHODS: Fifty-seven subjects with an ACL tear were screened for intrameniscal signal-intensity alteration. Morphologic and compositional MRI was performed before ACL reconstruction and 12 and 24 months after ACL reconstruction...
November 8, 2016: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/27822697/annular-ligament-reconstruction-with-the-superficial-head-of-the-brachialis-surgical-technique-and-biomechanical-evaluation
#17
Michael Hackl, Kilian Wegmann, Christian Ries, Sebastian Lappen, Martin Scaal, Lars Peter Müller
PURPOSE: The purpose of this study was to perform biomechanical testing of annular ligament (AL) reconstruction using the superficial head of the brachialis tendon (SHBT) as a distally based tendon graft. We hypothesized that posterior translation of the radial head following AL reconstruction with an SHBT graft does not significantly differ from intact specimens. METHODS: Six fresh-frozen elbow specimens were used. The stability of the radial head against posterior translation forces (30 N) was evaluated in 0°, 45°, 90° and 120° of elbow flexion...
November 7, 2016: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/27816290/clinical-and-arthrometric-outcomes-of-an-anatomic-outside-in-single-bundle-anterior-cruciate-ligament-reconstruction-using-a-retrodrill
#18
David Figueroa, Rafael Calvo, Francisco Figueroa, Daniel Paccot, Guillermo Izquierdo, Nelson Morales
BACKGROUND: The main option to perform an anatomic anterior cruciate ligament (ACL) reconstruction is the anteromedial portal (AMP) technique. It has several reported complications (iatrogenic chondral injury, posterior-wall blowout, short sockets, increased risk of injury to common peroneal nerve). In an attempt to avoid these complications the outside-in (OI) technique was revived with the addition of a retrodrill. The aim of this study is to evaluate the clinical and arthrometric outcomes of a series of anatomical OI single bundle ACL reconstruction using a retrodrill...
November 2, 2016: Knee
https://www.readbyqxmd.com/read/27780652/morphology-of-the-insertions-of-the-superficial-medial-collateral-ligament-and-posterior-oblique-ligament-using-3-dimensional-computed-tomography-a-cadaveric-study
#19
Takaaki Saigo, Goro Tajima, Shuhei Kikuchi, Jun Yan, Moritaka Maruyama, Atsushi Sugawara, Minoru Doita
PURPOSE: To describe the insertions of the superficial medial collateral ligament (sMCL) and posterior oblique ligament (POL) and their related osseous landmarks. METHODS: Insertions of the sMCL and POL were identified and marked in 22 unpaired human cadaveric knees. The surface area, location, positional relations, and morphology of the sMCL and POL insertions and related osseous structures were analyzed on 3-dimensional images. RESULTS: The femoral insertion of the POL was located 18...
October 22, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27780285/biomechanical-comparison-of-five-posterior-cruciate-ligament-reconstruction-techniques
#20
Clayton W Nuelle, Jeffrey L Milles, Ferris M Pfeiffer, James P Stannard, Patrick A Smith, Mauricio Kfuri, James L Cook
No surgical technique recreates native posterior cruciate ligament (PCL) biomechanics. We compared the biomechanics of five different PCL reconstruction techniques versus the native PCL. Cadaveric knees (n = 20) were randomly assigned to one of five reconstruction techniques: Single bundle all-inside arthroscopic inlay, single bundle all-inside suspensory fixation, single bundle arthroscopic-assisted open onlay (SB-ONL), double bundle arthroscopic-assisted open inlay (DB-INL), and double bundle all-inside suspensory fixation (DB-SUSP)...
October 25, 2016: Journal of Knee Surgery
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