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ACL reconstruction and biomechanics

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https://www.readbyqxmd.com/read/29318172/clinical-factors-that-predict-a-second-acl-injury-after-acl-reconstruction-and-return-to-sport-preliminary-development-of-a-clinical-decision-algorithm
#1
Mark V Paterno, Bin Huang, Staci Thomas, Timothy E Hewett, Laura C Schmitt
Background: Biomechanical predictors of a second anterior cruciate ligament (ACL) injury after ACL reconstruction (ACLR) and return to sport (RTS) have been identified; however, these measures may not be feasible in a standard clinical environment. Purpose/Hypothesis: The purpose of this study was to evaluate whether standard clinical measures predicted the risk of second ACL injuries. The hypothesis tested was that a combination of strength, function, and patient-reported measures at the time of RTS would predict the risk of second ACL injuries with high sensitivity and specificity...
December 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29304967/editorial-commentary-filling-the-void-in-translational-research-for-lateral-extra-articular-tenodesis-for-anterior-cruciate-ligament-reconstruction-are-we-saturated-with-biomechanical-studies
#2
EDITORIAL
Patrick A Smith
Anterior cruciate ligament (ACL) graft failure rates remain unacceptably high in certain populations, and researchers are examining the effect that the anterolateral ligament (ALL) has on knee stability following ACL reconstruction. Currently, most available research examining the ALL has focused on cadaveric biomechanical kinematic studies, including the effect of surgical techniques for ALL reconstruction/lateral extra-articular tenodesis (LET). However, it is critical for ongoing and future research to focus on clinical outcome measures relating to individuals who have had ALL reconstruction or LET along with their ACL reconstructions...
January 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29298079/effect-of-dynamic-changes-in-anterior-cruciate-ligament-in-situ-graft-force-on-the-biological-healing-response-of-the-graft-tunnel-interface
#3
Richard Ma, Michael Schär, Tina Chen, Marco Sisto, Joseph Nguyen, Clifford Voigt, Xiang-Hua Deng, Scott A Rodeo
BACKGROUND: Anterior cruciate ligament (ACL) grafts that are placed for reconstruction are subject to complex forces. Current "anatomic" ACL reconstruction techniques may result in greater in situ graft forces. The biological effect of changing magnitudes of ACL graft force on graft-tunnel osseointegration is not well understood. PURPOSE: The research objective is to determine how mechanical force on the ACL graft during knee motion affects tendon healing in the tunnel...
January 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29275984/independent-suture-tape-reinforcement-of-small-and-standard-diameter-grafts-for-anterior-cruciate-ligament-reconstruction-a-biomechanical-full-construct-model
#4
Samuel Bachmaier, Patrick A Smith, Jordan Bley, Coen A Wijdicks
PURPOSE: To compare the dynamic elongation, stiffness behavior, and ultimate failure load of standard with small diameter soft tissue grafts for anterior cruciate ligament (ACL) reconstruction with and without high-strength suture tape reinforcement. METHODS: Both a tripled "small" diameter and a "standard" quadrupled tendon graft with and without suture tape reinforcement were tested using suspensory fixation (n = 8 each group). The suture tape was passed through the suspensory fixation button on the femur and tibia to ensure independent (safety belt) fixation from the graft in vitro...
December 21, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29199191/an-animal-model-of-reconstruction-of-single-femoral-tunnel-with-single-bone-bi-quadruple-acl-and-internal-fixation
#5
T Gong, X-T Su, Q Xia, J-G Wang
We introduced several variables in an animal model of anterior cruciate ligament (ACL) reconstruction to determine the best parameters for surgery in humans. We divided 130 LYD pigs into two groups depending on whether the femoral tunnel goes through the medial tibial tunnel or through the medial fossa of the knee joint. Each subgroup was further divided. Four weeks after surgery the knee specimens were examined for passive flexion and extension test. No group showed a creep effect. In the biomechanical tests, we recorded maximal strength, maximum load, and stiffness parameters...
December 1, 2017: Journal of Musculoskeletal & Neuronal Interactions
https://www.readbyqxmd.com/read/29191469/role-of-anterolateral-reconstruction-in-patients-undergoing-anterior-cruciate-ligament-reconstruction
#6
REVIEW
C Lutz
There is renewed interest in anterolateral reconstruction (ALR) for patients undergoing anterior cruciate ligament (ACL) reconstruction. This is the result of isolated ACL reconstruction and double-bundle reconstruction providing inadequate control over the pivot shift, and recent anatomical and biomechanical studies on the anterolateral ligament (ALL) and its role in the knee's rotational stability.From a technical point of view, ALR can be performed either as a continuity of the intra-articular ACL reconstruction or an independent procedure...
November 27, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29185004/poor-knee-function-after-acl-reconstruction-is-associated-with-attenuated-landing-force-and-knee-flexion-moment-during-running
#7
Luke G Perraton, Michelle Hall, Ross A Clark, Kay M Crossley, Yong-Hao Pua, Tim S Whitehead, Hayden G Morris, Adam G Culvenor, Adam L Bryant
PURPOSE: Poor knee function after anterior cruciate ligament reconstruction (ACLR) may increase the risk of future knee symptoms and knee osteoarthritis via abnormal knee joint loading patterns, particularly during high-impact activity. This study aimed to assess the relationship between poor self-reported or clinically measured knee function and knee moments/vertical ground reaction force (vGRF) in individuals following ACLR. METHODS: 61 participants (mean 16.5 ± 3 months following ACLR, 23 women) completed a patient-reported knee function questionnaire and three hop tests (% of uninvolved limb)...
November 28, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29173560/extra-articular-tenodesis-in-combination-with-anterior-cruciate-ligament-reconstruction-an-overview
#8
REVIEW
Simone Cerciello, Cécile Batailler, Nader Darwich, Philippe Neyret
Anterior cruciate ligament (ACL) reconstruction is a successful procedure with high rates of return to sport. However, some patients experience persistent instability and graft failure. These adverse events have a significant impact, especially on high-level athletes. In an effort to improve outcomes for these patients, more attention is being paid to the anatomic structures at the anterolateral aspect of the knee. The anterolateral structures of the knee have been shown to play a major role in decreasing rotatory knee instability and forces across the ACL graft following reconstruction...
January 2018: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/29173559/anterolateral-ligament-reconstruction-or-extra-articular-tenodesis-why-and-when
#9
REVIEW
Manoj Mathew, Aad Dhollander, Alan Getgood
Residual rotational laxity following anterior cruciate ligament (ACL) reconstruction has been identified as significant concern in many patients, despite evolution of techniques. The expanding body of knowledge on the anatomy and biomechanics of the anterolateral soft tissue restraints in rotational control of the knee has reignited an interest in extra-articular reconstruction techniques for augmenting ACL reconstruction. Reconstruction techniques currently used can be broadly categorized as either lateral extra-articular tenodesis or reconstruction of the anterolateral ligament...
January 2018: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/29146161/intraoperative-workflow-for-all-inside-anterior-cruciate-ligament-reconstruction-an-in%C3%A2-vitro-biomechanical-evaluation-of-preconditioning-and-knot-tying
#10
Edoardo Monaco, Samuel Bachmaier, Mattia Fabbri, Riccardo Maria Lanzetti, Coen A Wijdicks, Andrea Ferretti
PURPOSE: To evaluate and compare the effect of preconditioning according to intraoperative workflow on the elongation behavior of single-side and fully knotted all-inside anterior cruciate ligament (ACL) reconstruction configurations in a biomechanical in vitro study. METHODS: Four full construct all-inside ACL reconstruction groups (n = 8 per group) were tested using porcine tibias and bovine tendons. Groups included both an all-inside configuration with one- (group 1) and both-side knotted adjustable loop-length devices (group 2), without and with performing intraoperative preconditioning (group 1-intraoperative preconditioned [IPC], group 2-IPC)...
November 13, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29078961/new-parameters-describing-how-knee-ligaments-carry-force-in-situ-predict-interspecimen-variations-in-laxity-during-simulated-clinical-exams
#11
Carl W Imhauser, Robert N Kent, James Boorman-Padgett, Ran Thein, Thomas L Wickiewicz, Andrew D Pearle
Knee laxity, defined as the net translation or rotation of the tibia relative to the femur in a given direction in response to an applied load, is highly variable from person to person. High levels of knee laxity as assessed during routine clinical exams are associated with first-time ligament injury and graft reinjury following reconstruction. During laxity exams, ligaments carry force to resist the applied load; however, relationships between intersubject variations in knee laxity and variations in how ligaments carry force as the knee moves through its passive envelope of motion, which we refer to as ligament engagement, are not well established...
October 7, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/29067474/restoring-tibiofemoral-alignment-during-acl-reconstruction-results-in-better-knee-biomechanics
#12
Frantzeska Zampeli, Ioannis Terzidis, João Espregueira-Mendes, Jim-Dimitris Georgoulis, Manfred Bernard, Evangelos Pappas, Anastasios D Georgoulis
PURPOSE: Anterior cruciate ligament (ACL) reconstruction (ACLR) aims to restore normal knee joint function, stability and biomechanics and in the long term avoid joint degeneration. The purpose of this study is to present the anatomic single bundle (SB) ACLR that emphasizes intraoperative correction of tibiofemoral subluxation that occurs after ACL injury. It was hypothesized that this technique leads to optimal outcomes and better restoration of pathological tibiofemoral joint movement that results from ACL deficiency (ACLD)...
October 24, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29064870/biomechanical-evaluation-of-pediatric-anterior-cruciate-ligament-acl-reconstruction-techniques-with-and-without-the-anterolateral-ligament-all
#13
Natasha Trentacosta, James L Pace, Melodie Metzger, Max Michalski, Trevor Nelson, Landon Polakof, Bert Mandelbaum
BACKGROUND: Two popular physeal-sparing procedures used in the management of anterior cruciate ligament (ACL) injuries in skeletally immature patients are the iliotibial band (ITB) ACL reconstruction (ACLR) and the all-epiphyseal (AE) ACLR. Although there has been concern for overconstraint of the lateral compartment of the knee with the ITB ACLR technique, rotational stability, as provided by the anterolateral ligament (ALL) and ACL, has not been assessed in the setting of pediatric ACLR techniques...
October 23, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29018544/verbal-augmented-feedback-in-the-rehabilitation-of-lower-extremity-musculoskeletal-dysfunctions-a-systematic-review
#14
REVIEW
Marianne Storberget, Linn Helen J Grødahl, Suzanne Snodgrass, Paulette van Vliet, Nicola Heneghan
BACKGROUND: Verbal augmented feedback (VAF) is commonly used in physiotherapy rehabilitation of individuals with lower extremity musculoskeletal dysfunction or to induce motor learning for injury prevention. Its effectiveness for acquisition, retention and transfer of learning of new skills in this population is unknown. OBJECTIVES: First, to investigate the effect of VAF for rehabilitation and prevention of lower extremity musculoskeletal dysfunction. Second, to determine its effect on motor learning and the stages of acquisition, retention and transfer in this population...
2017: BMJ Open Sport & Exercise Medicine
https://www.readbyqxmd.com/read/28985125/progressive-changes-in-walking-kinematics-and-kinetics-after-anterior-cruciate-ligament-injury-and-reconstruction-a-review-and-meta-analysis
#15
Lindsay V Slater, Joseph M Hart, Adam R Kelly, Christopher M Kuenze
CONTEXT:   Anterior cruciate ligament (ACL) injury and ACL reconstruction (ACLR) result in persistent alterations in lower extremity movement patterns. The progression of lower extremity biomechanics from the time of injury has not been described. OBJECTIVE:   To compare the 3-dimensional (3D) lower extremity kinematics and kinetics of walking among individuals with ACL deficiency (ACLD), individuals with ACLR, and healthy control participants from 3 to 64 months after ACLR...
September 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28972789/a-prospective-evaluation-of-femoral-tunnel-placement-for-anatomic-anterior-cruciate-ligament-reconstruction-using-3-dimensional-magnetic-resonance-imaging
#16
Adam Hart, Thiru Sivakumaran, Mark Burman, Tom Powell, Paul A Martineau
BACKGROUND: The recent emphasis on anatomic reconstruction of the anterior cruciate ligament (ACL) is well supported by clinical and biomechanical research. Unfortunately, the location of the native femoral footprint can be difficult to see at the time of surgery, and the accuracy of current techniques to perform anatomic reconstruction is unclear. PURPOSE: To use 3-dimensional magnetic resonance imaging (3D MRI) to prospectively evaluate patients with torn ACLs before and after reconstruction and thereby assess the accuracy of graft position on the femoral condyle...
January 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28967542/current-evidence-of-adult-stem-cells-to-enhance-anterior-cruciate-ligament-treatment-a-systematic-review-of-animal-trials
#17
REVIEW
Ruipeng Guo, Liang Gao, Bin Xu
PURPOSE: To systematically review the available preclinical evidence of adult stem cells as a biological augmentation in the treatment of animal anterior cruciate ligament (ACL) injury. STUDY DESIGN: Systematic review. METHODS: PubMed (MEDLINE) and Embase were searched for the eligible studies. The inclusion criteria were controlled animal trials of adult stem cells used in ACL treatment (repair or reconstruction). Studies of natural ACL healing without intervention, in vitro studies, ex vivo studies, and studies without controls were excluded...
September 26, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28932303/the-influence-of-anterior-cruciate-ligament-remnant-on-postoperative-clinical-results-in-patients-with-remnant-preserving-anterior-cruciate-ligament-reconstruction
#18
Alan Andonovski, Sonja Topuzovska, Milan Samardziski, Zoran Bozinovski, Biljana Andonovska, Zlatko Temelkovski
BACKGROUND: Anterior Cruciate Ligament (ACL) remnants have important biomechanical, vascular and proprioceptive function. AIM: To determine the influence of the ACL residual remnants after partial and complete ACL ruptures on postoperative clinical results in patients with remnant preserving ACL reconstruction. PATIENTS AND METHODS: The study included 66 patients divided into two groups. In patients from the investigation group remnant preserving ACL reconstruction was performed, in patients from the control group single bundle ACL reconstruction was performed...
August 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28913685/-ramp-lesions-tips-and-tricks-in-diagnostics-and-therapy
#19
REVIEW
R Seil, A Hoffmann, S Scheffler, D Theisen, C Mouton, D Pape
There is an increasing biomechanical and anatomical understanding of the different types of meniscal lesions. Lesions of the posterior part of the medial meniscus in the meniscosynovial area have recently received increased attention. They generally occur in association with anterior cruciate ligament (ACL) injuries. They are often missed ("hidden lesions") due to the fact that they cannot be seen by routine anterior arthroscopic inspection. Furthermore, meniscosynovial lesions play a role in anteroposterior knee laxity and, as such, they may be a cause of failure of ACL reconstruction or of postoperative persistent laxity...
October 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28898105/gait-characteristics-associated-with-a-greater-increase-in-medial-knee-cartilage-t1%C3%AF-and-t2-relaxation-times-in-patients-undergoing-anterior-cruciate-ligament-reconstruction
#20
Hsiang-Ling Teng, Daniel Wu, Favian Su, Valentina Pedoia, Richard B Souza, C Benjamin Ma, Xiaojuan Li
BACKGROUND: Osteoarthritis of the medial tibiofemoral joint (MTFJ) is prevalent among patients undergoing anterior cruciate ligament reconstruction (ACLR). Magnetic resonance T1ρ and T2 relaxation times provide noninvasive methods to quantify early cartilage degeneration. Altered sagittal-plane gait biomechanics have been observed after ACLR, but their associations with longitudinal changes in MTFJ cartilage T1ρ and T2 remain unclear. Hypothesis/Purpose: To examine whether the peak knee flexion moment (KFM), knee flexion angle (KFA), and vertical ground-reaction force (vGRF) during gait are associated with prospective changes in medial tibiofemoral cartilage T1ρ and T2 in ACL-reconstructed knees and to compare these gait characteristics between patients undergoing ACLR and healthy control participants...
September 1, 2017: American Journal of Sports Medicine
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