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ACL reconstruction and biomechanics

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https://www.readbyqxmd.com/read/28631112/risk-of-revision-was-not-reduced-by-a-double-bundle-acl-reconstruction-technique-results-from-the-scandinavian-registers
#1
Cathrine Aga, Jüri-Tomas Kartus, Martin Lind, Stein Håkon Låstad Lygre, Lars-Petter Granan, Lars Engebretsen
BACKGROUND: Double-bundle anterior cruciate ligament (ACL) reconstruction has demonstrated improved biomechanical properties and moderately better objective outcomes compared with single-bundle reconstructions. This could make an impact on the rerupture rate and reduce the risk of revisions in patients undergoing double-bundle ACL reconstruction compared with patients reconstructed with a traditional single-bundle technique. The National Knee Ligament Registers in Scandinavia provide information that can be used to evaluate the revision outcome after ACL reconstructions...
June 19, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28602934/biomechanical-factors-associated-with-pain-and-symptoms-following-anterior-cruciate-ligament-injury-and-reconstruction
#2
Aisia Azus, Hsiang-Ling Teng, Lauren Tufts, Daniel Wu, C Benjamin Ma, Richard B Souza, Xiaojuan Li
BACKGROUND: Few studies have investigated the associations between patient-reported outcome and gait in patients with anterior cruciate ligament (ACL) injury and reconstruction over time. Because there is an association between ACL rupture and the presence of osteoarthritis later in life, a better understanding of these relationships will help to elucidate how patients' gait pattern may affect pain and symptoms, potentially leading to better treatment for or preventing the development of knee OA...
June 8, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28577573/differences-in-placement-of-calcium-phosphate-hybridized-tendon-grafts-within-the-femoral-bone-tunnel-during-acl-reconstruction-do-not-influence-tendon-to-bone-healing
#3
Hirotaka Mutsuzaki, Hiromi Nakajima, Shunsuke Nomura, Masataka Sakane
BACKGROUND: Calcium phosphate (CaP)-hybridization of tendon grafts has been shown to improve tendon-to-bone healing. The purpose of this study was to clarify the influence of different tendon graft placement methods on tendon-to-bone healing using CaP-hybridized tendon grafts in anterior cruciate ligament (ACL) reconstructions in rabbits. METHODS: We compared two methods of tendon graft placement within the femoral bone tunnel: suspension of the tendon graft within the bone tunnel (suspension group) and implantation of the tendon graft coherent with the bone socket (coherence group)...
June 2, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28568474/the-biomechanical-effect-of-tunnel-placement-on-acl-graft-forces-in-double-bundle-acl-reconstruction-a-3d-computational-simulation
#4
Nathan H Varady, Willem A Kernkamp, Jingsheng Li, Lianxin Wang, Hiroshi Koga, Peter Asnis, Guoan Li
BACKGROUND: The posterolateral (PL) graft experiences a high failure rate in anterior cruciate ligament double-bundle (DB) reconstruction. It is hypothesized that tunnel positions could dramatically affect the graft forces. METHODS: A validated computational model was used to simulate DB reconstruction with various femoral PL tunnel locations (8-11 mm center-center tunnel spacing). Graft fixation was simulated at both 0° and 30°. Knee biomechanics were examined with the knee under a 134 N anterior load and 400 N quadriceps load at 0°, 30°, 60°, and 90° of flexion...
June 1, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/28567428/acl-roof-impingement-revisited-does-the-independent-femoral-drilling-technique-avoid-roof-impingement-with-anteriorly-placed-tibial-tunnels
#5
John A Tanksley, Brian C Werner, Evan J Conte, David P Lustenberger, M Tyrrell Burrus, Stephen F Brockmeier, F Winston Gwathmey, Mark D Miller
BACKGROUND: Anatomic femoral tunnel placement for single-bundle anterior cruciate ligament (ACL) reconstruction is now well accepted. The ideal location for the tibial tunnel has not been studied extensively, although some biomechanical and clinical studies suggest that placement of the tibial tunnel in the anterior part of the ACL tibial attachment site may be desirable. However, the concern for intercondylar roof impingement has tempered enthusiasm for anterior tibial tunnel placement...
May 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28559102/biomechanical-characteristics-of-the-anatomic-rectangular-tunnel-anterior-cruciate-ligament-reconstruction-with-a-bone-patellar-tendon-bone-graft
#6
Tatsuo Mae, Konsei Shino, Ryo Iuchi, Kazutaka Kinugasa, Ryohei Uchida, Shigeto Nakagawa, Hideki Yoshikawa, Ken Nakata
PURPOSE: To clarify 1) the force sharing between two portions of BTB graft in anatomic rectangular tunnel (ART) reconstruction and 2) the knee stability in ART technique under anterior tibial load. METHODS: Eleven fresh cadaveric knees were used. First, anterior-posterior (A-P) laxity was measured with Knee Laxity Tester(®) in response to 134 N of A-P tibial load at 20° on the normal knees. Then ART ACL reconstruction was performed with a BTB graft. For graft, the patellar bone plug and tendon portion was longitudinally cut into half as AM and PL portions...
May 27, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28549817/static-tensioning-promotes-hamstring-tendons-force-relaxation-more-reliably-than-cycling-tensioning
#7
Sérgio Rocha Piedade, Inácio Maria Dal Fabbro, Martha Maria Mischan, Cezar Piedade, Nicola Maffulli
BACKGROUND: Graft elongation might be a major reason for increased anterior laxity after anterior cruciate ligament (ACL) reconstruction. This study analyzed the force relaxation values and their stabilization when single strands of the gracilis and semitendinosus tendons underwent cyclic and static tensioning at 2.5% strain level, and compared the efficiency of static and cyclic tensioning in promoting force relaxation. METHODS: Eighteen gracilis tendons and 18 semitendinosus tendons from nine male cadavers (mean age: 22...
May 23, 2017: Knee
https://www.readbyqxmd.com/read/28536977/finite-element-simulations-of-different-hamstring-tendon-graft-lengths-and-related-fixations-in-anterior-cruciate-ligament-reconstruction
#8
Chao Wan, Zhixiu Hao, Zhichang Li, Jianhao Lin
As one of the most frequently used grafts in anterior cruciate ligament (ACL) reconstruction, hamstring tendon (HT) grafts are prepared with different lengths and fixed by specific fixations in knee joints. However, there are incomplete studies to investigate both the joint kinematics and graft biomechanics in the ACL reconstructions with different HT graft lengths. In this paper, three different graft lengths (i.e., 30, 50, and 70 mm) were developed in the ACL reconstruction and analyzed using finite element method under two usual clinical test loads (i...
May 23, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/28536855/rotational-laxity-control-by-the-anterolateral-ligament-and-the-lateral-meniscus-is-dependent-on-knee-flexion-angle-a-cadaveric-biomechanical-study
#9
Timothy Lording, Gillian Corbo, Dianne Bryant, Timothy A Burkhart, Alan Getgood
BACKGROUND: Injury to the anterolateral ligament (ALL) has been reported to contribute to high-grade anterolateral laxity after anterior cruciate ligament (ACL) injury. Failure to address ALL injury has been suggested as a cause of persistent rotational laxity after ACL reconstruction. Lateral meniscus posterior root (LMPR) tears have also been shown to cause increased internal rotation of the knee. QUESTIONS/PURPOSES: The purpose of this study was to determine the functional relationship between the ALL and LMPR in the control of internal rotation of the ACL-deficient knee...
May 23, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28535749/analysis-of-change-in-gait-in-the-ovine-stifle-normal-injured-and-anterior-cruciate-ligament-reconstructed
#10
B J Heard, J E Beveridge, M Atarod, E J O'Brien, C Rolian, C B Frank, D A Hart, N G Shrive
BACKGROUND: Many patients who undergo anterior cruciate ligament (ACL) reconstructive surgery develop post-traumatic osteoarthritis (PTOA). ACL reconstructive surgery may not fully restore pre-injury joint biomechanics, thereby resulting in further joint damage and contributing to the development of PTOA. In an ovine model of idealized ACL reconstruction (ACL-R), it has been shown that signs of PTOA develop within surgical joints by 20 weeks post-surgery. The aim of the present study was to investigate whether altered kinematics contribute to early PTOA development within ACL-R joints of the ovine injury model by comparing the gait of these surgical animals to the gait of a stable normal control group, and an unstable injury group in which the ACL and medial collateral ligament (MCL) had been transected...
May 23, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28530131/a-novel-combination-of-a-polycaprolactone-fumarate-pclf-scaffold-with-polyethylene-terephthalate-pet-sutures-for-intra-articular-ligament-regeneration
#11
Joshua Parry, Eric R Wagner, Peter Kok, Mahrokh Dadsetan, Michael J Yaszemski, Andre J van Wijnen, Sanjeev Kakar
Intra-articular ligamentous injuries are typically unrepairable and have limited outcomes after graft reconstruction. A combination of porous polycaprolactone fumarate (PCLF) scaffolds with polyethylene terephthalate (PET) sutures was developed with the goal of regenerating intra-articular ligaments. Scaffolds were fabricated by injecting PCLF over 3D-printed molds containing two strands of PET suture down its central pore followed by crosslinking. Scaffolds were seeded with human mesenchymal stem cells (MSCs) from adipose tissue...
May 20, 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/28522238/biomechanical-comparison-of-four-coupled-fixation-systems-for-acl-reconstruction-with-bone-socket-or-full-tunnel-on-the-tibial-side
#12
Edoardo Monaco, Mattia Fabbri, Riccardo Maria Lanzetti, Andrea Del Duca, Luca Labianca, Andrea Ferretti
BACKGROUND: To compare in an animal model the biomechanical properties of four coupled fixation devices currently used in ACL reconstruction. Three out of four devices used a full tibial tunnel with an interference screw, while the other one system used a tibial socket and an adjustable loop suspension device. The null hypothesis is that there are no biomechanical differences between all the techniques tested. METHODS: Thirty two femur-graft-tibia complexes were mounted on a tensile machine using bovine digital extensor tendons, porcine knees and four different fixation device combinations: After a preconditioning with a tensile load of 90N for five minutes, 1000cycles between 0 and 150N were applied to the complex before the final pulled to failure...
May 15, 2017: Knee
https://www.readbyqxmd.com/read/28502387/anterolateral-ligament-reconstruction-techniques-biomechanics-and-clinical-outcomes-a-systematic-review
#13
REVIEW
Nicholas N DePhillipo, Mark E Cinque, Jorge Chahla, Andrew G Geeslin, Robert F LaPrade
PURPOSE: To perform a systematic review of the described anterolateral ligament (ALL) reconstruction techniques, biomechanical performance, and clinical outcomes of ALL reconstruction in the setting of concurrent anterior cruciate ligament (ACL) reconstruction. METHODS: A systematic review was performed according to PRISMA guidelines using the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, PubMed, MEDLINE, and Embase, from 1980 to present...
May 11, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28461919/anterior-cruciate-ligament-reconstruction-principles-of-treatment
#14
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/28451617/return-to-sport-for-skeletally-immature-athletes-after-acl-reconstruction-preventing-a-second-injury-using-a-quality-of-movement-assessment-and-quantitative-measures-to-address-modifiable-risk-factors
#15
Jessica Graziano, Theresa Chiaia, Polly de Mille, Danyal H Nawabi, Daniel W Green, Frank A Cordasco
BACKGROUND: Reinjury rates after anterior cruciate ligament reconstruction (ACLR) are highest among young athletes, who consequently suffer from low rates of return to play. Historically, quantitative measures have been used to determine readiness to return to sport; however, they do not assess modifiable risk factors related to the quality of movement. PURPOSE: To determine the effectiveness of a criteria-based rehabilitation progression and return-to-sport criteria on efficient return to activity and prevention of second injury in young athletes post-ACLR...
April 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28426251/current-concepts-of-the-anterolateral-ligament-of-the-knee-anatomy-biomechanics-and-reconstruction
#16
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/28393268/the-scientific-rationale-for-lateral-tenodesis-augmentation-of-intra-articular-acl-reconstruction-using-a-modified-lemaire-procedure
#17
Andy Williams, Simon Ball, Jo Stephen, Nathan White, Mary Jones, Andrew Amis
PURPOSE: The purpose of this work was to develop the rationale for adding a lateral extra-articular tenodesis to an ACL reconstruction in a knee with an injury that included both the ACL and anterolateral structures, and to show the early clinical picture. METHODS: The paper includes a review of recent anatomical and biomechanical studies of the anterolateral aspect of the knee. It then provides a detailed description of a modified Lemaire tenodesis technique. A short-term clinical follow-up of a case and control group was performed, with two sequential groups of patients treated by isolated ACL reconstruction, and by combined ACL plus lateral tenodesis...
April 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28373946/anteromedial-portal-anterior-cruciate-ligament-reconstruction-with-tibialis-anterior-allograft
#18
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/28373940/tibial-tunnel-positioning-technique-using-bony-anatomical-landmarks-in-anatomical-anterior-cruciate-ligament-reconstruction
#19
Hiroki Shimodaira, Keiji Tensho, Yusuke Akaoka, Seiji Takanashi, Hiroyuki Kato, Naoto Saito
Because various biomechanical studies and clinical results have shown the effectiveness of an anatomical approach for anterior cruciate ligament (ACL) reconstruction, this approach has become gradually commonplace to improve postoperative performance. Standard tunnel positioning methods with accuracy, reproducibility, and adaptability to varied concepts are essential for the success of anatomical ACL reconstruction. However, there were no standard tibial tunnel positioning methods to satisfy these conditions...
February 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28370990/exploring-the-in-vitro-and-in-vivo-compatibility-of-pla-pla-gnp-and-pla-cnt-cooh-biodegradable-nanocomposites-prospects-for-tendon-and-ligament-applications
#20
Viviana Correia Pinto, Raquel Costa-Almeida, Ilda Rodrigues, Luísa Guardão, Raquel Soares, Rui Miranda Guedes
Anterior cruciate ligament (ACL) reconstructive surgeries are the most frequent orthopedic procedures in the knee. Currently, existing strategies fail in completely restoring tissue functionality and have a high failure rate associated, presenting a compelling argument towards the development of novel materials envisioning ACL reinforcement. Tendons and ligaments, in general, have a strong demand in terms of biomechanical features of developed constructs. We have previously developed polylactic acid (PLA)-based biodegradable films reinforced either with graphene nanoplatelets (PLA/GNP) or with carboxyl-functionalized carbon nanotubes (PLA/CNT-COOH)...
March 28, 2017: Journal of Biomedical Materials Research. Part A
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