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https://www.readbyqxmd.com/read/29354469/arthroscopic-primary-anterior-cruciate-ligament-repair-with-suture-augmentation
#1
Jelle P van der List, Gregory S DiFelice
Historically, poor results of open primary repair of anterior cruciate ligament (ACL) injuries have been reported. In hindsight, however, appropriate patient selection (i.e. proximal tears and good tissue quality) was not performed, because it has recently been recognized that good outcomes of primary ACL repair are possible when selectively performed in patients with proximal tears and good tissue quality. Moreover, with modern-day advances, arthroscopic primary repair can be an excellent treatment option for patients with proximal tears...
October 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29354466/intra-articular-anterior-cruciate-ligament-reconstruction-with-extra-articular-lateral-tenodesis-of-the-iliotibial-band
#2
João Luiz Ellera Gomes, Murilo Anderson Leie, Marcos Marczwski, George Sánchez, Márcio Balbinotti Ferrari
An increasing concern has been given to the rotation stability of the knee in the setting of an anterior cruciate ligament (ACL) reconstruction. This growing interest stems from a better understanding of the rotational stability of the knee afforded by the identification of the anterolateral ligament. Previously, a residual abnormal pivot-shift test had been found after an anatomic single-band reconstruction of the ACL because of a lack of rotational stability, which may lead to the development of osteoarthritis...
October 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29354434/acl-reconstruction-basics-quadruple-4-strand-hamstring-autograft-harvest
#3
Rachel M Frank, Jason T Hamamoto, Eamon Bernardoni, Gregory Cvetanovich, Bernard R Bach, Nikhil N Verma, Charles A Bush-Joseph
Hamstring tendon autograft remains a popular graft choice for anterior cruciate ligament (ACL) reconstruction. Although there are a variety of autograft and allograft options available for ACL reconstruction, advantages of hamstring tendon autografts include decreased postoperative knee pain and an overall easier surgical recovery compared with bone patellar tendon bone autograft. In addition, 4-stranded (quadruple) hamstring grafts are among the strongest grafts biomechanically (at time equals zero). Although the technique of hamstring autograft harvest is relatively straightforward, it is critical to pay attention to several technical steps to avoid iatrogenic neurovascular damage as well as to avoid premature amputation of the graft while using a tendon stripper...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29354433/stump-incorporation-for-anterior-cruciate-ligament-reconstruction-a-step-towards-a-more-anatomical-reconstruction
#4
Walid Reda, Ahmed Khedr
In most anterior cruciate ligament (ACL) tears, the tear is at the femoral side leaving a robust stump attached to the tibia. Stump-preserving ACL reconstruction carries the advantage of rapid reinnervation and revascularization of the graft. In this technique, the femoral tunnel is created after exposing the femoral footprint. The ACL tibial stump is split and the tip of the ACL tibial guide is introduced through this split to reach the center of the tibial footprint. The tibial tunnel is then created and the ACL stump is bored to allow the passage of the graft...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29354432/two-stage-revision-anterior-cruciate-ligament-reconstruction-using-allograft-bone-dowels
#5
Kadir Buyukdogan, Michael S Laidlaw, Mark D Miller
Revision anterior cruciate ligament (ACL) reconstruction is substantially more challenging than primary reconstruction. Management of previously malpositioned or widened tunnels often requires innovative approaches for managing bony defects. Massive osteolysis with poor bone stock and convergence or overlapping of revision tunnels into the previously placed tunnels may necessitate a staged revision procedure. In this surgical technique description, we describe a method for the management of bony deficiencies using allograft bone dowels in staged revision ACL reconstruction...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29354431/anterior-cruciate-ligament-tunnel-placement-using-the-pathfinder-guide
#6
Karan A Patel, Anikar Chhabra, Justin L Makovicka, Joshua Bingham, Dana P Piasecki, David E Hartigan
Reconstruction techniques for the anterior cruciate ligament (ACL) have evolved considerably over the past 3 decades. The femoral tunnel is most commonly made via a transtibial or separate anteromedial portal approach. Benefits and drawbacks for each of these techniques exist. Improper tunnel placement is the cause of failure for ACL reconstruction 70% of the time. We present a hybrid technique for femoral tunnel placement using the Pathfinder ACL guide, which attempts to give the surgeon many of the benefits of both the transtibial and anteromedial portal techniques without the drawbacks...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29354428/tibial-eminence-fracture-repair-with-double-hewson-suture-passer-technique
#7
Steven F DeFroda, Jonathan D Hodax, Kalpit N Shah, Aristides I Cruz
Displaced tibial eminence fractures are commonly encountered in pediatric patients and are often considered to be functionally equivalent to an anterior cruciate ligament (ACL) rupture. While a variety of techniques are available for fixation of this injury, we describe an anchorless technique relying on suture fixation tied over a bone bridge. This technique also relies on two intra-articular Hewson suture passers to quickly and effectively pass and shuttle sutures through the ACL and tibial bone tunnels in order to reduce and fix the fracture fragment...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29354425/autogenous-hamstring-bone-graft-preparation-for-anterior-cruciate-ligament-reconstruction
#8
Assem Mohamed Noureldin Zein, Mohamed Ali, Alaa Zenhom Mahmoud, Khaled Omran
Despite the popularity of anterior cruciate ligament (ACL) reconstruction procedures, the ideal graft for reconstruction remains a matter of controversy. The ideal graft for ACL reconstruction should have histologic and biomechanical characteristics similar to those of the native ACL; should be quickly and fully incorporated within the bony tunnels; should maintain its viscoelastic properties for a long time; should have minimal donor-site morbidity; should be of sufficient length and diameter; should have minimal adverse effects on the extensor mechanism; should have no risk of rejection or disease transmission; and should be cost-effective and readily available...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29354422/combined-anatomic-anterior-cruciate-ligament-and-double-bundle-anterolateral-ligament-reconstruction
#9
Assem Mohamed Noureldin Zein, Mohamed Elshafie, Ahmed Nady Saleh Elsaid, Mohamed Ahmed Elsaid Elrefai
The results of arthroscopic anterior cruciate ligament (ACL) reconstruction are so far satisfactory and improving over time as a result of the improved understanding of the anatomy and biomechanics of the ACL. Rotational instability confirmed by a positive pivot shift is present in more than 15% of cases who underwent successful ACL reconstruction. Persistent rotational instability interferes with performing pivoting sports, and also may lead to meniscal and chondral injuries, or re-rupture of the reconstructed ACL...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29354414/a-femoral-tunnel-view-test-during-acl-reconstruction
#10
Eduardo Frois Temponi, João Newton Penido Oliveira, Luiz Fernando Machado Soares, Lúcio Honório de Carvalho Júnior
Despite technologic advances in the surgical techniques for anterior cruciate ligament (ACL) reconstruction, some patients continue to have violation of the femoral cortex, commonly referred to as wall blowout. These posterior or lateral cortical breaches lead to loss of graft containment and subsequent difficulty with graft fixation. If this intraoperative error is not promptly recognized and treated, the graft is at an increased risk of premature failure. Thus, in these situations, recognizing the complication and knowing strategies for alternative or salvage fixation are of importance...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29354412/arthroscopic-anatomic-single-bundle-anterior-cruciate-ligament-reconstruction-using-bone-patellar-tendon-bone-autograft-pearls-for-an-accurate-reconstruction
#11
Jorge Chahla, Gilbert Moatshe, Mark E Cinque, Jonathan Godin, Sandeep Mannava, Robert F LaPrade
An anterior cruciate ligament (ACL) tear is one of the most common orthopaedic injuries. Optimal results are not always achieved after surgical reconstruction after a surgical technical error, namely, tunnel malposition. Understanding of the anatomy is vital, and several anatomic landmarks can be used to aid in an optimal reconstruction technique. The purpose of this Technical Note is to describe our preferred technique for an arthroscopic single-bundle anteromedial ACL reconstruction, using a bone-patellar tendon-bone autograft fixed with interference screws...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29353004/leishmania-tropica-isolates-from-non-healed-and-healed-patients-in-iran-a-molecular-typing-and-phylogenetic-analysis
#12
Mehdi Bamorovat, Iraj Sharifi, Mohammad Ali Mohammadi, Sana Eybpoosh, Saeid Nasibi, Mohammad Reza Aflatoonian, Ahmad Khosravi
The precise identification of the parasite species causing leishmaniasis is essential for selecting proper treatment modality. The present study aims to compare the nucleotide variations of the ITS1, 7SL RNA, and Hsp70 sequences between non-healed and healed anthroponotic cutaneous leishmaniasis (ACL) patients in major foci in Iran. A case-control study was carried out from September 2015 to October 2016 in the cities of Kerman and Bam, in the southeast of Iran. Randomly selected skin-scraping lesions of 40 patients (20 non-healed and 20 healed) were examined and the organisms were grown in a culture medium...
January 15, 2018: Microbial Pathogenesis
https://www.readbyqxmd.com/read/29350551/hip-and-knee-kinematics-and-kinetics-during-landing-tasks-after-anterior-cruciate-ligament-reconstruction-a-systematic-review-and-meta-analysis
#13
Adam S Lepley, Christopher M Kuenze
OBJECTIVE:   To evaluate the current evidence concerning kinematic and kinetic strategies adopted during dynamic landing tasks by patients with anterior cruciate ligament reconstruction (ACLR). DATA SOURCES:   PubMed, Web of Science. STUDY SELECTION:   Original research articles that evaluated kinematics or kinetics (or both) during a landing task in those with a history of ACLR were included. DATA EXTRACTION:   Methodologic quality was assessed using the modified Downs and Black checklist...
January 19, 2018: Journal of Athletic Training
https://www.readbyqxmd.com/read/29350081/assessment-of-the-anterolateral-ligament-of-the-knee-by-1-5-t-magnetic-resonance-imaging
#14
Volkan Kızılgöz, Ali Kemal Sivrioğlu, Hasan Aydın, Türkhun Çetin, Gökhan Ragıp Ulusoy
Objective This study was performed to evaluate the visibility of the knee's anterolateral ligament (ALL) by magnetic resonance (MR) imaging when evaluating injuries of the ALL in relation to injuries of the anterior cruciate ligament (ACL). Methods Two reviewers retrospectively analyzed MR images for the visibility and dimensions of the ALL and the relationship between ALL and ACL injuries. The intraclass correlation coefficient (ICC) and kappa analysis were used to assess interobserver reliability. The chi-square test was used to assess the relationship between ALL and ACL injuries...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29346717/anterior-cruciate-ligament-tear-induces-a-sustained-loss-of-muscle-fiber-force-production
#15
Jonathan P Gumucio, Kristoffer B Sugg, Elizabeth R Sibilsky Enselman, Alexis C Konja, Logan R Eckhardt, Asheesh Bedi, Christopher L Mendias
INTRODUCTION: Patients with anterior cruciate ligament (ACL) tears have persistent quadriceps strength deficits that are thought to be due to altered neurophysiological function. Our goal was to determine the changes in muscle fiber contractility independent of the ability of motor neurons to activate fibers. METHODS: We obtained quadriceps biopsies of patients undergoing ACL reconstruction, and additional biopsies one, two, and six months after surgery. Muscles fiber contractility was assessed in vitro, along with whole muscle strength testing...
January 18, 2018: Muscle & Nerve
https://www.readbyqxmd.com/read/29346631/anticardiolipin-antibodies-and-12-month-graft-function-in-kidney-transplant-recipients-a-prognosis-cohort-survey
#16
Marion Gauthier, Florence Canoui-Poitrine, Esther Guéry, Dominique Desvaux, Sophie Hue, Guillaume Canaud, Thomas Stehle, Philippe Lang, Tomek Kofman, Philippe Grimbert, Marie Matignon
Background: In kidney transplant recipients, anticardiolipin (ACL) antibodies without antiphospholipid syndrome (APS) are found in up to 38% of patients and could be associated with thrombotic events (TEs). However, the prognostic role of ACL regarding kidney transplant and patients outcomes have still not been well defined. Methods: We conducted an observational, monocentric, retrospective cohort study including 446 kidney transplant recipients and standardized follow-up: 36-month allograft and patient survival, 12-month estimated glomerular filtration rate (eGFR) and 3- and 12-month screening biopsies...
January 16, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29342292/clinical-utility-of-the-global-anti-phospholipid-syndrome-score-for-risk-stratification-a-pooled-analysis
#17
Savino Sciascia, Massimo Radin, Giovanni Sanna, Irene Cecchi, Dario Roccatello, Maria Laura Bertolaccini
Objective: Recently, our group conceived a risk score for clinical manifestations of APS (the global APS score, or GAPSS) that takes into account the combination of independent cardiovascular risk factors and the aPL positivity profile. These include hyperlipidaemia, arterial hypertension, aCL, anti-β2 glycoprotein-I, aPS-PT and the LA. A complementary version, the adjusted GAPSS (aGAPSS), which excludes aPS-PT, was also designed. The aim of our study was to systematically review the literature to assess the clinical utility of the GAPSS and aGAPSS for risk stratification of any APS clinical manifestation...
January 12, 2018: Rheumatology
https://www.readbyqxmd.com/read/29340745/a-6-week-warm-up-injury-prevention-programme-results-in-minimal-biomechanical-changes-during-jump-landings-a-randomized-controlled-trial
#18
Jeffrey B Taylor, Kevin R Ford, Randy J Schmitz, Scott E Ross, Terry A Ackerman, Sandra J Shultz
PURPOSE: To examine the extent to which an ACL injury prevention programme modifies lower extremity biomechanics during single- and double-leg landing tasks in both the sagittal and frontal plane. It was hypothesized that the training programme would elicit improvements in lower extremity biomechanics, but that these improvements would be greater during a double-leg sagittal plane landing task than tasks performed on a single leg or in the frontal plane. METHODS: Ninety-seven competitive multi-directional sport athletes that competed at the middle- or high-school level were cluster randomized into intervention (n = 48, age = 15...
January 16, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29338824/effects-of-preoperative-isokinetic-eccentric-training-and-whey-protein-isolate-supplement-on-quadriceps-strength-and-knee-function-in-patients-with-anterior-cruciate-ligament-rupture
#19
Xiao Yuan Zhang, Hong Shi Huang, Jie Yang, Yuan Yuan Yu, Dong Xia Zhang, Cui Qing Chang
Objective To explore the effect of preoperative isokinetic eccentric training with or not whey protein isolate supplement before operation on lower limb muscle strength and knee function in patients with anterior cruciate ligament (ACL) rupture. Methods A total of 22 male volunteers aged 18-40 years with ACL rupture were recruited in outpatient service. With randomized block design,subjects were randomly assigned to isokinetic eccentric training (IE) group and isokinetic eccentric training with whey protein isolate supplement (IE+WPI) group...
December 20, 2017: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/29337596/the-influence-of-graft-fixation-methods-on-revision-rates-after-primary-anterior-cruciate-ligament-reconstruction
#20
Niclas H Eysturoy, Kåre Amtoft Nissen, Torsten Nielsen, Martin Lind
BACKGROUND: The method of graft fixation in primary anterior cruciate ligament (ACL) reconstruction is important for initial stability of the graft. Poor graft fixation can result in failure of the reconstruction. The effect of ACL graft fixation principles and fixation implant combinations on the risk of revision after ACL reconstruction is not well understood. PURPOSE: The study aimed to compare the risk of revision among 4 categories of femoral fixation divided by their principle of function using a hamstring tendon (HT) graft only...
January 1, 2018: American Journal of Sports Medicine
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