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ACL Repair

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https://www.readbyqxmd.com/read/27909675/arthroscopic-primary-repair-of-proximal-anterior-cruciate-ligament-tears
#1
Gregory S DiFelice, Jelle P van der List
In a select group of patients with proximal anterior cruciate ligament (ACL) tears, primary repair can be a useful technique. Preservation of the native ACL may be advantageous for proprioceptive function and is thought to restore normal knee joint kinematics. The procedure is a less morbid and more conservative surgical approach to restore knee stability. Primary repair is preferably performed in the acute setting because of better healing capacity and tissue quality. We present the surgical technique of arthroscopic primary ACL repair with suture anchors in patients with proximal tears and excellent tissue quality...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27904518/testing-the-feasibility-and-safety-of-the-nintendo-wii-gaming-console-in-orthopedic-rehabilitation-a-pilot-randomized-controlled-study
#2
Andreas Ficklscherer, Jonas Stapf, Kay Michael Meissner, Thomas Niethammer, Matthias Lahner, Markus Wagenhäuser, Peter E Müller, Matthias F Pietschmann
INTRODUCTION: The Nintendo Wii game console is already used as an additional training device for e.g. neurological wards. Still there are limited data available regarding orthopedic rehabilitation. The authors' objective was to examine whether the Nintendo Wii is an appropriate and safe tool in rehabilitation after orthopedic knee surgery. MATERIAL AND METHODS: A prospective, randomized, controlled study comparing standard physiotherapy vs. standard physiotherapy plus game console training (Wii group) in patients having anterior cruciate ligament (ACL) repair or knee arthroplasty was conducted...
December 1, 2016: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/27900338/the-bridge-enhanced-anterior-cruciate-ligament-repair-bear-procedure-an-early-feasibility-cohort-study
#3
Martha M Murray, Brett M Flutie, Leslie A Kalish, Kirsten Ecklund, Braden C Fleming, Benedikt L Proffen, Lyle J Micheli
BACKGROUND: This study assessed the safety of the newly developed bridge-enhanced anterior cruciate ligament (ACL) repair (BEAR), which involves suture repair of the ligament combined with a bioactive scaffold to bridge the gap between the torn ligament ends. As the intra-articular environment is complex in its response to implanted materials, this study was designed to determine whether there would be a significant rate of adverse reaction to the implanted scaffold. HYPOTHESIS: The primary hypothesis was that the implanted scaffold would not result in a deep joint infection (arthrocentesis with positive culture) or significant inflammation (clinical symptoms justifying arthrocentesis but negative culture)...
November 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/27894146/variables-associated-with-chondral-and-meniscal-injuries-in-anterior-cruciate-ligament-surgery
#4
E Lyle Cain, Glenn S Fleisig, Brent A Ponce, Hikel A Boohaker, Martha P George, Gerald McGwin, James R Andrews, Lawrence J Lemak, William G Clancy, Jeffrey R Dugas
This article aims to evaluate factors associated with chondral and meniscal lesions in primary and revision anterior cruciate ligament (ACL) reconstructions. ACL reconstructions from 2001 to 2008 at a single institution were retrospectively analyzed. Logistic regression was used to estimate the association between chondral and meniscal injuries and age, gender, tear chronicity, additional ligamentous injuries, sport type, and participation level. Of the 3,040 ACL reconstructions analyzed, 90.4% were primary reconstructions and 9...
November 28, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27885394/sports-specific-differences-in-postsurgical-infections-after-arthroscopically-assisted-anterior-cruciate-ligament-reconstruction
#5
Werner Krutsch, Johannes Zellner, Florian Zeman, Michael Nerlich, Matthias Koch, Christian Pfeifer, Peter Angele
PURPOSE: Post-operative infection after arthroscopically assisted anterior cruciate ligament (ACL) reconstruction is a rare but severe complication, particularly for young and active patients. It is unclear whether the prevalence of knee infection is correlated with the type of sports or the level of performance. METHODS: From 2008 to 2012, the internal single-centre ACL registry of the FIFA Medical Centre of Excellence Regensburg was retrospectively screened for sex, age, time between isolated primary ACL rupture and surgery, surgical technique, rate of infection after ACL reconstruction and the type of sports practised...
November 24, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27879170/the-past-present-and-future-of-ligament-regenerative-engineering
#6
Paulos Y Mengsteab, Lakshmi S Nair, Cato T Laurencin
Regenerative engineering has been defined as the convergence of Advanced Materials Sciences, Stem Cell Sciences, Physics, Developmental Biology and Clinical Translation for the regeneration of complex tissues and organ systems. Anterior cruciate ligament (ACL) reconstruction necessitates the regeneration of bone, ligament and their interface to achieve superior clinical results. In the past, the ACL has been repaired with the use of autologous and allogeneic grafts, which have their respective drawbacks. Currently, investigations on the use of biodegradable matrices to achieve knee stability and permit tissue regeneration are making promising advancements...
December 2016: Regenerative Medicine
https://www.readbyqxmd.com/read/27846352/-risk-factors-and-frequency-in-re-ruptures-of-the-anterior-cruciate-ligament-in-adults
#7
M L Velázquez-Rueda, J P Martínez-Ávila, A G Pérez-Serna, F Gómez-García
BACKGROUND: The anterior cruciate ligament (ACL) takes part in the knees articular cinematic regulation, which is why its rupture should be repaired as soon as possible. The surgical treatment is targeted to substitute the ruptured ACL with a graft that recreates the anatomical and biomechanical functions. Nevertheless, there are different factors that may produce a second rupture. OBJECTIVE: To determine the risk factors and frequency of failure in the ACL reconstruction...
March 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/27843707/fresh-and-frozen-tissue-engineered-three-dimensional-bone-ligament-bone-constructs-for-sheep-anterior-cruciate-ligament-repair-following-a-2-year-implantation
#8
Vasudevan Mahalingam, Edward M Wojtys, Deneen M Wellik, Ellen M Arruda, Lisa M Larkin
Injuries to the anterior cruciate ligament (ACL) often require surgical reconstruction utilizing tendon grafts to restore knee function and stability. Some current graft options for ACL repair are associated with poor long-term outcomes. Our laboratory has fabricated tissue-engineered bone-ligament-bone (BLB) constructs that demonstrate native ligament regeneration and advancement toward native ACL mechanical properties in a sheep ACL reconstruction model. Prior work has shown that freezing BLBs as a method of preservation resulted in similar outcomes compared with fresh BLBs after 6-month implantation...
2016: BioResearch Open Access
https://www.readbyqxmd.com/read/27833408/postoperative-evaluation-after-anterior-cruciate-ligament-reconstruction-measurements-and-abnormalities-on-radiographic-and-ct-imaging
#9
Minchul Kim, Yun Sun Choi, Hyoungseop Kim, Nam-Hong Choi
Reconstruction of a ruptured anterior cruciate ligament (ACL) is a well-established procedure for repair of ACL injury. Despite improvement of surgical and rehabilitation techniques over the past decades, up to 25% of patients still fail to regain satisfactory function after an ACL reconstruction. With development of CT imaging techniques for reducing metal artifacts, multi-planar reconstruction, and three-dimensional reconstruction, early post-operative imaging is increasingly being used to provide immediate feedback to surgeons regarding tunnel positioning, fixation, and device placement...
November 2016: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
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
#10
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/27815015/arthroscopic-anterior-cruciate-ligament-repair-for-proximal-anterior-cruciate-ligament-tears-in-skeletally-immature-patients-surgical-technique-and-preliminary-results
#11
Marco Bigoni, Diego Gaddi, Massimo Gorla, Daniele Munegato, Marco Pungitore, Massimiliano Piatti, Marco Turati
BACKGROUND: Anterior cruciate ligament (ACL) tears in children are increasingly common and present difficult treatment decisions due to the risk of growth disturbance. Although open primary ACL repair was abandoned in the historical literature, recent studies have suggested that there is a role for arthroscopic primary repair in patients with proximal tears. METHODS: This is a retrospective review of five consecutive patients aged 9.2years (range 8 to 10) who underwent suture anchor ACL reinsertion...
November 2, 2016: Knee
https://www.readbyqxmd.com/read/27780286/preoperative-ultrasonographic-prediction-of-hamstring-tendon-diameter-for-anterior-cruciate-ligament-repair
#12
Luis Manuel Rodriguez-Mendez, Jose de Jesus Martinez-Ruiz, Ruben Perez-Manzo, Jorge Luis Corona-Hernandez, Juan Luis Alcala-Zermeno, Sergio Sanchez-Enriquez
The incidence of anterior cruciate ligament (ACL) injuries is rising every year. The autologous hamstring tendon graft, using semitendinosus tendon (SMT) and gracilis tendon (GR), is a common repair technique in the management of ACL injuries due to its multiple advantages. Using a final graft with a minimum diameter of 8 mm is necessary to avoid graft failure. The aim of this study was to find a correlation between preoperative ultrasound (USG) measurement of the SMT and GR tendon diameters (SMTd and GRd) and their actual diameters measured during the grafting procedure...
October 25, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27728954/anterior-cruciate-ligament-repair-with-internal-brace-ligament-augmentation
#13
William T Wilson, Graeme P Hopper, Paul A Byrne, Gordon M MacKay
BACKGROUND: Anterior cruciate ligament (ACL) reconstruction using tendon or ligament autograft is the gold standard surgical treatment for acute ruptures; however, this is still associated with subsequent problems and variable outcomes. Renewed interest in healing of injured ACL tissue has led to new surgical repair techniques. CASE DESCRIPTION: We report the case of one of the first patients to undergo this novel procedure of ACL repair with internal bracing. An internal brace is a bridging concept using braided suture tape and knotless bone anchors to reinforce ligament strength...
October 6, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27720666/primary-repair-of-the-anterior-cruciate-ligament-a-paradigm-shift
#14
Jelle P van der List, Gregory S DiFelice
Over the last century, many surgical treatments have been developed in the orthopedic field, including treatments of anterior cruciate ligament (ACL) injuries. These treatments ideally evolve in a process of trial and error with prospective comparison of new treatments to the current treatment standard. However, these evolutions are sometimes not linear and periodically undergo paradigm shifts. In this article, we review the evolution of ACL treatment and explain how it underwent a paradigm shift. Open primary ACL repair was the most common treatment in the 1970s and 1980s, but because multiple studies noted deterioration of outcomes at mid-term follow-up, in addition to several randomized clinical trials (RCTs) that noted better outcomes following ACL reconstruction, the open primary repair technique was abandoned...
October 6, 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27720193/peri-articular-local-infiltration-analgesia-versus-femoral-nerve-block-for-postoperative-pain-control-following-anterior-cruciate-ligament-reconstruction-prospective-comparative-non-inferiority-study
#15
N Lefevre, S Klouche, O de Pamphilis, S Herman, A Gerometta, Y Bohu
INTRODUCTION: Femoral nerve block (FNB) is considered as a major advance in anterior cruciate ligament (ACL) reconstruction as it reduces the need for parenteral opioids. However, the incidence of transient or even permanent neurological deficits due to the FNB is estimated at 1.94% after knee surgery. The primary objective of this study was to compare local infiltration analgesia (LIA) to FNB during ACL reconstruction procedures. The study hypothesis was that LIA was not less effective than FNB on early postoperative pain...
October 3, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27718092/white-tailed-deer-as-an-ex-vivo-knee-model-joint-morphometry-and-acl-rupture-strength
#16
Nicole L Zaino, Mark J Hedgeland, Mario J Ciani, Alexander Martin Clark, Laurel Kuxhaus, Arthur J Michalek
Animal joints are valuable proxies for those of humans in biomechanical studies, however commonly used quadruped knees differ greatly from human knees in scale and morphometry. To test the suitability of the cervine stifle joint (deer knee) as a laboratory model, gross morphometry, ACL cross section, and ACL rupture strength were measured and compared to values previously reported for the knees of humans and commonly studied animals. Twelve knee joints from wild white-tailed deer were tested. Several morphometry parameters, including bicondylar width (53...
October 7, 2016: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/27709056/primary-repair-of-tibial-sided-avulsion-of-the-anterior-cruciate-ligament
#17
Miten Rajendra Sheth, Sachin Ramchandra Tapasvi, Shantanu Sudhakar Patil
Lesions of the anterior cruciate ligament (ACL) are common; the current gold standard of treatment for such lesions is ACL reconstruction. Tibial-sided soft-tissue avulsion is a rare subtype of ACL injuries. Unlike femoral-sided ACL repair, surgery for acute tibial-sided ACL ruptures has been neither reported nor described. This technical note presents a method for primary anatomic ACL reinsertion for an acute distal soft-tissue avulsion-type ACL injury, using a transosseous pull-out repair technique. Our technique, as an alternative to reconstruction, has the potential to enhance healing due to marrow stimulation (tibial tunneling)...
August 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27692105/large-fracture-of-the-anteromedial-tibial-plateau-with-isolated-posterolateral-knee-corner-injury-case-series-of-an-often-missed-unusual-injury-pattern
#18
Jordi Tomás-Hernández, Joan Minguell Monyart, Jordi Teixidor Serra, Merce Reverté Vinaixa, Ernesto Guerra Farfan, Vicente Molero García, Enric Castellet Feliu
Tibial plateau fractures are a heterogeneous group of lesions with multiple fracture patterns. They are often associated with soft tissue injuries, the lateral meniscus and the anterior cruciate ligament (ACL) being the most common structures affected. The purpose of this article is to present a case series of an often missed unusual injury pattern that consists on the association of a large anteromedial tibial plateau fracture with a posterolateral (PL) knee corner injury without involvement of the cruciate ligaments...
September 2016: Injury
https://www.readbyqxmd.com/read/27687061/pain-after-out-patient-vs-in-patient-acl-reconstruction-french-prospective-study-of-1076-patients
#19
C Lutz, L Baverel, P Colombet, J Cournapeau, F Dalmay, N Lefevre, R Letartre, J-F Potel, X Roussignol, T Cucurulo, E Servien
BACKGROUND: Anterior cruciate ligament (ACL) repair is increasingly performed on an out-patient basis. In France, however, concern about post-operative pain remains a strong barrier to out-patient ACL repair. The primary objective of this study was to compare post-operative pain after ACL repair as out-patient versus in-patient surgery. The secondary objectives were to assess the time-course of post-operative pain and to identify factors associated with pain intensity. MATERIAL AND METHODS: A multicentre, prospective, comparative, non-randomised study was conducted in France for the French Society for Arthroscopy (SFA) symposium...
September 27, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27687060/complications-in-posteromedial-arthroscopic-suture-of-the-medial-meniscus
#20
N Jan, B Sonnery-Cottet, J-M Fayard, C Kajetanek, M Thaunat
INTRODUCTION: All-inside posteromedial suture for lesions of the posterior horn of the medial meniscus in anterior cruciate ligament (ACL) repair provides effective freshening and good healing. HYPOTHESIS: The posteromedial portal provides satisfactory healing rates without increasing morbidity or complications rates. MATERIAL AND METHODS: Intra- and postoperative complications were collected for a consecutive single-center series of 132 patients undergoing posteromedial hook suture of the medial meniscus in ACL repair...
September 26, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
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