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ACL tear

Joseph T Gamboa, Edward C Shin, Neil P Pathare, Patrick J McGahan, James L Chen
Anterior cruciate ligament (ACL) tears are an unfortunate and devastating injury in the athletic patient. Surgical reconstruction of the ACL with a taut graft construct is necessary to restore knee stability and help expedite the patient's return to an active lifestyle. Arthroscopy-assisted ACL reconstruction can be a technically involved procedure, where strong fixation limits graft motion to allow sufficient healing within the tibial and femoral tunnels at the bone-tendon interfaces. Loss of tension in a graft can cause symptomatic anterior or rotatory instability and potential retear of the ACL graft...
February 2018: Arthroscopy Techniques
Sachin Ramchandra Tapasvi, Anshu Shekhar, Shantanu Sudhakar Patil
Anterior cruciate ligament (ACL) tears are usually managed by reconstruction with autograft or allograft, but primary repair in carefully selected patients is a reasonable option. Proximal avulsions presenting early with excellent tissue quality are amenable to repair and healing. Restoration of native ACL preserves its proprioceptive and kinematic functions. A repair is less invasive and avoids graft-related problems, and faster rehabilitation is possible. Protection for the repair in the early stages will allow better healing...
February 2018: Arthroscopy Techniques
Jia-Ping Pan, Xu-Can Wang, Ming-Hong Huang
OBJECTIVE: To investigate the characteristics and clinical treatment of avulsion fracture of the lateral edge of tibial plateau(segond fracture) in knee joint injuries. METHODS: From January 2011 and December 2015, 29 patients with Segond fracture were treated with minimally invasive arthroscopy technology in intra-articular injuries combined with double anchor nail fixation in avulsion fracture of the lateral edge of tibial plateau, including 17 males and 12 females with an average age of 41 years old ranging from 27 to 62 years old...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Andres Kroker, Jennifer L Bhatla, Carolyn A Emery, Sarah L Manske, Steven K Boyd
Anterior cruciate ligament (ACL) tears are a common sports-related knee injury that increases the risk of developing post-traumatic osteoarthritis (OA). During OA progression bone microarchitecture changes in the affected knee, however, little is known about bone microarchitecture in knees with early stage OA. The purpose of this study is to investigate in a cohort of females predisposed to develop OA how bone microarchitecture in ACL reconstructed knees differs from uninjured contralateral knees as well as healthy control knees and how this relates to early changes in OA...
March 8, 2018: Bone
Bin Xu, Hanyuan Zhang, Bo Li, Weichao Wang
To compare the direct and indirect signs on magnetic resonance imaging (MRI) for patients with acute and chronic anterior cruciate ligament (ACL) tears.Two independent reviewers retrospectively evaluated the MRI images of 377 patients with ACL tear confirmed by arthroscopy. There were 160 cases with acute ACL tear and 217 cases with chronic ACL tear. Direct signs in T1- and T2-wighted images and indirect signs including meniscus injury, the collateral ligament injury, cartilage damage or osteoarthritis, kissing contusion, Notch syndrome and abnormal posterior cruciate ligament (PCL) and other indirect signs were evaluated...
March 2018: Medicine (Baltimore)
Robert E Boykin
Patients with radiographic evidence of femoroacetabular impingement and decreased hip internal rotation have a higher rate of anterior cruciate ligament (ACL) tears. Limited internal rotation of the hip increases strain and potentially resultant fatigue failure of the ACL. Although causation has not been proven, a better understanding of the lower extremity kinetic chain may allow improved ACL prevention strategies through measures (operative or nonoperative) to improve rotation of the hip.
March 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Hervé Ouanezar, William G Blakeney, Charles Latrobe, Adnan Saithna, Levi Reina Fernandes, Jean Romain Delaloye, Mathieu Thaunat, Bertrand Sonnery-Cottet
PURPOSE: Repairs of the posterior horn of the lateral meniscus can be technically challenging. In contrast to medial meniscus repairs, the capsule around the posterior segment attachment of the lateral meniscus is quite thin. This study evaluates the clinical results of an arthroscopic all-inside repair technique for unstable, vertical, lateral meniscus tears, using a suture repair placed directly into the popliteus tendon. METHODS: A retrospective analysis of prospectively collected data from the SANTI database was performed...
March 3, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Mark Phillips, Erik Rönnblad, Love Lopez-Rengstig, Eleonor Svantesson, Anders Stålman, Kalle Eriksson, Olufemi R Ayeni, Kristian Samuelsson
PURPOSE: To compare Knee Injury and Osteoarthritis Outcome Score (KOOS) and EuroQol-5D (EQ-5D) subscale scores at 2-year follow-up for patients with primary isolated ACL reconstruction with patients undergoing ACL reconstruction and simultaneous meniscal treatment in terms of either resection or repair in the Swedish National Knee Ligament Register (SNKLR). METHODS: All ACL reconstruction patients within the SNKLR at 2-year follow-up were reviewed. The KOOS and EQ-5D subscales were assessed in four distinct patient groups: isolated ACL reconstruction, ACL reconstruction + medial meniscus resection, ACL reconstruction + lateral meniscus resection, ACL reconstruction + medial meniscus repair, and ACL reconstruction + lateral meniscus repair...
February 28, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Kyoung Ho Yoon, Jung Suk Kim, Soo Yeon Park, Sang Eon Park
PURPOSE: To determine the prevalence of Segond fractures using computed tomography (CT) and to investigate the effects of Segond fractures on the outcomes of primary anterior cruciate ligament (ACL) reconstruction for isolated ACL injuries. METHODS: Between January 2010 and July 2015, we retrospectively evaluated 383 patients who underwent primary ACL reconstruction, who underwent CT scans immediately after surgery, and who were available at 2 years of follow-up...
February 24, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Julio Brandao Guimaraes, Luca Facchetti, Benedikt J Schwaiger, Alexandra S Gersing, Xiaojuan Li, Thomas M Link
OBJECTIVES: To assess (i) normal imaging anatomy of the popliteomeniscal fascicles, (ii) prevalence and natural evolution of popliteomeniscal fascicle tears (PMFT) in subjects with traumatic anterior cruciate ligament (ACL) tears over 2 years and (iii) compare knee cartilage degeneration in subjects with and without PMFT longitudinally. METHODS: 57 subjects with ACL tears were screened for PMFT. Morphological (high-resolution 3D fast spin-echo) and compositional (T1ρ and T2 mapping) MR imaging was performed prior to and 2 years after ACL reconstruction...
February 23, 2018: European Radiology
Mark E Cinque, Jorge Chahla, Justin J Mitchell, Gilbert Moatshe, Jonas Pogorzelski, Colin P Murphy, Nicholas I Kennedy, Jonathan A Godin, Robert F LaPrade
Background: Meniscal and chondral lesions are commonly associated with anterior cruciate ligament (ACL) tears, and these lesions may play a role in patient outcomes after ACL reconstruction. Purpose: To determine the effects of the presence and location of meniscal and chondral lesions at the time of ACL reconstruction on patient-reported outcomes at a minimum 2-year follow-up. Study Design: Cohort study; Level of evidence, 3. Methods: Patients with no prior knee surgery who underwent primary ACL reconstruction by a single surgeon between 2010 and 2014 were included in this study...
February 2018: Orthopaedic Journal of Sports Medicine
Jeffrey T Johnston, Bert R Mandelbaum, David Schub, Scott A Rodeo, Matthew J Matava, Holly J Silvers, Brian J Cole, Neil S ElAttrache, Tim R McAdams, Robert H Brophy
BACKGROUND: Anterior cruciate ligament (ACL) injuries are prevalent in contact sports that feature cutting and pivoting, such as American football. These injuries typically require surgical treatment, can result in significant missed time from competition, and may have deleterious long-term effects on an athlete's playing career and health. While the majority of ACL tears in other sports have been shown to occur from a noncontact mechanism, it stands to reason that a significant number of ACL tears in American football would occur after contact, given the nature of the sport...
February 1, 2018: American Journal of Sports Medicine
Kazuhisa Hatayama, Masanori Terauchi, Kenichi Saito, Jun Aoki, Satoshi Nonaka, Hiroshi Higuchi
PURPOSE: To prospectively evaluate the sensitivity and specificity of magnetic resonance imaging (MRI) for diagnosing ramp lesions, to compare them between 1.5- and 3-T MRI, and to evaluate whether bone contusion of the posterior lip of the medial tibial plateau was associated with ramp lesions. METHODS: For 155 knees that underwent primary ACL reconstruction, we prospectively examined for ramp lesions and medial meniscal body tears on MRI. MRI diagnosis of ramp lesions required high signal irregularity of the capsular margin or separation in the meniscocapsular junction of the medial meniscus posterior horn on sagittal images...
February 15, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Asheesh Bedi
Safety belt, or cerclage, reinforcement of anterior cruciate ligament (ACL) grafts may protect against various modes of failure including creep and irreversible stretch, traumatic tearing, and slippage of the tendon-bone interface. A time-zero, biomechanical study shows that suture reinforcement may protect small and vulnerable hamstring ACL reconstruction grafts from these various modes of failure. Thus, in vivo comparative outcome analysis is indicated to determine if the benefits of reinforcement translate from the benchtop to the operating room...
February 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Philipp Henle, Kathrin S Bieri, Janosch Haeberli, Nele Arnout, Jan Victor, Mirco Herbort, Clemens Koesters, Stefan Eggli
PURPOSE: Studies on dynamic intraligamentary stabilization (DIS) of acute anterior cruciate ligament (ACL) ruptures reported failure rates similar to those of conventional ACL reconstruction. This study aimed to determine whether surgeon experience with DIS is associated with revision rates or patient-reported outcomes. The hypothesis was that more experienced surgeons achieved better outcomes following DIS due to substantial learning curve. METHODS: The authors prospectively enrolled 110 consecutive patients that underwent DIS and evaluated them at a minimum of 2 years...
February 5, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Seong Hwan Kim, Sang Hak Lee, Kang-Il Kim, Jae Woo Yang
PURPOSE: To document the diagnostic accuracy and steps for sequential arthroscopic exploration of ramp lesions-peripheral tear within 4 mm of meniscocapsular junction of medial meniscus-associated with anterior cruciate ligament (ACL) injury. METHODS: This was a prospective consecutive study of 195 primary ACL reconstructions with arthroscopic exploration for ramp lesion in 4 steps: (1) standard exploration through the anterolateral portal, (2) through the intercondylar space using a 30° arthroscope, (3) through the intercondylar space using a 70° arthroscope, and (4) after creation of a posteromedial portal...
February 2, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
J Kristopher Ware, Brett D Owens, Matthew R Akelman, Naga Padmini Karamchedu, Paul D Fadale, Michael J Hulstyn, Robert M Shalvoy, Gary J Badger, Braden C Fleming
BACKGROUND: Anterior cruciate ligament (ACL) tears are associated with the development of knee osteoarthritis despite ACL reconstruction surgery. However, little evidence is available to determine which patients will develop symptomatic knee osteoarthritis. PURPOSE: To determine if preoperative outcome measures-KOOS (Knee injury and Osteoarthritis Outcome Score) and SF-36 (36-item Short Form Health Survey)-were associated with the development of a symptomatic knee 7 years after ACL reconstruction...
February 1, 2018: American Journal of Sports Medicine
Jerome Murgier, Jean Sebastien Béranger, Philippe Boisrenoult, Camille Steltzlen, Nicolas Pujol
BACKGROUND AND PURPOSE: Anterior knee laxity can be evaluated using different devices, the most commonly used being the Telos®, KT1000®, Rolimeter®, and GNRB®. However, the laxity values obtained with these devices have never been compared to one another. As such, the outcomes of studies using these different knee laxity measurement devices may not be comparable. The primary purpose of this study was to determine the side-to-side laxity difference in patients with one ACL-injured knee, using each of these devices, and to compare the values obtained from each...
February 2, 2018: International Orthopaedics
Janosch Häberli, Laurenz Jaberg, Kathrin Bieri, Stefan Eggli, Philipp Henle
BACKGROUND: The goal of this study was to perform an in-depth analysis of the frequency and cause of secondary interventions subsequent to primary anterior cruciate ligament (ACL) repair with dynamic intraligamentary stabilization (DIS). METHODS: Between July 2009 and June 2014, 455 patients underwent DIS treatment. The minimum follow-up was 21months (mean 28months, range 21-64months). RESULTS: A total of 215 (48.2%) reinterventions were performed in 190 (42...
January 29, 2018: Knee
Nobuaki Chinzei, Robert H Brophy, Xin Duan, Lei Cai, Ryan M Nunley, Linda J Sandell, Muhammad Farooq Rai
OBJECTIVE: Anterior cruciate ligament (ACL) injury initiates a cascade of events often leading to osteoarthritis. ACL reconstruction does not alter the course of osteoarthritis, suggesting that heightened osteoarthritis risk is likely due to factors in addition to the joint instability. We showed that torn ACL remnants express periostin (POSTN) in the acute phase of injury. Considering that ACL injury predisposes to osteoarthritis and that POSTN is associated with cartilage metabolism, we hypothesize that ACL injury affects chondrocytes via POSTN...
January 29, 2018: Osteoarthritis and Cartilage
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