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https://www.readbyqxmd.com/read/29140170/clinical-diagnostic-tests-versus-mri-diagnosis-of-acl-tears
#1
Megan P Brady, Windee Weiss
CLINICAL SCENARIO: A common injury among elite, recreational, and youth athletes is the anterior cruciate ligament (ACL) tear.(1) Approximately 200,000 ACL injuries occur every year.(2) The gold standard in ACL injury evaluation is diagnostic arthroscopy,(3,4) however the diagnostic accuracy of clinical diagnostic tests and magnetic resonance imaging (MRI) is debatable.(1,3-6) Due to the frequency of knee injury,(3) MRI is a common diagnostic tool used for imaging and diagnosis(5). ACL tears are also diagnosed using clinical diagnostic tests...
November 15, 2017: Journal of Sport Rehabilitation
https://www.readbyqxmd.com/read/29132386/primary-single-suture-anchor-re-fixation-of-anterior-cruciate-ligament-proximal-avulsion-tears-leads-to-good-functional-mid-term-results-a-preliminary-study-in-12-patients
#2
Christof Hoffmann, Jan Friederichs, Christian von Rüden, Christian Schaller, Volker Bühren, Christoph Moessmer
BACKGROUND: Current studies demonstrate encouraging short-term results after primary anterior cruciate ligament (ACL) suture anchor repair. However, earlier studies reported deterioration of knee function at 5-year follow-up following good clinical short-term recovery. Therefore, the aim of this study was to evaluate clinical long-term results after primary ACL repair at a minimum 5-year follow-up. METHODS: In a retrospective study, 13 patients were included between 2009 and 2012...
November 13, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29119285/lateral-femoral-notch-depth-is-not-associated-with-increased-rotatory-instability-in-acl-injured-knees-a-quantitative-pivot-shift-analysis
#3
Ajay C Kanakamedala, Jeremy M Burnham, Thomas R Pfeiffer, Elmar Herbst, Marcin Kowalczuk, Adam Popchak, James Irrgang, Freddie H Fu, Volker Musahl
PURPOSE: A deep lateral femoral notch (LFN) on lateral radiographs is indicative of ACL injury. Prior studies have suggested that a deep LFN may also be a sign of persistent rotatory instability and a concomitant lateral meniscus tear. Therefore, the purpose of this study was to evaluate the relationship between LFN depth and both quantitative measures of rotatory knee instability and the incidence of lateral meniscus tears. It was hypothesized that greater LFN depth would be correlated with increased rotatory instability, quantified by lateral compartment translation and tibial acceleration during a quantitative pivot shift test, and incidence of lateral meniscus tears...
November 8, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29116829/nonsurgical-management-of-an-anterior-cruciate-ligament-deficient-knee-in-a-women-s-soccer-player-a-validation-clinical-case-report
#4
Courtney E Gray, Chris Hummel, Todd Lazenby
BACKGROUND:   A collegiate women's soccer player sustained an isolated anterior cruciate ligament (ACL) tear and expressed a desire to continue her season without surgical intervention. DESIGN:   Case report. INTERVENTION(S):   Using the results of a randomized controlled trial and published clinical guidelines, the clinicians classified the patient as an ACL-deficient coper. The patient completed her soccer season without incident, consistent with the findings of the established clinical guidelines...
November 8, 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/29114629/knee-osteoarthritis-after-reconstruction-of-isolated-anterior-cruciate-ligament-injuries-a-systematic-literature-review
#5
REVIEW
Compagnoni Riccardo, Catani Fabio, Randelli Pietro
Purpose  The aim of this review was to analyze the current literature on osteoarthritic evolution of knees without any combined meniscal or ligament lesions undergoing anterior cruciate ligament (ACL) reconstruction. Methods  A PubMed/MEDLINE research was performed using the following keywords: "Anterior Cruciate Ligament Reconstruction" [Mesh] AND "Osteoarthritis, Knee" [Mesh]. Only English language literature and articles published after 2005 were included. Studies including concomitant meniscal tears, posterior cruciate or collateral ligament injuries, previous surgery in the affected knees, infections, osteochondral defects, loose bodies, synovial plica syndrome, and posteromedial or posterolateral corner injuries were not considered in this review...
March 2017: Joints
https://www.readbyqxmd.com/read/29066269/contact-versus-noncontact-anterior-cruciate-ligament-injuries-is-mechanism-of-injury-predictive-of-concomitant-knee-pathology
#6
Hytham S Salem, Weilong J Shi, Bradford S Tucker, Christopher C Dodson, Michael G Ciccotti, Kevin B Freedman, Steven B Cohen
PURPOSE: To determine if mechanism of injury is predictive of concomitant knee pathology found at the time of anterior cruciate ligament (ACL) reconstruction. METHODS: All patients aged 16 to 35 who underwent ACL reconstruction at our institution between January 2009 and December 2015 were retrospectively reviewed. Mechanism of injury was determined from patient history. The presence of meniscal or chondral damage was determined from operative records, while collateral ligament injuries were determined by the treating surgeon's diagnosis after physical examination and their review of magnetic resonance imaging findings...
October 21, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29065035/the-effect-of-soft-tissue-injuries-on-clinical-outcomes-following-tibial-plateau-fracture-fixation
#7
Stephen J Warner, Matthew R Garner, Patrick C Schottel, Peter D Fabricant, Ryan R Thacher, Michael L Loftus, David L Helfet, Dean G Lorich
OBJECTIVE: The purpose of this study was to determine if ligamentous and meniscal injuries as determined by initial magnetic resonance imaging altered clinical outcomes following the fixation of tibial plateau fractures. DESIGN: Comparative cohort study. SETTING: Academic level I trauma center. PATIENTS/PARTICIPANTS: Eighty-two patients from a prospective database of operatively treated tibial plateau fractures met the inclusion criteria, which consisted of injury radiographs, preoperative knee MRI, and a minimum of twelve months of clinical outcomes...
October 14, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29052744/tibiofemoral-joint-congruence-is-lower-in-females-with-acl-injuries-than-males-with-acl-injuries
#8
Antoine Schneider, Salim Si-Mohamed, Robert A Magnussen, Sebastien Lustig, Philippe Neyret, Elvire Servien
PURPOSE: Previous research has demonstrated that women have a higher risk of anterior cruciate ligament (ACL) injury than men. Tibiofemoral articular geometry may play a role in the occurrence of ACL tears. The purpose of this study was to analyze the gender-specific geometric characteristics differences in tibiofemoral morphology in ACL-deficient patients. METHODS: Medial tibial slope (MTS), lateral tibial slope (LTS), medial tibial plateau concavity, medial and lateral femoral condyle convexity, and lateral plateau convexity were analyzed in 276 patients with complete ACL injuries (138 females and 138 males)...
October 20, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29051899/surgical-treatment-of-segond-fractures-in-acute-anterior-cruciate-ligament-reconstruction
#9
Andrea Ferretti, Edoardo Monaco, Megan Rianne Wolf, Matteo Guzzini, Angelo De Carli, Daniele Mazza
BACKGROUND: The Segond fracture is an avulsion-type fracture located on the anterolateral aspect of the tibia associated with a ligament recently termed the anterolateral ligament. This injury has been described as pathognomonic for an anterior cruciate ligament (ACL) tear and is associated with a higher grade pivot shift. PURPOSE: To present and report 2-year clinical outcomes of a surgical technique for acute ACL reconstruction with fixation of a concomitant Segond fracture...
October 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29051898/accuracy-of-the-lever-sign-test-in-the-diagnosis-of-anterior-cruciate-ligament-injuries
#10
Keith A Jarbo, David E Hartigan, Kelly L Scott, Karan A Patel, Anikar Chhabra
BACKGROUND: The lever sign test is a new physical examination tool to diagnose anterior cruciate ligament (ACL) tears. Preliminary results suggest almost 100% sensitivity and specificity to diagnose acute and chronic complete ACL tears and clinically significant partial tears as compared with magnetic resonance imaging (MRI). PURPOSE: To assess the sensitivity and specificity of the lever sign test for the diagnosis of acute ACL injuries, as compared to MRI. We also aimed to determine the accuracy of the lever sign test compared with 3 other tests (anterior drawer, Lachman, and pivot shift) when performed by providers of various training levels, and with the patient awake or under anesthesia...
October 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29051896/outcomes-and-complication-rates-after-primary-anterior-cruciate-ligament-reconstruction-are-similar-in-younger-and-older-patients
#11
Mark E Cinque, Jorge Chahla, Gilbert Moatshe, Nicholas N DePhillipo, Nicholas I Kennedy, Jonathan A Godin, Robert F LaPrade
BACKGROUND: Until recently, anterior cruciate ligament (ACL) tears in older patients were treated conservatively; however, these patients often experienced significant pain and instability. PURPOSE/HYPOTHESIS: The purpose of this study was to compare the patient-reported outcomes, patient satisfaction, and failure rates of primary ACL reconstruction between a younger (age 20-30 years) and older (age 50-75 years) patient cohort. It was hypothesized that patients in the older cohort could achieve comparable clinical outcomes and retear rates following ACL reconstruction with a bone-tendon-bone autograft or allograft compared with the younger patients...
October 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29051869/case-of-acute-concomitant-rupture-of-anterior-cruciate-ligament-and-patellar-tendon-of-knee-surgical-decision-making-and-outcome
#12
Jithin Orville Lobo, Joe Joseph Cherian, Arnav Sahu
INTRODUCTION: Acute concomitant rupture of both anterior cruciate ligament (ACL) and patellar tendon is a rare injury. The diagnosis of either of the injuries may be missed on clinical examination in the emergency room. A high index of suspicion is necessary when active extension is absent, and necessary investigations like ultrasound or magnetic resonance imaging (MRI) should be done to confirm the diagnosis. There are no fixed treatment protocols in these injuries. The options include immediate repair of patellar tendon with either simultaneous or delayed reconstruction of ACL...
May 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29048929/the-effect-of-hamstring-tendon-autograft-harvest-on-the-restoration-of-knee-stability-in-the-setting-of-concurrent-anterior-cruciate-ligament-and-medial-collateral-ligament-injuries
#13
Thomas J Kremen, Landon S Polakof, Sean S Rajaee, Trevor J Nelson, Melodie F Metzger
BACKGROUND: A hamstring autograft is commonly used in anterior cruciate ligament (ACL) reconstruction (ACLR); however, there is evidence to suggest that the tendons harvested may contribute to medial knee instability. HYPOTHESIS: We tested the hypothesis that the gracilis (G) and semitendinosus (ST) tendons significantly contribute to sagittal, coronal, and/or rotational knee stability in the setting of ACLR with a concurrent partial medial collateral ligament (MCL) injury...
October 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28992997/association-of-tibial-plateau-fracture-morphology-with-ligament-disruption-in-the-context-of-multiligament-knee-injury
#14
REVIEW
Jack Porrino, Michael L Richardson, Keegan Hovis, Bruce Twaddle, Albert Gee
BACKGROUND: We identified common morphologies of tibial plateau fractures that arise with multiligament knee injuries (MLKIs), and investigated the relationship of the fracture with ligament tears. We also evaluated the correlation of 3 tibial plateau fracture classification systems (Schatzker, AO, and Duparc). METHODS: Over a 2-year period, a single orthopaedic surgeon at our institution managed 90 MLKIs. Images of those knees with a tibial plateau fracture were retrospectively reviewed and classified per Schatzker, AO, and Duparc systems...
September 12, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28989265/technical-considerations-in-revision-anterior-cruciate-ligament-acl-reconstruction-for-operative-techniques-in-orthopaedics
#15
Jeremy M Burnham, Elmar Herbst, Thierry Pauyo, Thomas Pfeiffer, Darren L Johnson, Freddie H Fu, Volker Musahl
As the incidence of anterior cruciate ligament (ACL) reconstruction continues to increase, the rate of revision surgery continues to climb. Revision surgery has inherent challenges that must be addressed in order to achieve successful results. The cause of the primary ACL reconstruction failure should be determined, and careful preoperative planning should be performed to address the cause(s) of failure. Each patient undergoing revision surgery should undergo a thorough history and physical examination, receive full length alignment radiographs, lateral radiographs, 45-degree flexion weight-bearing postero-anterior radiographs, and patellofemoral radiographs...
March 2017: Operative Techniques in Orthopaedics
https://www.readbyqxmd.com/read/28983841/evidence-based-concepts-for-prevention-of-knee-and-acl-injuries-2017-guidelines-of-the-ligament-committee-of-the-german-knee-society-dkg
#16
Julian Mehl, Theresa Diermeier, Elmar Herbst, Andreas B Imhoff, Thomas Stoffels, Thore Zantop, Wolf Petersen, Andrea Achtnich
INTRODUCTION: Knee injuries and especially anterior cruciate ligament (ACL) tears are frequent in athletes. Therefore, primary and secondary prevention of sports-related lower limb injuries is an ongoing topic of interest. The aim of present study was to establish guidelines for the prevention of knee and ACL injuries on the basis of evidence-based concepts represented in current literature. METHODS: A comprehensive literature review regarding prevention programs for knee and ACL injuries was conducted...
October 5, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28982255/high-rates-of-osteoarthritis-develop-after-anterior-cruciate-ligament-surgery-an-analysis-of-4108-patients
#17
Mark E Cinque, Grant J Dornan, Jorge Chahla, Gilbert Moatshe, Robert F LaPrade
BACKGROUND: Posttraumatic osteoarthritis (PTOA) after anterior cruciate ligament (ACL) reconstruction ultimately translates into a large economic effect on the health care system owing to the young ages of this population. Purpose/Hypothesis: The purposes were to perform a meta-analysis to determine the prevalence of osteoarthritis after an ACL reconstruction, examining the effects of length of time after surgery, preoperative time interval from injury to surgery, and patient age at the time of surgery...
September 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28975136/national-football-league-skilled-and-unskilled-positions-vary-in-opportunity-and-yield-in-return-to-play-after-an-anterior-cruciate-ligament-injury
#18
JaeWon Yang, Jonathan D Hodax, Jason T Machan, Eric S Secrist, Wesley M Durand, Brett D Owens, Adam E M Eltorai, Christopher C Dodson
BACKGROUND: Anterior cruciate ligament (ACL) injuries pose a significant risk to the careers of players in the National Football League (NFL). The relationships between draft round and position on return to play (RTP) among NFL players are not well understood, and the ability to return to preinjury performance levels remains unknown for most positions. PURPOSE: To test for differences in RTP rates and changes in performance after an ACL injury by position and draft round...
September 2017: Orthopaedic Journal of Sports Medicine
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
#19
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...
October 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28966380/management-of-anterior-cruciate-ligament-injury-what-s-in-and-what-s-out
#20
Benjamin Todd Raines, Emily Naclerio, Seth L Sherman
Sports medicine physicians have a keen clinical and research interest in the anterior cruciate ligament (ACL). The biomechanical, biologic, and clinical data researchers generate, help drive injury management and prevention practices globally. The current concepts in ACL injury and surgery are being shaped by technological advances, expansion in basic science research, resurging interest in ACL preservation, and expanding efforts regarding injury prevention. As new methods are being developed in this field, the primary goal of safely improving patient outcomes will be a unifying principle...
September 2017: Indian Journal of Orthopaedics
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