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anterior cruciate tear

Jae-Young Park, Tae-Joon Cho, Myung Chul Lee, Hyuk-Soo Han
A case of anterior cruciate ligament (ACL) reconstruction with meniscal repair in an osteogenesis imperfecta patient is reported. A 24-year-old female with osteogenesis imperfecta type 1a suffered from a valgus extension injury resulting in tear of ACL and medial meniscus. She underwent an arthroscopic-assisted ACL reconstruction and medial meniscus repair. Meniscal tear at the menisco-capsular junction of the posterior horn of medial meniscus was repaired with three absorbable sutures via inside-out technique...
March 20, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Patrick Prager, Manuela Kunz, Regina Ebert, Ludger Klein-Hitpass, Jakob Sieker, Thomas Barthel, Franz Jakob, Christian Konrads, Andre Steinert
Purpose: Mesenchymal stem cells (MSCs) isolated from the anterior cruciate ligament (ACL) share multiple characteristics of bone marrow-derived mesenchymal stem cells (BMSCs), allowing their use for regenerative therapies. Injuries to the ACL can affect people of all ages. This study assesses whether the regenerative potential of ACL-derived MSCs (ACL-MSCs) from old donors is as high as the potential of ACL-MSCs from young donors. Materials and Methods: ACL-MSCs were isolated from ACL tissues obtained from young and old donors at the time of ACL reconstruction or arthroplasty...
March 19, 2018: Knee Surgery & related Research
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
Etienne Cavaignac, Gregoire Laumond, Nicolas Reina, Karine Wytrykowski, Jérôme Murgier, Marie Faruch, Philippe Chiron
Ultrasonography (US) is a nonirradiating, low-cost, real-time imaging modality that has very good spatial resolution. US can be used to view the anterolateral ligament (ALL) and injuries to the ALL. Several authors have sought to analyze the anterolateral aspect of the knee using US with varying luck. All of them analyzed the ALL statically only. The goal of this Technical Note is to describe in detail the technique that we use to analyze the anterolateral aspect of the knee in patients with an anterior cruciate ligament tear...
January 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)
Volker Musahl, Elmar Herbst, Jeremy M Burnham, Freddie H Fu
The anterolateral structures of the knee have recently garnered considerable interest regarding their role in rotatory knee instability related to anterior cruciate ligament tears. Isolated anterior cruciate ligament reconstruction may not always restore rotatory stability of the knee. In these patients, additional procedures, such as lateral reconstruction or tenodesis, may be indicated. The anatomy of the anterolateral structures of the knee has been well described. Histologic and anatomic studies have reported conflicting findings regarding the presence of a discrete ligament...
March 6, 2018: Journal of the American Academy of Orthopaedic Surgeons
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
Berkcan Akpinar, Eric Thorhauer, James J Irrgang, Scott Tashman, Freddie H Fu, William J Anderst
BACKGROUND: Limited in vivo kinematic information exists on managing meniscal injury during anterior cruciate ligament reconstruction (ACLR). HYPOTHESIS: Isolated anatomic ACLR restores knee kinematics, whereas ACLR in the presence of medial meniscal injury is associated with altered long-term knee kinematics. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: From March 2011 to December 2012, 49 of 57 participants in a clinical trial underwent anatomic ACLR with successful kinematic testing at 24 months after ACLR...
March 1, 2018: American Journal of Sports Medicine
Neil S Kumar, Cory Edgar, Tiahna Spencer, James K Ware, Dale N Reed, Mark P Cote, Robert A Arciero
Separation of the posteromedial meniscocapsular junction (PMC) is a unique injury seen in patients with disruption of the anterior cruciate ligament. PMC tears may go unrecognized despite preoperative magnetic resonance imaging and diagnostic arthroscopy of the medial compartment. Unrepaired lesions may lead to persistent laxity of the knee after anterior cruciate ligament reconstruction. Inside-out repair techniques risk iatrogenic injury to the articular cartilage during needle passage and require dissection of the posteromedial knee for suture retrieval...
August 2017: Arthroscopy Techniques
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
Innocent Ouko, James Kigera, Kevin Ongeti, Anne Pulei
PURPOSE: Meniscal tears are common in Kenya, with prevalence rates ranging from 45 to 78% of intracapsular knee pathology. Diagnosis of these injuries relies on the use of both clinical signs and symptoms as well as radiological investigations. In a few instances, radiological detection could be difficult, partly because of variant attachment patterns of the medial meniscal anterior horn. Some of these unusual attachments of the anterior horn of the medial meniscus could even be mistaken for meniscal tears...
February 16, 2018: International Orthopaedics
Bancha Chernchujit, Renaldi Prasetia
The occurrence of posterior root tear of both the lateral and medial menisci, combined with anterior cruciate ligament rupture, is rare. Problems may be encountered such as the difficulty to access the medial meniscal root tear, the confusing circumstances about which structure to repair first, and the possibility of the tunnel for each repair to become taut inside the tibial bone. We present the arthroscopy technique step by step to overcome the difficulties in an efficient and time-preserving manner.
October 2017: Arthroscopy Techniques
Hervé Ouanezar, Mathieu Thaunat, Adnan Saithna, Levi Reina Fernandes, Bertrand Sonnery-Cottet
Full radial posterior lateral meniscus root tears are frequently associated with injuries to the anterior cruciate ligament. Left unrepaired, they result in loss of the meniscus hoop stress function and can lead to overload of the lateral compartment and early degenerative changes. Arthroscopic suture repairs show successful results with long-term follow-up. However, previously described suture repair techniques have often required special instrumentation and can be technically demanding. This Technical Note describes the use of an accessory portal through the patellar tendon as a safe and easy method for repairing full posterior radial tears of the lateral meniscus...
October 2017: Arthroscopy Techniques
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