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Hélène Pillet, Elena Bergamini, Goulven Rochcongar, Valentina Camomilla, Patricia Thoreux, Philippe Rouch, Aurelio Cappozzo, Wafa Skalli
In-vivo estimates of the positions of knee ligament attachment sites are crucial for subject-specific knee modelling. The present study provides template digital models of femur, tibia and fibula that embed the positions of centroids of the origins and insertions of cruciate and collateral ligaments, along with information on their dispersion related to inter-individual variability. By using a shape transformation procedure of choice, these templates can be made to match anatomical information measured on a subject under analysis...
October 3, 2016: Journal of Biomechanics
Robert Petretta, Vipul Mandalia
The use of an accessory posteromedial portal for posterior cruciate ligament reconstruction in bicruciate knee ligament reconstruction has often been described. However, the use of a posteromedial portal can be time consuming and has some inherent risks including injury to the saphenous vein or nerve. We describe our bicruciate knee ligament reconstruction using 4 exclusively anterior portals including a high anteromedial, high anterolateral, low anteromedial, and low anterolateral portals. Arthroscopy is performed using a combination of 30° and 70° arthroscopes...
August 2016: Arthroscopy Techniques
Ali M Naraghi, Lawrence M White
Acute knee injuries are a common source of morbidity in athletes and if overlooked may result in chronic functional impairment. Magnetic resonance (MR) imaging of the knee has become the most commonly performed musculoskeletal MR examination and is an indispensable tool in the appropriate management of the injured athlete. Meniscal and ligamentous tearing are the most frequent indications for surgical intervention in sports injuries and an understanding of the anatomy, biomechanics, mechanisms of injury, and patterns of injury are all critical to accurate diagnosis and appropriate management...
October 2016: Radiology
Jeffrey H Weinreb, Ryu Yoshida, Mark P Cote, Michael B O'Sullivan, Augustus D Mazzocca
PURPOSE: The purpose of this study was to evaluate how database use has changed over time in Arthroscopy: The Journal of Arthroscopic and Related Surgery and to inform readers about available databases used in orthopaedic literature. METHODS: An extensive literature search was conducted to identify databases used in Arthroscopy and other orthopaedic literature. All articles published in Arthroscopy between January 1, 2006, and December 31, 2015, were reviewed. A database was defined as a national, widely available set of individual patient encounters, applicable to multiple patient populations, used in orthopaedic research in a peer-reviewed journal, not restricted by encounter setting or visit duration, and with information available in English...
August 24, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
J J Bjerre, P K Jensen, B H Sparsø, M R Krogsgaard
We identified reasons for the low follow-up rate in the Danish Knee ligament Reconstruction Register (DKRR) and evaluated its influence on the data quality. All 946 primary ACL-reconstructed patients in the Capital Region of Denmark during 2012 were identified in the databases of 8 participating hospitals. We studied the patient files and compared them to figures reported to the DKRR. 92.5% of the operated patients was registered in DKRR. The 1-year follow-up rate reported to DKRR was 33.4%, and 14.5% filled in patient reported outcomes (KOOS and Tegner) at 1 year...
August 19, 2016: Scandinavian Journal of Medicine & Science in Sports
Chee Hwee Lee, Chih Feng Tan, Okwha Kim, Kyung Jin Suh, Min-Szu Yao, Wing P Chan, Jim S Wu
One of the most common knee injuries is ligament tear, which may initially manifest as an osseous injury in radiographs. Radiologists should therefore be able to recognize ligament tears of the knee as osseous abnormalities in images. This review focuses on the imaging features of knee ligament injuries and their related osseous injuries: anterior cruciate ligament (ACL) tear with Segond fracture; associated marrow contusion; ACL avulsion fracture; posterior cruciate ligament (PCL) tear with osseous avulsion of the ligament including arcuate sign; reverse Segond fracture; PCL avulsion fracture; medial collateral ligament tear with Pellegrini-Stieda disease; lateral collateral ligament tear with avulsion fracture of the fibular head; and patellar ligament injuries with Osgood-Schlatter and Sinding-Larsen-Johansson...
August 4, 2016: Canadian Association of Radiologists Journal, Journal L'Association Canadienne des Radiologistes
Endre Soreide, Lars-Petter Granan, Geir A Hjorthaug, Birgitte Espehaug, Sigbjørn Dimmen, Lars Nordsletten
BACKGROUND: The administration of nonsteroidal anti-inflammatory drugs (NSAIDs) to patients undergoing anterior cruciate ligament reconstruction (ACLR) is controversial because it may impair tissue healing and clinical outcomes. PURPOSE: To assess the effect of NSAID administration on patients undergoing ACLR. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Included patients were aged >15 years and were registered in the Norwegian Knee Ligament Registry from 2008 until 2013 after the primary ACLR...
August 5, 2016: American Journal of Sports Medicine
Simon Michael Thompson, Lucy J Salmon, Alison Waller, James Linklater, Justin P Roe, Leo A Pinczewski
BACKGROUND: Long-term prospective studies of isolated endoscopic anterior cruciate ligament (ACL) reconstruction are limited and may include confounding factors. PURPOSE: This study aimed to compare the outcomes of isolated ACL reconstruction using the patellar tendon (PT) autograft and the hamstring (HT) autograft in 180 patients over 20 years. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: A total of 180 participants undergoing isolated ACL reconstruction between 1993 and 1994 were prospectively recruited...
August 4, 2016: American Journal of Sports Medicine
Gilbert Moatshe, Erik L Slette, Lars Engebretsen, Robert F LaPrade
BACKGROUND: Knee dislocations are rare but potentially devastating injuries, often involving tears of multiple knee ligaments. Several studies have reported improved clinical and functional outcomes with surgical management of torn knee ligaments compared with nonsurgical management. Most multiple ligament reconstruction techniques involve creating several tunnels for various reconstruction grafts, posing a risk of tunnel convergence in the proximal tibia. PURPOSE: To assess the risk of tunnel convergence and determine the optimal tunnel placement for the reconstruction of multiple ligaments in the tibia...
July 28, 2016: American Journal of Sports Medicine
Shaoqi Tian, Bin Wang, Lun Liu, Yuanhe Wang, Chengzhi Ha, Qicai Li, Xu Yang, Kang Sun
BACKGROUND: Most studies on grafts for anterior cruciate ligament (ACL) reconstruction (ACLR) have been of autografts or nonirradiated allografts with a single-bundle (SB) technique. Outcome reports evaluating anatomic double-bundle (DB) ACLR with a hamstring tendon autograft versus irradiated allograft are rare. PURPOSE: To compare the clinical outcomes of arthroscopic anatomic DB ACLR with a hamstring tendon autograft versus irradiated allograft. STUDY DESIGN: Randomized controlled trial; Level of evidence, 2...
October 2016: American Journal of Sports Medicine
M Faruch-Bilfeld, F Lapegue, H Chiavassa, N Sans
Magnetic resonance imaging has now an indisputable role for the diagnosis of meniscus and ligament injuries of the knee. Some technical advances have improved the diagnostic capabilities of magnetic resonance imaging so that diagnoses, which may change the therapeutic approach, such as a partial tear of the anterior cruciate ligament or confirmation of unstable meniscal injuries, are now made easier. This article describes the essential about magnetic resonance imaging technique and pathological results for the menisci, collateral ligaments and damage to the central pivot of the cruciate knee ligaments...
July 2016: Diagnostic and Interventional Imaging
Volker Musahl, Chad Griffith, James J Irrgang, Yuichi Hoshino, Ryosuke Kuroda, Nicola Lopomo, Stefano Zaffagnini, Kristian Samuelsson, Jon Karlsson
BACKGROUND: Prior attempts to quantify the pivot-shift examination have been too invasive or impractical for clinical use. A noninvasive method for quantifying rotatory knee laxity is needed. HYPOTHESIS: Greater quantitative measurements of rotatory knee laxity (both of the involved knee as well as compared with the contralateral healthy knee) are associated with an increasing clinical pivot-shift grade. STUDY DESIGN: Cross-sectional study; Level of evidence, 3...
September 2016: American Journal of Sports Medicine
Gilbert Moatshe, Chase S Dean, Jorge Chahla, Raphael Serra Cruz, Robert F LaPrade
Fibular collateral ligament (FCL) injuries can lead to varus instability of the knee, causing a varus thrust gait and resulting in increased forces on the medial compartment of the knee. In the long term, this can result in meniscal injuries and medial compartment osteoarthritis. Varus instability is also reported to increase forces on the cruciate ligaments, which can lead to overload and failure of these reconstructions in cases of nonrecognized combined injuries. Historically, both repair and reconstruction have been used for grade III injuries to the FCL...
April 2016: Arthroscopy Techniques
Bertrand W Parcells, Alfred J Tria
The early knee replacements were hinge designs that ignored the ligaments of the knee and resurfaced the joint, allowing freedom of motion in a single plane. Advances in implant fixation paved the way for modern designs, including the posterior-stabilized (PS) total knee arthroplasty (TKA) that sacrifices both cruciate ligaments while substituting for the posterior cruciate ligament (PCL), and the cruciate-retaining (CR) TKA designs that sacrifice the anterior cruciate ligament but retain the PCL. The early bicruciate retaining (BCR) TKA designs suffered from loosening and early failures...
May 2016: American Journal of Orthopedics
Andrea Achtnich, Elmar Herbst, Philipp Forkel, Sebastian Metzlaff, Frederike Sprenker, Andreas B Imhoff, Wolf Petersen
PURPOSE: To compare clinical and radiologic results of primary anterior cruciate ligament (ACL) suture anchor repair and microfracturing with anatomic ACL single-bundle reconstruction in patients with acute proximal ACL avulsion tears. METHODS: Between January 2010 and December 2013, 420 patients underwent ACL treatment. Forty-one patients were included in this study. The inclusion criteria were as follows: unilateral acute proximal ACL rupture, concomitant meniscus lesions, no previous knee ligament surgery, and no additional ligament injuries or absence of ligament injury of the contralateral knee...
June 17, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Paul A Jones, Lee Herrington, Philip Graham-Smith
Most biomechanical studies into changing direction focus on final contact (FC), whilst limited research has examined penultimate contact (PEN). The aim of this study was to explore the kinematic and kinetic differences between PEN and FC of cutting and pivoting in 22 female soccer players (mean±SD; age: 21±3.1years, height: 1.68±0.07m, mass: 58.9±7.3kg). Furthermore, the study investigated whether horizontal force-time characteristics during PEN were related to peak knee abduction moments during FC. Three dimensional motion analyses of cutting and pivoting on the right leg were performed using Qualysis 'Proreflex' infrared cameras (240Hz)...
October 2016: Journal of Electromyography and Kinesiology
Shaoqi Tian, Yuanhe Wang, Bin Wang, Lun Liu, Chengzhi Ha, Qicai Li, Kang Sun
PURPOSE: To compare the clinical outcome of anatomic double-bundle (DB) anterior cruciate ligament (ACL) reconstruction with a hamstring tendon autograft versus fresh-frozen allograft. METHODS: Between January 2010 and December 2011, in a prospective randomized study, we included 157 patients who were planned to receive anatomic DB ACL reconstruction with a hamstring tendon autograft or fresh-frozen allograft. All surgeries were performed by the same senior surgeon with the DB reconstruction technique...
June 8, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Jia Li, Fanlong Kong, Xianda Gao, Yong Shen, Shijun Gao
PURPOSE: To evaluate posterior stability and proprioception after arthroscopic posterior cruciate ligament reconstruction with autograft, hybrid graft, and γ-irradiated allograft. METHODS: This prospective, randomized controlled trial (with 5 years' follow-up) included 90 patients who underwent posterior cruciate ligament reconstruction with autograft (gracilis and semitendinosus tendons), hybrid graft (γ-irradiated tibialis anterior tendon allograft and semitendinosus tendon autograft), or γ-irradiated allograft (tibialis anterior tendons)...
June 7, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Kevin G Shea, John D Polousky, John C Jacobs, Yi-Meng Yen, Theodore J Ganley
BACKGROUND: The anterolateral ligament (ALL) of the knee has been identified as a structure that limits internal rotation, and thus, affects the pivot shift mechanism. It has previously been reported in a high percentage of adult subjects. The purpose of the current study was to evaluate whether the ALL could be identified on pediatric cadaveric knee specimens and compare these findings to previously published reports. METHODS: Eight skeletally immature cadaver knee specimens were examined through gross dissection: ages 3 months, 4 months, 1 year, 2 years, 3 years, 3 years, 8 years, and 10 years...
July 2016: Journal of Pediatric Orthopedics
Bernardo Innocenti, Pasquale Salandra, Walter Pascale, Silvia Pianigiani
BACKGROUND: At present, increasing the accuracy of identification of knee ligament insertions is fundamental in developing accurate patient-specific three-dimensional (3D) models for preoperative planning surgeries, designing patient-specific instrumentation or implants, and conducting biomechanical analyses. The accuracy and reproducibility of magnetic resonance imaging (MRI) scans in identifying cruciate and collateral ligament insertions have not been investigated thus far, despite their wide use...
August 2016: Knee
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