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Ligament reconstruction

Sheeba M Joseph, Michael R Karns, Derrick M Knapik, James E Voos
Purpose: To purpose of this study was to compare arthroscopic anterior cruciate ligament (ACL) reconstruction femoral tunnel length measurements from the anterolateral portal between the standard notch view using a 30° arthroscope versus a "top-down" view utilizing a 70° arthroscope to visual the far side of the femoral tunnel aperture. Methods: Arthroscopic femoral tunnel length measurements using calibrated reamers from the standard notch versus the "top-down" view were obtained and reviewed in 54 skeletally mature patients undergoing ACL reconstruction with no prior bony knee surgery...
2018: Frontiers in Surgery
John Gliatis, Konstantinos Anagnostou, Pantelis Tsoumpos, Evdokia Billis, Maria Papandreou, Spyridon Plessas
AIM: To present the long-term results of complex knee injuries, treated early using the Ligament Augmentation and Reconstruction System (LARS) artificial ligament to reconstruct posterior cruciate ligament (PCL). METHODS: From September 1997 to June 2010, thirty-eight complex knee injuries were treated, where early arthroscopic PCL reconstructions were undergone, using the LARS (Surgical Implants and Devices, Arc-sur-Tille, France) artificial ligament. Exclusion criteria were: Late (> 4 wk) reconstruction, open technique, isolated PCL reconstruction, knee degenerative disease, combined fracture or vascular injury and use of allograft or autograft for PCL reconstruction...
March 18, 2018: World Journal of Orthopedics
Tserenchimed Purevsuren, Myagmarbayar Batbaatar, Batbayar Khuyagbaatar, Kyungsoo Kim, Yoon Hyuk Kim
Biomechanical studies have indicated that the conventional non-anatomic reconstruction techniques for lateral ankle sprain (LAS) tend to restrict subtalar joint motion compared to intact ankle joints. Excessive restriction in subtalar motion may lead to chronic pain, functional difficulties, and development of osteoarthritis. Therefore, various anatomic surgical techniques to reconstruct both the anterior talofibular and calcaneofibular ligaments have been introduced. In this study, ankle joint stability was evaluated using multibody computational ankle joint model to assess two new anatomic reconstruction and three popular non-anatomic reconstruction techniques...
March 12, 2018: Journal of Biomechanical Engineering
Levi Reina Fernandes, Herve Ouanezar, Adnan Saithna, Bertrand Sonnery-Cottet
The Segond fracture (SF) is considered pathognomonic of an anterior cruciate ligament (ACL) tear. However, the anatomy of the soft-tissue attachments responsible for the avulsion of SFs has been a cause of controversy. A 31-year-old male patient presented with an injury to his right knee that resulted in ACL tear and a SF. Open SF fixation and arthroscopic ACL reconstruction were performed. The anatomical dissection demonstrated that the avulsion of SFs had occurred because of the tibial attachment of the anterolateral ligament (ALL) with an intact Iliotibial band...
March 20, 2018: BMJ Case Reports
Sean Baran, Jeffrey G Belisle, Erin K Granger, Robert Z Tashjian
OBJECTIVES: To analyze the functional and radiographic outcomes of anatomic coracoclavicular ligament reconstruction (ACCR) using allograft tendon without interference screw fixation. DESIGN: Retrospective nonrandomized study. SETTING: Level I trauma center (University Hospital). PATIENTS: Seventeen patients (mean age of 44 years) with Rockwood III through V acromioclavicular joint disruptions. Twelve of 17 patients had a primary reconstruction, including 4 patients sustaining their injuries as part of a polytrauma incident...
April 2018: Journal of Orthopaedic Trauma
Andrew G Geeslin, Jorge Chahla, Gilbert Moatshe, Kyle J Muckenhirn, Bradley M Kruckeberg, Alex W Brady, Ashley Coggins, Grant J Dornan, Alan M Getgood, Jonathan A Godin, Robert F LaPrade
BACKGROUND: The individual kinematic roles of the anterolateral ligament (ALL) and the distal iliotibial band Kaplan fibers in the setting of anterior cruciate ligament (ACL) deficiency require further clarification. This will improve understanding of their potential contribution to residual anterolateral rotational laxity after ACL reconstruction and may influence selection of an anterolateral extra-articular reconstruction technique, which is currently a matter of debate. Hypothesis/Purpose: To compare the role of the ALL and the Kaplan fibers in stabilizing the knee against tibial internal rotation, anterior tibial translation, and the pivot shift in ACL-deficient knees...
March 1, 2018: American Journal of Sports Medicine
Felix G E Dyrna, Florian B Imhoff, Andreas Voss, Sepp Braun, Elifho Obopilwe, John M Apostolakos, Daichi Morikawa, Brendan Comer, Andreas B Imhoff, Augustus D Mazzocca, Knut Beitzel
BACKGROUND: The acromioclavicular (AC) capsule is an important stabilizer against horizontal translation and also contributes to the strut function of the clavicle, which guides rotation of the scapula. To best reproduce the biomechanical properties and the complex 3-dimensional (3D) guidance of the AC joint, detailed knowledge of the contribution of each of the distinctive capsular structures is needed. Purpose/Hypothesis: To perform a detailed biomechanical evaluation of the specific capsular structures of the AC joint and their contribution to translational and rotational stability...
March 1, 2018: American Journal of Sports Medicine
Audrey R C Elias, Kari J Harris, Paul C LaStayo, Ryan L Mizner
BACKGROUND: Limited knee flexion and increased muscle co-contraction during jump landing are believed to diminish outcomes after anterior cruciate ligament (ACL) reconstruction. The efficacy of jump training to improve patients' mechanical and neuromuscular deficits is understudied. HYPOTHESIS: Jump training will improve functional, mechanical, and neuromuscular outcomes and higher repetition training augmented by body weight support will result in better retention of gains...
March 1, 2018: American Journal of Sports Medicine
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
Philipp Schuster, Markus Geßlein, Philipp Mayer, Michael Schlumberger, Raul Mayr, Jörg Richter
PURPOSE: The purpose of this study was to determine the incidence of septic arthritis following arthroscopic posterior cruciate ligament (PCL) and multi-ligament reconstructions, and to evaluate a treatment regime with sequential arthroscopic irrigation and debridement procedures combined with antibiotic therapy that is focused on retention of the graft. METHODS: Between 2004 and 2016 a total of 866 PCL reconstructions and multi-ligament reconstructions were performed at our institution (408 isolated PCL reconstructions, 458 combined reconstructions)...
March 20, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Alejandro Lizaur-Utrilla, Daniel Martinez-Mendez, Santiago Gonzalez-Parreño, Luis Marco-Gomez, Francisco A Miralles Muñoz, Fernando A Lopez-Prats
BACKGROUND: Few studies have analyzed the outcomes of total knee arthroplasty (TKA) in patients with prior anterior cruciate ligament (ACL) reconstruction, and the reported outcomes are controversial. The purpose of this study is to assess if prior ACL reconstruction had any impact on the outcome of subsequent TKA. METHODS: A matched case-control study was conducted in patients who underwent TKA, including 37 with prior ACL reconstruction and 37 patients without ACL reconstruction...
February 21, 2018: Journal of Arthroplasty
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
Young-Mo Kim, Yong-Bum Joo, Ki-Young Lee, Sung-Jin Hwang
Purpose: To identify the femoral footprint of the anterior cruciate ligament (ACL) in Koreans. Materials and Methods: Eighteen embalmed cadaveric knees (mean age, 70 years) were examined. First, the shape of the ACL was determined macroscopically. After the ACL femoral footprint was defined, the ACL was cut from the femur and a Kirschner wire was inserted into the center of the ACL, and the position was verified with a C-arm. The position was quantified on the C-arm field using the quadrant method...
March 19, 2018: Knee Surgery & related Research
Matthew D LaPrade, Samantha L Kallenbach, Zachary S Aman, Gilbert Moatshe, Hunter W Storaci, Travis Lee Turnbull, Elizabeth A Arendt, Jorge Chahla, Robert F LaPrade
BACKGROUND: Quantification of the biomechanical properties of each individual medial patellar ligament will facilitate an understanding of injury patterns and enhance anatomic reconstruction techniques by improving the selection of grafts possessing appropriate biomechanical properties for each ligament. PURPOSE: To determine the ultimate failure load, stiffness, and mechanism of failure of the medial patellofemoral ligament (MPFL), medial patellotibial ligament (MPTL), and medial patellomeniscal ligament (MPML) to assist with selection of graft tissue for anatomic reconstructions...
March 1, 2018: American Journal of Sports Medicine
Marie E Boo, J Craig Garrison, Joseph P Hannon, Kalyssa M Creed, Shiho Goto, Angellyn N Grondin, James M Bothwell
Background: Female patients are more likely to suffer a second anterior cruciate ligament (ACL) injury after ACL reconstruction (ACLR) and return to sport (RTS) compared with healthy female controls. Few studies have examined the energy absorption contribution (EAC) that could lead to this subsequent injury. Hypothesis: The ACLR group would demonstrate an altered EAC between joints (hip, knee, and ankle) but no difference in quadriceps, hip abduction, or hip external rotation (ER) strength at the time of RTS...
March 2018: Orthopaedic Journal of Sports Medicine
Brian R Waterman, William Arroyo, Eric J Cotter, Michael A Zacchilli, E'Stephan J Garcia, Brett D Owens
Background: There remains a debate over whether to retain the index anterior cruciate ligament (ACL) graft in the setting of septic arthritis. Purpose: To evaluate and compare clinical outcomes for the treatment of septic arthritis after ACL reconstruction (ACLR) in those with and without early graft retention. Study Design: Case series; Level of evidence, 4. Methods: The Military Health System was queried for all ACLR procedures performed between 2007 and 2013...
March 2018: Orthopaedic Journal of Sports Medicine
Tetsuro Ushio, Ken Okazaki, Hideki Mizu-Uchi, Satoshi Hamai, Yukio Akasaki, Yasuharu Nakashima
Background: An anterior cruciate ligament (ACL) reconstruction has become more common and the surgical morbidity has decreased, it has been performed not only in younger people to play sports but also middle-aged people, with satisfactory results. Therefore, some patients might have comorbidities for which they take medicines. Especially the medicines, such as systemic steroids, might influence the reconstructed ligament strength and durability. Case report: A 49-year-old woman who was taking oral steroids for autoimmune hepatitis suffered a spontaneous ACL injury...
January 2018: Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology
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
Jesús Vilá-Rico, Enrique Sánchez-Morata, Elena Vacas-Sánchez, Cristina Ojeda-Thies
Injuries of the distal tibiofibular syndesmosis are commonly overlooked or mismanaged, and chronic instability is a debilitating condition leading to premature joint degeneration. Several methods of treatment have been described, mainly screw fixation, arthrodesis, or ligament reconstruction. Most clinical evidence is limited to case series, mainly screw fixation, and there is a general paucity of evidence regarding ligament reconstruction, which is considered to be more anatomic and to restore joint biomechanics...
February 2018: Arthroscopy Techniques
Kadir Buyukdogan, Michael S Laidlaw, Mark D Miller
The management of multiligament knee injury is a complex process starting with the adequate identification of the injury. A detailed physical and radiographic examination with a thorough understanding of knee anatomy is crucial to assess all damaged structures: anterior cruciate ligament, posterior cruciate ligament, posteromedial corner including the medial collateral ligament, and posterolateral corner including the lateral collateral ligament. Several surgical techniques have been developed throughout the years to adequately address these ligament insufficiencies...
February 2018: Arthroscopy Techniques
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