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Knee ligamentous tears

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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/29122125/tibial-plateau-fracture-management-arthroscopically-assisted-versus-orif-procedure-clinical-and-radiological-comparison
#3
Esmat Elabjer, Ivan Benčić, Tomislav Ćuti, Tomislav Cerovečki, Stjepan Ćurić, Dinko Vidović
INTRODUCTION: Tibial plateau fractures are articular injuries that may influence final functional outcome of the knee. Although these fractures comprise only 1% of all fractures, the fracture pattern is usually complex and requires anatomical reduction and absolutely stable fixation to achieve satisfactory results. The development of knee osteoarthritis is a common late complication and it can be strongly influenced by additional, underestimated cartilage defects, and meniscal and ligament tears...
November 2017: Injury
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
#4
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
#5
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
#6
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/29089003/knee-ligament-sprains-and-tears-clinical-practice-guidelines-ensuring-best-care
#7
(no author information available yet)
Knee injuries can sideline anyone. Physical therapists are leading the way to ensure that people with knee ligament injuries, including competitive and recreational athletes, receive the best care to optimize their recovery. JOSPT and the Orthopaedic Section of the American Physical Therapy Association first published clinical practice guidelines about knee ligament sprains in 2010. Now, revised guidelines in JOSPT's November 2017 issue provide updated recommendations based on best practices for evaluating, diagnosing, and treating knee ligament injuries...
November 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/29079672/fast-tracked-rehabilitation-and-return-to-sport-of-an-elite-rugby-player-with-a-complicated-posterolateral-corner-injury-and-associated-peroneal-paralysis
#8
L D A Paget, P P F M Kuijer, M Maas, G M M J Kerkhoffs
Acute posterolateral corner injuries of the knee with associated hamstring avulsions and peroneal paralysis are rare in rugby. Regain of motor function following a complete paralysis is documented to be 38%. To our knowledge, only one case describes return to preinjury level of competitive sport taking up to 27 months. A 24-year-old international level rugby player, a medical student, sustained an acute posterolateral knee injury with associated anterior cruciate ligament tear, bicep femoris and semimembranosus avulsions as well as a complete peroneal paralysis...
October 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29066269/contact-versus-noncontact-anterior-cruciate-ligament-injuries-is-mechanism-of-injury-predictive-of-concomitant-knee-pathology
#9
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
#10
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/29059114/findings-associated-with-knee-pathology-on-mri-in-patients-without-osteoarthritis
#11
James D Wylie, Christopher A Makarewich, Zach M Working, Lance Jacobson, Robert L Schmidt, Julia R Crim, Robert T Burks
INTRODUCTION: We conducted a retrospective study in patients with minimal or no radiographically evident knee osteoarthritis to determine whether presenting signs and symptoms were predictive of knee pathology that was evident on MRI and could be treated with nonarthroplasty knee surgery or could alter nonsurgical treatment. METHODS: We reviewed records of patients for whom sports medicine orthopaedic surgeons had ordered an MRI of the knee. Univariate analysis identified factors that were associated with positive MRI findings (eg, surgically treatable lesion, meniscal tear) or a finding that could alter treatment...
November 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29051899/surgical-treatment-of-segond-fractures-in-acute-anterior-cruciate-ligament-reconstruction
#12
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
#13
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
#14
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
#15
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
#16
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/29047243/three-dimensional-fast-spin-echo-imaging-without-fat-suppression-of-the-knee-diagnostic-accuracy-comparison-to-fat-suppressed-imaging-on-1-5t-mri
#17
Hee Woo Cho, Jin Suck Suh, Jin Oh Park, Hyoung Sik Kim, Soo Yoon Chung, Young Han Lee, Seok Hahn
PURPOSE: To evaluate the diagnostic performance of three-dimensional fast spin-echo (3D FSE-Cube) without fat suppression (NFS) for detecting knee lesions, using comparison to 3D FSE-Cube with fat suppression (FS). MATERIALS AND METHODS: One hundred twenty-four patients who underwent 1.5T knee magnetic resonance imaging (MRI) scans and 25 subsequent arthroscopic surgeries were retrospectively reviewed. Using arthroscopic results and two-dimensional images as reference standards, diagnostic performances of 3D FSE-Cube-NFS and FS imaging about lesions of ligament, meniscus, subchondral bone marrow edema (BME), and cartilage were compared...
November 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/29028358/posterior-tibial-translation-measurements-on-magnetic-resonance-imaging-improve-diagnostic-sensitivity-for-chronic-posterior-cruciate-ligament-injuries-and-graft-tears
#18
Nicholas N DePhillipo, Mark E Cinque, Jonathan A Godin, Gilbert Moatshe, Jorge Chahla, Robert F LaPrade
BACKGROUND: Magnetic resonance imaging (MRI) of the knee is a highly sensitive and specific method for diagnosing acute posterior cruciate ligament (PCL) tears, with a reported accuracy of 96% to 100%. In chronic and revision settings, these injuries may be missed on MRI because of the apparent continuity of nonfunctional PCL fibers. Posterior tibial translation (PTT) of the medial compartment has been identified as a potential secondary finding of PCL tear on routine MRI. Purpose/Hypothesis: The purpose of this study was to evaluate the sensitivity of PTT on MRI associated with PCL injuries and compare it with the sensitivity of a radiologist's MRI interpretation with preoperative posterior knee stress radiographs as the gold standard...
October 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29018143/knee-upside-down
#19
Steven G J van der Aart, Remko J A Sonnega, Dirk-Jan Hofstee
We present a case of a 19-year-old woman with a forced hyperextension trauma of the knee causing a posteromedial fracture, a medial meniscus root tear and rupture of the posterior cruciate ligament. The posteromedial fracture of the tibial plateau was treated operatively with open reduction and internal fixation. Anatomical reconstruction was achieved. Postoperative treatment included unlimited flexion and minimal weight bearing. After 3 months, the patient had minimal pain after weight bearing and returned to preoperative range of motion...
October 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28992997/association-of-tibial-plateau-fracture-morphology-with-ligament-disruption-in-the-context-of-multiligament-knee-injury
#20
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
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