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Knee ligamentous tears

Ingrid Eitzen, Hege Grindem, Agnethe Nilstad, Håvard Moksnes, May Arna Risberg
BACKGROUND: Reduced quadriceps strength influences knee function and increases the risk of knee osteoarthritis. Thus, it is of significant clinical relevance to precisely quantify strength deficits in patients with knee injuries. PURPOSE: To evaluate isokinetic concentric quadriceps muscle strength torque values, assessed both from peak torque and at specific knee flexion joint angles, in patients with anterior cruciate ligament (ACL) injury, focal cartilage lesions, and degenerative meniscus tears...
October 2016: Orthopaedic Journal of Sports Medicine
Paul Rothenberg, Luis Grau, Lee Kaplan, Michael G Baraga
Football has the highest injury rate amongst popular American sports. Of those injuries that end seasons or careers, the knee is the most common culprit. This is of particular concern because knee injuries are most common in football. This article reviews 4 of the most common knee injuries in American football, with emphasis on epidemiology, risk factors, and treatment outcomes. The injuries reviewed are tears of the anterior cruciate ligament, medial collateral ligament, medial patellofemoral ligament, and posterior cruciate ligament...
September 2016: American Journal of Orthopedics
Brett D Steineman, Samuel G Moulton, Tammy L Haut Donahue, Cristián A Fontboté, Christopher M LaPrade, Tyler R Cram, Chase S Dean, Robert F LaPrade
BACKGROUND: The anterolateral meniscal root (ALMR) has been reported to intricately insert underneath the tibial insertion of the anterior cruciate ligament (ACL). Previous studies have begun to evaluate the relationship between the insertion areas and the risk of iatrogenic injuries; however, the overlap of the insertions has yet to be quantified in the sagittal and coronal planes. PURPOSE: To investigate the insertions of the human tibial ACL and ALMR using scanning electron microscopy (SEM) and to quantify the overlap of the ALMR insertion in the coronal and sagittal planes...
October 11, 2016: American Journal of Sports Medicine
Ozkan Kose, Selahattin Ozyurek, Adil Turan, Ferhat Guler
Reverse Segond fracture is originally described as an indirect radiographic clue for a specific injury complex of the knee joint that includes posterior cruciate ligament (PCL) rupture and medial meniscal tear. Herein, we describe a case with reverse Segond fracture associated with PCL avulsion fracture instead of PCL rupture. According to current literature review, reverse Segond fracture is not only associated with PCL and medial meniscal injuries, but also frequently associated with anterior cruciate ligament (ACL) and medial collateral ligament (MCL) injuries...
October 7, 2016: Acta Orthopaedica et Traumatologica Turcica
M Cody O'Dell, Diego Jaramillo, Laura Bancroft, Laura Varich, Gregory Logsdon, Sabah Servaes
With increasing participation and intensity of training in youth sports in the United States, the incidence of sports-related injuries is increasing, and the types of injuries are shifting. In this article, the authors review sports injuries of the lower extremity, including both acute and overuse injuries, that are common in or specific to the pediatric population. Common traumatic injuries that occur in individuals of all ages (eg, tears of the acetabular labrum and anterior cruciate ligament) are not addressed, although these occur routinely in pediatric sports...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Andrew R Palisch, Ronald R Winters, Marc H Willis, Collin D Bray, Theodore B Shybut
The menisci play an important biomechanical role in axial load distribution of the knees by means of hoop strength, which is contingent on intact circumferentially oriented collagen fibers and meniscal root attachments. Disruption of the meniscal root attachments leads to altered biomechanics, resulting in progressive cartilage loss, osteoarthritis, and subchondral edema, with the potential for development of a subchondral insufficiency fracture. Identification of meniscal root tears at magnetic resonance (MR) imaging is crucial because new arthroscopic surgical techniques (transtibial pullout repair) have been developed to repair meniscal root tears and preserve the tibiofemoral cartilage of the knee...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Richard Kijowski, Humberto Rosas, Alexey Samsonov, Kevin King, Rob Peters, Fang Liu
PURPOSE: To investigate the feasibility of using compressed sensing (CS) to accelerate three-dimensional fast spin-echo (3D-FSE) imaging of the knee. MATERIALS AND METHODS: A 3D-FSE sequence was performed at 3T with CS (CUBE-CS with 3:16-minute scan time) and without CS (CUBE with 4:44-minute scan time) twice on the knees of 10 healthy volunteers to assess signal-to-noise ratio (SNR) using the addition-subtraction method and once on the knees of 50 symptomatic patients to assess diagnostic performance...
October 11, 2016: Journal of Magnetic Resonance Imaging: JMRI
N Lefevre, S Klouche, O de Pamphilis, S Herman, A Gerometta, Y Bohu
INTRODUCTION: Femoral nerve block (FNB) is considered as a major advance in anterior cruciate ligament (ACL) reconstruction as it reduces the need for parenteral opioids. However, the incidence of transient or even permanent neurological deficits due to the FNB is estimated at 1.94% after knee surgery. The primary objective of this study was to compare local infiltration analgesia (LIA) to FNB during ACL reconstruction procedures. The study hypothesis was that LIA was not less effective than FNB on early postoperative pain...
October 3, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Adrian Todor, Sergiu Caterev, Dan Viorel Nistor
Arthroscopic partial medial meniscectomy is a very common orthopaedic procedure performed for symptomatic, irreparable meniscus tears. It is usually associated with a very good outcome and minimal complications. In some patients with tight medial compartment, the posterior horn of the medial meniscus can be difficult to visualize, and access in this area with instruments may be challenging. To increase the opening of the medial compartment, after valgus-extension stress position of the knee, different techniques of deep medial collateral ligament release have been described...
August 2016: Arthroscopy Techniques
Michael D Ringler, Ezekiel E Shotts, Mark S Collins, B Matthew Howe
OBJECTIVE: Unlike with anterior cruciate ligament injury, little is known about the prevalence of intra-articular pathology associated with isolated posterior cruciate ligament (PCL) injury in the knee. The objectives of this study were to characterize and identify the frequency of meniscal tears and osteochondral injuries in these patients, and to see if management might be affected. MATERIALS AND METHODS: Altogether, 48 knee MRI exams with isolated PCL tears were evaluated for the presence of: grade and location of PCL tear, meniscal tear, articular chondral lesion, bone bruise, and fracture...
October 4, 2016: Skeletal Radiology
Christian Konrads, Stephan Reppenhagen, Daniel Belder, Sascha Goebel, Maximilian Rudert, Thomas Barthel
PURPOSE: To analyse subjective and objective long-term outcomes of patients with anterior cruciate ligament (ACL)-deficient knees and limited demands regarding sportive activities. This subgroup of patients might be well-treated without ligament reconstruction. METHODS: We included 303 patients with unilateral tears of the ACL and conservative treatment into a prospective study. Mean age at injury was 33.8 (min. 18, max. 66) years. Follow-up was 27.1 (min. 21.3, max...
October 3, 2016: International Orthopaedics
Alon Rabin, Sigal Portnoy, Zvi Kozol
Study Design Cross-sectional. Background Altered hip and knee kinematics have been associated with several knee disorders including anterior cruciate ligament tear, patellofemoral pain, and iliotibial band syndrome. Limited ankle dorsiflexion (DF) range of motion (ROM), which has been linked with some of these disorders, has also been associated with altered knee kinematics. Objective Explore the association of ankle DF ROM with hip and knee kinematics during a step down task. Methods Thirty healthy participants underwent a 3-dimensional analysis of hip and knee kinematics during a lateral step down test, followed by measurement of ankle DF ROM in weight-bearing (WB) and non-weight-bearing (NWB)...
September 29, 2016: Journal of Orthopaedic and Sports Physical Therapy
Alexandre Rambaud, Pierre Samozino, Pascal Edouard
OBJECTIVE: After anterior cruciate ligament (ACL) tear, the ACL reconstruction (ACLR) is the standard treatment to return to pivots/contacts sports. The goal of rehabilitation programs is to guide the functional recovery and the safe return to sport without additional knee injury or other injuries. Functional tests, like Hop tests and their side to-side difference index [limb symmetry index (LSI)], are commonly used following ACLR to help return to sport decision making. However, the most commonly used criterion to return to sport is the postoperative time: return to light activities (RtlA) at 3 or 4 month mark and return to sport with contacts and side-cuttings (RtS) between 6 and 9 month mark...
September 2016: Annals of Physical and Rehabilitation Medicine
Berardo Di Matteo, Markus Loibl, Luca Andriolo, Giuseppe Filardo, Johannes Zellner, Matthias Koch, Peter Angele
AIM: To systematically review the currently available literature concerning the application of biologic agents such as platelet-rich plasma (PRP) and stem cells to promote anterior cruciate ligament (ACL) healing. METHODS: A systematic review of the literature was performed on the use of biologic agents (i.e., PRP or stem cells) to favor ACL healing during reconstruction or repair. The following inclusion criteria for relevant articles were used: Clinical reports of any level of evidence, written in English language, on the use of PRP or stem cells during ACL reconstruction/repair...
September 18, 2016: World Journal of Orthopedics
Dyan V Flores, Edward Smitaman, Brady K Huang, Donald L Resnick
OBJECTIVE: To re-evaluate the Segond fragment emphasizing those structures that attach to the fragment in patients with reported acute/subacute anterior cruciate ligament (ACL) injuries, and to clarify the nomenclature used to describe these structures. MATERIALS AND METHODS: A search of databases of knee MR examinations over 4.5 years with reported ACL tears yielded 19,726 studies. Using strict exclusion criteria, a total of 146 MR studies with acute/subacute ACL tears were re-assessed with respect to the Segond fragment's size, shape, orientation, location, displacement, attaching soft tissue structures, and associated osseous and/or soft tissue injuries...
September 24, 2016: Skeletal Radiology
Shun-Li Kan, Zhi-Fang Yuan, Guang-Zhi Ning, Bo Yang, Hai-Liang Li, Jing-Cheng Sun, Shi-Qing Feng
BACKGROUND: Anterior cruciate ligament (ACL) reconstruction is considered as the standard surgical procedure for the treatment of ACL tear. However, there is a crucial controversy in terms of whether to use autograft or allograft in ACL reconstruction. The purpose of this meta-analysis is to compare autograft with allograft for patients undergoing ACL reconstruction. METHODS: PubMed, EMBASE, and the Cochrane Library were searched for randomized controlled trials that compared autograft with allograft in ACL reconstruction up to January 31, 2016...
September 2016: Medicine (Baltimore)
Christopher V Nagelli, James L Cook, Kei Kuroki, Chantelle Bozynski, Richard Ma, Timothy E Hewett
Complications following anterior cruciate ligament (ACL) injury and reconstruction that include chronic dysfunction, second ACL injury, and posttraumatic osteoarthritis (OA) may be interrelated and stem from the inability to fully restore native ACL integrity and function. The loss of ACL sensory input following injury may significantly contribute to joint dysfunction. We developed a novel preclinical animal model to assess the contributions of ACL sensory afferents to knee joint function and health. We hypothesized that ACL sensory denervation would manifest in knee joint dysfunction and development of early OA...
September 20, 2016: Journal of Knee Surgery
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
Robert W Westermann, Thomas Sean Lynch, Kurt P Spindler
Since 2015, the Multicenter Orthopedic Outcomes Network (MOON) has addressed several factors associated with patient outcome after anterior cruciate ligament (ACL) injury. These factors include predictors of high grade knee laxity, the impact of meniscus treatment on joint space narrowing after surgery, graft selection, treating diabetic patients, predictors of clinically significant pain, and outcomes of patients where meniscus tears were left in situ without treatment. The presence of meniscus tears and generalized laxity predict a lax examination under anesthesia prior to surgery...
October 2016: Journal of Knee Surgery
L Felli, G Garlaschi, A Muda, A Tagliafico, M Formica, A Zanirato, M Alessio-Mazzola
PURPOSE: The aim of this study was to compare the accuracy of clinical examination to that of MRI evaluated by two independent radiologists for the diagnosis of meniscal tears and chronic anterior cruciate ligament injuries and to assess the MRI accuracy in the diagnosis of cartilage defects. METHODS: Seventy-six consecutive patients with suspected intra-articular knee pathology were prospectively evaluated by objective examination, 1.5 T MRI, re-examined by trained radiologist and arthroscopy...
September 14, 2016: Musculoskeletal Surgery
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