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https://www.readbyqxmd.com/read/27916189/editorial-commentary-lateral-extra-articular-reconstructions-with-anterior-cruciate-ligament-surgery-are-these-operative-procedures-supported-by-in%C3%A2-vitro-biomechanical-studies
#1
EDITORIAL
Frank R Noyes
There remains controversy on the role of a concurrent lateral extra-articular procedure with anterior cruciate ligament (ACL) reconstruction. Previous biomechanical studies often are historical and inconclusive. Studies show the anterolateral ligament and iliotibial band are secondary restraints and, when injured in conjunction with the ACL, produce gross (Grade 3) pivot-shift subluxations. Recent robotic studies show a well-placed bone-patellar tendon-bone reconstruction does restore time-zero kinematics with a negative pivot-shift...
December 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27904518/testing-the-feasibility-and-safety-of-the-nintendo-wii-gaming-console-in-orthopedic-rehabilitation-a-pilot-randomized-controlled-study
#2
Andreas Ficklscherer, Jonas Stapf, Kay Michael Meissner, Thomas Niethammer, Matthias Lahner, Markus Wagenhäuser, Peter E Müller, Matthias F Pietschmann
INTRODUCTION: The Nintendo Wii game console is already used as an additional training device for e.g. neurological wards. Still there are limited data available regarding orthopedic rehabilitation. The authors' objective was to examine whether the Nintendo Wii is an appropriate and safe tool in rehabilitation after orthopedic knee surgery. MATERIAL AND METHODS: A prospective, randomized, controlled study comparing standard physiotherapy vs. standard physiotherapy plus game console training (Wii group) in patients having anterior cruciate ligament (ACL) repair or knee arthroplasty was conducted...
December 1, 2016: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/27903590/anterior-cruciate-ligament-derived-stem-cells-transduced-with-bmp2-accelerate-graft-bone-integration-after-acl-reconstruction
#3
Yohei Kawakami, Koji Takayama, Tomoyuki Matsumoto, Ying Tang, Bing Wang, Yutaka Mifune, James H Cummins, Ryan J Warth, Ryosuke Kuroda, Masahiro Kurosaka, Freddie H Fu, Johnny Huard
BACKGROUND: Strong graft-bone integration is a prerequisite for successful graft remodeling after reconstruction of the anterior cruciate ligament (ACL) using soft tissue grafts. Novel strategies to accelerate soft tissue graft-bone integration are needed to reduce the need for bone-tendon-bone graft harvest, reduce patient convalescence, facilitate rehabilitation, and reduce total recovery time after ACL reconstruction. HYPOTHESIS: The application of ACL-derived stem cells with enhanced expression of bone morphogenetic protein 2 (BMP2) onto soft tissue grafts in the form of cell sheets will both accelerate and improve the quality of graft-bone integration after ACL reconstruction in a rat model...
November 30, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27894180/causes-of-failure-of-anterior-cruciate-ligament-reconstruction-and-revision-surgical-strategies
#4
Paolo Di Benedetto, Enrico Di Benedetto, Andrea Fiocchi, Alessandro Beltrame, Araldo Causero
Purpose: Long-term outcomes of anterior cruciate ligament (ACL) reconstruction are good or excellent; however, 0.7%-20% of patients suffer from recurrent instability due to graft failure. The purpose of this paper was to analyse failure aetiology and the possibilities of revision surgical strategies, with a description of our experience. We obtained optimal and good results in most of our patients. Materials and Methods: We retrospectively reviewed 42 patients who underwent revision surgery (43 revisions) due to relapsing instability after ACL reconstruction between 2006 and 2015...
December 1, 2016: Knee Surgery & related Research
https://www.readbyqxmd.com/read/27894146/variables-associated-with-chondral-and-meniscal-injuries-in-anterior-cruciate-ligament-surgery
#5
E Lyle Cain, Glenn S Fleisig, Brent A Ponce, Hikel A Boohaker, Martha P George, Gerald McGwin, James R Andrews, Lawrence J Lemak, William G Clancy, Jeffrey R Dugas
This article aims to evaluate factors associated with chondral and meniscal lesions in primary and revision anterior cruciate ligament (ACL) reconstructions. ACL reconstructions from 2001 to 2008 at a single institution were retrospectively analyzed. Logistic regression was used to estimate the association between chondral and meniscal injuries and age, gender, tear chronicity, additional ligamentous injuries, sport type, and participation level. Of the 3,040 ACL reconstructions analyzed, 90.4% were primary reconstructions and 9...
November 28, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27885394/sports-specific-differences-in-postsurgical-infections-after-arthroscopically-assisted-anterior-cruciate-ligament-reconstruction
#6
Werner Krutsch, Johannes Zellner, Florian Zeman, Michael Nerlich, Matthias Koch, Christian Pfeifer, Peter Angele
PURPOSE: Post-operative infection after arthroscopically assisted anterior cruciate ligament (ACL) reconstruction is a rare but severe complication, particularly for young and active patients. It is unclear whether the prevalence of knee infection is correlated with the type of sports or the level of performance. METHODS: From 2008 to 2012, the internal single-centre ACL registry of the FIFA Medical Centre of Excellence Regensburg was retrospectively screened for sex, age, time between isolated primary ACL rupture and surgery, surgical technique, rate of infection after ACL reconstruction and the type of sports practised...
November 24, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27885380/anterior-cruciate-ligament-reconstruction-tunnel-size-causes-of-tunnel-enlargement-and-implications-for-single-versus-two-stage-revision-reconstruction
#7
REVIEW
Magda Rizer, Gregory Brian Foremny, Augustus Rush, Adam D Singer, Michael Baraga, Lee D Kaplan, Jean Jose
Anterior cruciate ligament (ACL) reconstructions have increased over the past 25 years. The increased incidence of ACL reconstructions has translated into a larger number of graft failures and revision ACL procedures. It is important to understand the causes of graft failure when evaluating for a revision ACL reconstruction and to appreciate changes in tunnel anatomy over time prior to planning revision surgery. In this manuscript, tunnel size for ACL reconstruction and implications for single-stage versus two-stage revision ACL reconstruction will be discussed, as well as causes of tunnel enlargement, including mechanical and biological factors...
November 24, 2016: Skeletal Radiology
https://www.readbyqxmd.com/read/27882413/double-bundle-anterior-cruciate-ligament-reconstruction-is-superior-to-single-bundle-reconstruction-in-terms-of-revision-frequency-a-study-of-22-460-patients-from-the-swedish-national-knee-ligament-register
#8
Eleonor Svantesson, David Sundemo, Eric Hamrin Senorski, Eduard Alentorn-Geli, Volker Musahl, Freddie H Fu, Neel Desai, Anders Stålman, Kristian Samuelsson
PURPOSE: Studies comparing single- and double-bundle anterior cruciate ligament (ACL) reconstructions often include a combined analysis of anatomic and non-anatomic techniques. The purpose of this study was to compare the revision rates between single- and double-bundle ACL reconstructions in the Swedish National Knee Ligament Register with regard to surgical variables as determined by the anatomic ACL reconstruction scoring checklist (AARSC). METHODS: Patients from the Swedish National Knee Ligament Register who underwent either single- or double-bundle ACL reconstruction with hamstring tendon autograft during the period 2007-2014 were included...
November 23, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27881383/clinical-and-radiological-outcomes-after-hamstring-anterior-cruciate-ligament-reconstructions-comparison-between-fixed-loop-and-adjustable-loop-cortical-suspension-devices
#9
Nam-Hong Choi, Bong-Seok Yang, Brian N Victoroff
BACKGROUND: Few studies have compared clinical and radiological outcomes after hamstring anterior cruciate ligament (ACL) reconstruction with fixed-loop and adjustable-loop cortical suspension devices. PURPOSE/HYPOTHESIS: The purpose of this retrospective study was to compare clinical outcomes and tunnel widening after hamstring ACL reconstructions with fixed- and adjustable-loop cortical suspension devices. The hypothesis was that compared with femoral graft fixation with the fixed-loop device, fixation with the adjustable-loop device would show similar clinical outcomes and would result in less tunnel widening after hamstring ACL reconstruction...
November 23, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27881382/early-changes-in-knee-center-of-rotation-during-walking-after-anterior-cruciate-ligament-reconstruction-correlate-with-later-changes-in-patient-reported-outcomes
#10
Matthew R Titchenal, Constance R Chu, Jennifer C Erhart-Hledik, Thomas P Andriacchi
BACKGROUND: Altered knee kinematics after anterior cruciate ligament injury and reconstruction (ACLR) have been implicated in the development of posttraumatic osteoarthritis (PTOA), leading to poor long-term clinical outcomes. PURPOSE: This study was conducted to determine (1) whether the average knee center of rotation (KCOR), a multidimensional metric of knee kinematics, of the ACL-reconstructed knee during walking differs from that of the uninjured contralateral knee; (2) whether KCOR changes between 2 and 4 years after surgery; and (3) whether early KCOR changes predict patient-reported outcomes 8 years after ACLR...
November 23, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27873020/beneficial-and-limiting-factors-for-return-to-work-following-anterior-cruciate-ligament-reconstruction-a-retrospective-cohort-study
#11
Judith A M Groot, Freerk J Jonkers, Arthur J Kievit, P Paul F M Kuijer, Marco J M Hoozemans
PURPOSE: Evidence-based advice for return to work (RTW) after anterior cruciate ligament (ACL) reconstruction is not available. Therefore, the objectives of this study were to determine when patients achieve full RTW, and to explore the beneficial and limiting factors for fully RTW after ACL reconstruction. METHODS: A retrospective cohort study was performed after ACL reconstruction among 185 patients in one hospital. Data from patient files and a questionnaire were used to explore whether patient-, injury-, surgery-, sports-, work- and rehabilitation-related factors are beneficial or limiting for fully RTW after ACL reconstruction, using a backward stepwise logistic regression analysis...
November 21, 2016: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/27871664/gross-arthroscopic-and-radiographic-anatomies-of-the-anterior-cruciate-ligament-foundations-for-anterior-cruciate-ligament-surgery
#12
REVIEW
Sebastián Irarrázaval, Marcio Albers, Tom Chao, Freddie H Fu
The anterior cruciate ligament (ACL) is one of the more studied structures in the knee joint. It is not a tubular structure, but is much narrower in its midsubstance and broader at its ends, producing an hourglass shape. The ACL is composed of 2 functional bundles, the anteromedial and posterolateral bundles, that are named for their location of insertion on the anterior surface of the tibial plateau. Although the relative contribution in terms of total cross-sectional area of the ACL has been noted to be equal in regards to each bundle, dynamically these bundles demonstrate different properties for knee function...
January 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27871662/indications-for-two-incision-outside-in-anterior-cruciate-ligament-reconstruction
#13
REVIEW
Barton R Branam, Christopher J Utz
Anterior cruciate ligament (ACL) reconstruction is a commonly performed procedure. Drilling the femoral tunnel independent of the tibial tunnel has become popular as surgeons strive to create tunnels in the anatomic locations of the femoral and tibial attachments of the native ligament. The 2-incision technique effectively and reproducibly accomplishes this goal. The 2-incision technique for ACL reconstruction is a valuable tool in the skillset of the reconstructive knee surgeon. Indications for the 2-incision surgery are reviewed in detail...
January 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27871659/graft-selection-in-anterior-cruciate-ligament-surgery-who-gets-what-and-why
#14
REVIEW
Kyle R Duchman, T Sean Lynch, Kurt P Spindler
Anterior cruciate ligament (ACL) injuries are common and affect a young, active patient population. Despite much research, ACL reconstruction graft choice remains a topic of debate. Based on the best available evidence, autograft seems to be superior to allograft for ACL reconstruction in young, active patients. Future high-level studies are required in order to better define the role of allograft in ACL reconstruction. As graft choice is often influenced by surgeon preference, it is important that surgeons understand the current literature as well as the goals of their patients...
January 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27871658/rehabilitation-principles-of-the-anterior-cruciate-ligament-reconstructed-knee-twelve-steps-for-successful-progression-and-return-to-play
#15
REVIEW
Kevin E Wilk, Christopher A Arrigo
The rehabilitation process begins immediately after injury to the anterior cruciate ligament (ACL). The goal of preoperative rehabilitation is to prepare the patient for surgery. Current rehabilitation programs focus on strengthening exercises and proprioceptive and neuromuscular control drills to provide a neurologic stimulus. It is also important to address preexisting factors, especially for the female athlete, that may predispose to future injury, such as hip and hamstring weakness. Our goal in the rehabilitation program is to restore full, unrestricted function and to assist the patient to return to 100% of the preinjury level while achieving excellent long-term outcomes...
January 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27871657/surgical-pearls-in-revision-anterior-cruciate-ligament-surgery-when-must-i-stage
#16
REVIEW
Dustin L Richter, Brian C Werner, Mark D Miller
Failed anterior cruciate ligament (ACL) reconstruction is a challenging clinical entity and revision ACL reconstruction is a technically challenging procedure. This article reviews the etiology of ACL failures, the need for appropriate examination and imaging studies, and discusses the technical considerations to allow for a successful revision reconstruction. Furthermore, we elaborate on the decision-making process of when a 2-stage revision is preferred to a single-stage revision.
January 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27871656/etiologic-factors-that-lead-to-failure-after-primary-anterior-cruciate-ligament-surgery
#17
REVIEW
James D Wylie, Lucas S Marchand, Robert T Burks
Anterior cruciate ligament (ACL) reconstruction is common in the active young population. Failure of ACL reconstruction can be due to continued or recurrent instability, stiffness, or patient-reported failure in the setting of seemingly successful surgical reconstruction, such as pain that limits activity. Multiple preoperative, intraoperative, and postoperative variables can be optimized to give the greatest likelihood of success. Some of these include timing of surgery, identification, and treatment of associated ligamentous, meniscal and chondral injuries, tunnel placement, graft choice, fixation, tensioning, and postoperative rehabilitation...
January 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27868076/synovial-c-shaped-tibial-footprint-of-the-anterior-cruciate-ligament
#18
César Janovsky, Camila Cohen Kaleka, Maria Teresa Seixas Alves, Mario Ferretti, Moises Cohen
BACKGROUND: Although numerous anatomic studies about the anterior cruciate ligament (ACL) structure and attachments have been performed, these studies have not reached consensus on the ACL footprint. PURPOSE: To investigate the existing controversy regarding the morphology of the tibial ACL insertion (footprint) and confirm histologically that the tibial ACL footprint is not completely filled with ligament tissue. STUDY DESIGN: Descriptive laboratory study...
November 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/27859527/gait-mechanics-and-second-acl-rupture-implications-for-delaying-return-to-sport
#19
Jacob J Capin, Ashutosh Khandha, Ryan Zarzycki, Kurt Manal, Thomas S Buchanan, Lynn Snyder-Mackler
Second anterior cruciate ligament rupture is a common and devastating injury among young women who return to sport after ACL reconstruction, but it is inadequately understood. The purpose of this study was to compare gait biomechanics and return-to-sport time frames in a matched cohort of young female athletes who, after primary ACLR, returned to sport without re-injury or sustained a second ACL injury. Approximately 6 months after primary reconstruction, 14 young women (age 16 ± 2 years) involved in jumping, cutting, and pivoting sports underwent motion analysis testing after physical therapy and impairment resolution...
November 9, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/27857501/prospective-study-of-the-anterior-cruciate-ligament-reconstruction-associated-with-high-tibial-opening-wedge-osteotomy-in-knee-arthritis-associated-with-instability
#20
Raju Vaishya, Vipul Vijay, Gyanendra Kumar Jha, Amit Kumar Agarwal
INTRODUCTION: Chronic ACL insufficiency with associated varus malalignment due to knee osteoarthritis (OA) is challenging to treat surgically. A combined ACL reconstruction (ACLR) with medial open wedge high tibial osteotomy (HTO) without using any metallic implant for HTO is an effective technique. MATERIALS AND METHOD: All the patients attending the outpatient department ACL injury and with associated medial compartment OA (Kellegren's grade 2 and grade 3) were considered for inclusion in the study...
October 2016: Journal of Clinical Orthopaedics and Trauma
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