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https://www.readbyqxmd.com/read/28439635/high-incidence-of-partially-anatomic-tunnel-placement-in-primary-single-bundle-acl-reconstruction
#1
Andrea Achtnich, Francesco Ranuccio, Lukas Willinger, Jonas Pogorzelski, Andreas B Imhoff, Sepp Braun, Elmar Herbst
PURPOSE: The purpose of this study was to evaluate tunnel position and width in failed primary single-bundle (SB) anterior cruciate ligament (ACL) reconstructions. It was hypothesized that both femoral and tibial bone tunnels are frequently malplaced in terms of a partially anatomic position in the setting of failed SB ACL reconstruction. METHODS: Patients with recurrent instability following isolated SB ACL reconstruction using hamstring tendon autografts, undergoing revision ACL surgery, were retrospectively included...
April 24, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28426251/current-concepts-of-the-anterolateral-ligament-of-the-knee-anatomy-biomechanics-and-reconstruction
#2
Matthew J Kraeutler, K Linnea Welton, Jorge Chahla, Robert F LaPrade, Eric C McCarty
In 1879, Paul Segond described an avulsion fracture (now known as a Segond fracture) at the anterolateral proximal tibia with the presence of a fibrous band at the location of this fracture. Although references to this ligament were occasionally made in the anatomy literature after Segond's discovery, it was not until 2012 that Vincent et al named this ligament what we know it as today, the anterolateral ligament (ALL) of the knee. The ALL originates near the lateral epicondyle of the distal femur and inserts on the proximal tibia near Gerdy's tubercle...
April 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28409108/hamstring-graft-biological-preparation-for-anterior-cruciate-ligament-reconstruction
#3
Nuno Camelo Barbosa, Francisco Guerra-Pinto, Claudia Cabeleira, Pedro Beja da Costa
The all-inside anterior cruciate ligament reconstruction (ACLR) success depends on biologic integration of the graft in the bone tunnel. Sutures wrapping the tendon in the bone tunnel may affect tendon-bone healing in shorter bone tunnels. To achieve better graft integration, we propose a variation of the graft link suture technique wherein the graft is linked chain-like to the femoral and tibial TightRope (Arthrex), which increases the tendon-bone contact area by eliminating sutures from the noose of the graft and thus may allow better graft integration...
February 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28400663/tunnel-widening-prevention-with-the-allo-achilles-tendon-graft-in-anterior-cruciate-ligament-reconstruction-surgical-tips-and-short-term-followup
#4
Dong Won Suh, Seung Beom Han, Woo Jin Yeo, Won Hee Lee, Jae Ho Kwon, Bong Soo Kyung
BACKGROUND: Tunnel widening (TW) after anterior cruciate ligament (ACL) reconstruction can be a serious complication, and there is controversy over how to prevent it. This study aimed to suggest surgical approaches to prevent TW using an allo-Achilles tendon graft, and then to evaluate TW after these surgical tips were applied. MATERIALS AND METHODS: Sixty two patients underwent ACL reconstruction with an allo-Achilles tendon graft. Four surgical approaches were used: Making a tibial tunnel by bone impaction, intraarticular reamer application, bone portion application for the femoral tunnel, and an additional bone plug application for the tibial tunnel...
March 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28349206/impingement-of-the-patellar-component-against-the-tibial-post-after-posterior-stabilized-and-constrained-tka-a-pilot-study
#5
Yukihide Minoda, Ryo Sugama, Yoichi Ohta, Hiroaki Nakamura
INTRODUCTION: Patella-post impingement (PPI), contact of the patellar component with the tibial post, occurs during deep knee flexion after posterior stabilized total knee arthroplasty (TKA). PPI can cause anterior knee pain, increased patellar pressure, wear of the polyethylene patellar component and tibial post, and poor range of motion. There have been no reports on the relationship between PPI and tibial post design. The aim of this study was to compare different tibial post designs with regard to PPI incidence...
March 27, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28298055/the-effect-of-graft-pretensioning-on-bone-tunnel-diameter-and-bone-formation-after-anterior-cruciate-ligament-reconstruction-in-a-rat-model
#6
Jian-Chun Zong, Richard Ma, Hongsheng Wang, Guang-Ting Cong, Amir Lebaschi, Xiang-Hua Deng, Scott A Rodeo
BACKGROUND: Moderate graft pretensioning in anterior cruciate ligament (ACL) reconstruction is paramount to restore knee stability and normalize knee kinematics. However, little is known about the effect of graft pretensioning on graft-to-bone healing after ACL reconstruction. HYPOTHESIS: Moderate graft pretensioning will improve bone formation within the bone tunnel after ACL reconstruction, resulting in superior load to failure. STUDY DESIGN: Controlled laboratory study...
February 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28293698/anterolateral-ligament-abnormalities-are-associated-with-peripheral-ligament-and-osseous-injuries-in-acute-ruptures-of-the-anterior-cruciate-ligament
#7
Camilo Partezani Helito, Paulo Victor Partezani Helito, Renata Vidal Leão, Marco Kawamura Demange, Marcelo Bordalo-Rodrigues
PURPOSE: Few studies have used MRI to identify the ALL. As it was shown that it is not possible to precisely characterize this ligament in all examination, it is important to identify concomitant lesions that can help in diagnosing ALL abnormalities. It is important to characterise this injury due to its association with anterolateral knee instability. Thus, the present study was performed to determine the frequency of ALL injuries in patients with acute ACL rupture and to analyse its associated knee lesions...
March 14, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28282242/influence-of-the-injury-to-surgery-interval-on-the-healing-potential-of-human-anterior-cruciate-ligament-derived-cells
#8
Takao Inokuchi, Tomoyuki Matsumoto, Koji Takayama, Naoki Nakano, Shurong Zhang, Daisuke Araki, Takehiko Matsushita, Ryosuke Kuroda
BACKGROUND: Vascular CD34+ cells in anterior cruciate ligament (ACL) tissue have the potential for high proliferation and multilineage differentiation that can accelerate tendon-bone healing. While patient characteristics, such as age, can affect tendon-bone healing, the influence of elapsed time after injury on the healing process is unclear. HYPOTHESIS: Cells obtained during the early phase after injury will exhibit a greater tendon-bone healing potential compared with chronic phase counterparts when applied to an immunodeficient rat model of ACL reconstruction...
March 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28277745/3d-computed-tomography-evaluation-of-morphological-changes-in-the-femoral-tunnel-after-medial-patellofemoral-ligament-reconstruction-with-hamstring-tendon-graft-for-recurrent-patellar-dislocation
#9
Keisuke Kita, Yoshinari Tanaka, Yukiyoshi Toritsuka, Hiroshi Amano, Ryohei Uchida, Yoshiki Shiozaki, Rikio Takao, Shuji Horibe
BACKGROUND: Reconstruction of the medial patellofemoral ligament (MPFL) for recurrent lateral patellar dislocation is gaining popularity. However, the morphological changes in the femoral tunnel after MPFL reconstruction are still not fully documented. PURPOSE: This study used 3-dimensional (3D) computed tomography to evaluate morphological changes in the femoral tunnel after MPFL reconstruction with hamstring tendon graft to investigate factors affecting the phenomenon and to elucidate whether it is associated with clinical outcomes...
March 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28267362/variability-in-patellofemoral-alignment-measurements-on-mri-influence-of-knee-position
#10
Alejandro Marquez-Lara, Jason Andersen, Leon Lenchik, Cristin M Ferguson, Pushpender Gupta
OBJECTIVE: The purpose of this study was to determine the variability of distances between four distinct anatomic landmarks used for the evaluation of patellofemoral alignment while implementing controlled changes in patient positioning during MRI. MATERIALS AND METHODS: Limited MRI was performed of 12 knees in healthy volunteers (10 men, two women; mean age, 28 years) with the knees in four different positions. The four landmarks used were TT (the most anterior point of the osseous tibial tubercle), TG (the nadir of the cartilaginous trochlear groove), PT (the center of the patellar tendon insertion on the tibia), and PCL (the medial border of the posterior cruciate ligament at its insertion along the posterior tibia)...
May 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28211291/a-biomechanical-analysis-of-tibial-acl-reconstruction-with-graft-length-mismatch
#11
Evan B Gaines, Diana Lau, Qais Naziri, Westley Hayes, Julio J Jauregui, Bhaveen H Kapadia, William P Urban, Bashir A Zikria
INTRODUCTION: The incidence of graft length mismatch (GLM) during anterior cruciate ligament (ACL) reconstruction is reported to be up to 13%, with a rate of 20% when using bone-patellar tendon-bone (BPTB) allografts. Multiple techniques have been described to accommodate for the longer BPTB graft. As no study has compared the biomechanical properties of these methods (with cyclic loading), we evaluated the strength of four different surgical techniques used to accommodate for GLM during ACL reconstruction...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28207972/anatomical-study-of-the-inferior-patellar-pole-and-patellar-tendon
#12
M Edama, I Kageyama, M Nakamura, T Kikumoto, E Nakamura, W Ito, T Takabayashi, T Inai, H Onishi
In this study, detailed investigations of the shape of the inferior patellar pole, the site of the patellar tendon attachment, and the length and course of the patellar tendon were performed with the aim of examining the anatomical factors involved in the developmental mechanism of patellar tendinitis.  The investigation examined 100 legs from 50 cadavers. The inferior patellar pole was classified into three types: Pointed, Intermediate, and Blunt. The attachment of the patellar tendon to the inferior patellar pole was classified into two types: an anterior and a posterior...
February 16, 2017: Scandinavian Journal of Medicine & Science in Sports
https://www.readbyqxmd.com/read/28198793/proximity-and-risks-of-the-anterior-neurovascular-and-tendinous-anatomy-of-the-distal-leg-relative-to-anteriorly-applied-distal-locking-screws-for-tibia-nailing-a-plea-for-open-insertion
#13
Phillip M Mitchell, Cory A Collinge, Eric Barcak, Edward Perez, Kostas Triantafillou
PURPOSE: To determine the proximity and potential risks to distal leg anatomy from anterior to posteriorly (A-P) applied distal tibia locking screws for tibial nailing. DESIGN: Retrospective. SETTING: ACS level I trauma center. PATIENTS/PARTICIPANTS: Twenty consecutive adult patients undergoing computed tomograms with intravenous contrast (CTAs) on uninjured legs. MAIN OUTCOME MEASUREMENTS: Simulated 5 mm distal interlocking screws placed in the A-P axis of an ideally placed tibial nail at 10 mm increments from the tibial plafond (10 to 40mm) were studied in relation to the distal leg's anterior anatomy...
February 14, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28195983/management-of-the-relapsed-clubfoot-following-treatment-using-the-ponseti-method
#14
Pooya Hosseinzadeh, Derek M Kelly, Lewis E Zionts
The Ponseti method to treat idiopathic clubfoot deformity has proven to be reliable, and several centers have reported excellent outcomes. Although the method has been dependable in obtaining initial correction of the foot, relapse rates ranging from 26% to 48% have been reported. When a relapsed deformity is detected early, treatment with a short series of manipulations and cast applications followed by resumption of postcorrective bracing may be all that is required to regain and maintain correction. In patients aged >2...
March 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28149730/quadruple-bundle-semitendinosus-gracilis-graft-technique-for-all-inside-anterior-cruciate-ligament-reconstruction
#15
Michael Kern, David Love, Eric J Cotter, William Postma
Hamstring tendon autograft has been shown to be an excellent option for anterior cruciate ligament (ACL) reconstruction. Adequate graft size can usually be achieved through either a double-bundle technique of semitendinosus and gracilis tendons or a quadruple-bundle technique using a single tendon. To minimize failure rates that result from graft insufficiency, a minimum graft thickness of 8 mm is recommended for reconstruction. However, certain patients possess small native hamstring tendons that do not allow for recommended graft thickness using either of these traditional techniques...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28149722/combined-anterior-cruciate-ligament-and-anterolateral-ligament-reconstruction
#16
Bertrand Sonnery-Cottet, Matt Daggett, Camilo Partezani Helito, Jean-Marie Fayard, Mathieu Thaunat
Despite technologic advances in the surgical technique for anterior cruciate ligament (ACL) reconstruction, some patients continue to have rotational instability postoperatively. Recently, authors have reported the anatomic and functional characteristics of the anterolateral ligament (ALL), a structure that originates near the lateral epicondyle on the femur and inserts on the tibia between the Gerdy tubercle and the fibular head. Recent biomechanical studies have shown the ALL is an important stabilizer against anterolateral tibial rotation, and its reconstruction has shown excellent initial clinical results...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28144149/can-achilles-tendon-be-used-as-a-new-distal-landmark-for-coronal-tibial-component-alignment-in-total-knee-replacement-surgery-an-observational-mri-study
#17
Uğur Tiftikçi, Sancar Serbest, Veysel Burulday
BACKGROUND: In total knee arthroplasty, it is better to use more than one reference point for correct alignment of the components. By measuring the distances of Achilles tendon (AT) and other conventional landmarks from the mechanical axis in magnetic resonance imaging (MRI) of the ankle, we aimed to demonstrate that, as a novel landmark which can help for correct alignment in the coronal plane, AT is a better option than other landmarks. MATERIALS AND METHODS: This retrospective study was done on 53 ankle MRIs that met the criteria for inclusion to the study among 158 ankle MRIs...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28130031/comparison-between-intra-and-extra-articular-tension-of-the-graft-during-fixation-in-anterior-cruciate-ligament-reconstruction
#18
Yuichiro Nishizawa, Yuichi Hoshino, Kouki Nagamune, Daisuke Araki, Kanto Nagai, Masahiro Kurosaka, Ryosuke Kuroda
PURPOSE: To evaluate the tension deprivation through the tunnels with and without preconditioning at the time of fixation, and the influences of cyclic loading and pretensioning on graft tension in anatomic single bundle anterior cruciate ligament (ACL) reconstruction using a hamstring tendon. METHODS: Nine fresh-frozen cadaveric knees underwent anatomic ACL reconstruction using hamstring grafts. Each specimen was examined to ensure that there was no severe osteoarthritic change, ligament insufficiency, or torn menisci by manual and arthroscopic evaluation...
January 24, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28089795/comparison-of-postoperative-biomechanical-function-between-anatomic-double-bundle-and-single-bundle-acl-reconstructions-using-calcium-phosphate-hybridized-tendon-grafts-in-goats
#19
H Mutsuzaki, H Fujie, H Nakajima, M Fukagawa, S Nomura, M Sakane
BACKGROUND: Calcium phosphate (CaP)-hybridized tendon grafts improved biomechanical function compared with untreated grafts after single-bundle (SB) anterior cruciate ligament (ACL) reconstruction. The purpose of this study was to compare the biomechanical function between anatomic double-bundle (DB) and single-bundle (SB) ACL reconstructions using CaP-hybridized tendon grafts at 6 months postoperatively in goats. HYPOTHESIS: We hypothesized that the postoperative biomechanical function in the DB group will be better than that in the SB group...
April 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28076887/in-vivo-bone-tunnel-evaluation-of-nanoparticle-grafts-using-an-acl-reconstruction-rabbit-model
#20
Sheila A Grant, Sarah E Smith, Hilary Schmidt, Ferris Pfeiffer, Kei Kuroki, Seth Sherman, Richard White, David A Grant
Acellular human gracilis tendons conjugated with gold nanoparticles (AuNP) and hydroxyapatite nanoparticles (nano-HAp) were used as a graft in an anterior cruciate ligament (ACL) reconstruction rabbit model. The ACLs of 11 New Zealand rabbits were reconstructed using grafts conjugated without nanoparticles, with AuNP only, and with both AuNP and nano-HAp. Semi-quantitative histological scoring of bone tunnel portion of grafts was performed after 14 weeks. Bone tunnels were scored for graft degeneration, graft remodeling, percentage of new host fibrous connective, collateral connection, head-to-head connection, graft collagen fiber organization, new host fibrous connective tissue organization, and graft and interface vascularity...
April 2017: Journal of Biomedical Materials Research. Part A
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