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anterior tibial tendon

Christoph Ihle, H Nakayama, Christoph Gonser, Ulrich Stöckle, Stefan Döbele, Steffen Schröter, Marc-Daniel Ahrend, Atesch Ateschrang
BACKGROUND: The established surgical technique for lesion of the anterior cruciate ligament (ACL) is reconstruction with an autologous tendon. However, patients after ACL-replacement have increased osteoarthritis rates. Possible explanations are persistent knee instability and the loss of the ACL's proprioceptive function. Therefore, surgeons have developed an alternative treatment to preserve the ACL by readapting femoral ACL lesions by temporary protective dynamic intraligamentary stabilisation (DIS)...
February 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
Shaohua Liu, Hong Li, Hongyue Tao, Yaying Sun, Shiyi Chen, Jiwu Chen
BACKGROUND: The hamstring tendons are commonly harvested for anterior cruciate ligament (ACL) reconstruction with detachment of the tibial insertion. Retaining the insertion may help to preserve vascularity and viability of the graft and bypass the stages of avascular necrosis and revascularization, which might be beneficial to graft maturity. PURPOSE: To investigate and compare graft maturity by magnetic resonance imaging (MRI) after ACL reconstruction with preservation or detachment of hamstring tendon tibial insertion at up to 2 years...
February 1, 2018: American Journal of Sports Medicine
Cristian Tudor Buescu, Cristian Mircea Dudescu, Sergiu Caterev, Dan Gheorghe Osvald Lucaciu
Background and aims: Using free quadriceps tendon graft for anterior cruciate ligament (ACL) reconstruction has become more popular in the last years due to the low morbidity at the harvest site and biomechanical and structural properties similar to other types of graft (hamstring and patellar tendons). As long as the tibial tunnel fixation with interference screws is considered the standard fixation, femoral fixation is still an open subject. Even though the most common type of femoral tunnel fixation are the cortical suspension devices, the type of suture used for tying the graft to the loop is still evaluated and discussed...
2018: Clujul Medical (1957)
Alejandro Espejo-Baena, Alejandro Espejo-Reina, Abel Gómez-Cáceres, Maria Josefa Espejo-Reina, Jaime Dalla Rosa-Nogales
The anterior cruciate ligament (ACL) rupture is a common disease that accounts for 250,000 cases/year in the United States. The anterolateral ligament (ALL) has been suggested to be an important restraint for rotational instability, and its reconstruction provides a reinforcement to the ACL reconstruction in this aspect, especially in high-demand athletes and in knees with high-grade pivot shift. Different techniques for associated ACL and ALL reconstruction have been described, but the ideal technique remains unclear...
October 2017: Arthroscopy Techniques
Mohamed Aboalata, Ashraf Elazab, Abdelsamie Halawa, Andreas B Imhoff, Yehia Bassiouny
The anterior cruciate ligament suture augmentation technique is a method to augment anterior cruciate ligament reconstruction (ACLR) with autologous hamstring tendons using a braided ultrahigh-molecular weight polyester or polyethylene suture or suture tape and fixed on both the femoral and tibial sides independent of the graft to act as a backup or secondary stabilizer until complete integration and ligamentization of the graft take place. The technique is proposed to allow early rehabilitation and return to sports after ACLR and may be advantageous in patients with a high body mass index and in cases with small grafts (7 or 7...
October 2017: Arthroscopy Techniques
Tsukasa Teramoto, Shota Harada, Motoyuki Takaki, Tomohiko Asahara, Narutaka Kato, Nobuyuki Takenaka, Takasi Matsushita, Yosiaki Makino, Kouitiro Tasiro, Ootuka Kazutaka, Yukinobu Nishi, Kiyoto Kinugsa
We have devised a medial peri-articular osteotomy, the distal tibial oblique osteotomy (DTOO), and have used this technique since 1994 for ankle osteoarthritis of advanced and late stages associated with varus inclination. This report describes the surgical technique and its applicability. DTOO can be used for cases of varus ankle osteoarthritis with a range of the ankle joint movement of at least 10° or more. The osteotomy is obliquely directed cut across the distal tibia from proximal-medial to distal lateral and is of an opening-wedge type with the centre of rotation coincident with the centre of the tibiofibular joint...
January 29, 2018: Strategies in Trauma and Limb Reconstruction
Wesley Zhang Yang, Joseph S Park, Seth Robert Yarboro
CASE: A 47-year-old Caucasian woman spontaneously developed an isolated anterior compartment pressure of >100 mm Hg in the left leg. Despite fasciotomies, the musculature was nonviable and required debridement. Following Achilles tendon lengthening, a posterior tibial tendon (PTT) to anterior tibial tendon (ATT) transfer was supplemented with a flexor digitorum longus tendon transfer to the remaining PTT in order to prevent a flatfoot deformity while restoring active dorsiflexion. CONCLUSION: Preservation of the tendinous portion of the ATT during debridement allowed for transfer of the PTT to the ATT using a modified Pulvertaft transfer...
January 24, 2018: JBJS Case Connector
Assem Mohamed Noureldin Zein, Mohamed Elshafie, Ahmed Nady Saleh Elsaid, Mohamed Ahmed Elsaid Elrefai
The results of arthroscopic anterior cruciate ligament (ACL) reconstruction are so far satisfactory and improving over time as a result of the improved understanding of the anatomy and biomechanics of the ACL. Rotational instability confirmed by a positive pivot shift is present in more than 15% of cases who underwent successful ACL reconstruction. Persistent rotational instability interferes with performing pivoting sports, and also may lead to meniscal and chondral injuries, or re-rupture of the reconstructed ACL...
August 2017: Arthroscopy Techniques
Lauro Augusto Costa, Noel Oizerovici Foni, Eliane Antonioli, Rogério Teixeira de Carvalho, Isabela Dias Paião, Mário Lenza, Mário Ferretti
PURPOSE: The aims of this study are to describe the epidemiological characteristics of anterior cruciate ligament reconstructions in a private hospital in Brazil and to determine trends in medical practice for comparison with previous studies. METHODS: We retrospectively reviewed the anterior cruciate ligament institutional register to obtain data from all patients who underwent primary anterior cruciate ligament reconstruction from July 2014 to June 2016. Descriptive statistics were used to summarize the sample...
2018: PloS One
Mohamed Aboalata, Ashraf Elazab, Abdelsamie Halawa, Moheib S Ahmed, Andreas B Imhoff, Yehia Bassiouny
The crossing internal suture augmentation technique is an all-inside technique of anterior cruciate ligament reconstruction with augmentation of the hamstring tendon autograft with a braided ultrahigh-molecular-weight polyester-polyethylene suture tape resting on the adjustable cortical buttons on both the femoral and tibial sides. The internal suture augmentation acts as a backbone supporting and protecting the graft until the process of healing and ligamentization of the graft is completed. The ends of the suture tape are tied on the tibial button and additionally fixed to the tibia with a knotless anchor as a backup fixation with the knee in full extension...
December 2017: Arthroscopy Techniques
Niclas H Eysturoy, Kåre Amtoft Nissen, Torsten Nielsen, Martin Lind
BACKGROUND: The method of graft fixation in primary anterior cruciate ligament (ACL) reconstruction is important for initial stability of the graft. Poor graft fixation can result in failure of the reconstruction. The effect of ACL graft fixation principles and fixation implant combinations on the risk of revision after ACL reconstruction is not well understood. PURPOSE: The study aimed to compare the risk of revision among 4 categories of femoral fixation divided by their principle of function using a hamstring tendon (HT) graft only...
January 1, 2018: American Journal of Sports Medicine
K-T Kang, Y-G Koh, J Son, O-R Kwon, J-S Lee, S K Kwon
OBJECTIVES: Posterior condylar offset (PCO) and posterior tibial slope (PTS) are critical factors in total knee arthroplasty (TKA). A computational simulation was performed to evaluate the biomechanical effect of PCO and PTS on cruciate retaining TKA. METHODS: We generated a subject-specific computational model followed by the development of ± 1 mm, ± 2 mm and ± 3 mm PCO models in the posterior direction, and -3°, 0°, 3° and 6° PTS models with each of the PCO models...
January 2018: Bone & Joint Research
Yasutaka Tashiro, Ken Okazaki, Koji Murakami, Hirokazu Matsubara, Kanji Osaki, Yukihide Iwamoto, Yasuharu Nakashima
AIM: To quantitatively assess rotatory and anterior-posterior instability in vivo after anterior cruciate ligament (ACL) reconstruction using bone-patellar tendon-bone (BTB) autografts, and to clarify the influence of tunnel positions on the knee stability. METHODS: Single-bundle ACL reconstruction with BTB autograft was performed on 50 patients with a mean age of 28 years using the trans-tibial (TT) ( n = 20) and trans-portal (TP) ( n = 30) techniques. Femoral and tibial tunnel positions were identified from the high-resolution 3D-CT bone models two weeks after surgery...
December 18, 2017: World Journal of Orthopedics
Aishwarya Gulati, Christopher McElrath, Vibhor Wadhwa, Jay P Shah, Avneesh Chhabra
Anterior knee pain in active young adults is commonly related to patellofemoral pain syndrome, which can be broadly classified into patellar malalignment and patellar maltracking. Imaging is performed to further elucidate the exact malalignment and maltracking abnormalities and exclude other differentials. This article details the role of the stabilizers of the patellofemoral joint, findings on conventional and multimodality imaging aiding in patellofemoral pain syndrome diagnosis and characterization, and current perspectives of various treatment approaches...
January 22, 2018: British Journal of Radiology
Shuji Taketomi, Hiroshi Inui, Ryota Yamagami, Nobuyuki Shirakawa, Kohei Kawaguchi, Takumi Nakagawa, Sakae Tanaka
The purpose of this retrospective study was to first compare the clinical outcome of anatomical double-bundle (DB) anterior cruciate ligament reconstruction (ACLR) with hamstring tendon (HT) autografts and anatomical rectangular tunnel ACLR with bone-patellar tendon-bone (BPTB) autografts. Secondly, we aimed to demonstrate the quantitative locations of the femoral and tibial tunnel apertures using postoperative three-dimensional computed tomography (3D CT).Twenty-five patients underwent anatomical rectangular tunnel ACLR using BPTB grafts (Group B) and 23 patients underwent anatomical DB ACLR using HT grafts (Group H)...
December 28, 2017: Journal of Knee Surgery
Lucy J Salmon, Emma Heath, Hawar Akrawi, Justin P Roe, James Linklater, Leo A Pinczewski
BACKGROUND: No well-controlled studies have compared the long-term outcome of anterior cruciate ligament (ACL) reconstruction with hamstring tendon autograft between adolescents and adults. Increased posterior tibial slopes (PTSs) have been reported in the ACL-injured versus controls, but the effect of PTS on the outcome after reconstruction is relatively unexplored. PURPOSE: To compare the prospective longitudinal outcome of "isolated" ACL ruptures treated with anatomic endoscopic ACL reconstruction using hamstring tendon autograft over 20 years in adolescent and adult cohorts and to examine factors for repeat ACL injury...
December 1, 2017: American Journal of Sports Medicine
Efstathios G Lykoudis, Ioannis Dalianoudis, Konstantinos Seretis, George E Lykoudis, Marios G Lykissas
Reconstruction of complex soft tissue defects in the distal lower leg remains challenging, since anatomical constraints limit the local options available in this area. In this report, we present a case of single stage functional reconstruction of both peroneal tendons and overlying skin with an anterolateral thigh flap and vascularized fascia lata. A 55-year-old patient underwent wide excision of a synovial sarcoma in the distal lower leg, which resulted in a complex defect including the peroneus longus and brevis tendons (10 cm), and the overlying skin (14 × 8 cm)...
December 3, 2017: Microsurgery
Jing Hui Yik, Bryan Thean Howe Koh, Wilson Wang
BACKGROUND: Bucket-handle meniscus tears (BHMT) are often displaced and unstable. The inside-out technique of repairing such tears is currently the gold standard. All-inside repair with meniscal fixators is getting increasingly popular. Shortcomings of the inside-out technique include neurovascular complications, especially saphenous nerve palsy, and retention of a non-resorbable suture which can result in discomfort to patient, granuloma formation, and a foci of infection. Hence, the purpose of this project was to innovate a novel all-inside technique to precisely reduce and fix BHMT while avoiding neurovascular complications and retention of a non-resorbable suture...
December 4, 2017: Journal of Orthopaedic Surgery and Research
C Lutz
There is renewed interest in anterolateral reconstruction (ALR) for patients undergoing anterior cruciate ligament (ACL) reconstruction. This is the result of isolated ACL reconstruction and double-bundle reconstruction providing inadequate control over the pivot shift, and recent anatomical and biomechanical studies on the anterolateral ligament (ALL) and its role in the knee's rotational stability. From a technical point of view, ALR can be performed either as a continuity of the intra-articular ACL reconstruction or an independent procedure...
February 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Hee-June Kim, Hyun-Joo Lee, Ji-Yeon Shin, Young-Seo Choi, Hee-Soo Kyung
Purpose: This study evaluated the efficacy of a smartphone application in the measurement of rotation angles in porcine knees. Materials and Methods: Two K-wires were fixated to the femoral condyle and anterior tibial crest of 10 porcine legs. The angle created between the K-wires with an external rotation force applied was measured on a photograph and defined as the true angle. The same force was applied to the legs placed on a splint with a smartphone attached to the plantar side...
December 1, 2017: Knee Surgery & related Research
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