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https://www.readbyqxmd.com/read/28211291/a-biomechanical-analysis-of-tibial-acl-reconstruction-with-graft-length-mismatch
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
Hirotaka Mutsuzaki, Hiromichi Fujie, Hiromi Nakajima, Makoto Fukagawa, Shunsuke Nomura, Masataka 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 functionbetweenanatomic double-bundle (DB)and single-bundle (SB)ACL reconstructions using CaP-hybridized tendon grafts at 6 months postoperativelyin goats. HYPOTHESIS: We hypothesized that the postoperativebiomechanicalfunctioninthe DBgroupwill bebetterthan that inthe SB group...
January 9, 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
#10
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...
January 11, 2017: Journal of Biomedical Materials Research. Part A
https://www.readbyqxmd.com/read/28056513/is-an-anterolateral-ligament-reconstruction-required-in-acl-reconstructed-knees-with-associated-injury-to-the-anterolateral-structures
#11
Frank R Noyes, Lauren E Huser, Darin Jurgensmeier, James Walsh, Martin S Levy
BACKGROUND: The effect of an anterolateral ligament (ALL) reconstruction on rotational knee stability and corresponding anterior cruciate ligament (ACL) graft forces using multiple knee loading conditions including the pivot-shift phenomenon has not been determined. PURPOSE: First, to determine the rotational stability and ACL graft forces provided by an anatomic bone-patellar tendon-bone ACL reconstruction in the ACL-deficient knee alone and with an associated ALL/iliotibial band (ITB) injury...
January 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28056178/is-there-any-benefit-in-anterior-cruciate-ligament-reconstruction-in-patients-older-than-60-years
#12
Cécile Toanen, Guillaume Demey, Panagiotis G Ntagiopoulos, Paolo Ferrua, David Dejour
BACKGROUND: Results of anterior cruciate ligament (ACL) reconstruction are traditionally excellent in younger and nonarthritic patients. During the past few decades, people older than 60 years have become more active than ever, with more demanding physical lifestyles. An increase also has been noted in active patients with diagnosed ACL injuries. More patients are requesting treatment for ACL deficiency in hopes of returning to preinjury levels of activity. PURPOSE: The aims of this study were to evaluate the results of ACL reconstruction in patients older than 60 years in terms of functional recovery, return to sports, and postoperative incidence of osteoarthritis and to compare their results with published results of different age groups...
December 1, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28054146/revision-anterior-cruciate-ligament-reconstruction-with-ipsi-or-contralateral-hamstring-tendon-grafts
#13
Claudio Legnani, Giuseppe Peretti, Enrico Borgo, Stefania Zini, Alberto Ventura
OBJECTIVES: With the increasing number of primary anterior cruciate ligament (ACL) reconstructions, the need for revision ACL surgery has risen over the past few years. The purpose of the present study is to retrospectively compare the clinical outcome of ipsilateral versus contralateral hamstring tendon autografts for ACL revision surgery, specifically with regard to patient satisfaction, post-operative functional outcomes, and return to sports. METHODS: Between 2004 and 2011, 64 patients underwent ACL revision surgery...
January 4, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28050536/functional-and-clinical-results-achieved-in-congenital-clubfoot-patients-treated-by-ponseti-s-technique
#14
Pedro Augusto Jaqueto, Guilherme Salgado Martins, Fernando Saddi Mennucci, Cintia Kelly Bittar, José Luís Amim Zabeu
OBJECTIVES: To analyze and evaluate functional and clinical results in patients with congenital clubfoot treated with Ponseti's technique. METHODS: This study evaluated 31 patients diagnosed with 51 congenital clubfeet, treated between April 2006 and September 2011 with Ponseti's technique. The patients who did not achieve an equinus correction with manipulation were treated with Achilles tenotomy. An anterior tibial tendon transfer was performed in patients who maintained residual adduction...
November 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28050456/femoral-and-tibial-tunnel-widening-following-anterior-cruciate-ligament-reconstruction-using-various-modalities-of-fixation-a-prospective-observational-study
#15
Dileep Krishnamoorthy Srinivas, Mahesha Kanthila, Rama Prakasha Saya, Jvs Vidyasagar
INTRODUCTION: Bone tunnel enlargement after Anterior Cruciate Ligament Reconstruction (ACL-R) is a well-accepted phenomenon but there are very few published data comparing the extent of tunnel widening by various methods of fixation after ACL-R. AIM: To compare the femoral and tibial tunnel widening following ACL-R with different methods of fixation using CT scan. MATERIALS AND METHODS: This one year prospective study included all patients with chronic Anterior Cruciate Ligament (ACL) injury who underwent primary arthroscopic ACL-R using tripled hamstring tendon autograft...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28043751/bone-incorporation-of-silicate-substituted-calcium-phosphate-in-2-stage-revision-anterior-cruciate-ligament-reconstruction-a-histologic-and-radiographic-study
#16
Jan von Recum, Johannes Schwaab, Thorsten Guehring, Paul-Alfred Grützner, Marc Schnetzke
PURPOSE: To evaluate the histologic and radiographic outcomes of using silicate-substituted calcium phosphate (Si-CaP) as bone graft substitute for the augmentation of tunnel defects in 2-stage revision anterior cruciate ligament (ACL) reconstruction. METHODS: Forty patients undergoing 2-stage revision ACL reconstruction were included in a prospective, randomized controlled clinical trial between 2012 and 2015. The inclusion criteria were tunnel diameter of the tibial and/or femoral tunnel of 10 mm or greater after failed ACL reconstruction...
December 30, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28006992/increasing-hip-and-knee-flexion-during-a-drop-jump-task-reduces-tibiofemoral-shear-and-compressive-forces-implications-for-acl-injury-prevention-training
#17
Liang-Ching Tsai, Yi-An Ko, Kyle E Hammond, John W Xerogeanes, Gordon L Warren, Christopher M Powers
Although most ACL injury prevention programmes encourage greater hip and knee flexion during landing, it remains unknown how this technique influences tibiofemoral joint forces. We examined whether a landing strategy utilising greater hip and knee flexion decreases tibiofemoral anterior shear and compression. Twelve healthy women (25.9 ± 3.5 years) performed a drop-jump task before and after a training session (10-15 min) that emphasised greater hip and knee flexion. Peak tibiofemoral anterior shear and compressive forces were calculated using an electromyography (EMG)-driven knee model that incorporated joint kinematics, EMG and participant-specific muscle volumes and patella tendon orientation measured using magnetic resonance imaging (MRI)...
December 23, 2016: Journal of Sports Sciences
https://www.readbyqxmd.com/read/28005102/tibial-tubercle-fracture-after-bone-patellar-tendon-bone-autograft
#18
Matthew J Brown, Leslie J Bisson, Mark J Anders
Fractures occurring with anterior cruciate ligament (ACL) reconstruction are rare and those that do occur take place on the patellar side of a bone-patellar tendon-bone (BPTB) autograft. Here we discuss a far more infrequent occurrence, fracture of the tibial tubercle aspect of the BPTB autograft. This fracture type occurs even more infrequently than tibial plateau fractures after ACL reconstruction based on the published literature. In this article we discuss the third published episode of a tibial tubercle fracture after BPTB allograft...
November 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/27984690/-pretibial-pseudocyst-after-anterior-cruciate-ligament-reconstruction-with-a-biocomposite-screw
#19
B Alonso, F B Sobrón, C Vidal, J Vaquero
We report the case of a patient who presented a pretibial extra-articular cyst two years after an arthroscopically assisted ACL reconstruction using an autologous bone-patellar tendon-bone graft. The tibial fixation was achieved with a bioabsorbable screw made of poly-L, D-lactic and -tricalcium phosphate (-TCP). A subcutaneous pseudocystic lesion was excised. It consisted of a capsular fibrous tissue with minimal milky fluid (1 ml) centrally. It penetrated into the tibial tunnel but did not communicate with the knee joint space...
May 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/27939069/reverse-anterior-cruciate-ligament-reconstruction-fixation-a-biomechanical-comparison-study-of-tibial-cross-pin-and-femoral-interference-screw-fixation
#20
Richard J Lawley, Samuel E Klein, Steven C Chudik
PURPOSE: To evaluate the biomechanical performance of tibial cross-pin (TCP) fixation relative to femoral cross-pin (FCP), femoral interference screw (FIS), and tibial interference screw (TIS) fixation. METHODS: We randomized 40 porcine specimens (20 tibias and 20 femurs) to TIS fixation (group 1, n = 10), FIS fixation (group 2, n = 10), TCP fixation (group 3, n = 10), or FCP fixation (group 4, n = 10) and performed biomechanical testing to compare ultimate load, stiffness, yield load, cyclic displacement, and load at 5-mm displacement...
December 8, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
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