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R LaPrade

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
Justin J Mitchell, Chase S Dean, Jorge Chahla, Gilbert Moatshe, Tyler R Cram, Robert F LaPrade
Valgus knee alignment in excess of physiological valgus leads to excessive loading of the lateral compartment, which can potentially increase the risk of osteoarthritis and can place the medial knee structures at risk of chronic attenuation. Varus-producing distal femoral osteotomies have been proposed for correction of valgus malalignment, to relieve tension on medial-sided structures, as well as to off-load the lateral compartment. Understanding that symptomatic valgus deformity of the knee represents a complex problem that is magnified in the setting of lateral compartment arthritis or medial ligamentous incompetence, we present our preferred technique for a varus-producing distal femoral osteotomy using plate osteosynthesis and cancellous bone allograft...
August 2016: Arthroscopy Techniques
Thomas O Clanton, Brady T Williams, Jonathon D Backus, Grant J Dornan, Daniel J Liechti, Scott R Whitlow, Adriana J Saroki, Travis Lee Turnbull, Robert F LaPrade
BACKGROUND: Biomechanical data and contributions to ankle joint stability have been previously reported for the individual distal tibiofibular ligaments. These results have not yet been validated based on recent anatomic descriptions or using current biomechanical testing devices. METHODS: Eight matched-pair, lower leg specimens were tested using a dynamic, biaxial testing machine. The proximal tibiofibular joint and the medial and lateral ankle ligaments were left intact...
September 28, 2016: Foot & Ankle International
Thomas O Clanton, Scott R Whitlow, Brady T Williams, Daniel J Liechti, Jonathon D Backus, Grant J Dornan, Adriana J Saroki, Travis Lee Turnbull, Robert F LaPrade
BACKGROUND: Significant debate exists regarding optimal repair for unstable syndesmosis injuries. Techniques range from screw fixation, suture-button fixation, or a combination of the two. In this study, 3 common repairs were compared using a simulated weightbearing protocol with internal and external rotation of the foot. METHODS: Twenty-four lower leg specimens with mean age 54 years (range, 38-68 years) were used for testing. Following creation of a complete syndesmotic injury (AITFL, ITFL, PITFL, interosseous membrane), specimens were repaired using 1 of 3 randomly assigned techniques: (1) one 3...
September 25, 2016: Foot & Ankle International
Chase S Dean, Jorge Chahla, Lauren M Matheny, Tyler R Cram, Samuel G Moulton, Grant J Dornan, Justin J Mitchell, Robert F LaPrade
PURPOSE: To document the effectiveness of a novel technique to decrease tibial slope in patients who underwent a proximal opening-wedge osteotomy with an anteriorly sloped plate placed in a posteromedial position. The hypothesis was that posteromedial placement of an anteriorly sloped osteotomy plate with an adjunctive anterior bone staple on the tibia would decrease, and maintain, the tibial slope correction at a minimum of 6 months following the osteotomy. METHODS: All patients who underwent biplanar medial opening-wedge proximal tibial osteotomy with anterior staple augmentation to decrease sagittal plane tibial slope were included, and data were collected prospectively and reviewed retrospectively...
September 9, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
V Musahl, S Zaffagnini, R LaPrade, M T Hirschmann, J Karlsson
No abstract text is available yet for this article.
August 17, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Jorge Chahla, Chase S Dean, Gilbert Moatshe, Justin J Mitchell, Tyler R Cram, Carlos Yacuzzi, Robert F LaPrade
Meniscal ramp lesions are more frequently associated with anterior cruciate ligament (ACL) injuries than previously recognized. Some authors suggest that this entity results from disruption of the meniscotibial ligaments of the posterior horn of the medial meniscus, whereas others support the idea that it is created by a tear of the peripheral attachment of the posterior horn of the medial meniscus. Magnetic resonance imaging (MRI) scans have been reported to have a low sensitivity, and consequently, ramp lesions often go undiagnosed...
July 2016: Orthopaedic Journal of Sports Medicine
Samuel K Van de Velde, William A Kernkamp, Ali Hosseini, Robert F LaPrade, Ewoud R van Arkel, Guoan Li
BACKGROUND: Both anatomic anterolateral ligament (ALL) and nonanatomic anterolateral reconstructions are performed to improve the stability of anterior cruciate ligament (ACL)-deficient patients. However, the in vivo length change patterns and isometry of these anterolateral reconstructions are unknown. PURPOSE: To measure the theoretical length change patterns of the ALL and various anterolateral extra-articular reconstructions in healthy and ACL-deficient knees during in vivo weightbearing flexion...
June 23, 2016: American Journal of Sports Medicine
Justin J Mitchell, Chase S Dean, Jorge Chahla, Travis J Menge, Tyler R Cram, Robert F LaPrade
Violation of the posterior femoral cortex, commonly referred to as posterior wall blowout, can be a devastating intraoperative complication in anterior cruciate ligament (ACL) reconstruction and lead to loss of graft fixation or early graft failure. If cortical blowout occurs despite careful planning and adherence to proper surgical technique, a thorough knowledge of the anatomy and alternative fixation techniques is imperative to ensure optimal patient outcomes. This article highlights anatomic considerations for femoral tunnel placement in ACL reconstruction and techniques for avoidance and salvage of a posterior wall blowout...
June 2016: Orthopaedic Journal of Sports Medicine
Samuel G Moulton, Brett D Steineman, Tammy L Haut Donahue, Cristián A Fontboté, Tyler R Cram, Robert F LaPrade
PURPOSE: To further elucidate the direct and indirect fibre insertion morphology within the human ACL femoral attachment using scanning electron microscopy and determine where in the footprint each fibre type predominates. The hypothesis was that direct fibre attachment would be found centrally in the insertion site, while indirect fibre attachment would be found posteriorly adjacent to the posterior articular cartilage. METHODS: Ten cadaveric knees were dissected to preserve and isolate the entirety of the femoral insertion of the ACL...
June 13, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Brent T Warner, Samuel G Moulton, Tyler R Cram, Robert F LaPrade
Proximal tibiofibular joint (PTFJ) instability can be easily missed or confused for other, more common lateral knee pathologies such as meniscal tears, fibular collateral ligament injury, biceps femoris pathology, or iliotibial band syndrome. Because of this confusion, some authors believe that PTFJ instability is more common than initially appreciated. Patients with PTFJ subluxation may have no history of inciting trauma or injury, and it is not uncommon for these patients to have bilateral symptoms and generalized ligamentous laxity...
February 2016: Arthroscopy Techniques
Jorge Chahla, Chase S Dean, Tyler R Cram, David Civitarese, Luke O'Brien, Samuel G Moulton, Robert F LaPrade
Outcomes of primary anterior cruciate ligament (ACL) reconstruction have been reported to be far superior to those of revision reconstruction. However, as the incidence of ACL reconstruction is rapidly increasing, so is the number of failures. The subsequent need for revision ACL reconstruction is estimated to occur in up to 13,000 patients each year in the United States. Revision ACL reconstruction can be performed in one or two stages. A two-stage approach is recommended in cases of improper placement of the original tunnels or in cases of unacceptable tunnel enlargement...
February 2016: Arthroscopy Techniques
Chase S Dean, Jorge Chahla, Raphael Serra Cruz, Tyler R Cram, Robert F LaPrade
Recurrent patellar instability can be very debilitating and may require surgical intervention. A thorough workup must be completed in this subset of patients. Risk factors for recurrent instability include patella alta, trochlear dysplasia, an increased tibial tubercle-trochlear groove distance, and insufficiencies in the medial retinacular structures. Necessary treatment of these risk factors, once identified, should be addressed surgically. Patellofemoral reconstruction must be individually tailored to each patient's anatomy and may necessitate medial patellofemoral ligament reconstruction, tibial tubercle osteotomy, or trochleoplasty in any combination or as a standalone procedure...
February 2016: Arthroscopy Techniques
Jorge Chahla, Raphael Serra Cruz, Tyler R Cram, Chase S Dean, Robert F LaPrade
Preservation of meniscal tissue has been proven to be the best approach in most cases of meniscal tears. Currently available techniques for treating a peripheral meniscal tear include inside-out, outside-in, and all-inside techniques. Each of these techniques present potential advantages and disadvantages. Despite technologic advances in all-inside devices, because of implant-related complications, cost concerns, and device availability, the inside-out technique is still the preferred method among many surgeons...
February 2016: Arthroscopy Techniques
Robert F LaPrade, Jason L Dragoo, Jason L Koh, Iain R Murray, Andrew G Geeslin, Constance R Chu
Strategies that seek to enhance musculoskeletal tissue regeneration and repair by modulating the biologic microenvironment at the site of injury have considerable therapeutic potential. Current and emerging biologic approaches include the use of growth factors, platelet-rich plasma, stem cell therapy, and scaffolds. The American Academy of Orthopaedic Surgeons hosted a research symposium in November 2015 to review the current state-of-the-art biologic treatments of articular cartilage, muscle, tendon, and bone injuries and identify knowledge gaps related to these emerging treatments...
July 2016: Journal of the American Academy of Orthopaedic Surgeons
Robert F LaPrade, Andrew G Geeslin, Iain R Murray, Volker Musahl, Jason P Zlotnicki, Frank Petrigliano, Barton J Mann
Biologic therapies, including stem cells, platelet-rich plasma, growth factors, and other biologically active adjuncts, have recently received increased attention in the basic science and clinical literature. At the 2015 AOSSM Biologics II Think Tank held in Colorado Springs, Colorado, a group of orthopaedic surgeons, basic scientists, veterinarians, and other investigators gathered to review the state of the science for biologics and barriers to implementation of biologics for the treatment of sports medicine injuries...
March 29, 2016: American Journal of Sports Medicine
Jason P Zlotnicki, Andrew G Geeslin, Iain R Murray, Frank A Petrigliano, Robert F LaPrade, Barton J Mann, Volker Musahl
Focal chondral defects of the articular surface are a common occurrence in the field of orthopaedics. These isolated cartilage injuries, if not repaired surgically with restoration of articular congruency, may have a high rate of progression to posttraumatic osteoarthritis, resulting in significant morbidity and loss of function in the young, active patient. Both isolated and global joint disease are a difficult entity to treat in the clinical setting given the high amount of stress on weightbearing joints and the limited healing potential of native articular cartilage...
April 2016: Orthopaedic Journal of Sports Medicine
Iain R Murray, Robert F LaPrade, Volker Musahl, Andrew G Geeslin, Jason P Zlotnicki, Barton J Mann, Frank A Petrigliano
Rotator cuff tears are common and result in considerable morbidity. Tears within the tendon substance or at its insertion into the humeral head represent a considerable clinical challenge because of the hostile local environment that precludes healing. Tears often progress without intervention, and current surgical treatments are inadequate. Although surgical implants, instrumentation, and techniques have improved, healing rates have not improved, and a high failure rate remains for large and massive rotator cuff tears...
March 2016: Orthopaedic Journal of Sports Medicine
Natacha Laprade, Michel Cloutier, David R Lapen, Edward Topp, Graham Wilkes, Richard Villemur, Izhar U H Khan
Campylobacter species are one of the leading causes of bacterial gastroenteritis in humans worldwide. This twofold study was sought to: i) develop and optimize four single-tube multiplex PCR (mPCR) assays for the detection of six virulence (ciaB, dnaJ, flaA, flaB, pldA and racR), three toxin (cdtA, cdtB and cdtC) and one antibiotic resistance tet(O) genes in thermophilic Campylobacter spp. and ii) apply and evaluate the developed mPCR assays by testing 470 previously identified C. jejuni, C. coli and C. lari isolates from agricultural water...
May 2016: Journal of Microbiological Methods
William R Mook, David Civitarese, Travis Lee Turnbull, Nicholas I Kennedy, Luke O'Brien, Jarod B Schoeberl, Robert F LaPrade
PURPOSE: The purpose of this study was to determine the biomechanical effects of simulated immediate motion and weightbearing during rehabilitation on different double-bundle posterior cruciate ligament reconstruction (DB-PCLR) graft options. METHODS: Nine each of commercially prepared (allograft) Achilles tendon allografts, fresh-frozen (autograft) bone-patellar tendon-bone grafts, and fresh-frozen quadriceps tendon grafts were paired with commercially prepared anterior tibialis allografts, fresh-frozen semitendinosus grafts, and fresh-frozen semitendinosus grafts, respectively...
March 21, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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