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https://www.readbyqxmd.com/read/27909681/double-bundle-all-inside-posterior-cruciate-ligament-reconstruction-a-technique-using-2%C3%A2-separate-autologous-grafts
#1
Roy A G Hoogeslag, Bart W Oudelaar, Rianne Huis In't Veld, Reinoud W Brouwer
In a double-bundle posterior cruciate ligament reconstruction, several surgical techniques are available. Compared with other techniques, the advantages of the all-inside technique and cortical suspension devices with variable loop length are that shorter grafts can be used, tendons can be quadrupled, and a double-bundle posterior cruciate ligament reconstruction can be performed with autologous grafts. Furthermore, the all-inside technique provides independent outside-in socket reaming and is soft tissue, cortex, and bone sparing because no full diameter tunnels but sockets are created with a small diameter guide pin, which can transform into a retrograde drill...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27909674/minimally-invasive-quadriceps-tendon-harvest-and-graft-preparation-for-all-inside-anterior-cruciate-ligament-reconstruction
#2
Harris S Slone, William B Ashford, John W Xerogeanes
The quadriceps tendon is an infrequently used graft option for anterior cruciate ligament reconstruction despite favorable clinical results in the literature with low donor site morbidity. It is a versatile graft that can be harvested with bone or as a soft tissue graft alone. In addition, it can be used for anatomic, double-bundle, transtibial, and all-inside reconstructions. The unique characteristics of the quadriceps tendon allow for the ability to harvest a single-bundle large-diameter graft and minimize disruption of normal anatomy, which makes the quadriceps tendon an excellent choice for all-inside techniques...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27904225/the-inferior-medial-genicular-artery-and-its-vascularization-of-the-pes-anserinus-superficialis-a-cadaveric-study
#3
Lena Hirtler, Manuel Ederer, Mike Faber, Patrick Weninger
BACKGROUND: A common method for reconstruction of the anterior cruciate ligament (ACL) is it's replacement by a free avascular graft, using the gracilis and/or semitendinosus tendons. These grafts pass a vulnerable phase in the ligamentization-process during the 1(st) year after reconstruction. The aims of this study were first to evaluate the vascularization of the pes anserinus superficialis (PAS) by the inferior medial genicular artery (IMGA) and second to develop a pedunculated surgical technique for ACL reconstruction, to preserve a maximal amount of natural vascularization of the tendons inserting at the PAS...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27904216/scapholunate-ligament-reconstruction-using-the-palmaris-longus-tendon-and-suture-anchor-fixation-in-chronic-scapholunate-instability
#4
Maulik Jagdish Gandhi, Timothy Paul Knight, Peter John Ratcliffe
BACKGROUND: Multiple reconstruction techniques have been described in the management of chronic scapholunate (SL) instability, either based on the capsulodesis or tenodesis principle. It is uncertain which surgical method produces the best patient outcomes. We describe results of a technique using palmaris longus (PL) tendon for surgical reconstruction of the SL ligament and provide functional outcomes scores. MATERIALS AND METHODS: We surgically reconstructed the SL ligament using a PL tendon graft secured with Mitek(®) bone anchors...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27903590/anterior-cruciate-ligament-derived-stem-cells-transduced-with-bmp2-accelerate-graft-bone-integration-after-acl-reconstruction
#5
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/27900338/the-bridge-enhanced-anterior-cruciate-ligament-repair-bear-procedure-an-early-feasibility-cohort-study
#6
Martha M Murray, Brett M Flutie, Leslie A Kalish, Kirsten Ecklund, Braden C Fleming, Benedikt L Proffen, Lyle J Micheli
BACKGROUND: This study assessed the safety of the newly developed bridge-enhanced anterior cruciate ligament (ACL) repair (BEAR), which involves suture repair of the ligament combined with a bioactive scaffold to bridge the gap between the torn ligament ends. As the intra-articular environment is complex in its response to implanted materials, this study was designed to determine whether there would be a significant rate of adverse reaction to the implanted scaffold. HYPOTHESIS: The primary hypothesis was that the implanted scaffold would not result in a deep joint infection (arthrocentesis with positive culture) or significant inflammation (clinical symptoms justifying arthrocentesis but negative culture)...
November 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/27900311/biological-enhancement-of-graft-tunnel-healing-in-anterior-cruciate-ligament-reconstruction
#7
Maristella F Saccomanno, Luigi Capasso, Luca Fresta, Giuseppe Milano
The sites where graft healing occurs within the bone tunnel and where the intra-articular ligamentization process takes place are the two most important sites of biological incorporation after anterior cruciate ligament (ACL) reconstruction, since they help to determine the mechanical behavior of the femur-ACL graft-tibia complex. Graft-tunnel healing is a complex process influenced by several factors, such as type of graft, preservation of remnants, bone quality, tunnel length and placement, fixation techniques and mechanical stress...
July 2016: Joints
https://www.readbyqxmd.com/read/27899355/the-anatomic-centers-of-the-femoral-and-tibial-insertions-of-the-anterior-cruciate-ligament-a-systematic-review-of-imaging-and-cadaveric-studies-reporting-normal-center-locations
#8
Anagha P Parkar, Miraude E A P M Adriaensen, Søren Vindfeld, Eirik Solheim
BACKGROUND: The anterior cruciate ligament (ACL) is regularly reconstructed if knee joint function is impaired. Anatomic graft tunnel placement, often assessed with varying measurement methods, in the femur and tibia is considered important for an optimal clinical outcome. A consensus on the exact location of the femoral and tibial footprint centers is lacking. PURPOSE: To systematically review the literature regarding anatomic centers of the femoral and tibial ACL footprints and assess the mean, median, and percentiles of normal centers...
November 29, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27896678/no-clinically-important-difference-in-knee-scores-or-instability-between-transtibial-and-inlay-techniques-for-pcl-reconstruction-a-systematic-review
#9
REVIEW
Young-Soo Shin, Hyun-Jung Kim, Dae-Hee Lee
BACKGROUND: It is unclear whether the biomechanical superiority of the inlay technique over the transtibial technique, arising from avoidance of the killer turn at the graft-tunnel margin of the proximal tibia during posterior cruciate ligament (PCL) reconstruction, leads to better knee scores or greater knee stability. QUESTIONS/PURPOSES: This systematic review was designed to compare Tegner and Lysholm scores, and posterior residual laxity of the knee, between single-bundle PCL reconstruction using transtibial and inlay techniques...
November 28, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27896290/do-clinical-results-and-return-to-sport-rates-after-ulnar-collateral-ligament-reconstruction-differ-based-on-graft-choice-and-surgical-technique
#10
Brandon J Erickson, Gregory L Cvetanovich, Rachel M Frank, Bernard R Bach, Mark S Cohen, Charles A Bush-Joseph, Brian J Cole, Anthony A Romeo
BACKGROUND: Ulnar collateral ligament reconstruction (UCLR) has become a common procedure performed in overhead-throwing athletes of many athletic levels. PURPOSE/HYPOTHESIS: The purpose of this study was to determine whether clinical outcomes and return-to-sport (RTS) rates differ among patients undergoing UCLR based on graft choice, surgical technique, athletic competition level, handedness, and treatment of the ulnar nerve. We hypothesized that no differences would exist in clinical outcomes or RTS rates between technique, graft choice, or other variables...
November 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/27894180/causes-of-failure-of-anterior-cruciate-ligament-reconstruction-and-revision-surgical-strategies
#11
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/27885380/anterior-cruciate-ligament-reconstruction-tunnel-size-causes-of-tunnel-enlargement-and-implications-for-single-versus-two-stage-revision-reconstruction
#12
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/27881383/clinical-and-radiological-outcomes-after-hamstring-anterior-cruciate-ligament-reconstructions-comparison-between-fixed-loop-and-adjustable-loop-cortical-suspension-devices
#13
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/27879170/the-past-present-and-future-of-ligament-regenerative-engineering
#14
Paulos Y Mengsteab, Lakshmi S Nair, Cato T Laurencin
Regenerative engineering has been defined as the convergence of Advanced Materials Sciences, Stem Cell Sciences, Physics, Developmental Biology and Clinical Translation for the regeneration of complex tissues and organ systems. Anterior cruciate ligament (ACL) reconstruction necessitates the regeneration of bone, ligament and their interface to achieve superior clinical results. In the past, the ACL has been repaired with the use of autologous and allogeneic grafts, which have their respective drawbacks. Currently, investigations on the use of biodegradable matrices to achieve knee stability and permit tissue regeneration are making promising advancements...
December 2016: Regenerative Medicine
https://www.readbyqxmd.com/read/27876265/a-prospective-randomized-comparison-of-two-distinct-allogenic-tissue-constructs-for-anterior-cruciate-ligament-reconstruction
#15
Michael B Rose, Christopher Domes, Mehwish Farooqi, Dennis C Crawford
BACKGROUND: Conduct a prospective randomized study to compare clinical outcomes of anterior cruciate ligament (ACL) reconstruction using quadrupled hamstring tendon (HT) allograft or doubled tibialis anterior (TA) allograft. Limited level 1 data exist comparing outcomes of different soft tissue allograft constructs for ACL reconstruction. We hypothesized no difference would exist in the patient reported outcomes (PRO), arthrometric testing, or rate of re-rupture between the two constructs...
November 18, 2016: Knee
https://www.readbyqxmd.com/read/27874911/outcomes-of-acl-reconstruction-with-fixed-versus-variable-loop-button-fixation
#16
Brent T Wise, Nick N Patel, Garrison Wier, Sameh A Labib
Suspensory femoral fixation of anterior cruciate ligament (ACL) grafts with fixed loop button and variable loop button devices has gained popularity for ACL reconstruction. This study examined these 2 methods of fixation to determine their effect on graft laxity and patient-reported outcome scores. A database search was performed to identify patients who had undergone ACL reconstruction with either a fixed loop or a variable loop button technique performed by the primary surgeon. Lysholm, Tegner, and 12-Item Short Form Health Survey scores were obtained, and KT-1000 knee ligament arthrometer (MEDmetric, San Diego, California) mechanical knee testing was performed...
November 22, 2016: Orthopedics
https://www.readbyqxmd.com/read/27871909/histone-deacetylase-inhibition-enhances-in-vivo-bone-regeneration-induced-by-human-periodontal-ligament-cells
#17
Nam Cong-Nhat Huynh, Vincent Everts, Akira Nifuji, Prasit Pavasant, Ruchanee Salingcarnboriboon Ampornaramveth
: Periodontal ligament cells have the potential to differentiate into bone forming osteoblasts and thus represent a good cellular candidate for bone regeneration. This study aimed to investigate the effect of inhibition of histone deacetylases, using the inhibitor Trichostatin A (TSA), on bone regeneration by human periodontal ligament cells (hPDLCs) in a mouse calvaria bone defect. METHODS: RUNX2 protein and its acetylation was analyzed by immunoprecipitation and western blotting...
November 18, 2016: Bone
https://www.readbyqxmd.com/read/27871660/management-of-the-anterior-cruciate-ligament-injured-knee-in-the-skeletally-immature-athlete
#18
REVIEW
Christian N Anderson, Allen F Anderson
Intrasubstance tears of the anterior cruciate ligament (ACL) are being diagnosed with increasing frequency in the skeletally immature. Management options include nonoperative/ early surgical, or delayed surgical reconstruction. Nonoperative/delayed reconstruction results in worse functional outcomes than early reconstruction. Physicians are faced with a treatment dilemma; clinical and basic science studies have demonstrated risk of limb-length discrepancy and angular deformity with ACL reconstruction. Vertical drill tunnels decrease physeal damage and minimize growth deformity; however, this technique results in nonanatomic ACL graft placement...
January 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27871659/graft-selection-in-anterior-cruciate-ligament-surgery-who-gets-what-and-why
#19
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/27871656/etiologic-factors-that-lead-to-failure-after-primary-anterior-cruciate-ligament-surgery
#20
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
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