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ligament graft

John J Elias, Kerwyn C Jones, S Cyrus Rezvanifar, Joseph N Gabra, Melanie A Morscher, Andrew J Cosgarea
BACKGROUND: Continued patellar instability can occur following medial patellofemoral ligament (MPFL) reconstruction. Computational simulation of function was used to investigate the influence of the lateral position of the tibial tuberosity, trochlear dysplasia and patella alta on lateral patellar tracking following MPFL reconstruction. METHODS: Multibody dynamic simulation models were developed to represent nine knees being treated for recurrent patellar instability...
March 12, 2018: Knee
Chae Chil Lee, Yoon Seok Youm, Sung Do Cho, Seung Hyun Jung, Mun Hee Bae, Seon Jae Park, Han Wook Kim
PURPOSE: The purpose of this study was to evaluate the association between posterior tibial slope (PTS) and anterior cruciate ligament (ACL) graft rupture in patients who have undergone ACL reconstruction by comparing results in patients who experienced graft rupture and a matched control group. METHODS: The study included 64 knees of 64 patients (58 men and 6 women), of mean age 31 years (range, 18-60 years) who underwent revision ACL reconstruction for ACL graft rupture, as well as a control group without ACL graft rupture matched for age, sex, body mass index (BMI), and left or right side...
March 9, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Darren de Sa, Ajaykumar Shanmugaraj, Melissa Weidman, Devin C Peterson, Nicole Simunovic, Volker Musahl, Olufemi R Ayeni
The all-inside technique (AIT) for anterior cruciate ligament reconstruction (ACLR) is gaining popularity as a more anatomic, less invasive, technique with the potential for more rapid recovery. This systematic review aims to critically assess components of the technique, its safety profile, outcomes, and complications. PUBMED, EMBASE, and MEDLINE were searched for studies discussing primary ACLR using the AIT. Article screening, quality assessment, and data abstraction were completed in duplicate, and a minimal clinically important difference (MCID) was used to frame the descriptive results in a clinically significant context...
February 8, 2018: Journal of Knee Surgery
James E Christensen, Mark D Miller
Anterior cruciate ligament (ACL) reconstruction is one of the most commonly performed procedures in the United States. Although complications are rare in ACL surgery, failure to appreciate them can lead to significant patient morbidity in the short and long terms. More common complications in ACL reconstruction include tunnel malposition, infection, tunnel osteolysis, fixation failure, fracture, arthrofibrosis, graft site morbidity, and deep vein thrombosis or pulmonary embolism. Tunnel malposition is the most common technical error in ACL reconstruction leading to failure...
April 2018: Clinics in Sports Medicine
Haitao Chen, Biao Chen, Kai Tie, Zhengdao Fu, Liaobin Chen
BACKGROUND: Both single-bundle (SB) and double-bundle (DB) techniques were widely used in anterior cruciate ligament (ACL) reconstruction recently. Nevertheless, up to now, no consensus has been reached on whether the DB technique was superior to the SB technique. Moreover, follow-up of the included studies in the published meta-analyses is mostly short term. Our study aims to compare the mid- to long-term outcome of SB and DB ACL reconstruction concerning knee stability, clinical function, graft failure rate, and osteoarthritis (OA) changes...
March 10, 2018: Journal of Orthopaedic Surgery and Research
Chao Wan, Zhixiu Hao
Graft tissues within bone tunnels remain mobile for a long time after anterior cruciate ligament (ACL) reconstruction. However, whether the graft-tunnel friction affects the finite element (FE) simulation of the ACL reconstruction is still unclear. Four friction coefficients (from 0 to 0.3) were simulated in the ACL-reconstructed joint model as well as two loading levels of anterior tibial drawer. The graft-tunnel friction did not affect joint kinematics and the maximal principal strain of the graft. By contrast, both the relative graft-tunnel motion and equivalent strain for the bone tunnels were altered, which corresponded to different processes of graft-tunnel integration and bone remodeling, respectively...
March 9, 2018: Computer Methods in Biomechanics and Biomedical Engineering
Thomas Bartels, Kay Brehme, Martin Pyschik, Stephan Schulze, Karl-Stefan Delank, Georg Fieseler, Kevin G Laudner, Souhail Hermassi, René Schwesig
There are currently no longitudinal data describing the pre- and postoperative postural regulation and stability of patients with anterior cruciate ligament (ACL) damage. Therefore, the aim of this study was to evaluate postural regulation and stability prior to and during rehabilitation following surgery of the ACL. Fifty-four physically active subjects (age: 30.5±10.9 years, 29 male subjects) were examined with the Interactive Balance System pre-, 6, and at 12 weeks following surgical reconstruction of the ACL using a hamstring tendon graft...
February 2018: Journal of Exercise Rehabilitation
Ping Chen, Jun Ouyang, Jiangwei Xiao, Zhongyu Han, Qiang Yu, Jing Tian, Li Zhang
The objective of this study was to investigate whether the co-injection of human adipose stromal cells (hASCs) and rhBMP-2/fibrin gel into the bone tunnels of anterior cruciate-ligament reconstructions can effectively enhance tendon graft osteointegration. We performed bilateral reconstructions using autologous semitendinosus tendons in 45 New Zealand rabbits, which we divided into three groups. We injected the bone tunnels with fibrin gel for group 1, rhBMP-2 (1 μg/ml)/fibrin gel for group 2, and hASCs wrapped in rhBMP-2 (1 μg/ml)/fibrin gel for group 3...
2018: American Journal of Translational Research
Jason Silvestre, Joseph Upton, Benjamin Chang, David R Steinberg
BACKGROUND: Hand surgery fellowship programs in the United States are predominately sponsored by departments or divisions of orthopaedic surgery or plastic surgery. This study compares the operative experiences of hand surgery fellows graduating from orthopaedic or plastic surgery hand surgery fellowships. METHODS: Operative case logs of 3 cohorts of hand surgery fellows graduating during the academic years of 2012-2013, 2013-2014, and 2014-2015 were analyzed. The median case volumes were compared by specialty via Mann-Whitney U tests...
March 7, 2018: Journal of Bone and Joint Surgery. American Volume
Melissa A Christino, Frances A Tepolt, Dai Sugimoto, Lyle J Micheli, Mininder S Kocher
BACKGROUND: Revision anterior cruciate ligament (ACL) reconstruction in pediatric patients has not been well studied. The purpose of this study was to assess the demographics, technique, and results of ACL revision surgery in children and adolescents. METHODS: This was a retrospective case series with outcomes assessment of patients 18 years old and younger who underwent revision ACL surgery over a 16-year period at a single institution. Medical records were reviewed for demographics, clinical and operative data, and patients were contacted for outcomes at a minimum of 1 year after revision surgery...
March 5, 2018: Journal of Pediatric Orthopedics
Haobo Wu, Chiyuan Ma, Yan Xiong, Shigui Yan, Lidong Wu, Weigang Wu
PURPOSE: To compare the clinical outcomes of double-bundle (DB) single-tibial tunnel technique and double-tunnel technique for ACL reconstruction in patients with knee hyperextension. METHODS: Defined as having constitutional hyperextension of greater than 10°, 56 patients with knee hyperextension who underwent ACL reconstruction were included in this study. To exclude concomitant lesions, preoperative magnetic resonance imaging (MRI) was performed in all knees...
March 5, 2018: Archives of Orthopaedic and Trauma Surgery
Mark P Cote
Septic arthritis is a rare but potentially devastating complication after anterior cruciate ligament (ACL) reconstruction. Studies examining surgical treatment options including graft retention and removal are largely inconclusive. Although the literature indicated that 43.8% of patients who have the graft removed later go on to have a revision ACL reconstruction compared with only 6.5% among those whose graft is retained, this expected-value decision analysis found removal to be the optimal treatment for patients with septic arthritis after ACL reconstruction...
March 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Dong-Ho Lee, Jae Hwan Cho, Choon Sung Lee, Chang Ju Hwang, Sung Hoon Choi, Chul Gie Hong
BACKGROUND CONTEXT: Conventional anterior decompression surgery for cervical myelopathy, including anterior corpectomy and fusion, is technically demanding and known to be associated with a higher incidence of surgery-related complications, including cerebrospinal fluid (CSF) leakage, neurologic deterioration, and graft failure compared with posterior surgery. PURPOSE: We introduce a novel anterior decompression technique (vertebral body sliding osteotomy; VBSO) for cervical myelopathy caused by ossification of posterior longitudinal ligament (OPLL) and evaluate the efficacy and safety of this procedure...
February 26, 2018: Spine Journal: Official Journal of the North American Spine Society
Raashad Hasan, Wiqqas Jamil
The medial patellofemoral ligament (MPFL) is a key soft tissue stabilizer of the medial patella, with deficiency proven to be a key contributor to patellar dislocation. Reconstruction of this ligament has become a widely employed procedure in managing patients with recurrent patellar dislocation, and is also gaining popularity in the setting of primary dislocation. A wide variety of techniques have been described, differing in the type of graft used, sites for fixation and fixation technique. A number of complications have also been reported in the literature, including post-operative stiffness, apprehension, patellar fracture and recurrence of instability and dislocation...
February 2018: Journal of Surgical Case Reports
Yoshinari Tanaka, Keisuke Kita, Rikio Takao, Hiroshi Amano, Ryohei Uchida, Yoshiki Shiozaki, Yasukazu Yonetani, Kazutaka Kinugasa, Tatsuo Mae, Shuji Horibe
Background: Accumulating evidence suggests that long-term anterior cruciate ligament (ACL) deficiency can give rise to an abnormal tibiofemoral relationship and subsequent intra-articular lesions. However, the effects of chronic ACL deficiency (ACLD) on early graft failure after anatomic reconstruction remain unclear. Hypothesis: We hypothesized that patients with long-term ACLD lasting more than 5 years would have a greater rate of early graft failure due to insufficient intraoperative reduction of the tibia and that the preoperative and immediately postoperative abnormal tibiofemoral relationship in the sagittal plane, such as anterior tibial subluxation (ATS), would correlate with the graft status on postoperative magnetic resonance imaging (MRI)...
February 2018: Orthopaedic Journal of Sports Medicine
Bosco Mpatswenumugabo, Emmanuel Bukara, Muhammed Semakula, Albert Nzayisenga, Rene Mukezamfura, Lambert Dusingizimana, Basile Habumugisha, Salvador Kamarampaka, Leon Mutesa, Alex Butera
INTRODUCTION: Combined anterior cruciate ligament (ACL) and posterolateral corner (PLC) reconstruction are a rare clinical entity in orthopedic literature, whose management requires different types of tendon grafts. Missed PLC injury leads to the failure of ACL repair due to the joint instability. PRESENTATION OF CASE: We are presenting a case of posttraumatic right ACL, PLC and lateral meniscus injury. The patient was taken to theatre for arthroscopic meniscectomy, ACL and PLC reconstruction...
February 17, 2018: International Journal of Surgery Case Reports
Takehiko Matsushita, Daisuke Araki, Yuichi Hoshino, Shinya Oka, Kyohei Nishida, Toshikazu Tanaka, Nobuaki Miyaji, Noriyuki Kanzaki, Kazuyuki Ibaraki, Tomoyuki Matsumoto, Masahiro Kurosaka, Ryosuke Kuroda
BACKGROUND: A fluoroscopic guidance method for medial patellofemoral ligament (MPFL) reconstruction has been widely used to determine the anatomic femoral attachment site. PURPOSE: To examine the graft length change patterns in MPFL reconstruction with a fluoroscopic guidance method. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Forty-four knees of 42 patients who underwent MPFL reconstruction for the treatment of recurrent patellar dislocation were examined prospectively...
February 1, 2018: American Journal of Sports Medicine
Dai Sugimoto, Benton E Heyworth, Jeffery J Brodeur, Dennis E Kramer, Mininder S Kocher, Lyle J Micheli
CONTEXT: Recent epidemiology studies indicated a steady increase of anterior cruciate ligament (ACL) injury in young athletes. ACL reconstruction (ACLR) is currently a standard of the care, but effect of ACLR graft including bone patellar tendon bone (BTB), hamstring tendon (HT), or iliotibial band (ITB) on balance and hop performance is understudied. OBJECTIVE: To compare balance and hop deficits between uninvolved and reconstructed limbs in each autograft type (aim 1) and among the three autograft groups (aim 2)...
February 21, 2018: Journal of Sport Rehabilitation
Sung-Jae Kim, Chong Hyuk Choi, Su-Keon Lee, Wonyong Lee, Haemosu An, Min Jung
BACKGROUND: The purposes of this investigation were to compare outcomes of anterior cruciate ligament (ACL) reconstruction between patients with generalized joint laxity and those without it and to investigate the effect of generalized joint laxity on outcomes of ACL reconstruction from 2 to 8 years postoperatively. METHODS: We retrospectively reviewed 163 patients who had undergone unilateral ACL reconstruction from January 2001 to December 2008. Patients were divided into 2 groups according to presence or absence of generalized joint laxity...
February 21, 2018: Journal of Bone and Joint Surgery. American Volume
M A Faisal, A Z Chowdhury, I K Kundu, K N Arifeen, A S Ullah, C I Mahmud, O M Dastagir, M A Islam, M S Paul
Graft selection for primary anterior cruciate ligament reconstruction is very important part of knee stability. The purpose of this Qasi experimental study was to compare the clinical outcomes after ACL reconstruction using either a BPTB graft or a four-strand hamstrings graft and conducted from January 2012 to December 2013. Patients presented with a symptomatic unilateral ACL rupture who were underwent ACL reconstruction by using either BPTB or Hamstrings graft, IPD of Department of Orthopedics at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka as well as in a private hospital in Dhaka, Bangladesh were selected as study population...
January 2018: Mymensingh Medical Journal: MMJ
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