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https://www.readbyqxmd.com/read/29352758/-arthroscopic-rotator-cuff-surgery-new-and-established-methods
#1
REVIEW
S Pauly, M Scheibel
This present article summarizes established and current developments and aspects of rotator cuff surgery. Achieved milestones as well as current approaches are presented and assessed with respect to their clinical and radiographic impact. Despite biomechanical and technical improvements in modern rotator cuff repair techniques, re-defect and re-tearing rates could not be fully eliminated. Meanwhile, the importance of biological processes around successful tendon-bone reintegration has been increasingly recognized...
January 19, 2018: Der Orthopäde
https://www.readbyqxmd.com/read/29351870/de-novo-generation-in-an-in-vivo-rat-model-and-biomechanical-characterization-of-autologous-transplants-for-ligament-and-tendon-reconstruction
#2
Marc Soubeyrand, Elisabeth Laemmel, Nathalie Maurel, Amadou Diop, Thierry Lazure, Jacques Duranteau, Eric Vicaut
BACKGROUND: Surgical reconstruction of ligaments and tendons is frequently required in clinical practice. The commonly used autografts, allografts, or synthetic transplants present limitations in terms of availability, biocompatibility, cost, and mechanical properties that tissue bioengineering aims to overcome. It classically combines an exogenous extracellular matrix with cells, but this approach remains complex and expensive. Using a rat model, we tested a new bioengineering strategy for the in vivo and de novo generation of autologous grafts without the addition of extracellular matrix or cells, and analyzed their biomechanical and structural properties...
December 14, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/29351558/analysis-of-500-anterior-cruciate-ligament-reconstructions-from-a-private-institutional-register
#3
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
https://www.readbyqxmd.com/read/29349030/augmentation-of-patellar-tendon-repair-with-autologous-semitendinosus-graft-porto-technique
#4
João Espregueira-Mendes, Renato Andrade, M J S Fredrick Michael, André Sarmento, Nuno Sevivas, Rui Rocha, Ricardo Bastos Filho
Patellar tendon ruptures can lead to significant functional deficiency of the extensor mechanism of the knee. These injuries, because of their inherent nature and associated complications, may require a complex treatment and remains a challenge for orthopaedic surgeons. Current surgical techniques present significant complications, including patellar fracture, damage to patellar articular cartilage, and abnormal patella height. This note describes a surgical technique to provide an additional reinforcement to the patellar tendon repair with a semitendinous autograft, without the necessity to perform any transosseous tunnels at the patella bone...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349025/anterior-capsule-reconstruction-for-irreparable-subscapularis-tears
#5
Jason P Rogers, Adam Kwapisz, John M Tokish
A subscapularis complete tear presents its own challenges in management. The glenohumeral biomechanics and force couple are reliant on a competent and functioning subscapularis muscle. An irreparable subscapularis makes those same challenges even more difficult to address. Traditionally, this problem has been addressed with tendon transfers, including pectoralis major or latissimus dorsi. These techniques can alter the ideal biomechanics of the shoulder and have high rates or failure. Iliotibial autograft or tibialis anterior have also been wrought with high failure rates...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349024/the-crossing-internal-suture-augmentation-technique-to-protect-the-all-inside-anterior-cruciate-ligament-reconstruction-graft
#6
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
https://www.readbyqxmd.com/read/29349014/graft-preparation-technique-to-optimize-hamstring-graft-diameter-for-anterior-cruciate-ligament-reconstruction
#7
Brett Fritsch, Francisco Figueroa, Bertrand Semay
Hamstring autografts are frequently used for anterior cruciate ligament reconstruction. The inherent variability in graft diameter has been stated as a disadvantage in its use because the presence of smaller graft diameters has been correlated with increased risk of re-rupture. Several techniques have been described to address this concern. Modifications of the basic Graftlink technique allows for increased control over final graft diameter using a standard harvest of the semitendinosus tendon with or without the gracilis tendon, and results in a graft of adequate length and diameter in all patients with rigid cortical fixation on the femur and tibia...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349000/hamstring-graft-preparation-techniques-for-anterior-cruciate-ligament-reconstruction
#8
Gustavo Vinagre, Nicholas I Kennedy, Jorge Chahla, Mark E Cinque, Zaamin B Hussain, Morten L Olesen, Robert F LaPrade
Anterior cruciate ligament reconstruction is one of the most commonly performed procedures in orthopaedics, with more than 125,000 performed in the United States per year. There are several reconstruction graft choices that can be used to reconstruct the native anterior cruciate ligament, with autograft hamstring tendons being one of the most commonly used. Preparation of a hamstring autograft varies depending on patient characteristics and physician preference. The purpose of this Technical Note is to describe in detail different variants of hamstring graft preparation techniques that are commonly used in practice...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29337596/the-influence-of-graft-fixation-methods-on-revision-rates-after-primary-anterior-cruciate-ligament-reconstruction
#9
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
https://www.readbyqxmd.com/read/29330711/boosting-tendon-repair-interplay-of-cells-growth-factors-and-scaffold-free-and-gel-based-carriers
#10
REVIEW
Zexing Yan, Heyong Yin, Michael Nerlich, Christian G Pfeifer, Denitsa Docheva
BACKGROUND: Tendons are dense connective tissues and critical components for the integrity and function of the musculoskeletal system. Tendons connect bone to muscle and transmit forces on which locomotion entirely depends. Due to trauma, overuse and age-related degeneration, many people suffer from acute or chronic tendon injuries. Owing to their hypovascularity and hypocellularity, tendinopathies remain a substantial challenge for both clinicians and researchers. Surgical treatment includes suture or transplantation of autograft, allograft or xenograft, and these serve as the most common technique for rescuing tendon injuries...
January 5, 2018: Journal of Experimental Orthopaedics
https://www.readbyqxmd.com/read/29321844/foreign-body-reaction-with-granuloma-following-achilles-tendon-reconstruction-with-the-lars-ligament
#11
Joshua Henry, Alistar J Konarski, Leena Joseph, Anand Pillai
Ligament reconstruction with the LARS ligament has been a popular choice owing to its low-complication rates compared with previously commercially available grafts. The non-active nature of the implant also meant that there were no foreign body reactions that had been described with other synthetic grafts. We describe the first reported case of a granulomatous foreign body reaction in a LARS ligament Achilles tendon graft and a technique to reconstruct the tendon following its excision.
January 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29318179/preoperative-ultrasonography-is-unreliable-in-predicting-hamstring-tendon-graft-diameter-for-acl-reconstruction
#12
Amit M Momaya, Clint Beicker, Paul Siffri, Michael J Kissenberth, Jeffrey Backes, Lane Bailey, Gabriel J Rulewicz, Jennifer M Mercuri, E Carlisle Shealy, John M Tokish, Charles A Thigpen
Background: Hamstring autograft size <8 mm has been shown to be a predictor for failure after anterior cruciate ligament (ACL) reconstruction. The ability to predict graft size preoperatively is helpful in counseling patients about the possible need for graft augmentation. Purpose: To determine whether preoperative ultrasound (US) measurements of hamstring tendons can predict intraoperative graft diameter during ACL reconstruction. Study Design: Cohort study (diagnosis); Level of evidence, 2...
January 2018: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29318178/outcomes-after-dermal-allograft-reconstruction-of-chronic-or-subacute-pectoralis-major-tendon-ruptures
#13
Julie A Neumann, Christopher M Klein, Carola F van Eck, Hithem Rahmi, John M Itamura
Background: Avoiding delay in the surgical management of pectoralis major (PM) ruptures optimizes outcomes. However, this is not always possible, and when a tear becomes chronic or when a subacute tear has poor tissue quality, a graft can facilitate reconstruction. Purpose: The primary aim was to evaluate the clinical outcomes of PM reconstruction with dermal allograft augmentation for chronic tears or for subacute tears with poor tissue quality. A second aim was to determine patient and surgical factors affecting outcome...
January 2018: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29312850/anterolateral-rotatory-instability-in-vivo-correlates-tunnel-position-after-anterior-cruciate-ligament-reconstruction-using-bone-patellar-tendon-bone-graft
#14
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
https://www.readbyqxmd.com/read/29305291/medial-patellofemoral-ligament-reconstruction-impact-of-knee-flexion-angle-during-graft-fixation-on-dynamic-patellofemoral-contact-pressure-a-biomechanical-study
#15
Olaf Lorbach, Nikolaus Zumbansen, Matthias Kieb, Turgay Efe, Antonius Pizanis, Dieter Kohn, Alexander Haupert
PURPOSE: Objective evaluation of the optimal graft tension angle to fully restore patellofemoral contact pressure in reconstruction of the medial patellofemoral ligament (MPFL) in comparison to the native knee. METHODS: Twelve cadaveric knee specimens were fixed in a custom-made fixation device. A sensitive pressure film (Tekscan) was fixed in the patellofemoral joint, and patellofemoral contact pressure was assessed during a dynamic flexion movement from 0° to 90°...
January 2, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29304962/editorial-commentary-three-dimensional-printing-and-stem-cells-may-be-a-game-changer-for-recovery-after-anterior-cruciate-ligament-reconstruction
#16
EDITORIAL
Vipool K Goradia
Placing stem cells at the tendon-bone interface of a soft tissue anterior cruciate ligament (ACL) reconstruction in an animal model accelerates graft incorporation at 12 weeks. A 3D-printed scaffold used to deliver the stem cells completely degraded at 12 weeks. Future clinical application of similar technology may improve outcomes after ACL reconstruction.
January 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29304955/editorial-commentary-superior-capsule-reconstruction-graft-healing-for-success
#17
EDITORIAL
Teruhisa Mihata
In my experience, after superior capsule reconstruction for irreparable rotator cuff tears, if the graft heals, we can expect a successful outcome, such as an American Shoulder and Elbow Surgeons score of more than 90 points and a visual analog scale score of less than 1.0. To decrease the graft tear rate after surgery, I have found that a thicker, stiffer graft than can be achieved with a dermal allograft alone is required to restore superior stability in the glenohumeral joint. Furthermore, the graft size should be determined precisely from the size of the defect in the rotator cuff tendons...
January 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29304843/effect-of-cox-2-inhibition-on-tendon-to-bone-healing-and-pge2-concentration-after-anterior-cruciate-ligament-reconstruction
#18
Martin Sauerschnig, Josef Stolberg-Stolberg, Carmen Schmidt, Valerie Wienerroither, Michael Plecko, Karin Schlichting, Carsten Perka, Christian Dynybil
BACKGROUND: Non-steroidal anti-inflammatory drugs are commonly used to reduce pain and inflammation in orthopaedic patients. Selective cyclooxygenase-2 (COX-2) inhibitors have been developed to minimize drug-specific side effects. However, they are suspected to impair both bone and tendon healing. The objective of this study is to evaluate the effect of COX-2 inhibitor administration on tendon-to-bone healing and prostaglandin E (PGE2) concentration. METHODS: Thirty-two New Zealand white rabbits underwent reconstructions of the anterior cruciate ligaments and were randomized into four groups: Two groups postoperatively received a selective COX-2 inhibitor (Celecoxib) on a daily basis for 3 weeks, the two other groups received no postoperative COX-2 inhibitors at all and were examined after three or 6 weeks...
January 5, 2018: European Journal of Medical Research
https://www.readbyqxmd.com/read/29298454/risk-factors-for-contralateral-acl-injury-a-single-institution-case-control-study
#19
Todd P Pierce, Kimona Issa, Kaitlin Cassidy, Anthony Festa, Vincent K McInerney, Anthony J Scillia
Our purpose was to evaluate if there is any association between requiring contralateral anterior cruciate ligament (ACL) reconstruction and various: (1) demographics, (2) patient characteristics, and (3) surgery-specific factors. A prospectively collected database at a single institution was queried to find all patients who underwent primary ACL reconstruction between 2012 and 2014. We identified 312 primary ACL reconstruction patients with a mean age of 24 years and a mean follow-up of 3 years (range, 2-5 years)...
January 3, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29298079/effect-of-dynamic-changes-in-anterior-cruciate-ligament-in-situ-graft-force-on-the-biological-healing-response-of-the-graft-tunnel-interface
#20
Richard Ma, Michael Schär, Tina Chen, Marco Sisto, Joseph Nguyen, Clifford Voigt, Xiang-Hua Deng, Scott A Rodeo
BACKGROUND: Anterior cruciate ligament (ACL) grafts that are placed for reconstruction are subject to complex forces. Current "anatomic" ACL reconstruction techniques may result in greater in situ graft forces. The biological effect of changing magnitudes of ACL graft force on graft-tunnel osseointegration is not well understood. PURPOSE: The research objective is to determine how mechanical force on the ACL graft during knee motion affects tendon healing in the tunnel...
January 1, 2018: American Journal of Sports Medicine
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