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Byung Hoon Lee, Dong Ho Kum, Im Joo Rhyu, Youngjun Kim, Hyunchul Cho, Joon Ho Wang
PURPOSE: To evaluate the clinical advantages of a navigation system developed with an emphasis on attaining an appropriate femoral tunnel length and posterior wall margin with no posterior wall blowout, as well as having accurate tunnel positioning, in anatomical anterior cruciate ligament reconstruction (ACLR). METHODS: Ten freshly frozen human knees were transected at mid-femur and mid-tibia. Each knee specimen underwent arthroscopic single-bundle anterior cruciate ligament reconstruction using the outside-in technique, with two knees by manual ACLR (control group) and another eight knees by only the navigational ACLR without arthroscopic assistance (experimental group)...
October 19, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Jeong-Ku Ha, Dhong-Won Lee, Jin-Goo Kim
BACKGROUND: Numerous studies have elucidated the functional anatomy and biomechanics of the anterior cruciate ligament (ACL), as a result, double-bundle (DB) ACL reconstruction has received much attention and has become a popular choice because it gives better rotational stability. Many other studies, however, found no differences with respect to stability, and/or other clinical outcomes between the DB and single-bundle (SB) techniques. There is still not enough evidence as to whether the anatomical DB anterior cruciate ligament reconstruction (ACLR) is superior to anatomical SB reconstruction...
September 2016: Indian Journal of Orthopaedics
Gulcan Harput, Jennifer Sebert Howard, Carl Mattacola
Study Design Cross-sectional, controlled laboratory study. Background Quantification of muscular activation during different phases of functional activities is important to understand activation deficits in individuals who have undergone anterior cruciate ligament reconstruction (ACLR). Objectives To compare activation levels of vastus medialis (VM), medial hamstrings (MH) and gluteus medius (GMed) muscles during the different phases of weight bearing tasks between individuals who had undergone ACLR and healthy controls...
October 12, 2016: Journal of Orthopaedic and Sports Physical Therapy
A G Culvenor, B E Øiestad, I Holm, R B Gunderson, K M Crossley, M A Risberg
OBJECTIVE: To prospectively evaluate the relationship between the presence or persistence of anterior knee pain (AKP) during the first 2-years following anterior cruciate ligament reconstruction (ACLR) and patellofemoral osteoarthritis (PFOA) at 15- and 20-years. DESIGN: This study was ancillary to a long-term prospective cohort study of 221 participants following bone-patellar-tendon-bone ACLR. AKP was assessed at 1- and 2-years post-ACLR using part of the Cincinnati knee score with an additional pain location question (persistence defined as presence at both follow-ups)...
September 30, 2016: Osteoarthritis and Cartilage
Hiroshi Higuchi, Atsushi Kobayashi, Keiko Ikeda, Kazuhisa Hatayama, Sinya Yanagisawa, Kazuo Kato
This prospective pilot study investigated whether grafting β-tricalcium phosphate (B-TCP) into the bone-patellar tendon-bone (BPTB)-harvesting site after anterior cruciate ligament reconstruction would accelerate bone and tendon regeneration in the grafted site. Overall, 19 patients agreed prospectively to undergo regular morphological and histological examinations of the B-TCP-grafted site. Postoperative radiographic, ultrasonographic, and magnetic resonance imaging (MRI) examinations were performed to evaluate the grafted site at 1, 3, 6, and 12 months...
September 28, 2016: Journal of Knee Surgery
Alexandre Rambaud, Pierre Samozino, Pascal Edouard
OBJECTIVE: After anterior cruciate ligament (ACL) tear, the ACL reconstruction (ACLR) is the standard treatment to return to pivots/contacts sports. The goal of rehabilitation programs is to guide the functional recovery and the safe return to sport without additional knee injury or other injuries. Functional tests, like Hop tests and their side to-side difference index [limb symmetry index (LSI)], are commonly used following ACLR to help return to sport decision making. However, the most commonly used criterion to return to sport is the postoperative time: return to light activities (RtlA) at 3 or 4 month mark and return to sport with contacts and side-cuttings (RtS) between 6 and 9 month mark...
September 2016: Annals of Physical and Rehabilitation Medicine
Alexandre Rambaud, Bertrand Semay, Jean-Benoit Morin, Rémi Phillipot, Pierre Samozino, Pascal Edouard
OBJECTIVE: A criterion of the anterior cruciate ligament reconstruction (ACLR) success is the return to sport at the same level as before surgery. Return to sport (RtS) decision seems to be a key element in this success: if too early RtS exposes to risk of injury, too late RtS influences the motivation to return to the same level. Functional tests (Hop Tests) and isokinetic assessments (Isok Tests) are usually performed to guide this decision. However, a precise and objective biomechanical analysis of running pattern would be more similarly to the sport activity...
September 2016: Annals of Physical and Rehabilitation Medicine
Jason Beng Teck Lim, Bryan Loh, Hwei Chi Chong, Andrew Hwee Chye Tan
BACKGROUND: Patients with a history of previous knee surgeries, such as anterior cruciate ligament reconstruction (ACLR) and high tibial osteotomy (HTO), often have a higher likelihood of requiring a subsequent total knee arthroplasty (TKA). However, there is relatively limited data, especially in the Asian population, on how previous knee surgery could affect the clinical outcomes of TKA. Therefore, this study aims to evaluate the impact of previous knee surgeries on the clinical outcomes of future TKA...
August 2016: Annals of Translational Medicine
Bryan M Saltzman, Gregory L Cvetanovich, Daniel D Bohl, Brian J Cole, Bernard R Bach, Anthony A Romeo
BACKGROUND: There has been increased emphasis in orthopaedics on high-quality prospective research to provide evidence-based treatment guidelines, particularly in sports medicine/shoulder surgery. The external validity of these studies has not been established, and the generalizability of the results to clinical practice in the United States is unknown. HYPOTHESIS: Comparison of patient demographics in major prospective studies of arthroscopic sports and shoulder surgeries to patients undergoing the same procedures in the National Surgical Quality Improvement Program (NSQIP) database will show substantial differences to question the generalizability and external validity of those studies...
September 2016: Orthopaedic Journal of Sports Medicine
Peter Faunø, Lone Rømer, Torsten Nielsen, Martin Lind
BACKGROUND: Anterior cruciate ligament reconstruction (ACLR) in skeletally immature patients can result in growth plate injury, which can cause growth disturbances. PURPOSE: To evaluate radiological tibial and femoral length and axis growth disturbances as well as clinical outcomes in skeletally immature ACLR patients treated with a transphyseal drilling technique. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A total of 39 pediatric patients with ACL injury and open physes at time of surgery, as diagnosed clinically and with magnetic resonance imaging (MRI), were treated using transphyseal ACLR using hamstring graft...
September 2016: Orthopaedic Journal of Sports Medicine
Robert W Westermann, Thomas Sean Lynch, Kurt P Spindler
Since 2015, the Multicenter Orthopedic Outcomes Network (MOON) has addressed several factors associated with patient outcome after anterior cruciate ligament (ACL) injury. These factors include predictors of high grade knee laxity, the impact of meniscus treatment on joint space narrowing after surgery, graft selection, treating diabetic patients, predictors of clinically significant pain, and outcomes of patients where meniscus tears were left in situ without treatment. The presence of meniscus tears and generalized laxity predict a lax examination under anesthesia prior to surgery...
October 2016: Journal of Knee Surgery
Ana Tichonova, Inesa Rimdeikienė, Daiva Petruševičienė, Eglė Lendraitienė
BACKGROUND AND OBJECTIVE: Psychological responses to the initial injury and rehabilitation might be an important additional determinant of functional level outcomes after knee surgery. The objectives of this study were (1) to measure pain catastrophizing and kinesiophobia levels and (2) determine their association with self-reported subjective knee function during rehabilitation, following anterior cruciate ligament reconstruction (ACLR) and meniscectomy. MATERIALS AND METHODS: The study involved 41 participants...
2016: Medicina
Adam Meierbachtol, Eric Rohman, Eric Paur, John Bottoms, Marc Tompkins
BACKGROUND: In patients who have undergone anterior cruciate ligament reconstruction (ACLR), the effect of neuromuscular re-education (NMR) programs on standard hop tests outcomes, including limb symmetry indices (LSIs), is unknown. HYPOTHESIS: Both legs will show improvement in hop test-measured units after neuromuscular training, but the involved leg will show relatively greater improvement leading to improved limb symmetry. Patients younger than 18 years will show more improvement than patients who are older...
September 12, 2016: Sports Health
Matthew N Abourezk, Matthew P Ithurburn, Michael P McNally, Louise M Thoma, Matthew S Briggs, Timothy E Hewett, Kurt P Spindler, Christopher C Kaeding, Laura C Schmitt
BACKGROUND: Anterior cruciate ligament reconstruction (ACLR) using a hamstring tendon autograft often results in hamstring muscle strength asymmetry. However, the effect of hamstring muscle strength asymmetry on knee mechanics has not been reported. HYPOTHESIS: Participants with hamstring strength asymmetry would demonstrate altered involved limb knee mechanics during walking and jogging compared with those with more symmetric hamstring strength at least 2 years after ACLR with a hamstring tendon autograft...
September 2, 2016: American Journal of Sports Medicine
Bradley R Wasserman, Brian C Singh, Daniel J Kaplan, Maxwell Weinberg, Robert Meislin, Laith M Jazrawi, Eric J Strauss
PURPOSE: To determine when patients recover the ability to safely operate the brakes of an automobile after a right-knee anterior cruciate ligament reconstruction (ACLR). METHODS: A computerized driving simulator was used to determine braking ability after an isolated right-knee ACLR. Thirty healthy volunteers were tested at 1 visit to determine normal mean values, and 27 treatment subjects were tested at 1 week, 3 weeks, and 6 weeks after ACLR. Nine study subjects were treated with a patella tendon (BPTB) autograft, 9 were treated with a hamstring (HS) autograft, and 9 were treated with a tibialis anterior (TA) allograft...
August 25, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Valentina Pedoia, Favian Su, Amano Keiko, Li Qi, Charles E McCulloch, Richard B Souza, Thomas M Link, C Benjamin, Xiaojuan Li
The objectives of this study were twofold: (1) to evaluate the longitudinal change in cartilage T1ρ and T2 6- and 12-months after ACL reconstruction (ACLR) in both reconstructed and intact contralateral knees with the aim of validating the role of the contralateral knee as an internal control in longitudinal studies; (2) to explore relationships between bone shape at the time of injury and the progression of T1ρ and T2 over 12-months after ACLR. T1ρ and T2 cartilage relaxation times and 3D MRI-based Statistical Shape Modeling (SSM) of tibia and femur were computed for both knees of forty ACL-injured patients and fifteen healthy controls...
August 24, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Adrian Kurz, Nathan Evaniew, Marco Yeung, Kristian Samuelsson, Devin Peterson, Olufemi R Ayeni
PURPOSE: This systematic review examined the methodological credibility and quality of reporting of all meta-analyses which have compared bone-patellar tendon-bone (BPTB) versus hamstring tendon (HT) for anterior cruciate ligament (ACL) reconstruction (ACLR). METHODS: EMBASE, MEDLINE, and The Cochrane Library were systematically searched, and two reviewers independently assessed eligibility, credibility according to the Users' Guide to medical literature, and completeness of reporting according to the preferred reporting items for systematic review and meta-analyses (PRISMA) checklist...
August 20, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Matthew J Jordan, Per Aagaard, Walter Herzog
PURPOSE: The acute effects of fatigue on functional inter-limb asymmetry and quadriceps/hamstring muscle activity levels including preparatory co-activation during squat jump takeoff and landing was evaluated in elite alpine ski racers with/without anterior cruciate ligament (ACL) reconstruction (ACLR). METHODS: Twenty-two elite ski racers (ACLR: n=11; Control: n=11) performed an 80-second repeated squat jump test (jump-test) on a dual force plate system with simultaneous electromyography (EMG) recordings in vastus lateralis (VL), vastus medialis (VM), semitendinosus (ST) and biceps femoris (BF)...
August 17, 2016: Medicine and Science in Sports and Exercise
Eric Hamrin Senorski, Kristian Samuelsson, Christoffer Thomeé, Susanne Beischer, Jón Karlsson, Roland Thomeé
PURPOSE: To characterise patients who returned to knee-strenuous sports after an anterior cruciate ligament (ACL) reconstruction. METHODS: Data from isotonic tests of muscle function and patient-reported outcome measures, Tegner activity scale (Tegner and Lysholm in Clin Orthop Relat Res 198:43-49, 1985), physical activity scale, knee injury and osteoarthritis scale and knee self-efficacy scale were extracted from a registry. The 157 included patients, 15-30 years of age, had undergone primary ACL reconstruction and were all involved in knee-strenuous sports, i...
August 16, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Thomas L Sanders, Ayoosh Pareek, Timothy E Hewett, Bruce A Levy, Diane L Dahm, Michael J Stuart, Aaron J Krych
PURPOSE: Graft failure following anterior cruciate ligament reconstruction (ACLR) is a devastating injury among patients returning to activity. The goals of this study were to define the long-term rate of graft failure after ACLR in the general population and evaluate factors associated with graft failure. METHODS: This long-term observational study included a population-based incidence cohort of patients who underwent primary ACLR after diagnosis with new-onset, isolated ACL tears between 1990 and 2010...
August 13, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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