Immunohistological evaluation of proprioceptive potential of the residual stump of injured anterior cruciate ligaments (ACL)
Abstract To evaluate proprioceptive potential in residual remnants, tissue harvested from ruptured ACLs in 63 consecutive patients
was examined for evidence of residual proprioceptive fibres using H&E, and monoclonal antibodies to S-100 and NFP (neurofilament
protein). Histological examination showed good subsynovial and intra-fascicular vascularity with free nerve endings in the
majority. Morphologically normal mechanoreceptors (H&E) and proprioceptive fibres (positivity with monoclonal antibody for
NFP) were found in 46% and 52.4% of stumps, respectively. A statistically significant correlation between injury duration
and persistence of mechanoreceptors and proprioceptive fibres was noted. More fibres were seen where ACL remnant was adherent
to PCL. Our study has shown t......
POSTED 02/04/2010 at 12:09 PM --
|
Transphyseal reconstruction of the anterior cruciate ligament in prepubescent athletes
Abstract ACL reconstruction in adolescents undergoing or being beyond the final growth spurt can be performed as in adults without
major concern of growth disturbance. Whereas for the young athlete with wide-open physis a lot of controversy still exists
about the technical aspect of the procedure to minimise the risk of growth disturbance. Between 10/1997 and 10/2002 31 children
graded Tanner stage 1 or 2 (median age 11 years) with an intraligamental rupture of the anterior cruciate ligament were enrolled.
Seventeen patients with coexisting intraarticular damage (meniscus, osteochondral flake) underwent transphsyeal reconstruction
of the ACL with the use of an autogenous semitendinosus tendon graft, whereas 14 patients without coexisting pathologies received
a nonoper......
POSTED 02/04/2010 at 12:59 AM --
|
No bone tunnel enlargement in patients with open growth plates after transphyseal ACL reconstruction
Abstract Bone tunnel enlargement after ACL reconstruction has been described extensively in adults. However, little is known about
this phenomenon in patients with open growth plates. Thus, the goals of the current study were to evaluate changes in bone
tunnel size in patients with open growth plates after transphyseal ACL reconstruction with suspensory fixation and to correlate
tunnel size with clinical outcome after medium-term follow-up. Fourteen patients with open growth plates were included that
underwent primary transphyseal ACL reconstruction using hamstrings autografts and suspensory fixation. Mean follow-up time
was 7 years. At the time of follow-up, MRIs of the operated knee were performed, and outcome was assessed using KOS-ADLS,
Lysholm score, IKDC Subject......
POSTED 02/03/2010 at 01:59 AM --
|
Focal Cartilage Defects in the Knee Impair Quality of Life as Much as Severe Osteoarthritis: A Comparison of Knee Injury and Osteoarthritis Outcome Score in 4 Patient Categories Scheduled for Knee Surgery
Conclusion
Patients with focal cartilage lesions have major problems with pain and functional impairment. Their complaints are worse than those of patients with anterior cruciate ligament–deficient knees, and quality of life is affected to the same extent as in patients scheduled for knee replacement. (Source: The American Journal of Sports Medicine)...
POSTED 02/01/2010 at 06:57 PM --
|
Effect of Graft Selection on the Incidence of Postoperative Infection in Anterior Cruciate Ligament Reconstruction
Conclusion
Hamstring tendon autografts have a higher incidence of infection than BPTB autografts or allografts. The use of allograft material in ACL reconstructions does not increase the risk of infection or the need for graft removal with infection. (Source: The American Journal of Sports Medicine)...
POSTED 02/01/2010 at 06:57 PM --
|
The Effect of Medial Meniscectomy and Meniscal Allograft Transplantation on Knee and Anterior Cruciate Ligament Biomechanics
Conclusions: In most cases medial meniscectomy produced a significant increase in tibial displacement relative to the femur, and meniscal allograft transplantation restored displacement values to normal. Meniscectomy increased ACL strain and meniscal allograft transplant restored strain values to normal in 2 of 3 tested flexion angles.Clinical Relevance: The absence of the medial meniscus exposes the ACL to increased strain, whereas meniscal allograft lowered the strain on the native ACL. This could have implications for those patients undergoing ACL reconstruction who have concomitant removal of the medial meniscus. (Source: Arthroscopy)...
POSTED 01/31/2010 at 06:00 PM --
|
Anatomic Single- and Double-Bundle Anterior Cruciate Ligament Reconstruction Flowchart
Anatomy is the foundation of orthopaedic surgery, and the advancing knowledge of the anterior cruciate ligament (ACL) anatomy has led to the development of improved modern reconstruction techniques that approach the anatomy of the native ACL. Current literature on the anatomy of the ACL and its reconstruction techniques, as well as our surgical experience, was used to develop a flowchart that can aid the surgeon in performing anatomic ACL reconstruction. We define anatomic ACL reconstruction as the functional restoration of the ACL to its native dimensions, collagen orientation, and insertion sites. A guideline was written to accompany this flowchart with more detailed information on anatomic ACL reconstruction and its pitfalls, all accompanied by relevant literature and helpful figures. A......
POSTED 01/31/2010 at 06:00 PM --
|
The Use of Platelet-Rich Plasma in Arthroscopy and Sports Medicine: Optimizing the Healing Environment
Abstract: Platelet-rich plasma (PRP) is a new technology focused on enhancing the healing response after injury of different tissue types. PRP is prepared by withdrawal of patients' peripheral blood and centrifugation to obtain a highly concentrated sample of platelets, which undergo degranulation to release growth factors with healing properties. It also contains plasma, cytokines, thrombin, and other growth factors that are implicated in wound healing and have inherent biological and adhesive properties. The prepared concentrate is then injected back into the patient at the site of morbidity. This may be intralesional, intra-articular, or surrounding the involved tissue bed. PRP preparations have been used therapeutically in various medical fields from implantology to vascular ulcers, wi......
POSTED 01/31/2010 at 06:00 PM --
|
Good results five years after surgical management of anterior cruciate ligament tears, and meniscal and cartilage injuries
Abstract In athletes with anterior cruciate ligament (ACL) tears combined with meniscal and cartilage injuries, the goals are to restore
knee laxity and relieve symptoms, while long-term goals are the return to pre-injury sport activity and to prevent onset of
degenerative changes. We compared the post-operative (minimum 5 years) clinical and radiological outcomes of 50 patients,
similar for ACL rupture and meniscal tears, but different for the grade of cartilage lesion. The patient population was divided
into two groups similar for ACL reconstruction and surgical meniscal management. Group 1 included 25 patients undergoing microfracture
management of grade III–IV cartilage lesions, while Group 2 included 25 patients with grade I–II cartilage lesions, managed
by r......
POSTED 01/28/2010 at 11:58 AM --
|
Femoral tunnel enlargement after anatomic ACL reconstruction: a biological problem?
Abstract Tunnel enlargement after anterior cruciate ligament (ACL) reconstruction may compromise revision surgery. The cause of this
tunnel enlargement is not yet fully understood, but it is thought to be multifactorial, with biomechanical and biological
factors playing a role. Tunnel enlargement has been described particularly in patients who underwent ACL reconstruction with
hamstring tendons with extracortical fixation devices. The purpose of our study was to evaluate prospectively with magnetic
resonance imaging (MRI) the changes in femoral tunnel diameter following arthroscopic anatomic ACL reconstruction with hamstring
tendons. At 3-month post-op, all tunnels had enlarged compared to the diameter of the drill and most tunnels enlarged more
in the midsection than at t......
POSTED 01/28/2010 at 11:58 AM --
|
Implant-free press-fit fixation for bone–patellar tendon–bone ACL reconstruction: 10-year results
Conclusion The implant-free fixation of the graft with bone dowels and BTT implantation has good and excellent results after 10 years
in more than 80% of the patients. Loss of the meniscus is a main factor contributing to osteoarthritis. Advantages of patellar
tendon bone press-fit fixation include anatomical positioning and fast bone-to-bone healing, ease for revision surgery and
cost effectiveness.
Content Type Journal ArticleCategory Arthroscopy and Sports MedicineDOI 10.1007/s00402-010-1050-2Authors
Gernot Felmet, Clinic for Orthopedics and Sports Traumatology Orthopädische Praxis, ARTICO Sportklinik Hirschbergstr. 25 78054 Villingen-Schwenningen Germany
Journal Archives of Orthopaedic and Trauma SurgeryOnline ISSN 1434-3916Print ISSN 0936-8051 (Sour......
POSTED 01/22/2010 at 04:08 AM --
|
Imaging of Anterior Cruciate Ligament Repair and Its Complications
CONCLUSION. Given the number of patients undergoing ACL
reconstruction, it is important for radiologists to be familiar with the
different reconstruction surgeries and their common complications. (Source: American Journal of Roentgenology)...
POSTED 01/21/2010 at 02:14 PM --
|
Ketoprofen Absorption by Muscle and Tendon after Topical or Oral Administration in Patients Undergoing Anterior Cruciate Ligament Reconstruction.
In conclusion, following topical application in a patch, ketoprofen shows rapid and sustained delivery to the underlying tissues without a significant increase of the plasma drug concentration.
PMID: 20087696 [PubMed - as supplied by publisher] (Source: AAPS PharmSciTech)...
POSTED 01/19/2010 at 06:00 PM --
|
Femoral nerve block with ropivacaine or bupivacaine in day case anterior crucial ligament reconstruction
Our aim was to evaluate analgesia, motor block and pharmacokinetics of ropivacaine 0.2% and 0.75% in a femoral nerve block (FNB) in day case patients for anterior crucial ligament (ACL)-reconstruction compared with bupivacaine 0.25% and placebo. Following ethics committee approval and informed consent, 280 patients were randomly allocated to four groups for single-shot FNB [30 ml ropivacaine 0.2% (group RO2.0), 0.75% (RO7.5), bupivacaine 0.25% (BU2.5) and NaCl 0.9% (NaCl)]. Analgesia (pain scores, primary outcome) and motor block were assessed at 4 h (dismissal) and up to 24 h. Plasma concentration was determined up to 240 min thereafter. Pain scores at 4 h were significantly higher for NaCl 4 (0[ndash]8) (median, range) (vs.) BU2.5 2 (0[ndash]8), RO2.0 3 (0[ndash]9) and RO7.5 2 (0[ndash]8......
POSTED 01/17/2010 at 06:00 PM --
|
Evidence-based rehabilitation following anterior cruciate ligament reconstruction
Abstract Following a bone-patellar tendon-bone autograft (BPTB) or four-stranded semitendinosus/gracilis tendons autograft (ST/G) anterior
cruciate ligament (ACL) reconstruction, the speed and safety with which an athlete returns to sports (or regains the pre-injury
level of function) depends on the rehabilitation protocol. Considering the large differences in clinical and outpatient protocols,
there is no consensus regarding the content of such a rehabilitation program. Therefore, we conducted a systematic review
to develop an optimal evidence-based rehabilitation protocol to enable unambiguous, practical and useful treatment after ACL
reconstruction. The systematic literature search identified 1,096 citations published between January 1995 and December 2006.
Thirty-two s......
POSTED 01/13/2010 at 12:50 AM --
|
Comparison between bovine bone and titanium interference screws for implant fixation in ACL reconstruction: a biomechanical study
Conclusion Interference screws derived from bovine compact bone show similar good results as the titanium interference screws. Therefore,
the safety and in vivo performance of products derived from xenogenic bone should be the focus of further investigations.
Content Type Journal ArticleCategory Arthroscopy and Sports MedicineDOI 10.1007/s00402-010-1052-0Authors
Turgay Efe, University Hospital Marburg Department of Orthopaedics and Rheumatology Baldingerstraße 35043 Marburg GermanyJoscha Bauer, University Hospital Marburg Department of Orthopaedics and Rheumatology Baldingerstraße 35043 Marburg GermanySilke Herdrich, Department of Orthopaedics Gotenstraße 1-6 65929 Frankfurt/Main GermanyLeo Gotzen, Esculapclinic Nordanlage 19 35390 Giessen GermanyBilal Farouk El-Zay......
POSTED 01/11/2010 at 12:20 PM --
|
Delayed Foreign Body Reaction Due to Bioabsorbable Pins Used for Femoral Fixation in Anterior Cruciate Ligament Reconstruction: A Case Report
(Source: The American Journal of Sports Medicine)...
POSTED 01/05/2010 at 04:07 PM --
|
Does the Graft Source Really Matter in the Outcome of Patients Undergoing Anterior Cruciate Ligament Reconstruction?: An Evaluation of Autograft Versus Allograft Reconstruction Results: A Systematic Review
Conclusion
After a comprehensive examination and statistical analysis of the modern literature, the authors could not identify an individual graft source that was clearly superior to the other graft sources. This led them to believe that, with currently available data, the graft source has a minimal effect on the outcome of patients undergoing anterior cruciate ligament reconstruction. (Source: The American Journal of Sports Medicine)...
POSTED 01/05/2010 at 04:07 PM --
|
Comparison Between Single-and Double-Bundle Anterior Cruciate Ligament Reconstruction: A Prospective, Randomized, Single-Blinded Clinical Trial
Conclusion
In the 2-year minimum follow-up, DB ACL reconstructions showed better VAS, anterior knee laxity, and final objective IKDC scores than SB. However, longer follow-up and accurate instrumented in vivo rotational stability assessment are needed. (Source: The American Journal of Sports Medicine)...
POSTED 01/05/2010 at 04:07 PM --
|
Rapid Chondrolysis of the Knee After Anterior Cruciate Ligament Reconstruction: A Case Report
(Source: JBJS [Am])...
POSTED 01/04/2010 at 12:02 PM --
|
