Clinical and Second-Look Arthroscopic Evaluation of Repaired Medial Meniscus in Anterior Cruciate Ligament-Reconstructed Knees
Conclusion
Repaired MMPH tears in knees with reconstructed ACLs healed without complications and had satisfactory clinical results. The tear location and type were factors associated with healing on the univariate analysis and location only on the multivariate analysis. (Source: The American Journal of Sports Medicine)...
POSTED 03/01/2010 at 05:18 PM --
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Early Versus Late Start of Isokinetic Hamstring-Strengthening Exercise After Anterior Cruciate Ligament Reconstruction With Patellar Tendon Graft
Conclusion
The results of this study suggest that hamstring as well as quadriceps strength can be increased via early hamstring strengthening after anterior cruciate ligament reconstruction with no negative impact on knee function. (Source: The American Journal of Sports Medicine)...
POSTED 03/01/2010 at 05:18 PM --
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Biodegradable Screw Versus a Press-Fit Bone Plug Fixation for Hamstring Anterior Cruciate Ligament Reconstruction: A Prospective Randomized Study
Conclusion
Both interference screw and a press-fit fixation lead to a high number of good or very good outcomes after ACL reconstruction. Tibial press-fit fixation decreases the amount of proximal bone tunnel enlargement. (Source: The American Journal of Sports Medicine)...
POSTED 03/01/2010 at 05:18 PM --
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In Situ Forces in the Anteromedial and Posterolateral Bundles of the Anterior Cruciate Ligament Under Simulated Functional Loading Conditions
Conclusion
Under externally applied loads, in general, the AM bundle carried a greater portion of the load at all flexion angles, whereas the PL bundle only shared the load at low flexion angles. The bundles functioned in a complementary rather than a reciprocal manner to each other.
Clinical Relevance
The data appear to support the concept that both bundles function in a complementary manner. Thus, how to re-create the 2 bundle functions in an ACL reconstruction should be further investigated. (Source: The American Journal of Sports Medicine)...
POSTED 03/01/2010 at 05:18 PM --
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Time Line for Noncopers to Pass Return-to-Sports Criteria After Anterior Cruciate Ligament Reconstruction.
CONCLUSION: Functional outcomes suggest that a subgroup of noncopers require additional supervised rehabilitation to pass stringent criteria to return to sports. LEVEL OF EVIDENCE: Therapy, level 2b.Note: If watching the first video, we recommend downloading and referring to the accompanying PowerPoint slides for any text that is not readable. J Orthop Sports Phys Ther 2010;40(3):141-154, Epub 30 January 2010. doi:10.2519/jospt.2010.3168.
PMID: 20195019 [PubMed - in process] (Source: Physical Therapy)...
POSTED 02/28/2010 at 06:00 PM --
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Transtibial Versus Anteromedial Portal Drilling for Anterior Cruciate Ligament Reconstruction: A Cadaveric Study of Femoral Tunnel Length and Obliquity
Conclusions: The anteromedial portal technique allows for slightly greater femoral tunnel obliquity compared with transtibial drilling. However, there is a substantially increased risk of critically short tunnels ( (Source: Arthroscopy)...
POSTED 02/28/2010 at 06:00 PM --
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Combined reconstruction for posterolateral rotatory instability with anterior cruciate ligament injuries of the knee
Abstract If posterolateral rotatory instability (PLRI) injury in patients with a torn anterior cruciate ligament (ACL) is not diagnosed
and treated, ACL reconstruction can fail. We retrospectively evaluated the clinical outcome after reconstructions between
2002 and 2007 of both the ACL and the posterolateral corner (PLC) in 44 knees with combined ACL and PLC injuries. The median
follow-up duration was 49 months (range, 24–68 months). ACL reconstruction employed autogenous hamstring grafts from the ipsilateral
knee. For grade II PLRI, a posterolateral corner sling through the fibular head was placed obliquely from the anteroinferior
aspect to the posterosuperior aspect using autogenous hamstring grafts of the contralateral knee. Clinical outcomes were evaluated
......
POSTED 02/25/2010 at 12:47 AM --
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Growth disturbances without growth arrest after ACL reconstruction in children
Abstract Growth arrest is a major concern after ACL reconstruction in children. It usually occurs in patients near to closure of the
growth plates. Growth disturbances without growth arrest are also possible and more vicious; the authors analyse the mechanism
of two patients with growth disturbance due to overgrowth following ACL reconstruction. One was a symmetrical overgrowth process
with 15 mm limb length discrepancy treated with percutaneous epiphysiodesis. Full correction at the time of skeletal maturity
was achieved. The second patient developed an asymmetrical overgrowth with progressive tibial valgus deformity. This mechanism
was similar to a posttraumatic tibial valgus deformity. After nonoperative treatment, a spontaneous correction of the deformity
was noti......
POSTED 02/25/2010 at 12:46 AM --
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All-epiphyseal Anterior Cruciate Ligament Reconstruction in Skeletally Immature Patients.
CONCLUSIONS: Although longer-term followup will be necessary, this technique provides for an anatomic all-epiphyseal-based ACL reconstruction using intraoperative 3-D imaging to minimize the risk of growth disturbance. LEVEL OF EVIDENCE: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
PMID: 20174901 [PubMed - as supplied by publisher] (Source: Clinical Orthopaedics and Related Research)...
POSTED 02/19/2010 at 06:00 PM --
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Anterior cruciate ligament reconstruction with synthetic grafts. A review of literature
Abstract Anterior cruciate ligament (ACL) rupture, one of the most common knee injuries in sports, results in anteroposterior laxity,
which often leads to an unstable knee. Traditional ACL reconstruction is performed with autograft; disadvantages of this technique
are donor site morbidity and a long rehabilitation period. In the 1980s, artificial ligaments became an attractive alternative
to biological grafts. The initial enthusiasm surrounding their introduction stemmed from their lack of donor morbidity, their
abundant supply and significant strength, immediate loading and reduced postoperative rehabilitation. Synthetic grafts made
of different materials such as carbon fibers, polypropylene, Dacron and polyester have been utilised either as a prosthesis
or as an augmenta......
POSTED 02/15/2010 at 11:58 AM --
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Biomechanical evaluation of different anterior cruciate ligament fixation techniques for hamstring graft
Conclusion Load to failure and stiffness was significantly different between the ACL fixation techniques. All but one of the fixation
techniques showed sufficient properties for adequate postoperative rehabilitation. Bone cement used as a fixation device in
soft tissue grafts did not seem to provide adequate initial fixation suitable for early rehabilitation after ACL reconstruction.
Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00776-009-1417-9Authors
E. Monaco, University “La Sapienza” Orthopaedic Unit, “Kirk Kilgour” Sports Injury Center, Sant’Andrea Hospital Via di Grottarossa 1035 Rome 00100 ItalyL. Labianca, University “La Sapienza” Orthopaedic Unit, “Kirk Kilgour” Sports Injury Center, Sant’Andrea Hospital Via di Grottaro......
POSTED 02/12/2010 at 01:24 AM --
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Arthroscopic anterior cruciate ligament reconstruction with modified “wireless” cross-screw transfix femoral fixation
Abstract Among several graft fixation options in arthroscopic ACL reconstruction for hamstring tendons, transcondylar fixation has
been suggested to offer mechanical advantages compared to other femoral fixation systems. Blind nature of the procedure may
result in several complications including iliotibial band irritation syndrome, breakage of the bio absorbable cross-pin, stress
fracture of the femoral cortex, and more commonly intraoperative wire loop twisting, resulting in fixation failure, wire breakage
or graft laceration. We used “wireless” transfixation technique to avoid complications associated with wire loop.
Content Type Journal ArticleCategory KneeDOI 10.1007/s00167-010-1079-3Authors
Fereidoon M. Jaberi, Shiraz University of Medical Sciences Department o......
POSTED 02/12/2010 at 01:06 AM --
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Double-bundle ACL reconstruction: how big is the learning curve?
Abstract The study aim was to determine whether an experienced ACL surgeon could convert from a single-bundle to a double-bundle technique
with relative accuracy. We also wanted to determine whether there was a significant learning curve. Ten double-bundle ACL
reconstruction procedures were carried out on suitable individuals. Following the procedure, all patients underwent a CT scan
of the relevant knee. Femoral and tibial tunnel locations were then measured and compared to reference anatomical locations
previously described in the literature. The results were not known to the surgeon until all 10 cases were completed. The total
percentage difference between the sum of all four study tunnel locations from their reference anatomical positions was calculated
for each patien......
POSTED 02/05/2010 at 11:52 AM --
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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 --
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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 --
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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 --
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Comparative Kinematic Evaluation of All-Inside Single-Bundle and Double-Bundle Anterior Cruciate Ligament Reconstruction: A Biomechanical Study
Conclusion
We found that an all-inside double-bundle ACL reconstruction demonstrated significant improvement in restoring normal rotational knee motion during simulated pivot-shift testing compared with single-bundle ACL reconstructions in vitro, with no significant differences in other knee loading conditions.
Clinical Relevance
All-inside double-bundle ACL reconstruction may provide advantages over single-bundle ACL reconstruction for rotational knee stability. (Source: The American Journal of Sports Medicine)...
POSTED 02/01/2010 at 06:57 PM --
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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 --
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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 --
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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 --
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