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41. Recurrent lateral patella dislocation affects knee function as much as ACL deficiency - however patients wait five times longer for treatment. Full Text available with Trip Pro

Recurrent lateral patella dislocation affects knee function as much as ACL deficiency - however patients wait five times longer for treatment. Surgical treatment of young patients with recurrent lateral patella dislocation (RLDP) is often recommended because of loss of knee function that compromises their level of activity or even their daily life functioning. This situation is comparable to young patients with an anterior cruciate ligament (ACL) rupture. The purpose of this study was therefore (...) to explore the time from injury to surgery and the pre-operative symptoms and knee function of young RLPD patients scheduled for stabilizing surgery and compare this group to age and sex-matched ACL-deficient patients.Forty-seven patients with unilateral RLPD listed for isolated medial patellofemoral ligament reconstruction were included in the study (RLPD-group). This group was compared to an age, sex and BMI matched ACL patient group obtained from the Norwegian knee ligament registry (ACL-group

2019 BMC Musculoskeletal Disorders Controlled trial quality: uncertain

42. Surgery for patellar tendinopathy (jumper's knee). (Abstract)

Surgery for patellar tendinopathy (jumper's knee). Patellar tendinopathy is an overuse condition that commonly affects athletes. Surgery is usually offered if medical and physical therapies fail to treat it effectively. There is variation in the type of surgery performed for the condition.To assess the benefits and harms of surgery for patellar tendinopathy in adults.We searched the following databases, to 17 July 2018: the Cochrane Central Register of Controlled Trials (CENTRAL) via (...) the Cochrane Library, OVID MEDLINE, OVID Embase, clinical trial registries (www.ClinicalTrials.gov) and the WHO trials portal (www.who.int/ictrp/en/).We included all randomised controlled trials (RCTs) that compared surgical techniques (open or arthroscopic) with non-operative treatment (including placebo surgery, exercise or other non-surgical modalities) in adults with patellar tendinopathy.Major outcomes assessed were knee pain, function, quality of life, participant global assessment of success

2019 Cochrane

43. Anterior Cruciate Ligament Reconstruction Using a Bone–Patellar Tendon–Bone Graft With and Without a Ligament Augmentation Device: A 25-Year Follow-up of a Prospective Randomized Controlled Trial Full Text available with Trip Pro

Anterior Cruciate Ligament Reconstruction Using a Bone–Patellar Tendon–Bone Graft With and Without a Ligament Augmentation Device: A 25-Year Follow-up of a Prospective Randomized Controlled Trial Various grafts and ligament augmentation devices (LADs) have been used in the search for optimal reconstruction of the anterior cruciate ligament (ACL).To compare 25-year follow-up results after ACL reconstruction using a bone-patellar tendon-bone (BPTB) graft with or without the Kennedy (...) LAD.Randomized controlled trial; Level of evidence, 1.One hundred patients undergoing ACL reconstruction between 1991 and 1993 were randomized into 2 groups: reconstruction using a BPTB graft alone (BPTB group, 51 patients) or a BPTB graft with the Kennedy LAD (LAD group, 49 patients). The 25-year follow-up evaluation included a clinical knee examination, patient-reported outcome measures, and an assessment of radiological osteoarthritis (OA) according to the Ahlbäck classification. Additional outcomes were

2018 Orthopaedic journal of sports medicine Controlled trial quality: uncertain

44. Anterior cruciate ligament injury

treatment for most patients consists of protection, rest, ice, compression, elevation, and analgesia (as appropriate). Subsequent treatment varies by an individual patient's health and fitness status and goals. Treatment may range from minimal or no additional intervention to bracing, physiotherapy, and activity modification, and to surgical reconstruction (either early or delayed). Definition A torn anterior cruciate ligament (ACL) usually occurs as the result of an acute non-contact deceleration (...) injury, forceful hyperextension, or excessive rotational forces about the knee. Boden BP, Dean GS, Feagin JA, et al. Mechanisms of anterior cruciate ligament injury. Orthopedics. 2000;23:573-578. http://www.ncbi.nlm.nih.gov/pubmed/10875418?tool=bestpractice.com Ettlinger CF, Johnson RJ, Shealy JE. A method to help reduce the risk of serious knee sprains incurred in alpine skiing. Am J Sports Med. 1995;23:531-537. http://www.ncbi.nlm.nih.gov/pubmed/8526266?tool=bestpractice.com The ligament may

2018 BMJ Best Practice

45. Translation, cross-cultural adaptation, validation, and measurement properties of the Spanish version of the anterior cruciate ligament-return to sport after injury (ACL-RSI-Sp) scale. (Abstract)

Translation, cross-cultural adaptation, validation, and measurement properties of the Spanish version of the anterior cruciate ligament-return to sport after injury (ACL-RSI-Sp) scale. To translate into Spanish and validate the anterior cruciate ligament-return to sport after injury (ACL-RSI) scale, and to evaluate the psychological factors that have the greatest impact on the return to play among Spanish football players.The ACL-RSI was first translated into Spanish by two teams of bilingual (...) experts. At the time of discharge, 114 amateur and semi-professional football players who underwent ACL reconstruction answered a questionnaire regarding demographic and injury-related data, along with the translated ACL-RSI, the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Tampa Scale for Kinesiophobia (TSK-11SV) and the injury-psychological readiness to return to sport (I-PRRS). Statistical analysis included reliability tests (Cronbach's alpha and test-retest), construct validity

2019 Knee Surgery, Sports Traumatology, Arthroscopy

46. Cartilage damage at the time of anterior cruciate ligament reconstruction is associated with weaker quadriceps function and lower risk of future ACL injury. (Abstract)

Cartilage damage at the time of anterior cruciate ligament reconstruction is associated with weaker quadriceps function and lower risk of future ACL injury. To determine whether articular cartilage damage noted at the time of primary anterior cruciate ligament reconstruction (ACLR) affects the likelihood of achieving ≥ 90% symmetry for isokinetic extension strength at 6 months after surgery or risk of recurrent ACL injury.Five hundred and eight patients underwent primary ACLR and diagnostic (...) arthroscopy. All identified cartilage lesions were graded using the Outerbridge system. All patients underwent isokinetic strength testing. The association between cartilage Outerbridge grade and a ≥ 90% Limb Symmetry Index (LSI) and recurrent ACL injury risk at mean 38.7 month follow-up (SD 31.8) was evaluated via multivariate regression analysis.Grade 2 or higher damage was present in 394 (77.5%) of patients, grade 3 or higher in 143 (28.1%) and grade 4 in 83 (16.4%) at time of ACLR. Ipsilateral ACLR

2019 Knee Surgery, Sports Traumatology, Arthroscopy

47. Good mid-term outcomes and low rates of residual rotatory laxity, complications and failures after revision anterior cruciate ligament reconstruction (ACL) and lateral extra-articular tenodesis (LET). (Abstract)

Good mid-term outcomes and low rates of residual rotatory laxity, complications and failures after revision anterior cruciate ligament reconstruction (ACL) and lateral extra-articular tenodesis (LET). Residual rotational instability remains a controversial factor when analysing failure rates of anterior cruciate ligament (ACL) reconstruction. Anatomical and biomechanical studies have demonstrated a very important role of anterolateral structures for rotational control. Revision ACL (...) is considered one of the main indications for a lateral extra-articular tenodesis (LET). Yet, few series evaluating these procedures are published.To perform a systematic review of studies that assessed outcomes in patients treated with revision ACL surgery associated with a lateral extra-articular procedure.Systematic review.A comprehensive literature search was performed in February 2018 using PubMed, Scopus, Web of Search and Cochrane. Inclusion criteria were series of ACL revision reconstructions

2019 Knee Surgery, Sports Traumatology, Arthroscopy

48. Evidence-based recommendations for the management of anterior cruciate ligament (ACL) rupture. Full Text available with Trip Pro

Evidence-based recommendations for the management of anterior cruciate ligament (ACL) rupture. Anterior cruciate ligament (ACL) rupture occurs most commonly in young and active individuals and can have negative long-term physical and psychological impacts. The diagnosis is made with a combination of patient's history, clinical examination, and, if appropriate, magnetic resonance imaging. The objectives of management are to restore knee function, address psychological barriers to activity (...) participation, prevent further injury and osteoarthritis, and optimize long-term quality of life. The three main treatment options for ACL rupture are (1) rehabilitation as first-line treatment (followed by ACL reconstruction (ACLR) in patients, who develop functional instability), (2) ACLR and post-operative rehabilitation as the first-line treatment, and (3) pre-operative rehabilitation followed by ACLR and post-operative rehabilitation. We provide practical recommendations for informing and discussing

2019 Best practice & research. Clinical rheumatology

49. Knee sensorimotor control following anterior cruciate ligament reconstruction: A comparison between reconstruction techniques. Full Text available with Trip Pro

Knee sensorimotor control following anterior cruciate ligament reconstruction: A comparison between reconstruction techniques. The sensorimotor system helps to maintain functional joint stability during movement. After anterior cruciate ligament (ACL) injury and reconstruction, several sensorimotor deficits may arise, including altered proprioception and changes in neuromuscular control. It is still unknown whether the type of autograft used in the reconstruction may influence knee sensorimotor (...) impairments. The aim of this study was to comparatively assess the effects of the hamstring tendon (HT) and bone-patellar tendon-bone (BPTB) ACL reconstruction techniques on knee sensorimotor control 6-12 months post-operation. A total of 83 male subjects participated in this study: 27 healthy participants, 30 BPTB-operated patients and 26 HT-operated patients. Active joint position sense in 3 ranges of motion (90-60°, 60-30°, and 30-0° of knee flexion), isometric steadiness, and onset of muscle

2018 PLoS ONE

50. Varus-valgus instability in the anterior cruciate ligament-deficient knee: effect of posterior tibial load Full Text available with Trip Pro

Varus-valgus instability in the anterior cruciate ligament-deficient knee: effect of posterior tibial load Anterior cruciate ligament (ACL) injury is often accompanied with medial collateral ligament (MCL) injury. Assessment of varus-valgus (V-V) instability in the ACL-deficient knee is crucial for the management of the concomitant ACL-collateral ligaments injury. We evaluated the V-V laxity and investigated the effect of additional posterior tibial load on the laxity in the ACL-deficient knee (...) . Our hypothesis was that the V-V laxity in the ACL-deficient knee was greater than that in the intact knee and attenuated by additional posterior tibial load.Eight fresh-frozen porcine knees were used, and a 6°-of-freedom (DOF) robotic system was utilized. A 5 Nm of V-V torque was applied to the intact knee, the ACL-deficient knee, and the ACL-deficient knee with 30 N of constant posterior tibial load, at 30° and 60° of flexion. Then, the 3D path in the intact knee was reproduced on the ACL

2017 Journal of experimental orthopaedics

51. In-Vivo Elongation of Anterior and Posterior Cruciate Ligament in Bi-Cruciate Retaining Total Knee Arthroplasty. Full Text available with Trip Pro

In-Vivo Elongation of Anterior and Posterior Cruciate Ligament in Bi-Cruciate Retaining Total Knee Arthroplasty. Anterior and posterior cruciate ligament (ACL and PCL) sacrifice in contemporary total knee arthroplasty (TKA) has been considered a potential factor leading to abnormal knee kinematics. Bi-cruciate retaining (BCR) TKA design allows retention of both ACL and PCL. However, there is a limited data on the ACL/PCL in-vivo elongation characteristics of BCR TKA. The study aimed to evaluate (...) during BCR TKA surgery. Our findings suggest that BCR TKA did not fully restore "near-normal" cruciate ligament elongation patterns and anteroposterior stability. Considerable heterogeneity remains in the retained ligament elongation patterns and warrants further investigations of multifactorial factors to optimize ACL/PCL functions in BCR TKA. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:3239-3246, 2018.© 2018 Orthopaedic Research Society. Published

2018 Journal of Orthopaedic Research

52. Can the Anterolateral Ligament Be Reliably Identified in Anterior Cruciate Ligament–Intact and Anterior Cruciate Ligament–Injured Knees on 3-T Magnetic Resonance Imaging? Full Text available with Trip Pro

inconsistent across the literature.The aims of this study were 2-fold. The first objective was to further investigate the appearance of the uninjured ALL on MRI and provide data regarding interrater agreement in identifying the ligament. The second objective was to describe the incidence of concomitant ALL injuries in anterior cruciate ligament (ACL)-injured knees and provide data regarding interrater agreement in identifying and grading these injuries.Cohort study (diagnosis); Level of evidence, 3.Fifty (...) Can the Anterolateral Ligament Be Reliably Identified in Anterior Cruciate Ligament–Intact and Anterior Cruciate Ligament–Injured Knees on 3-T Magnetic Resonance Imaging? The anterolateral ligament (ALL) has been described as an extracapsular stabilizer of knee rotational stability. Investigators have shown a renewed interest in the ALL and further evaluated its anatomy and biomechanical role as a knee stabilizer. The appearance of the ALL on magnetic resonance imaging (MRI) remains

2018 Orthopaedic journal of sports medicine

53. Comparison of patellar tendon versus hamstrings autografts for anterior cruciate ligament reconstruction in Indian population: A randomised control trial study. (Abstract)

Comparison of patellar tendon versus hamstrings autografts for anterior cruciate ligament reconstruction in Indian population: A randomised control trial study. Disruption of anterior cruciate ligament (ACL) is a common ligamentous injury of the knee. The best choice of graft for reconstruction remains undecided. This prospective, randomized clinical trial aimed to compare clinical results of bone-patellar tendon-bone (BPTB) grafts and four-strand semitendinosus-gracilis (QHT) grafts for ACL (...) reconstruction over a 1-year follow-up interval in Indian population.42 consecutive patients with ACL injury were recruited, by pick and draw method and allotted into two groups with 21 patients in each group. Group A patients underwent arthroscopic ACL reconstruction using BPTB graft while QHT autograft was used for patients in Group B. All the patients underwent standard ipsilateral arthroscopic ACL reconstruction procedure using a single incision, antero-medial (AM) portal technique for BPTB or the QHT

2019 Journal of clinical orthopaedics and trauma Controlled trial quality: uncertain

54. Femoral press-fit fixation versus interference screw fixation in anterior cruciate ligament reconstruction with bone-patellar tendon-bone autograft: 20-year follow-up. Full Text available with Trip Pro

Femoral press-fit fixation versus interference screw fixation in anterior cruciate ligament reconstruction with bone-patellar tendon-bone autograft: 20-year follow-up. The aim of this paper is to present our experience with femoral press-fit fixation in anterior cruciate ligament reconstruction using bone-patellar tendon-bone autograft.The patient population was randomly placed in two groups: group A (58 patients), who underwent femoral screw fixation; group B (62 patients), who underwent (...) femoral press-fit fixation.At last follow-up 9.2% of patients were lost; 28% of patients in group A and 64% of patients in group B had excellent International Knee Documentation Committee score (grade A); 66% of patients in group A and 32% of patients in group B had good International Knee Documentation Committee scores (grade B). The difference was statistically significant (p < 0.05).Femoral press-fit fixation of bone- patellar tendon- bone autograft provides stable fixation at low cost, it ensures

2019 Journal of clinical orthopaedics and trauma Controlled trial quality: uncertain

55. Incidence of Anterolateral Ligament Tears in the Anterior Cruciate Ligament-Deficient Knee: A Magnetic Resonance Imaging Analysis. (Abstract)

Incidence of Anterolateral Ligament Tears in the Anterior Cruciate Ligament-Deficient Knee: A Magnetic Resonance Imaging Analysis. The purpose of this study is to determine the incidence of anterolateral ligament (ALL) tears on magnetic resonance imaging (MRI) in patients diagnosed with anterior cruciate ligament (ACL) tears. Furthermore, this study sought to determine the inter- and intraobserver reliability in diagnosing an ALL tear.The MRI radiologic database at a community military hospital (...) was queried for ACL tears over the period of January 2011 to April 2015. During this time, 181 MRIs were identified as having ACL tears. The MRIs were then independently reviewed by an orthopaedic surgeon and a musculoskeletal (MSK) trained radiologist. Both reviewers, independently confirmed the ACL tears, and the ALL was noted to be either torn, intact, or not visualized on axial, sagittal, and coronal images. Four weeks later the same MRIs were then reviewed for the presence and location of an ALL tear

2018 Arthroscopy

56. Anterolateral ligament injuries in knees with an anterior cruciate ligament tear: Contribution of ultrasonography and MRI. Full Text available with Trip Pro

Anterolateral ligament injuries in knees with an anterior cruciate ligament tear: Contribution of ultrasonography and MRI. To describe the pathological appearance of the anterolateral ligament (ALL) on US and MRI in knees with an anterior cruciate ligament (ACL) tear.This prospective study included 30 patients who had a suspected acute ACL tear. Their injured and contralateral knees were evaluated with radiography, US and MRI. Two radiologists evaluated the ALL on the MRI and US examinations (...) instances (k = 0.93).ALL injuries that occur with ACL tears are located at the tibial enthesis. They are often associated with bone avulsion at the enthesis and are better viewed on US.• ALL injuries often occur in combination with ACL tears. • ALL injuries can be assessed with ultrasonography and MRI. • ALL injuries associated with ACL tears are located at the tibial enthesis.

2018 European radiology Controlled trial quality: uncertain

57. Allograft for anterior and posterior cruciate ligament reconstruction. Decision Support Document 116.

Allograft for anterior and posterior cruciate ligament reconstruction. Decision Support Document 116. Allograft for anterior and posterior cruciate ligament reconstruction - Repository of AIHTA GmbH English | Browse - - - Allograft for anterior and posterior cruciate ligament reconstruction Goetz, G. and De Villiers, C. (2019): Allograft for anterior and posterior cruciate ligament reconstruction. Decision Support Document 116. Preview - Sie müssen einen PDF-Viewer auf Ihrem PC installiert (...) haben wie z. B. , oder 1MB Abstract This report evaluated the effectiveness and safety of allograft cruciate ligament reconstruction compared to other cruciate ligament reconstruction technologies, e.g. autografts or conservative management in five indications. Evidence for effectiveness and safety comparing these allografts with autografts was found for three of the indications. In total, eight randomised controlled trials and one comparative cohort study met the eligibility criteria

2019 Austrian Institute of Health Technology Assessment

58. Application of a Beta-Tricalcium Phosphate Graft to Minimize Bony Defect in Bone–Patella Tendon–Bone Anterior Cruciate Ligament Reconstruction Full Text available with Trip Pro

Application of a Beta-Tricalcium Phosphate Graft to Minimize Bony Defect in Bone–Patella Tendon–Bone Anterior Cruciate Ligament Reconstruction Anterior cruciate ligament (ACL) reconstruction with a bone-patellar tendon-bone autograft yields good clinical outcomes. Despite appropriate clinical outcomes, the most common complaint after reconstruction with a bone-patellar tendon-bone autograft is anterior knee pain at the donor graft sites. Synthetic bone grafts, such as beta-tricalcium (...) phosphate (β-TCP), have been previously used to fill the bony defect in fractures as well as removal of bony tumors, and have shown positive utility in improving anterior knee pain after ACL reconstruction. In this Technical Note, we describe the technique of placing a β-TCP graft in the donor graft site after bone-patellar tendon-bone ACL reconstruction. After standard arthroscopic ACL reconstruction, the β-TCP is appropriately sized with an osteotome and sagital saw before being placed

2018 Arthroscopy techniques

59. Individualized Anterior Cruciate Ligament Graft Matching: In Vivo Comparison of Cross-sectional Areas of Hamstring, Patellar, and Quadriceps Tendon Grafts and ACL Insertion Area. (Abstract)

Individualized Anterior Cruciate Ligament Graft Matching: In Vivo Comparison of Cross-sectional Areas of Hamstring, Patellar, and Quadriceps Tendon Grafts and ACL Insertion Area. Recent literature correlated anterior cruciate ligament (ACL) reconstruction failure to smaller diameter of the harvested hamstring (HS) autograft. However, this approach may be a simplification, as relation of graft size to native ACL size is not typically assessed and oversized grafts may impart their own (...) complications.To evaluate in vivo data to determine if the commonly used autografts reliably restore native ACL size.Descriptive laboratory study.Intraoperative data of the tibial insertion area and HS graft diameter were collected and retrospectively evaluated for 46 patients who underwent ACL reconstruction with HS autografts. Magnetic resonance imaging measurements of the cross-sectional area (CSA) of the possible patellar tendon (PT) and quadriceps tendon (QT) autografts were also done for each patient

2018 American Journal of Sports Medicine

60. Greater knee flexion excursion/moment in hopping is associated with better knee function following anterior cruciate ligament reconstruction. (Abstract)

Greater knee flexion excursion/moment in hopping is associated with better knee function following anterior cruciate ligament reconstruction. Individuals with impaired knee function after anterior cruciate ligament reconstruction (ACLR) may be at greater risk of developing knee osteoarthritis related to abnormal knee joint movement and loading. The aim of this study was to assess the association between knee biomechanics and knee laxity during hopping and clinically assessed knee function (i.e (...) ., patient-reported knee function and hop tests) following ACLR.Sixty-six participants (23 women, mean age 28 ± 6 years, mean 18 ± 3 months following ACLR) completed a standardized single-leg hopping task. Three-dimensional movement analysis was used to assess knee flexion excursion and body weight/height normalized knee flexion moments during landing for the involved limb. Anterior-posterior knee laxity was assessed with a KT-1000 knee arthrometer. Participants then completed a patient-reported knee

2018 Knee Surgery, Sports Traumatology, Arthroscopy

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